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
HB=DISPENSING FEE
Low
$1
Average
$496
Median
$296
High
$8.2k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
106 hospitals; the 90th percentile is 13.5× 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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132 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 | Childrens Hospital Colorado Aurora, CO percent of total billed charges · outpatientfrom % of charges | 1 | $131 | $131 | — | — | 24 | $131 – $131 |
| 2 | Connecticut Children's Hartford, CT percent of total billed charges · outpatientfrom % of charges | 1 | $1.5k | $1.5k | — | — | 2–20 | $1.5k – $1.5k |
| 3 | University of Colorado Hospital Authority Aurora, CO percent of total billed charges · outpatientfrom % of charges | 3 | $595 | $646 | $80 | 12% | 1–10 | $586 – $759 |
| 4 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 1 | $436 | $436 | — | — | — | $436 – $436 |
| 5 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 6 | Blue Hill Memorial Hospital Hill, ME facility · fee schedule · outpatient | 1 | $215 | $215 | — | — | — | $215 – $215 |
| 7 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $206 | $206 | — | — | — | $206 – $206 |
| 8 | Bristol Regional Medical Center BRISTOL, VA percent of total billed charges · bothfrom % of charges | 4 | $64 | $66 | $3 | 5% | — | $64 – $71 |
| 9 | CAPE CORAL HOSPITAL CAPE CORAL, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $84 | $84 | — | — | — | $84 – $84 |
| 10 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 1 | $436 | $436 | — | — | — | $436 – $436 |
| 11 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 1 | $436 | $436 | — | — | — | $436 – $436 |
| 12 | Charles A. Dean Memorial Hospital Greenville, ME facility · fee schedule · outpatient | 1 | $215 | $215 | — | — | — | $215 – $215 |
| 13 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 1 | $206 | $206 | — | — | — | $206 – $206 |
| 14 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 2 | $220 | $220 | — | — | — | $220 – $220 |
| 15 | Children's Hospital Medical Center Mason, OH percent of total billed charges · inpatientfrom % of charges | 1 | $144 | $144 | — | — | — | $144 – $144 |
| 16 | Children's Hospital Medical Center Mason, OH percent of total billed charges · outpatientfrom % of charges | 1 | $286 | $286 | — | — | — | $286 – $286 |
| 17 | Children's Mercy Hospital Kansas City, MO facility · percent of total billed charges · inpatientfrom % of charges | 2 | $173 | $173 | $32 | 18% | — | $141 – $204 |
| 18 | Children's Mercy Hospital Kansas City, MO facility · percent of total billed charges · outpatientfrom % of charges | 2 | $173 | $173 | $32 | 18% | — | $141 – $204 |
| 19 | Children's Mercy Hospital Kansas Overland Park, KS facility · percent of total billed charges · inpatientfrom % of charges | 2 | $173 | $173 | $32 | 18% | — | $141 – $204 |
| 20 | Children's Mercy Hospital Kansas Overland Park, KS facility · percent of total billed charges · outpatientfrom % of charges | 2 | $173 | $173 | $32 | 18% | — | $141 – $204 |
| 21 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · fee schedule · outpatient | 3 | $329 | $336 | $12 | 4% | — | $326 – $354 |
| 22 | Conway Hospital, Inc. Conway, SC facility · percent of total billed charges · inpatientfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 23 | Conway Hospital, Inc. Conway, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 24 | Eastern Maine Medical Center Bangor, ME facility · fee schedule · outpatient | 1 | $215 | $215 | — | — | — | $215 – $215 |
| 25 | Eastern Maine Medical Center Bangor, ME professional · fee schedule · outpatient | 1 | $206 | $206 | — | — | — | $206 – $206 |
← Payers reporting HCPCS V5090 · Snapshot 20261111T120946Z-9134e7f7