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.
Generation details were not recorded for this description.
Original text from hospital filings
Fee Schedule
Low
$166
Average
$1.6k
Median
$1.2k
High
$6.0k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
41 hospitals; the 90th percentile is 3.5× 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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42 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | Billings Clinic Billings, MT fee schedule · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 2 | Covenant Medical Center Lubbock, TX fee schedule · outpatient | 4 | $3.0k | $3.0k | $14 | 0% | — | $3.0k – $3.0k |
| 3 | Hoag Memorial Hospital Presbyterian Irvine, CA facility · fee schedule · outpatient | 3 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 4 | Keck Hospital of USC Los Angeles, CA facility · fee schedule · outpatient | 5 | $1.3k | $1.6k | $432 | 27% | — | $1.3k – $2.2k |
| 5 | Long Beach Memorial Medical Center Long Beach, CA fee schedule · outpatient | 5 | $842 | $842 | — | — | — | $842 – $842 |
| 6 | Lubbock Heritage Hospital LLC Lubbock, TX fee schedule · outpatient | 4 | $3.0k | $3.0k | $14 | 0% | — | $3.0k – $3.0k |
| 7 | MEDICAL CITY DENTON Denton, TX percent of total billed charges · outpatientfrom % of charges | 8 | $6.0k | $6.0k | $1.1k | 19% | — | $4.6k – $8.3k |
| 8 | McLeod Health Cheraw, SC fee schedule · both | 1 | $69 | $69 | — | — | — | $69 – $69 |
| 9 | McLeod Health Cheraw, SC percent of total billed charges · bothfrom % of charges | 1 | $262 | $262 | — | — | — | $262 – $262 |
| 10 | McLeod Health Manning, SC percent of total billed charges · bothfrom % of charges | 1 | $772 | $772 | — | — | — | $772 – $772 |
| 11 | Medical City Argyle Argyle, TX percent of total billed charges · outpatientfrom % of charges | 8 | $6.0k | $6.0k | $1.1k | 19% | — | $4.6k – $8.3k |
| 12 | MemorialCare Miller Children's & Women's Hospital Long Beach Long Beach, CA fee schedule · outpatient | 5 | $842 | $842 | — | — | — | $842 – $842 |
| 13 | MemorialCare Orange Coast Medical Center Fountain Valley, CA fee schedule · outpatient | 5 | $842 | $842 | — | — | — | $842 – $842 |
| 14 | MemorialCare Saddleback Medical Center Laguna Hills, CA fee schedule · outpatient | 5 | $842 | $842 | — | — | — | $842 – $842 |
| 15 | Methodist Children's Hospital Lubbock, TX fee schedule · outpatient | 4 | $3.0k | $3.0k | $14 | 0% | — | $3.0k – $3.0k |
| 16 | Methodist Hospital Levelland Levelland, TX fee schedule · outpatient | 4 | $2.9k | $3.0k | $10 | 0% | — | $2.9k – $3.0k |
| 17 | Methodist Hospital Plainview Plainview, TX fee schedule · outpatient | 4 | $2.9k | $3.0k | $10 | 0% | — | $2.9k – $3.0k |
| 18 | Mission Hospital Regional Med Center Laguna Beach, CA fee schedule · outpatient | 2 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 19 | NorCal HealthConnect LLC Petaluma, CA fee schedule · outpatient | 3 | $1.1k | $1.0k | $86 | 8% | — | $925 – $1.1k |
| 20 | NorCal HealthConnect LLC Healdsburg, CA fee schedule · outpatient | 3 | $842 | $1.3k | $715 | 53% | — | $842 – $2.4k |
| 21 | Providence Health System - Southern California Santa Monica, CA fee schedule · outpatient | 5 | $842 | $1.1k | $475 | 44% | — | $842 – $2.0k |
| 22 | Providence Health System - Southern California Burbank, CA fee schedule · outpatient | 5 | $941 | $1.2k | $668 | 53% | — | $842 – $2.6k |
| 23 | Providence Health System - Southern California Mission Hills, CA fee schedule · outpatient | 5 | $941 | $1.3k | $824 | 62% | — | $842 – $3.0k |
| 24 | Providence Health System - Southern California Torrance, CA fee schedule · outpatient | 6 | $941 | $1.3k | $789 | 62% | — | $842 – $3.0k |
| 25 | Providence Health System - Southern California San Pedro, CA fee schedule · outpatient | 6 | $941 | $1.3k | $835 | 65% | — | $842 – $3.2k |
← Payers reporting HCPCS S1090 · Snapshot 20261113T090226Z-3ce6c0b8