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
Home episodic case 30 days
Low
$25
Average
$80
Median
$79
High
$159
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
24 hospitals; the 90th percentile is 2.7× 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 Anthem 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 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 2 | $50 | $50 | — | — | — | $50 – $50 |
| 2 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 2 | $67 | $75 | $11 | 15% | — | $67 – $90 |
| 3 | COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 4 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 2 | $50 | $50 | — | — | — | $50 – $50 |
| 5 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 6 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 7 | Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 8 | Eastern Maine Medical Center Bangor, ME professional · fee schedule · outpatient | 2 | $50 | $50 | — | — | — | $50 – $50 |
| 9 | Gundersen Luthern Medical Center Inc La Crosse, WI facility · fee schedule · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 10 | Maine Coast Regional Health Facilities Ellsworth, ME professional · fee schedule · outpatient | 2 | $50 | $50 | — | — | — | $50 – $50 |
| 11 | Mayo Regional Hospital Dover Foxcroft, ME professional · fee schedule · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 12 | Memorial Hospital of Boscobel Boscobel, WI facility · fee schedule · outpatient | 1 | $124 | $124 | — | — | — | $124 – $124 |
| 13 | Mercy Hospital Portland, ME professional · fee schedule · outpatient | 2 | $50 | $50 | — | — | — | $50 – $50 |
| 14 | Moundview Memorial Hospital and Clinics, Inc. Friendship, WI facility · fee schedule · outpatient | 1 | $159 | $159 | — | — | — | $159 – $159 |
| 15 | Nationwide Children's Hospital Columbus, OH facility · fee schedule · outpatient | 1 | $140 | $140 | — | — | — | $140 – $140 |
| 16 | Riverside Hospital Inc Newport News, VA fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 17 | Riverside Middle Peninsula Hospital, Inc Gloucester, VA fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 18 | SHORE HEALTH SERVICES INC. Onancock, VA fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 19 | Sebasticook Valley Health Pittsfield, ME professional · fee schedule · outpatient | 2 | $50 | $50 | — | — | — | $50 – $50 |
| 20 | St Joseph’s Health Services Inc Hillsboro, WI facility · fee schedule · outpatient | 1 | $144 | $144 | — | — | — | $144 – $144 |
| 21 | The Aroostook Medical Center Isle, ME professional · fee schedule · outpatient | 2 | $50 | $50 | — | — | — | $50 – $50 |
| 22 | Tri-County Memorial Hospital Inc Whitehall, WI facility · fee schedule · outpatient | 1 | $124 | $124 | — | — | — | $124 – $124 |
| 23 | VCU HEALTH TAPPAHANNOCK HOSPITAL Tappahannock, VA case rate · outpatient | 1 | $85 | $85 | — | — | — | $85 – $85 |
| 24 | VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY Richmond, VA case rate · outpatient | 1 | $85 | $85 | — | — | — | $85 – $85 |
← Payers reporting HCPCS S0272 · Snapshot 20261113T090226Z-3ce6c0b8