RC 174
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
NEWBORN - LEVEL IV
Low
$74
Average
$5.6k
Median
$6.1k
High
$10.0k
Each hospital's average Optum rate, under the methodology and billing class chosen below.
33 hospitals; the 90th percentile is 5.6× 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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34 hospital rates
iThe hospitals that file a Optum 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 | Affinity Hospital LLC Birmingham, AL facility · per diem · inpatient | 1 | $3.1k | $3.1k | — | — | — | $3.1k – $3.1k |
| 2 | BRFHH MONROE, LLC Monroe, LA other · outpatient | 1 | $3.6k | $3.6k | — | — | — | $3.6k – $3.6k |
| 3 | Boston Children's Hospital Boston, MA percent of total billed charges · inpatientfrom % of charges | 1 | $9.5k | $9.5k | — | — | — | $9.5k – $9.5k |
| 4 | CATHOLIC HEALTH INITIATIVES COLORADO Canon City, CO per diem · inpatient | 1 | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
| 5 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · per diem · inpatient | 1 | $7.7k | $7.7k | — | — | — | $7.7k – $7.7k |
| 6 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · per diem · inpatient | 1 | $7.7k | $7.7k | — | — | — | $7.7k – $7.7k |
| 7 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · per diem · inpatient | 1 | $7.7k | $7.7k | — | — | — | $7.7k – $7.7k |
| 8 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · per diem · inpatient | 1 | $7.7k | $7.7k | — | — | — | $7.7k – $7.7k |
| 9 | Childrens Hospital of Los Angeles Angeles, CA facility · per diem · inpatient | 1 | $6.1k | $6.1k | — | — | — | $6.1k – $6.1k |
| 10 | City Hospital, Inc. Martinsburg, WV facility · per diem · inpatient | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 11 | Connecticut Children's Hartford, CT per diem · inpatient | 3 | $10.4k | $10.0k | $1.1k | 11% | — | $8.5k – $11.0k |
| 12 | DIGNITY HEALTH Phoenix, AZ per diem · inpatient | 1 | $4.6k | $4.6k | — | — | — | $4.6k – $4.6k |
| 13 | ENUMCLAW REGIONAL HOSPITAL ASSOCIATION Enumclaw, WA per diem · inpatient | 1 | $4.4k | $4.4k | — | — | — | $4.4k – $4.4k |
| 14 | Fairview Hospital Cleveland, OH facility · per diem · inpatient | 1 | $7.7k | $7.7k | — | — | — | $7.7k – $7.7k |
| 15 | GLENDALE ADVENTIST MEDICAL CENTER Glendale, CA per diem · inpatient | 2 | $4.8k | $4.8k | $225 | 5% | — | $4.6k – $5.0k |
| 16 | Herbert J Thomas Memorial Hospital Association South Charleston, WV facility · per diem · inpatient | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 17 | LAFAYETTE GENERAL MEDICAL CENTER INC Lafayette, LA other · outpatient | 1 | $9.6k | $9.6k | — | — | — | $9.6k – $9.6k |
| 18 | LUTHERAN HOSPITAL Cleveland, OH facility · per diem · inpatient | 1 | $7.7k | $7.7k | — | — | — | $7.7k – $7.7k |
| 19 | MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · per diem · inpatient | 1 | $7.7k | $7.7k | — | — | — | $7.7k – $7.7k |
| 20 | MEDINA HOSPITAL Medina, OH facility · per diem · inpatient | 1 | $7.7k | $7.7k | — | — | — | $7.7k – $7.7k |
| 21 | OCHSNER LSU HEALTH SHREVEPORT - ST. MARY MEDICAL CENTER, LLC Shreveport, LA other · outpatient | 1 | $8.6k | $8.6k | — | — | — | $8.6k – $8.6k |
| 22 | Pennsylvania Hospital of the University of Pennsylvania Health System Philadelphia, PA facility · other · inpatient | 1 | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 23 | Rush Medical Foundation Meridian, MS other · outpatient | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 24 | St Tammany Hosptial Service District No 2 Slidell, LA other · outpatient | 1 | $4.3k | $4.3k | — | — | — | $4.3k – $4.3k |
| 25 | St Tammany Hosptial Service District No 2 Slidell, LA other · outpatient | 1 | $4.3k | $4.3k | — | — | — | $4.3k – $4.3k |
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