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
Wellsville, NY
See all hospitals reporting CPT 0169U →Price type
Memorial Hosp of Wm F & Gertrude F Jones A/K/A Jones Memorial Hosp’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, 13 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 united healthcare 515803 fee schedule · outpatient | $195.79 | $195.79 | $195.79 – $195.79 |
| 2 | Highmark highmark bcbs medicaid 170201 child health plus 170204 fee schedule · outpatient | $428.88 | $428.88 | $428.88 – $428.88 |
| 3 | Cigna mvp commercial ppo fully insured 290006, cigna healthcare (pob 182223) 514405 fee schedule · outpatient | $438.20 | $438.20 | $438.20 – $438.20 |
| 4 | Highmark highmark bcbs medicare 130101 fee schedule · outpatient | $466.17 | $466.17 | $466.17 – $466.17 |
| 5 | Humana humana medicare 131201 fee schedule · outpatient | $466.17 | $466.17 | $466.17 – $466.17 |
| 6 | UnitedHealthcare united healthcare medicare 130901 fee schedule · outpatient | $466.17 | $466.17 | $466.17 – $466.17 |
| 7 | WellCare wellcare medicare 131001 fee schedule · outpatient | $466.17 | $466.17 | $466.17 – $466.17 |
| 8 | Aetna aetna medicare 130001 fee schedule · outpatient | $494.14 | $494.14 | $494.14 – $494.14 |
| 9 | Excellus excellus 220101, excellus simply blue 220106, excellus blue choice 220107 fee schedule · outpatient | $523.56 | $523.56 | $523.56 – $523.56 |
| 10 | Excellus excellus metal tiers 220102 fee schedule · outpatient | $523.56 | $523.56 | $523.56 – $523.56 |
| 11 | Highmark highmark bcbs 514301 hmo / pos fee schedule · outpatient | $748.02 | $748.02 | $748.02 – $748.02 |
| 12 | Aetna aetna 270002 fee schedule · outpatient | $769.18 | $769.18 | $769.18 – $769.18 |
| 13 | Highmark highmark bcbs 514301 indemnity / ppo fee schedule · outpatient | $941.06 | $941.06 | $941.06 – $941.06 |
Last updated: Jan 1, 2026
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