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 Mdi Spacer With Mask
Low
$0
Average
$47
Median
$15
High
$220
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
41 hospitals; the 90th percentile is 17.8× 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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49 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 | University of Virginia Medical Center Charlottesville, VA percent of total billed charges · bothfrom % of charges | 3 | $95 | $96 | $9 | 9% | 1–10 | $86 – $108 |
| 2 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $78 | $78 | — | — | — | $78 – $78 |
| 3 | Benefis Community Hospitals, Inc Choteau, MT percent of total billed charges · bothfrom % of charges | 1 | $69 | $69 | — | — | — | $69 – $69 |
| 4 | Benefis Hospitals Inc Helena, MT percent of total billed charges · bothfrom % of charges | 1 | $69 | $69 | $11 | 16% | — | $59 – $80 |
| 5 | Benefis Teton Medical Center Choteau, MT percent of total billed charges · bothfrom % of charges | 1 | $77 | $77 | — | — | — | $77 – $77 |
| 6 | Blue Hill Memorial Hospital Hill, ME facility · fee schedule · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 7 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 8 | Charles A. Dean Memorial Hospital Greenville, ME facility · fee schedule · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 9 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 10 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 2 | $7 | $7 | — | — | — | $7 – $7 |
| 11 | Children's Healthcare of Atlanta Atlanta, GA percent of total billed charges · outpatientfrom % of charges | 1 | $220 | $220 | — | — | — | $220 – $220 |
| 12 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · fee schedule · outpatient | 3 | $9 | $9 | $0 | 4% | — | $9 – $10 |
| 13 | Deaconess Health System Gibson General Hospital Princeton, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 14 | Deaconess Health System Henderson Hospital Henderson, KY professional · percent of total billed charges · bothfrom % of charges | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 15 | Deaconess Health System Union County Hospital Morganfield, KY professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 16 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 17 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 18 | Deaconess Illinois Crossroads Inc Mount Vernon, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 19 | Deaconess Illinois Union County Hospital Inc Anna, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 20 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · percent of total billed charges · bothfrom % of charges | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 21 | Eastern Maine Medical Center Bangor, ME facility · fee schedule · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 22 | Eastern Maine Medical Center Bangor, ME professional · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 23 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $29 | $29 | $3 | 9% | — | $27 – $32 |
| 24 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · fee schedule · outpatient | 3 | $13 | $12 | $1 | 10% | — | $11 – $14 |
| 25 | MARTIN MEMORIAL MEDICAL CENTER INC Port St Lucie, FL facility · fee schedule · outpatient | 3 | $11 | $12 | $3 | 23% | — | $9 – $15 |
← Payers reporting HCPCS S8101 · Snapshot 20261111T120946Z-9134e7f7