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 LS F/E/E/N/L/M>4.0
Teaneck, NJ
See all hospitals reporting CPT 17286 →Price type
Holy Name’s median price of $721 is 3% below the median hospital's median price ($744), higher than 47% of the 1,571 hospitals reporting CPT 17286. 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 | $649 | $649 | — | — | — | $649 – $649 |
| 2 | Aetna golden medicare facility · fee schedule · outpatient | $721 | $721 | — | — | — | $721 – $721 |
| 3 | Clover clover facility · fee schedule · outpatient | $721 | $721 | — | — | — | $721 – $721 |
| 4 | UnitedHealthcare medicare facility · fee schedule · outpatient | $721 | $721 | — | — | — | $721 – $721 |
| 5 | WellCare medicare facility · fee schedule · outpatient | $728 | $728 | — | — | — | $728 – $728 |
| 6 | Cigna hmo/pos facility · fee schedule · outpatient | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
Last updated: Nov 10, 2025
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