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
$27
Median
$9
High
$471
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
60 hospitals; the 90th percentile is 38.9× 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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75 hospital rates
iThe hospitals that file a Aetna 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 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · outpatient | 1 | $39 | $39 | $13 | 35% | — | $25 – $52 |
| 2 | Atoka County Medical Center Atoka, OK percent of total billed charges · outpatientfrom % of charges | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 3 | Beaufort Memorial Hospital Beaufort, SC facility · percent of total billed charges · inpatientfrom % of charges | 1 | $86 | $86 | — | — | — | $86 – $86 |
| 4 | Beaufort Memorial Hospital Beaufort, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $84 | $84 | — | — | — | $84 – $84 |
| 5 | Capital Health System Inc Trenton, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $4 | $37 | $47 | 125% | — | $4 – $103 |
| 6 | Capital Health System Inc Browns Mills, NJ percent of total billed charges · outpatientfrom % of charges | 1 | $4 | $37 | $47 | 125% | — | $4 – $103 |
| 7 | Chambers Health Anahuac, TX percent of total billed charges · outpatientfrom % of charges | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 8 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 2 | $1 | $1 | — | — | — | $1 – $1 |
| 9 | Conway Hospital, Inc. Conway, SC professional · fee schedule · outpatient | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 10 | Conway Regional Medical Center Conway, AR facility · fee schedule · outpatient | 1 | $6 | $6 | $2 | 26% | — | $3 – $7 |
| 11 | Conway Regional Medical Center Conway, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $20 | $5 | 26% | — | $12 – $26 |
| 12 | Covenant Medical Center Lubbock, TX fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 13 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 14 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 15 | Craig Hospital Englewood, CO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $471 | $471 | — | — | — | $471 – $471 |
| 16 | East Valley Glendora Hospital, LLC Glendora, CA facility · percent of total billed charges · bothfrom % of charges | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 17 | Garnet Health Medical Center Middletown, NY facility · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 18 | Garnet Health Medical Center Catskills Harris, NY facility · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 19 | HCA HOUSTON HEALTHCARE CLEAR LAKE WEBSTER, TX percent of total billed charges · outpatientfrom % of charges | 1 | $1 | $1 | $0 | 10% | — | $1 – $1 |
| 20 | HCA HOUSTON HEALTHCARE CONROE CONROE, TX percent of total billed charges · outpatientfrom % of charges | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 21 | HCA HOUSTON HEALTHCARE PEARLAND HOUSTON, TX percent of total billed charges · outpatientfrom % of charges | 1 | $9 | $9 | $2 | 18% | — | $7 – $11 |
| 22 | HCA HOUSTON HEALTHCARE TOMBALL Tomball, TX percent of total billed charges · outpatientfrom % of charges | 1 | $3 | $5 | $3 | 68% | — | $2 – $10 |
| 23 | HCA HOUSTON MAINLAND Texas City, TX percent of total billed charges · outpatientfrom % of charges | 1 | $1 | $1 | $0 | 11% | — | $1 – $1 |
| 24 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 25 | Kalkaska Memorial Health Center Kalkaska, MI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $15 | $34 | $34 | 101% | — | $5 – $82 |
← Payers reporting HCPCS S0077 · Snapshot 20261112T181611Z-3fa9fb76