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
Bone srgry cmptr fluor image
Lebanon, NH
See all hospitals reporting CPT 0054T →Price type
Mary Hitchcock Memorial Hospital’s median price of $497 is 67% below the median hospital's median price ($1.5k), higher than 33% of the 1,025 hospitals reporting CPT 0054T. 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, 41 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 | Amerihealth Caritas amerihealth caritas - nh managed medicaid professional · percent of total billed charges · outpatientfrom % of charges | $97.44 | $97.44 | $97.44 – $97.44 |
| 2 | Anthem anthem - medicare advantage - dhp professional · fee schedule · outpatient | $160.27 | $160.27 | $160.27 – $160.27 |
| 3 | Bcbs Vt bcbs of vermont - medicare advantage - dhp professional · fee schedule · outpatient | $160.27 | $160.27 | $160.27 – $160.27 |
| 4 | UnitedHealthcare uhc - medicare advantage - dhp professional · fee schedule · outpatient | $160.27 | $160.27 | $160.27 – $160.27 |
| 5 | UnitedHealthcare uhc - va community care network - dhpn professional · fee schedule · outpatient | $160.27 | $160.27 | $160.27 – $160.27 |
| 6 | UnitedHealthcare uhc - va community care network - dhps professional · fee schedule · outpatient | $160.27 | $160.27 | $160.27 – $160.27 |
| 7 | Aetna aetna medicare advantage - dhp professional · fee schedule · outpatient | $165.07 | $165.07 | $165.07 – $165.07 |
| 8 | Cigna cigna medicare advantage - dhp professional · fee schedule · outpatient | $165.07 | $165.07 | $165.07 – $165.07 |
| 9 | Bcbs Vt bcbs of vermont - the vermont health plan professional · fee schedule · outpatient | $165.08 | $165.08 | $165.08 – $165.08 |
| 10 | WellCare wellcare - medicare advantage - dhp professional · fee schedule · outpatient | $166.68 | $166.68 | $166.68 – $166.68 |
| 11 | Ambetter ambetter commercial - exchange behavioral health - dhp professional · fee schedule · outpatient | $168.28 | $168.28 | $168.28 – $168.28 |
| 12 | Aetna aetna hmo/pos/ppo professional · fee schedule · outpatient | $311.91 | $311.91 | $311.91 – $311.91 |
| 13 | Aetna aetna hmo/pos/ppo - arnb professional · fee schedule · outpatient | $311.91 | $311.91 | $311.91 – $311.91 |
| 14 | Ambetter ambetter commercial - exchange - dhps professional · fee schedule · outpatient | $380.16 | $380.16 | $380.16 – $380.16 |
| 15 | UnitedHealthcare uhc - freedom plan professional · percent of total billed charges · outpatientfrom % of charges | $422.26 | $422.26 | $422.26 – $422.26 |
| 16 | UnitedHealthcare uhc - freedom plan professional · percent of total billed charges · inpatientfrom % of charges | $436.88 | $436.88 | $436.88 – $436.88 |
| 17 | Bcbs Vt bcbs of vermont - the vermont health plan professional · percent of total billed charges · outpatientfrom % of charges | $471.28 | $471.28 | $471.28 – $471.28 |
| 18 | Bcbs Vt bcbs of vermont - vermont health partnership professional · percent of total billed charges · outpatientfrom % of charges | $471.28 | $471.28 | $471.28 – $471.28 |
| 19 | UnitedHealthcare uhc - freedom plan - dhp professional · fee schedule · outpatient | $500.00 | $500.00 | $500.00 – $500.00 |
| 20 | UnitedHealthcare uhc - tiered freedom plan professional · fee schedule · outpatient | $500.00 | $500.00 | $500.00 – $500.00 |
| 21 | Cigna cigna hmo-pos professional · percent of total billed charges · outpatientfrom % of charges | $520.30 | $520.30 | $520.30 – $520.30 |
| 22 | Ambetter ambetter commercial - exchange - dhpn professional · fee schedule · outpatient | $526.16 | $526.16 | $525.44 – $526.88 |
| 23 | Aetna aetna hmo/pos/ppo - arnb professional · percent of total billed charges · inpatientfrom % of charges | $528.04 | $528.04 | $528.04 – $528.04 |
| 24 | Aetna aetna hmo/pos/ppo - arnb professional · percent of total billed charges · outpatientfrom % of charges | $528.04 | $528.04 | $528.04 – $528.04 |
| 25 | Bcbs Vt bcbs of vermont non-managed care plans professional · percent of total billed charges · outpatientfrom % of charges | $574.48 | $574.48 | $574.48 – $574.48 |
Last updated: Jan 1, 2026
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