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
TRIAGE ONLY
Low
$11
Average
$47
Median
$18
High
$324
Each hospital's average Molina rate, under the methodology and billing class chosen below.
26 hospitals; the 90th percentile is 8.8× 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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27 hospital rates
iThe hospitals that file a Molina 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 | $15 | $15 | — | — | — | $15 – $15 |
| 2 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 3 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 4 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 5 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 6 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 7 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 8 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 9 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 10 | Granbury Hospital Corporation Granbury, TX facility · fee schedule · outpatient | 3 | $48 | $81 | $47 | 58% | — | $48 – $147 |
| 11 | Jackson HMA LLC Jackson, MS facility · fee schedule · outpatient | 1 | $324 | $324 | — | — | — | $324 – $324 |
| 12 | LODI COMMUNITY HOSPITAL Lodi, OH facility · case rate · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 13 | LUTHERAN HOSPITAL Cleveland, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 14 | Laredo Texas Hospital Company LP Laredo, TX facility · fee schedule · outpatient | 1 | $97 | $97 | — | — | — | $97 – $97 |
| 15 | Laredo Texas Hospital Company LP Laredo, TX facility · per diem · outpatient | 3 | $31 | $27 | $8 | 28% | — | $16 – $33 |
| 16 | Longview Medical Center LP Longview, TX facility · per diem · outpatient | 2 | $20 | $20 | $7 | 36% | — | $13 – $27 |
| 17 | MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · case rate · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 18 | MEDINA HOSPITAL Medina, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 19 | NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC Toledo, OH facility · other · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 20 | Nationwide Children's Hospital Columbus, OH facility · other · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 21 | Navarro Hospital LP Corsicana, TX facility · other · outpatient | 4 | $189 | $179 | $64 | 36% | — | $86 – $252 |
| 22 | Piney Woods Healthcare System LP Lufkin, TX facility · fee schedule · outpatient | 3 | $53 | $59 | $8 | 13% | — | $53 – $70 |
| 23 | THE UNION HOSPITAL ASSOCIATION Dover, OH facility · case rate · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 24 | The Cleveland Clinic Foundation Brunswick, OH facility · case rate · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 25 | Victoria of Texas LP Victoria, TX facility · per diem · outpatient | 3 | $18 | $18 | — | — | — | $18 – $18 |
← Payers reporting HCPCS T5999 · Snapshot 20261111T120946Z-9134e7f7