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
$29
Average
$816
Median
$29
High
$4.5k
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
25 hospitals; the 90th percentile is 152.6× 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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28 hospital rates
iThe hospitals that file a Anthem 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 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 4 | $1.8k | $2.1k | $1.3k | 63% | 8–80 | $521 – $5.2k |
| 2 | Ascension St. Vincent Heart Center Carmel, IN fee schedule · both | 3 | $29 | $29 | — | — | — | $29 – $29 |
| 3 | Carmel AmbSurg Carmel, IN fee schedule · both | 3 | $29 | $29 | — | — | — | $29 – $29 |
| 4 | Covenant Medical Center Inc Saginaw, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $56 | $56 | $46 | 82% | — | $10 – $102 |
| 5 | Covenant Medical Center Inc Saginaw, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $56 | $56 | $46 | 82% | — | $10 – $102 |
| 6 | Endo Surgery Center Carmel, IN fee schedule · both | 3 | $29 | $29 | — | — | — | $29 – $29 |
| 7 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · inpatientfrom % of charges | 3 | $57 | $58 | $39 | 67% | — | $4 – $124 |
| 8 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · outpatientfrom % of charges | 3 | $47 | $52 | $38 | 73% | — | $2 – $124 |
| 9 | Grady Memorial Hospital Atlanta, GA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $4.4k | $4.4k | — | — | — | $4.4k – $4.4k |
| 10 | Grady Memorial Hospital Atlanta, GA facility · percent of total billed charges · outpatientfrom % of charges | 4 | $4.1k | $4.2k | $154 | 4% | — | $4.1k – $4.4k |
| 11 | Naab Road Surgery Center Indianapolis, IN fee schedule · both | 3 | $29 | $29 | — | — | — | $29 – $29 |
| 12 | ST MARYS HOSPITAL MEDICAL CENTER OF GREEN BAY INC HOSPITAL SISTERS GREEN BAY, WI percent of total billed charges · bothfrom % of charges | 2 | $4.5k | $4.5k | — | — | — | $4.5k – $4.5k |
| 13 | ST NICHOLAS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS Sheboygan, WI percent of total billed charges · bothfrom % of charges | 2 | $4.5k | $4.5k | — | — | — | $4.5k – $4.5k |
| 14 | ST VINCENT HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS Oconto Falls, WI percent of total billed charges · bothfrom % of charges | 2 | $4.5k | $4.5k | — | — | — | $4.5k – $4.5k |
| 15 | St. Joseph Hospital & Health Center, Inc. Kokomo, IN fee schedule · both | 3 | $29 | $29 | — | — | — | $29 – $29 |
| 16 | St. Mary's Health, Inc. IN 47750; 10388 Warrick Wellness Trail Newburgh, IN fee schedule · both | 3 | $29 | $29 | — | — | — | $29 – $29 |
| 17 | St. Mary's Health, Inc. IN 47750; 10388 Warrick Wellness Trail Newburgh, IN fee schedule · outpatient | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 18 | St. Mary's Warrick Hospital, Inc. Boonville, IN fee schedule · both | 3 | $29 | $29 | — | — | — | $29 – $29 |
| 19 | St. Vincent Anderson Regional Hospital, Inc. Anderson, IN fee schedule · both | 3 | $29 | $29 | — | — | — | $29 – $29 |
| 20 | St. Vincent Carmel Hospital, Inc. Carmel, IN fee schedule · both | 3 | $29 | $29 | — | — | — | $29 – $29 |
| 21 | St. Vincent Clay Hospital, Inc. Brazil, IN fee schedule · both | 3 | $29 | $29 | — | — | — | $29 – $29 |
| 22 | St. Vincent Fishers Hospital, Inc. Fishers, IN fee schedule · both | 3 | $29 | $29 | — | — | — | $29 – $29 |
| 23 | St. Vincent Jennings Hospital, Inc. Vernon, IN fee schedule · both | 3 | $29 | $29 | — | — | — | $29 – $29 |
| 24 | St. Vincent Madison County Health System, Inc. Elwood, IN fee schedule · both | 3 | $29 | $29 | — | — | — | $29 – $29 |
| 25 | St. Vincent Randolph Hospital, Inc. Winchester, IN fee schedule · both | 3 | $29 | $29 | — | — | — | $29 – $29 |
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