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
$28
Median
$11
High
$114
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
65 hospitals; the 90th percentile is 44.2× 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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85 hospital rates
iThe hospitals that file a UnitedHealthcare 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 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 2 | Bay Park Community Hospital Oregon, OH facility · fee schedule · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 3 | Bay Park Community Hospital Oregon, OH professional · fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 4 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $45 | $45 | — | — | — | $45 – $45 |
| 5 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $82 | $82 | — | — | — | $82 – $82 |
| 6 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 7 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 8 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $53 | $53 | — | — | — | $53 – $53 |
| 9 | COQUILLE VALLEY HOSPITAL COQUILLE, OR percent of total billed charges · bothfrom % of charges | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 10 | Carle BroMenn Medical Center Normal, IL fee schedule · inpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 11 | Carle BroMenn Medical Center Normal, IL fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 12 | Carle Eureka Hospital Eureka, IL fee schedule · inpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 13 | Carle Eureka Hospital Eureka, IL fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 14 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 2 | $1 | $1 | $1 | 38% | — | $1 – $2 |
| 15 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 16 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $2 | $7 | $8 | 104% | — | $2 – $18 |
| 17 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2 | $7 | $8 | 104% | — | $2 – $18 |
| 18 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 19 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 20 | Fostoria Hospital Association Fostoria, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 21 | Fostoria Hospital Association Fostoria, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 22 | Fostoria Hospital Association Fostoria, OH professional · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 23 | HCA HOUSTON HEALTHCARE CLEAR LAKE WEBSTER, TX percent of total billed charges · outpatientfrom % of charges | 2 | $10 | $10 | $4 | 44% | — | $6 – $14 |
| 24 | HCA HOUSTON HEALTHCARE MEDICAL CENTER HOUSTON, TX percent of total billed charges · outpatientfrom % of charges | 2 | $22 | $26 | $24 | 92% | — | $2 – $84 |
| 25 | HCA HOUSTON HEALTHCARE NORTHWEST HOUSTON, TX percent of total billed charges · outpatientfrom % of charges | 2 | $20 | $25 | $25 | 97% | — | $2 – $76 |
← Payers reporting HCPCS S0171 · Snapshot 20261112T181611Z-3fa9fb76