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
N-et; encounter/trip
Low
$0
Average
$29
Median
$10
High
$103
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
38 hospitals; the 90th percentile is 235.4× 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 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 | $103 | $103 | — | — | — | $103 – $103 |
| 2 | Blue Hill Memorial Hospital Hill, ME facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 3 | Boston Medical Center Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $31 | $31 | $3 | 10% | — | $28 – $34 |
| 4 | Charles A. Dean Memorial Hospital Greenville, ME facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 5 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 2 | $11 | $11 | — | — | — | $11 – $11 |
| 6 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · fee schedule · outpatient | 3 | $0 | $0 | $0 | 3% | — | $0 – $0 |
| 7 | Eastern Maine Medical Center Bangor, ME facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 8 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $39 | $39 | $3 | 9% | — | $36 – $42 |
| 9 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · fee schedule · outpatient | 3 | $0 | $0 | $0 | 9% | — | $0 – $0 |
| 10 | Indiana University Health Arnett Inc. Lafayette, IN percent of total billed charges · outpatientfrom % of charges | 7 | $67 | $63 | $10 | 15% | — | $39 – $67 |
| 11 | Indiana University Health Ball Memorial Hospital Inc. Muncie, IN percent of total billed charges · outpatientfrom % of charges | 7 | $56 | $56 | $3 | 6% | — | $48 – $58 |
| 12 | Indiana University Health Bedford Inc. Bedford, IN percent of total billed charges · outpatientfrom % of charges | 7 | $83 | $83 | — | — | — | $83 – $83 |
| 13 | Indiana University Health Bloomington Inc. Bloomington, IN percent of total billed charges · outpatientfrom % of charges | 7 | $88 | $84 | $10 | 12% | — | $60 – $88 |
| 14 | Indiana University Health Frankfort Inc. Frankfort, IN percent of total billed charges · outpatientfrom % of charges | 6 | $64 | $64 | — | — | — | $64 – $64 |
| 15 | Indiana University Health Inc. Martinsville, IN percent of total billed charges · outpatientfrom % of charges | 7 | $66 | $66 | $7 | 11% | — | $50 – $73 |
| 16 | Indiana University Health Jay Inc. Portland, IN percent of total billed charges · outpatientfrom % of charges | 7 | $83 | $79 | $10 | 13% | — | $54 – $83 |
| 17 | Indiana University Health North Hospital Inc. Carmel, IN percent of total billed charges · outpatientfrom % of charges | 7 | $66 | $66 | $7 | 11% | — | $50 – $73 |
| 18 | Indiana University Health Paoli Inc. Paoli, IN percent of total billed charges · outpatientfrom % of charges | 6 | $84 | $84 | — | — | — | $84 – $84 |
| 19 | Indiana University Health Tipton Hospital Inc. Tipton, IN percent of total billed charges · outpatientfrom % of charges | 7 | $40 | $54 | $18 | 33% | — | $40 – $81 |
| 20 | Indiana University Health West Hospital Inc. Avon, IN percent of total billed charges · outpatientfrom % of charges | 7 | $66 | $66 | $7 | 11% | — | $50 – $73 |
| 21 | Indiana University Health White Memorial Hospital Inc. Monticello, IN percent of total billed charges · outpatientfrom % of charges | 6 | $59 | $59 | — | — | — | $59 – $59 |
| 22 | MARTIN MEMORIAL MEDICAL CENTER INC Port St Lucie, FL facility · fee schedule · outpatient | 3 | $0 | $0 | $0 | 22% | — | $0 – $1 |
| 23 | Maine Coast Regional Health Facilities Ellsworth, ME facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 24 | Mary Hitchcock Memorial Hospital Lebanon, NH professional · fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 25 | Mayo Regional Hospital Dover Foxcroft, ME facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
← Payers reporting HCPCS T2003 · Snapshot 20261113T090226Z-3ce6c0b8