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
$2
Average
$23
Median
$21
High
$46
Each hospital's average First Health rate, under the methodology and billing class chosen below.
27 hospitals; the 90th percentile is 20.1× 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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32 hospital rates
iThe hospitals that file a First Health 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 | Adena Fayette Medical Center Washington Court House, OH facility · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 2 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 3 | Greenfield Area Medical Center Greenfield, OH facility · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 4 | HCA HOUSTON HEALTHCARE CLEAR LAKE WEBSTER, TX percent of total billed charges · outpatientfrom % of charges | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 5 | HCA HOUSTON HEALTHCARE MEDICAL CENTER HOUSTON, TX percent of total billed charges · outpatientfrom % of charges | 1 | $38 | $46 | $33 | 73% | — | $7 – $99 |
| 6 | HCA HOUSTON HEALTHCARE NORTHWEST HOUSTON, TX percent of total billed charges · outpatientfrom % of charges | 1 | $34 | $44 | $34 | 78% | — | $7 – $90 |
| 7 | HCA HOUSTON HEALTHCARE PEARLAND HOUSTON, TX percent of total billed charges · outpatientfrom % of charges | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 8 | HCA HOUSTON HEALTHCARE SOUTHEAST HOUSTON, TX percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $21 | $10 | 50% | — | $10 – $31 |
| 9 | HCA HOUSTON HEALTHCARE TOMBALL Tomball, TX percent of total billed charges · outpatientfrom % of charges | 1 | $9 | $13 | $8 | 64% | — | $5 – $24 |
| 10 | HCA Houston Rehabilitation Hospital Southeast Pasadena, TX percent of total billed charges · outpatientfrom % of charges | 1 | $21 | $21 | $10 | 50% | — | $10 – $31 |
| 11 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $35 | $35 | $1 | 2% | — | $34 – $35 |
| 12 | Kalkaska Memorial Health Center Kalkaska, MI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 13 | Kalkaska Memorial Health Center Kalkaska, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 14 | METHODIST HOSPITAL HELOTES, TX percent of total billed charges · outpatientfrom % of charges | 3 | $30 | $30 | — | — | — | $30 – $30 |
| 15 | METHODIST HOSPITAL ATASCOSA Jourdanton, TX percent of total billed charges · outpatientfrom % of charges | 3 | $39 | $39 | — | — | — | $39 – $39 |
| 16 | METHODIST HOSPITAL LANDMARK SAN ANTONIO, TX percent of total billed charges · outpatientfrom % of charges | 3 | $39 | $39 | — | — | — | $39 – $39 |
| 17 | METHODIST HOSPITAL STONE OAK SPRING BRANCH, TX percent of total billed charges · outpatientfrom % of charges | 3 | $39 | $39 | — | — | — | $39 – $39 |
| 18 | METHODIST TEXSAN HOSPITAL SAN ANTONIO, TX percent of total billed charges · outpatientfrom % of charges | 3 | $39 | $39 | — | — | — | $39 – $39 |
| 19 | METHODIST TEXSAN HOSPITAL REHAB SAN ANTONIO, TX percent of total billed charges · outpatientfrom % of charges | 3 | $39 | $39 | — | — | — | $39 – $39 |
| 20 | Marshfield Medical Center - Dickinson Iron Mountain, MI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 21 | Marshfield Medical Center - Dickinson Iron Mountain, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 22 | Mid Hudson Regional Hospital Poughkeepsie, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 23 | Mid Hudson Regional Hospital Poughkeepsie, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 24 | Pemiscot Memorial Health System Hayti, MO percent of total billed charges · outpatientfrom % of charges | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 25 | Pike Health Services Inc Waverly, OH facility · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
← Payers reporting HCPCS S0171 · Snapshot 20261112T181611Z-3fa9fb76