RC 269
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
TX/PROPH/DG ADDL SEQ IV INF
Low
$25
Average
$595
Median
$495
High
$1.3k
Each hospital's average MultiPlan rate, under the methodology and billing class chosen below.
16 hospitals; the 90th percentile is 37.9× 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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21 hospital rates
iThe hospitals that file a MultiPlan 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 | CAPE CORAL HOSPITAL CAPE CORAL, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 2 | East Alabama Medical Center OPELIKA, AL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 3 | GULF COAST MEDICAL CENTER FORT MYERS, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 4 | HEALTHPARK MEDICAL CENTER FORT MYERS, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 5 | LEE MEMORIAL HOSPITAL FORT MYERS, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 6 | Marshall Medical Center Placerville, CA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $559 | $559 | — | — | — | $559 – $559 |
| 7 | Marshall Medical Center Placerville, CA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $559 | $559 | — | — | — | $559 – $559 |
| 8 | Mid Hudson Regional Hospital Poughkeepsie, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $449 | $478 | $264 | 55% | — | $190 – $997 |
| 9 | Mid Hudson Regional Hospital Poughkeepsie, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $482 | $512 | $283 | 55% | — | $203 – $1.1k |
| 10 | PMC HOSPITAL, LLC Pasadena, TX fee schedule · inpatient | 1 | $25 | $25 | $9 | 36% | — | $16 – $35 |
| 11 | PMC HOSPITAL, LLC Pasadena, TX fee schedule · outpatient | 1 | $25 | $25 | $9 | 36% | — | $16 – $35 |
| 12 | REHAB HOSPITAL FORT MYERS, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 13 | San Juan Hospital Spanish Valley, UT facility · fee schedule · both | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 14 | The University of Tennessee Medical Center Knoxville, TN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $47 | $64 | $24 | 37% | — | $34 – $95 |
| 15 | The University of Tennessee Medical Center Knoxville, TN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $47 | $64 | $24 | 37% | — | $34 – $95 |
| 16 | University of Virginia Culpeper Medical Center Culpeper, VA percent of total billed charges · bothfrom % of charges | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 17 | University of Virginia Haymarket Medical Center Haymarket, VA percent of total billed charges · bothfrom % of charges | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 18 | University of Virginia Medical Center Charlottesville, VA percent of total billed charges · bothfrom % of charges | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 19 | University of Virginia Prince William Medical Center Manassas, VA percent of total billed charges · bothfrom % of charges | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 20 | Westchester Medical Center Valhalla, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $449 | $478 | $264 | 55% | — | $190 – $997 |
| 21 | Westchester Medical Center Valhalla, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $482 | $512 | $283 | 55% | — | $203 – $1.1k |
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