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
HC Adc Daily Charge Restricted (Mdpl)
Low
$15
Average
$90
Median
$73
High
$136
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
39 hospitals; the 90th percentile is 2.5× 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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45 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 | $56 | $56 | — | — | — | $56 – $56 |
| 2 | Boston Medical Center Boston, MA percent of total billed charges · bothfrom % of charges | 2 | $83 | $84 | $13 | 15% | — | $67 – $103 |
| 3 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 4 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $100 | $100 | — | — | — | $100 – $100 |
| 5 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 6 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 7 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $65 | $65 | — | — | — | $65 – $65 |
| 8 | Carle BroMenn Medical Center Normal, IL fee schedule · inpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 9 | Carle BroMenn Medical Center Normal, IL fee schedule · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 10 | Carle Eureka Hospital Eureka, IL fee schedule · inpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 11 | Carle Eureka Hospital Eureka, IL fee schedule · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 12 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 13 | Fairview Bethesda Hospital St. Paul, MN percent of total billed charges · inpatientfrom % of charges | 2 | $132 | $132 | $5 | 4% | — | $127 – $137 |
| 14 | Fairview Bethesda Hospital St. Paul, MN percent of total billed charges · outpatientfrom % of charges | 2 | $132 | $132 | $5 | 4% | — | $127 – $137 |
| 15 | Fairview Health Services Edina, MN percent of total billed charges · outpatientfrom % of charges | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 16 | Fairview Health Services Minneapolis, MN percent of total billed charges · outpatientfrom % of charges | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 17 | Fairview Health Services Burnsville, MN percent of total billed charges · outpatientfrom % of charges | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 18 | Fairview Health Services Wyoming, MN percent of total billed charges · outpatientfrom % of charges | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 19 | Fairview Health Services Princeton, MN percent of total billed charges · outpatientfrom % of charges | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 20 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $59 | $59 | — | — | — | $59 – $59 |
| 21 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 22 | HealthEast St John's Hospital Maplewood, MN percent of total billed charges · outpatientfrom % of charges | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 23 | HealthEast Woodwinds Hospital Woodbury, MN percent of total billed charges · outpatientfrom % of charges | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 24 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 3 | $97 | $72 | $46 | 64% | — | $5 – $114 |
| 25 | Holy Name Teaneck, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $15 | $15 | — | — | — | $15 – $15 |
← Payers reporting HCPCS S5102 · Snapshot 20261111T120946Z-9134e7f7