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 ct/mri imag
Lebanon, NH
See all hospitals reporting CPT 0055T →Price type
Mary Hitchcock Memorial Hospital’s median price of $500 is 68% below the median hospital's median price ($1.6k), higher than 28% of the 1,101 hospitals reporting CPT 0055T. 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 | $376.40 | $376.40 | $376.40 – $376.40 |
| 13 | Aetna aetna hmo/pos/ppo - arnb professional · fee schedule · outpatient | $376.40 | $376.40 | $376.40 – $376.40 |
| 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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