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
DSTR MAL LES S/N/H/F/G 3.1-4
Teaneck, NJ
See all hospitals reporting CPT 17274 →Price type
Holy Name’s median price of $471 is 1% above the median hospital's median price ($465), higher than 50% of the 1,642 hospitals reporting CPT 17274. 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 | $423 | $423 | — | — | — | $423 – $423 |
| 2 | Aetna golden medicare facility · fee schedule · outpatient | $471 | $471 | — | — | — | $471 – $471 |
| 3 | Clover clover facility · fee schedule · outpatient | $471 | $471 | — | — | — | $471 – $471 |
| 4 | UnitedHealthcare medicare facility · fee schedule · outpatient | $471 | $471 | — | — | — | $471 – $471 |
| 5 | WellCare medicare facility · fee schedule · outpatient | $475 | $475 | — | — | — | $475 – $475 |
| 6 | Cigna hmo/pos facility · fee schedule · outpatient | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
Last updated: Nov 10, 2025
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