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
DSTRJ MAL LES T/A/L 2.1-3.0
Teaneck, NJ
See all hospitals reporting CPT 17263 →Price type
Holy Name’s median price of $234 is 7% below the median hospital's median price ($252), higher than 44% of the 1,728 hospitals reporting CPT 17263. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 6 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 medicare prime facility · fee schedule · outpatient | $211 | $211 | — | — | — | $211 – $211 |
| 2 | Aetna golden medicare facility · fee schedule · outpatient | $234 | $234 | — | — | — | $234 – $234 |
| 3 | Clover clover facility · fee schedule · outpatient | $234 | $234 | — | — | — | $234 – $234 |
| 4 | UnitedHealthcare medicare facility · fee schedule · outpatient | $234 | $234 | — | — | — | $234 – $234 |
| 5 | WellCare medicare facility · fee schedule · outpatient | $236 | $236 | — | — | — | $236 – $236 |
| 6 | Cigna hmo/pos facility · fee schedule · outpatient | $664 | $664 | — | — | — | $664 – $664 |
Last updated: Nov 10, 2025
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