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
$0
Average
$51
Median
$39
High
$323
Each hospital's average Molina rate, under the methodology and billing class chosen below.
68 hospitals; the 90th percentile is 7.3× 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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79 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 | Bexar County Hospital District San Antonio, TX other · outpatient | 1 | $39 | $39 | — | — | 3–30 | $39 – $39 |
| 2 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 3 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE fee schedule · outpatient | 1 | $64 | $64 | $13 | 20% | — | $52 – $77 |
| 4 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE other · outpatient | 1 | $80 | $130 | $90 | 69% | — | $54 – $257 |
| 5 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE percent of total billed charges · outpatientfrom % of charges | 2 | $34 | $44 | $32 | 73% | — | $23 – $108 |
| 6 | Bronson LakeView Hospital Paw Paw, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 7 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 8 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 9 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 10 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 11 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 12 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · fee schedule · outpatient | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 13 | Childrens Hospital Colorado Aurora, CO percent of total billed charges · inpatientfrom % of charges | 1 | $36 | $39 | $5 | 13% | — | $36 – $47 |
| 14 | Childrens Hospital Colorado Aurora, CO percent of total billed charges · outpatientfrom % of charges | 1 | $36 | $39 | $5 | 13% | — | $36 – $47 |
| 15 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 16 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 17 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · outpatient | 1 | $44 | $44 | $19 | 43% | — | $25 – $63 |
| 18 | Deaconess Health System Henderson Hospital Henderson, KY professional · fee schedule · both | 4 | $0 | $0 | — | — | — | $0 – $0 |
| 19 | Deaconess Health System Union County Hospital Morganfield, KY professional · fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 20 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 21 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 22 | Deaconess Illinois Crossroads Inc Mount Vernon, IL professional · fee schedule · both | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 23 | Deaconess Illinois Union County Hospital Inc Anna, IL professional · fee schedule · both | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 24 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL professional · fee schedule · both | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 25 | FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER Fresno, CA facility · fee schedule · outpatient | 1 | $28 | $28 | — | — | — | $28 – $28 |
← Payers reporting HCPCS V5264 · Snapshot 20261111T120946Z-9134e7f7