Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Fee Schedule
Low
$70
Average
$25.8k
Median
$207
High
$179.6k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
7 hospitals; the 90th percentile is 476.5× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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7 hospital rates
iThe hospitals that file a Blue Cross Blue Shield rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Covenant Medical Center Lubbock, TX fee schedule · outpatient | 4 | $206 | $207 | $1 | 0% | — | $206 – $208 |
| 2 | John Muir Health Walnut Creek, CA percent of total billed charges · bothfrom % of charges | 2 | $164.9k | $179.6k | $99.3k | 55% | — | $53.2k – $358.5k |
| 3 | Lubbock Heritage Hospital LLC Lubbock, TX fee schedule · outpatient | 4 | $206 | $207 | $1 | 0% | — | $206 – $208 |
| 4 | Methodist Children's Hospital Lubbock, TX fee schedule · outpatient | 4 | $206 | $207 | $1 | 0% | — | $206 – $208 |
| 5 | Methodist Hospital Levelland Levelland, TX fee schedule · outpatient | 4 | $204 | $205 | $1 | 0% | — | $204 – $206 |
| 6 | Methodist Hospital Plainview Plainview, TX fee schedule · outpatient | 4 | $204 | $205 | $1 | 0% | — | $204 – $206 |
| 7 | The University of Tennessee Medical Center Knoxville, TN facility · fee schedule · outpatient | 7 | $63 | $70 | $15 | 21% | — | $57 – $92 |
← Payers reporting HCPCS Q9995 · Snapshot 20261113T090226Z-3ce6c0b8