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
Earmold Standard
Low
$1
Average
$92
Median
$69
High
$323
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
10 hospitals; the 90th percentile is 186.2× 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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10 hospital rates
iThe hospitals that file a Medicaid 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 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 2 | GLENDALE ADVENTIST MEDICAL CENTER Glendale, CA fee schedule · outpatient | 1 | $323 | $323 | — | — | — | $323 – $323 |
| 3 | Geisinger Lewistown Hospital Lewistown, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 4 | Geisinger Medical Center Muncy, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 5 | Geisinger Wyoming Valley Wilkes-Barre, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 6 | HealthAlliance - Clinton Hospital MA 01453; 201 Highland St Clinton, MA percent of total billed charges · bothfrom % of charges | 2 | $68 | $70 | $32 | 45% | — | $31 – $150 |
| 7 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $67 | $67 | — | — | — | $67 – $67 |
| 8 | UMass Memorial Health - Harrington Hospital, Inc. 2nd Floor Webster, MA percent of total billed charges · bothfrom % of charges | 3 | $77 | $78 | $32 | 42% | — | $31 – $150 |
| 9 | UMass Memorial Medical Center MA 01605; 157 Union Street Marlborough, MA percent of total billed charges · bothfrom % of charges | 4 | $75 | $158 | $254 | 161% | — | $20 – $999 |
| 10 | WHITE MEMORIAL MEDICAL CENTER MONTEBELLO, CA fee schedule · outpatient | 1 | $171 | $171 | — | — | — | $171 – $171 |
← Payers reporting HCPCS V5264 · Snapshot 20261111T120946Z-9134e7f7