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
Lutheran Monaural HA Right - HA Monaural ITC Premi
Bluffton, IN
See all hospitals reporting HCPCS V5255 →Price type
Bluffton Health System LLC’s median price of $720 is 62% below the median hospital's median price ($1.9k), higher than 15% of the 296 hospitals reporting HCPCS V5255. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 15 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna node aetna mcr adv facility · other · outpatient | $364 | $384 | $157 | 41% | — | $208 – $598 |
| 2 | Devoted node devoted health mcr adv facility · fee schedule · outpatient | $420 | $443 | $182 | 41% | — | $240 – $690 |
| 3 | Cigna cigna hmo facility · percent of total billed charges · outpatientfrom % of charges | $444 | $468 | $192 | 41% | — | $254 – $729 |
| 4 | Cigna cigna ppo facility · percent of total billed charges · outpatientfrom % of charges | $496 | $522 | $214 | 41% | — | $283 – $814 |
| 5 | Aetna aetna nbd facility · percent of total billed charges · inpatientfrom % of charges | $507 | $534 | $219 | 41% | — | $290 – $833 |
| 6 | Aetna aetna nbd facility · percent of total billed charges · outpatientfrom % of charges | $507 | $534 | $219 | 41% | — | $290 – $833 |
| 7 | Aetna aetna pssd jj facility · percent of total billed charges · inpatientfrom % of charges | $507 | $534 | $219 | 41% | — | $290 – $833 |
| 8 | Aetna aetna pssd jj facility · percent of total billed charges · outpatientfrom % of charges | $507 | $534 | $219 | 41% | — | $290 – $833 |
| 9 | Aetna aetna facility · percent of total billed charges · inpatientfrom % of charges | $624 | $658 | $270 | 41% | — | $357 – $1.0k |
| 10 | Aetna aetna facility · percent of total billed charges · outpatientfrom % of charges | $624 | $658 | $270 | 41% | — | $357 – $1.0k |
| 11 | UnitedHealthcare uhc apa facility · percent of total billed charges · inpatientfrom % of charges | $655 | $690 | $283 | 41% | — | $374 – $1.1k |
| 12 | MultiPlan multiplan complementary facility · percent of total billed charges · inpatientfrom % of charges | $1.1k | $1.2k | $485 | 41% | — | $640 – $1.8k |
| 13 | MultiPlan multiplan complementary facility · percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.2k | $485 | 41% | — | $640 – $1.8k |
| 14 | First Health first health non-exclusive facility · percent of total billed charges · inpatientfrom % of charges | $1.2k | $1.3k | $521 | 41% | — | $688 – $2.0k |
| 15 | First Health first health non-exclusive facility · percent of total billed charges · outpatientfrom % of charges | $1.2k | $1.3k | $521 | 41% | — | $688 – $2.0k |
Last updated: Apr 1, 2026
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