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.
Generation details were not recorded for this description.
Original text from hospital filings
Conformity Evaluation
Low
$12
Average
$168
Median
$97
High
$8.2k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
153 hospitals; the 90th percentile is 5.0× 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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189 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 | Vanderbilt University Medical Center Nashville, TN percent of total billed charges · bothfrom % of charges | 7 | $84 | $80 | $11 | 13% | 4–40 | $48 – $88 |
| 2 | Massachusetts Eye and Ear Boston, MA percent of total billed charges · outpatientfrom % of charges | 2 | $53 | $53 | $17 | 32% | 2–20 | $36 – $70 |
| 3 | Childrens Hospital Colorado Aurora, CO percent of total billed charges · outpatientfrom % of charges | 1 | $316 | $316 | — | — | 1–10 | $316 – $316 |
| 4 | Connecticut Children's Hartford, CT percent of total billed charges · outpatientfrom % of charges | 1 | $34 | $34 | — | — | 1–10 | $34 – $34 |
| 5 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 6 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $252 | $252 | — | — | — | $252 – $252 |
| 7 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · inpatientfrom % of charges | 3 | $86 | $90 | $24 | 26% | — | $56 – $131 |
| 8 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · outpatientfrom % of charges | 3 | $86 | $90 | $24 | 26% | — | $56 – $131 |
| 9 | Berkshire Medical Center Great Barrington, MA facility · percent of total billed charges · outpatientfrom % of charges | 3 | $145 | $147 | $2 | 2% | — | $145 – $150 |
| 10 | Berkshire Medical Center Great Barrington, MA professional · fee schedule · outpatient | 3 | $145 | $147 | $2 | 2% | — | $145 – $150 |
| 11 | Blue Hill Memorial Hospital Hill, ME facility · fee schedule · outpatient | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 12 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 13 | Boston Children's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $173 | $173 | $5 | 3% | — | $167 – $178 |
| 14 | Boston Children's Hospital Lexington, MA percent of total billed charges · bothfrom % of charges | 1 | $173 | $173 | $5 | 3% | — | $167 – $178 |
| 15 | Boston Children's Hospital Brookline, MA percent of total billed charges · bothfrom % of charges | 1 | $173 | $173 | $5 | 3% | — | $167 – $178 |
| 16 | Boston Children's Hospital Dartmouth, MA percent of total billed charges · bothfrom % of charges | 1 | $173 | $173 | $5 | 3% | — | $167 – $178 |
| 17 | Boston Children's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 2 | $170 | $172 | $4 | 3% | — | $167 – $178 |
| 18 | Boston Children's Hospital Peabody, MA percent of total billed charges · bothfrom % of charges | 1 | $173 | $173 | $5 | 3% | — | $167 – $178 |
| 19 | Boston Children's Hospital Waltham, MA percent of total billed charges · bothfrom % of charges | 2 | $170 | $172 | $4 | 3% | — | $167 – $178 |
| 20 | Boston Children's Hospital Needham, MA percent of total billed charges · bothfrom % of charges | 1 | $173 | $173 | $5 | 3% | — | $167 – $178 |
| 21 | Boston Children's Hospital Weymouth, MA percent of total billed charges · bothfrom % of charges | 1 | $173 | $173 | $5 | 3% | — | $167 – $178 |
| 22 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 23 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 1 | $76 | $76 | — | — | — | $76 – $76 |
| 24 | Charles A. Dean Memorial Hospital Greenville, ME facility · fee schedule · outpatient | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 25 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
← Payers reporting HCPCS V5020 · Snapshot 20261111T120946Z-9134e7f7