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
69200 - REM FB-EXT AUDIT CANAL WO ANES
Suffern, NY
See all hospitals reporting CPT 69200 →Price type
Good Samaritan Hospital’s median price of $2.4k is 1319% above the median hospital's median price ($172), higher than 96% of the 2,361 hospitals reporting CPT 69200. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 22 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 | Blue Cross Blue Shield blue cross small group facility · percent of total billed charges · outpatientfrom % of charges | $344.70 | $344.70 | $344.70 – $344.70 |
| 2 | Blue Cross Blue Shield blue cross hmo facility · percent of total billed charges · outpatientfrom % of charges | $383.00 | $383.00 | $383.00 – $383.00 |
| 3 | Cigna cigna ppo facility · percent of total billed charges · outpatientfrom % of charges | $536.20 | $536.20 | $536.20 – $536.20 |
| 4 | MultiPlan multiplan facility · percent of total billed charges · outpatientfrom % of charges | $574.50 | $574.50 | $574.50 – $574.50 |
| 5 | Phcs phcs facility · percent of total billed charges · outpatientfrom % of charges | $574.50 | $574.50 | $574.50 – $574.50 |
| 6 | First Health first health facility · percent of total billed charges · outpatientfrom % of charges | $651.10 | $651.10 | $651.10 – $651.10 |
| 7 | UnitedHealthcare uhc exchange facility · fee schedule · outpatient | $1,530 | $1,530 | $1,530 – $1,530 |
| 8 | UnitedHealthcare uhc commercial facility · fee schedule · outpatient | $1,800 | $1,800 | $1,800 – $1,800 |
| 9 | UnitedHealthcare uhc empire facility · fee schedule · outpatient | $1,800 | $1,800 | $1,800 – $1,800 |
| 10 | Medicare medicare facility · fee schedule · outpatient | $1,818 | $1,818 | $166.08 – $3,471 |
| 11 | Molina affinity by molina mcr facility · fee schedule · outpatient | $1,909 | $1,909 | $173.53 – $3,644 |
| 12 | UnitedHealthcare uhc exchange facility · case rate · outpatient | $2,500 | $2,500 | $2,500 – $2,500 |
| 13 | UnitedHealthcare uhc commercial facility · case rate · outpatient | $2,941 | $2,941 | $2,941 – $2,941 |
| 14 | UnitedHealthcare uhc empire facility · case rate · outpatient | $2,941 | $2,941 | $2,941 – $2,941 |
| 15 | Tricare tricare facility · fee schedule · outpatient | $3,131 | $3,131 | $166.08 – $6,096 |
| 16 | Blue Cross Blue Shield blue cross connection/exchange facility · case rate · outpatient | $3,966 | $3,966 | $3,966 – $3,966 |
| 17 | Blue Cross Blue Shield blue cross small group facility · case rate · outpatient | $4,759 | $4,759 | $4,759 – $4,759 |
| 18 | Blue Cross Blue Shield blue cross hmo facility · case rate · outpatient | $4,886 | $4,886 | $4,886 – $4,886 |
| 19 | Cigna cigna ppo facility · case rate · outpatient | $5,853 | $5,853 | $5,853 – $5,853 |
| 20 | Aetna aetna hp network facility · case rate · outpatient | $6,273 | $6,273 | $2,676 – $9,869 |
| 21 | Aetna aetna facility · case rate · outpatient | $6,969 | $6,969 | $2,973 – $10,965 |
| 22 | Aetna aetna employee facility · case rate · outpatient | $6,969 | $6,969 | $2,973 – $10,965 |
Last updated: Jun 29, 2026
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