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
Nudt15&tpmt gene com vrnt
Lebanon, NH
See all hospitals reporting CPT 0169U →Price type
Mary Hitchcock Memorial Hospital’s median price of $466 is 3% below the median hospital's median price ($482), higher than 9% of the 1,292 hospitals reporting CPT 0169U. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 35 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 | UnitedHealthcare uhc - hmo/pos/ppo - dhp professional · fee schedule · outpatient | $195.79 | $195.79 | $195.79 – $195.79 |
| 2 | UnitedHealthcare uhc - tiered freedom plan professional · fee schedule · outpatient | $251.73 | $251.73 | $251.73 – $251.73 |
| 3 | UnitedHealthcare uhc - freedom plan - dhp professional · fee schedule · outpatient | $279.70 | $279.70 | $279.70 – $279.70 |
| 4 | Anthem anthem - indemnity/federal employee program professional · fee schedule · outpatient | $303.01 | $303.01 | $303.01 – $303.01 |
| 5 | Anthem anthem hmo/pos; individual non qhp on or off exch; shop off exch - dhp professional · fee schedule · outpatient | $303.01 | $303.01 | $303.01 – $303.01 |
| 6 | Anthem anthem indiv qhp - exchange - dhp professional · fee schedule · outpatient | $303.01 | $303.01 | $303.01 – $303.01 |
| 7 | Anthem anthem ppo - dhp professional · fee schedule · outpatient | $303.01 | $303.01 | $303.01 – $303.01 |
| 8 | Anthem anthem shop - exchange - dhp professional · fee schedule · outpatient | $303.01 | $303.01 | $303.01 – $303.01 |
| 9 | Anthem anthem - medicare advantage facility · fee schedule · outpatient | $466.17 | $466.17 | $466.17 – $466.17 |
| 10 | Anthem anthem - medicare advantage - dhp professional · fee schedule · outpatient | $466.17 | $466.17 | $466.17 – $466.17 |
| 11 | Bcbs Vt bcbs of vermont - medicare advantage facility · fee schedule · outpatient | $466.17 | $466.17 | $466.17 – $466.17 |
| 12 | Bcbs Vt bcbs of vermont - medicare advantage - dhp professional · fee schedule · outpatient | $466.17 | $466.17 | $466.17 – $466.17 |
| 13 | UnitedHealthcare uhc - medicare advantage facility · fee schedule · outpatient | $466.17 | $466.17 | $466.17 – $466.17 |
| 14 | UnitedHealthcare uhc - va community care network facility · fee schedule · outpatient | $466.17 | $466.17 | $466.17 – $466.17 |
| 15 | UnitedHealthcare uhc - medicare advantage - dhp professional · fee schedule · outpatient | $466.17 | $466.17 | $466.17 – $466.17 |
| 16 | UnitedHealthcare uhc - va community care network - dhpn professional · fee schedule · outpatient | $466.17 | $466.17 | $466.17 – $466.17 |
| 17 | UnitedHealthcare uhc - va community care network - dhps professional · fee schedule · outpatient | $466.17 | $466.17 | $466.17 – $466.17 |
| 18 | Aetna aetna medicare advantage - dhp professional · fee schedule · outpatient | $480.15 | $480.15 | $480.15 – $480.15 |
| 19 | Cigna cigna medicare advantage - dhp professional · fee schedule · outpatient | $480.15 | $480.15 | $480.15 – $480.15 |
| 20 | Aetna aetna medicare advantage facility · fee schedule · outpatient | $480.16 | $480.16 | $480.16 – $480.16 |
| 21 | Bcbs Vt bcbs of vermont - the vermont health plan professional · fee schedule · outpatient | $480.16 | $480.16 | $480.16 – $480.16 |
| 22 | Cigna cigna medicare advantage facility · fee schedule · outpatient | $480.16 | $480.16 | $480.16 – $480.16 |
| 23 | WellCare wellcare - medicare advantage - dhp professional · fee schedule · outpatient | $484.81 | $484.81 | $484.81 – $484.81 |
| 24 | WellCare wellcare - medicare advantage facility · fee schedule · outpatient | $484.82 | $484.82 | $484.82 – $484.82 |
| 25 | Ambetter ambetter commercial - exchange behavioral health - dhp professional · fee schedule · outpatient | $489.47 | $489.47 | $489.47 – $489.47 |
Last updated: Jan 1, 2026
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