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
SMPL PLM STRSS TST/OX/EKG
Norfolk, VA
See all hospitals reporting CPT 94617 →Price type
Children's Hospital of the King's Daughters’s median price of $631 is 299% above the median hospital's median price ($158), higher than 93% of the 1,599 hospitals reporting CPT 94617. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 12 payers, 24 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 | Anthem all products facility · fee schedule · outpatient | $86.64 | $86.64 | $86.64 – $86.64 |
| 2 | UnitedHealthcare all products facility · fee schedule · outpatient | $87.22 | $87.22 | $87.22 – $87.22 |
| 3 | Aetna Better Health all products facility · fee schedule · outpatient | $106.96 | $106.96 | $106.96 – $106.96 |
| 4 | Humana all products facility · fee schedule · outpatient | $106.96 | $106.96 | $106.96 – $106.96 |
| 5 | Amerihealth Caritas all products facility · percent of total billed charges · outpatientfrom % of charges | $191.83 | $191.83 | $191.83 – $191.83 |
| 6 | WellCare all products facility · percent of total billed charges · outpatientfrom % of charges | $197.59 | $197.59 | $197.59 – $197.59 |
| 7 | Anthem all commercial products except healthkeepers facility · fee schedule · outpatient | $457.15 | $457.15 | $457.15 – $457.15 |
| 8 | Anthem healthkeepers facility · fee schedule · outpatient | $457.15 | $457.15 | $457.15 – $457.15 |
| 9 | Cigna all commercial products facility · percent of total billed charges · inpatientfrom % of charges | $553.81 | $553.81 | $553.81 – $553.81 |
| 10 | Cigna all commercial products facility · percent of total billed charges · outpatientfrom % of charges | $553.81 | $553.81 | $553.81 – $553.81 |
| 11 | UnitedHealthcare mamsi facility · percent of total billed charges · inpatientfrom % of charges | $631.38 | $631.38 | $631.38 – $631.38 |
| 12 | UnitedHealthcare mamsi facility · percent of total billed charges · outpatientfrom % of charges | $631.38 | $631.38 | $631.38 – $631.38 |
| 13 | Aetna all commercial products facility · percent of total billed charges · inpatientfrom % of charges | $685.59 | $685.59 | $685.59 – $685.59 |
| 14 | Aetna all commercial products facility · percent of total billed charges · outpatientfrom % of charges | $685.59 | $685.59 | $685.59 – $685.59 |
| 15 | UnitedHealthcare onenet options facility · percent of total billed charges · inpatientfrom % of charges | $685.59 | $685.59 | $685.59 – $685.59 |
| 16 | UnitedHealthcare onenet options facility · percent of total billed charges · outpatientfrom % of charges | $685.59 | $685.59 | $685.59 – $685.59 |
| 17 | Medcost all commercial products facility · percent of total billed charges · outpatientfrom % of charges | $708.94 | $708.94 | $708.94 – $708.94 |
| 18 | First Health all commercial products facility · percent of total billed charges · inpatientfrom % of charges | $750.64 | $750.64 | $750.64 – $750.64 |
| 19 | First Health all commercial products facility · percent of total billed charges · outpatientfrom % of charges | $750.64 | $750.64 | $750.64 – $750.64 |
| 20 | Medcost all commercial products facility · percent of total billed charges · inpatientfrom % of charges | $767.33 | $767.33 | $767.33 – $767.33 |
| 21 | MultiPlan all commercial products facility · percent of total billed charges · inpatientfrom % of charges | $767.33 | $767.33 | $767.33 – $767.33 |
| 22 | MultiPlan all commercial products facility · percent of total billed charges · outpatientfrom % of charges | $767.33 | $767.33 | $767.33 – $767.33 |
| 23 | Phcs all commercial products facility · percent of total billed charges · inpatientfrom % of charges | $767.33 | $767.33 | $767.33 – $767.33 |
| 24 | Phcs all commercial products facility · percent of total billed charges · outpatientfrom % of charges | $792.35 | $792.35 | $792.35 – $792.35 |
Last updated: Mar 17, 2026
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