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
$1
Average
$55
Median
$11
High
$274
Each hospital's average MultiPlan rate, under the methodology and billing class chosen below.
16 hospitals; the 90th percentile is 57.6× 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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24 hospital rates
iThe hospitals that file a MultiPlan 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 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 2 | Covenant Medical Center Inc Saginaw, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 3 | Covenant Medical Center Inc Saginaw, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 4 | Henry Ford Health System West Bloomfield, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $11 | $11 | $7 | 69% | — | $3 – $18 |
| 5 | Henry Ford Health System Plymouth, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $11 | $11 | $7 | 69% | — | $3 – $18 |
| 6 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $11 | $11 | $7 | 69% | — | $3 – $18 |
| 7 | Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI facility · percent of total billed charges · bothfrom % of charges | 1 | $11 | $11 | $7 | 69% | — | $3 – $18 |
| 8 | Kalkaska Memorial Health Center Kalkaska, MI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 9 | Kalkaska Memorial Health Center Kalkaska, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 10 | Mid Hudson Regional Hospital Poughkeepsie, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 11 | Mid Hudson Regional Hospital Poughkeepsie, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 12 | Munson Healthcare Manistee Hospital Manistee, MI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 13 | Munson Healthcare Manistee Hospital Manistee, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 14 | Munson Medical Center Traverse City, MI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 15 | Munson Medical Center Traverse City, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 16 | Paul Oliver Memorial Hospital Frankfort, MI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 17 | Paul Oliver Memorial Hospital Frankfort, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 18 | UPMC Magee-Womens Hospital Pittsburgh, PA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $228 | $228 | $6 | 3% | — | $222 – $235 |
| 19 | UPMC Magee-Womens Hospital Pittsburgh, PA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $228 | $228 | $6 | 3% | — | $222 – $235 |
| 20 | UPMC Passavant - McCandless Cranberry Township, PA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $286 | $286 | — | — | — | $286 – $286 |
| 21 | UPMC Passavant - McCandless Cranberry Township, PA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $262 | $262 | — | — | — | $262 – $262 |
| 22 | WA Foote Memorial Hospital Jackson, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $14 | $14 | $10 | 69% | — | $5 – $24 |
| 23 | Westchester Medical Center Valhalla, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 24 | Westchester Medical Center Valhalla, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $3 | $3 | — | — | — | $3 – $3 |
← Payers reporting HCPCS S0030 · Snapshot 20261112T181611Z-3fa9fb76