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
Med admin- not oral/inject
Low
$0
Average
$101
Median
$65
High
$442
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
45 hospitals; the 90th percentile is 9.3× 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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51 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 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · case rate · outpatient | 4 | $66 | $86 | $32 | 37% | — | $55 – $125 |
| 2 | Benson Hospital Corporation Benson, AZ facility · fee schedule · outpatient | 1 | $420 | $420 | — | — | — | $420 – $420 |
| 3 | COLUMBIA MEMORIAL HOSPITAL Hudson, NY facility · case rate · outpatient | 3 | $103 | $87 | $22 | 26% | — | $55 – $103 |
| 4 | Corewell Health Farmington Hills Hospital Farmington Hills, MI facility · fee schedule · outpatient | 2 | $83 | $83 | — | — | — | $83 – $83 |
| 5 | Covenant Medical Center Inc Saginaw, MI facility · fee schedule · outpatient | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 6 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 7 | Covenant Medical Center Inc Saginaw, MI facility · fee schedule · outpatient | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 8 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 9 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · outpatient | 3 | $67 | $58 | $13 | 22% | — | $40 – $68 |
| 10 | GLENS FALLS HOSPITAL INC Falls, NY facility · case rate · outpatient | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 11 | Henry Ford Health System West Bloomfield, MI facility · fee schedule · outpatient | 3 | $46 | $52 | $8 | 16% | — | $46 – $63 |
| 12 | Henry Ford Health System Plymouth, MI facility · fee schedule · outpatient | 3 | $92 | $83 | $14 | 16% | — | $63 – $92 |
| 13 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI facility · fee schedule · outpatient | 3 | $40 | $48 | $11 | 23% | — | $40 – $63 |
| 14 | Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI facility · fee schedule · outpatient | 3 | $46 | $52 | $8 | 15% | — | $46 – $63 |
| 15 | HonorHealth Florence Medical Center Florence, AZ facility · fee schedule · outpatient | 1 | $211 | $211 | $2 | 1% | — | $209 – $213 |
| 16 | Honorhealth Deer Valley Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $213 | $213 | — | — | — | $213 – $213 |
| 17 | Honorhealth Four Peaks Medical Center Mesa, AZ facility · fee schedule · outpatient | 1 | $211 | $211 | $2 | 1% | — | $209 – $213 |
| 18 | Honorhealth John C. Lincoln Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $213 | $213 | — | — | — | $213 – $213 |
| 19 | Honorhealth Scottsdale Osborn Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $213 | $213 | — | — | — | $213 – $213 |
| 20 | Honorhealth Scottsdale Shea Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $213 | $213 | — | — | — | $213 – $213 |
| 21 | Honorhealth Scottsdale Thompson Peak Med Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $213 | $213 | — | — | — | $213 – $213 |
| 22 | Honorhealth Sonoran Crossing Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $213 | $213 | — | — | — | $213 – $213 |
| 23 | Kalkaska Memorial Health Center Kalkaska, MI professional · fee schedule · both | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 24 | Montefiore Medical Center Bronx, NY fee schedule · both | 7 | $101 | $99 | $16 | 16% | — | $66 – $119 |
| 25 | Montefiore Medical Center Bronx, NY percent of total billed charges · bothfrom % of charges | 3 | $33 | $33 | $13 | 38% | — | $20 – $45 |
← Payers reporting HCPCS T1503 · Snapshot 20261112T181611Z-3fa9fb76