RC 622
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
WIRE DOC 22260 ACS
Low
$5
Average
$698
Median
$14
High
$6.6k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
45 hospitals; the 90th percentile is 371.6× 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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55 hospital rates
iThe hospitals that file a Aetna 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 | Shannon Medical Center San Angelo, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $295 | $295 | — | — | 1–10 | $295 – $295 |
| 2 | Shannon Medical Center Big Spring Big Spring, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $295 | $295 | — | — | 1–10 | $295 – $295 |
| 3 | Shannon River Crest Hospital San Angelo, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $295 | $295 | — | — | 1–10 | $295 – $295 |
| 4 | Baptist Memorial Hospital-Collierville Collierville, TN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $5 | $5 | $0 | 4% | — | $5 – $5 |
| 5 | Baptist Memorial Hospital-Crittenden West Memphis, AR facility · percent of total billed charges · outpatientfrom % of charges | 2 | $5 | $5 | $0 | 6% | — | $5 – $6 |
| 6 | Baptist Memorial Hospital-DeSoto Southaven, MS facility · percent of total billed charges · outpatientfrom % of charges | 2 | $5 | $5 | $0 | 4% | — | $5 – $5 |
| 7 | Baptist Memorial Hospital-Memphis Memphis, TN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $5 | $5 | $0 | 4% | — | $5 – $5 |
| 8 | Baptist Memorial Hospital-NEA Jonesboro, AR facility · percent of total billed charges · outpatientfrom % of charges | 3 | $6 | $7 | $3 | 37% | — | $5 – $11 |
| 9 | Baptist Memorial Hospital-North Mississippi Oxford, MS facility · percent of total billed charges · outpatientfrom % of charges | 2 | $9 | $9 | $4 | 40% | — | $5 – $12 |
| 10 | Baptist Memorial Hospital-Union City Union City, TN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $9 | $9 | $3 | 38% | — | $5 – $12 |
| 11 | Baptist Memorial Hospital-Women's Memphis, TN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $5 | $5 | $0 | 4% | — | $5 – $5 |
| 12 | Baxter County Regional Hospital, Inc. Home, AR facility · percent of total billed charges · inpatientfrom % of charges | 1 | $6 | $6 | $2 | 38% | — | $3 – $8 |
| 13 | Baxter County Regional Hospital, Inc. Home, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $6 | $6 | $2 | 38% | — | $3 – $8 |
| 14 | Covenant Medical Center Inc Saginaw, MI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $101 | $101 | $82 | 82% | — | $18 – $183 |
| 15 | Covenant Medical Center Inc Saginaw, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $101 | $101 | $82 | 82% | — | $18 – $183 |
| 16 | Covenant Medical Center Inc Saginaw, MI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $101 | $101 | $82 | 82% | — | $18 – $183 |
| 17 | Covenant Medical Center Inc Saginaw, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $101 | $101 | $82 | 82% | — | $18 – $183 |
| 18 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · inpatientfrom % of charges | 2 | $31 | $40 | $35 | 88% | — | $1 – $118 |
| 19 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · outpatientfrom % of charges | 2 | $31 | $40 | $35 | 88% | — | $1 – $118 |
| 20 | Gottlieb Memorial Hospital Melrose Park, IL facility · percent of total billed charges · outpatientfrom % of charges | 2 | $11 | $11 | $3 | 25% | — | $8 – $14 |
| 21 | Grady Memorial Hospital Atlanta, GA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $2.2k | $2.2k | $263 | 12% | — | $1.9k – $2.5k |
| 22 | HERITAGE VALLEY BEAVER BEAVER, PA percent of total billed charges · bothfrom % of charges | 1 | $887 | $1.1k | $955 | 84% | — | $151 – $3.8k |
| 23 | HERITAGE VALLEY SEWICKLEY SEWICKLEY, PA percent of total billed charges · bothfrom % of charges | 1 | $887 | $1.1k | $955 | 84% | — | $151 – $3.8k |
| 24 | Indiana University Health Arnett Inc. Lafayette, IN fee schedule · outpatient | 5 | $14 | $14 | — | — | — | $14 – $14 |
| 25 | Indiana University Health Ball Memorial Hospital Inc. Muncie, IN fee schedule · outpatient | 5 | $14 | $14 | — | — | — | $14 – $14 |
← Payers reporting RC 622 · Snapshot 20261111T120946Z-9134e7f7