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 St Re-Eval (Medicaid)
Low
$23
Average
$186
Median
$118
High
$570
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
69 hospitals; the 90th percentile is 21.8× 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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85 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 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $409 | $409 | — | — | — | $409 – $409 |
| 2 | AnMed Health Anderson, SC professional · percent of total billed charges · inpatientfrom % of charges | 1 | $83 | $83 | — | — | — | $83 – $83 |
| 3 | AnMed Health Anderson, SC professional · percent of total billed charges · outpatientfrom % of charges | 1 | $83 | $83 | — | — | — | $83 – $83 |
| 4 | AnMed Health Cannon Pickens, SC professional · percent of total billed charges · inpatientfrom % of charges | 1 | $83 | $83 | — | — | — | $83 – $83 |
| 5 | AnMed Health Cannon Pickens, SC professional · percent of total billed charges · outpatientfrom % of charges | 1 | $83 | $83 | — | — | — | $83 – $83 |
| 6 | AnMed Piedmont Piedmont, SC professional · percent of total billed charges · inpatientfrom % of charges | 1 | $83 | $83 | — | — | — | $83 – $83 |
| 7 | BSA Hospital Amarillo, TX facility · percent of total billed charges · bothfrom % of charges | 2 | $238 | $238 | $72 | 30% | — | $167 – $310 |
| 8 | Blue Hill Memorial Hospital Hill, ME facility · fee schedule · outpatient | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 9 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 10 | Charles A. Dean Memorial Hospital Greenville, ME facility · fee schedule · outpatient | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 11 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 12 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 2 | $32 | $32 | — | — | — | $32 – $32 |
| 13 | Clara Maass Medical Center Belleville, NJ other · outpatient | 3 | $125 | $118 | $15 | 12% | — | $98 – $132 |
| 14 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · fee schedule · outpatient | 3 | $25 | $26 | $1 | 4% | — | $25 – $27 |
| 15 | Community Medical Center Toms River, NJ other · outpatient | 3 | $125 | $118 | $15 | 12% | — | $98 – $132 |
| 16 | Cooperman Barnabas Medical Center Livingston, NJ other · outpatient | 2 | $129 | $129 | $4 | 3% | — | $125 – $132 |
| 17 | Covenant Medical Center Inc Saginaw, MI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 18 | Covenant Medical Center Inc Saginaw, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 19 | Covenant Medical Center Inc Saginaw, MI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 20 | Covenant Medical Center Inc Saginaw, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 21 | Cuero Regional Hospital Cuero, TX percent of total billed charges · inpatientfrom % of charges | 1 | $271 | $271 | — | — | — | $271 – $271 |
| 22 | DIGNITY COMMUNITY CARE Glendale, CA fee schedule · outpatient | 2 | $570 | $570 | — | — | — | $570 – $570 |
| 23 | Eastern Maine Medical Center Bangor, ME facility · fee schedule · outpatient | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 24 | Eastern Maine Medical Center Bangor, ME professional · fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 25 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $155 | $155 | $13 | 9% | — | $141 – $168 |
← Payers reporting HCPCS S9152 · Snapshot 20261111T120946Z-9134e7f7