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
Description Not Available
Low
$5
Average
$71
Median
$50
High
$377
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
128 hospitals; the 90th percentile is 7.0× 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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128 hospital rates
iThe hospitals that file a Cigna 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 | AdventHealth Avista Louisville, CO fee schedule · outpatient | 2 | $72 | $72 | $2 | 3% | — | $71 – $74 |
| 2 | AdventHealth Castle Rock Castle Rock, CO fee schedule · outpatient | 2 | $72 | $72 | $2 | 3% | — | $71 – $74 |
| 3 | AdventHealth Littleton Littleton, CO fee schedule · outpatient | 2 | $72 | $72 | $2 | 3% | — | $71 – $74 |
| 4 | AdventHealth Parker Aurora, CO fee schedule · outpatient | 2 | $72 | $72 | $2 | 3% | — | $71 – $74 |
| 5 | AdventHealth Porter Denver, CO fee schedule · outpatient | 2 | $72 | $72 | $2 | 3% | — | $71 – $74 |
| 6 | Adventhealth Ottawa Ottawa, KS fee schedule · outpatient | 2 | $11 | $11 | $0 | 4% | — | $11 – $11 |
| 7 | Adventhealth Shawnee Mission Lenexa, KS fee schedule · outpatient | 2 | $11 | $11 | $0 | 4% | — | $11 – $11 |
| 8 | Adventhealth South Overland Park Overland Park, KS fee schedule · outpatient | 2 | $11 | $11 | $0 | 4% | — | $11 – $11 |
| 9 | Beth Israel Deaconess Hospital-Milton Inc Milton, MA fee schedule · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 10 | Beth Israel Deaconess Medical Center Boston, MA fee schedule · outpatient | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 11 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 12 | CHRISTUS Good Shepherd Hospital - Northpark Longview, TX fee schedule · outpatient | 2 | $63 | $63 | $24 | 38% | — | $39 – $86 |
| 13 | CHRISTUS Health - Pine Street Texarkana, TX fee schedule · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 14 | CHRISTUS Hospital - Orange Orange, TX fee schedule · outpatient | 2 | $48 | $48 | $6 | 12% | — | $42 – $54 |
| 15 | CHRISTUS West Beaumont Beaumont, TX fee schedule · outpatient | 2 | $48 | $48 | $6 | 12% | — | $42 – $54 |
| 16 | COMMUNITY MEMORIAL HOSPITAL Hill, VA fee schedule · outpatient | 1 | $80 | $80 | — | — | — | $80 – $80 |
| 17 | Central Georgia Rehabilitation LLC Macon, GA fee schedule · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 18 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 2 | $5 | $5 | — | — | — | $5 – $5 |
| 19 | ChristianaCare Wilmington, DE facility · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 20 | Christus Health Southeast Texas Beaumont, TX fee schedule · outpatient | 2 | $48 | $48 | $6 | 12% | — | $42 – $54 |
| 21 | Christus Health Southeast Texas Port Arthur, TX fee schedule · outpatient | 2 | $48 | $48 | $6 | 12% | — | $42 – $54 |
| 22 | Covenant Medical Center Lubbock, TX fee schedule · outpatient | 1 | $70 | $70 | — | — | — | $70 – $70 |
| 23 | Danbury Hospital New Milford, CT fee schedule · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 24 | Davis Medical Center Elkins, WV professional · fee schedule · both | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 25 | Floyd Healthcare Management Inc Rome, GA fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
← Payers reporting HCPCS S3722 · Snapshot 20261112T181611Z-3fa9fb76