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
TH-ALC DRG SERVS C&T PER 15
Valhalla, NY
See all hospitals reporting HCPCS H0004 →Price type
Westchester Medical Center’s median price of $50 is 2% above the median hospital's median price ($49), higher than 51% of the 330 hospitals reporting HCPCS H0004. 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, 18 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 | Blue Cross Blue Shield blue cross connection/exchange facility · percent of total billed charges · outpatientfrom % of charges | $35 | $35 | — | — | — | $35 – $35 |
| 2 | Blue Cross Blue Shield blue cross access facility · percent of total billed charges · outpatientfrom % of charges | $37 | $37 | — | — | — | $37 – $37 |
| 3 | Blue Cross Blue Shield blue cross small group facility · percent of total billed charges · outpatientfrom % of charges | $42 | $42 | — | — | — | $42 – $42 |
| 4 | Aetna aetna hp network facility · percent of total billed charges · outpatientfrom % of charges | $45 | $45 | — | — | — | $45 – $45 |
| 5 | Blue Cross Blue Shield blue cross commercial/healthy ny facility · percent of total billed charges · outpatientfrom % of charges | $46 | $46 | — | — | — | $46 – $46 |
| 6 | Aetna aetna facility · percent of total billed charges · outpatientfrom % of charges | $50 | $50 | — | — | — | $50 – $50 |
| 7 | Aetna aetna employee facility · percent of total billed charges · outpatientfrom % of charges | $50 | $50 | — | — | — | $50 – $50 |
| 8 | Cigna cigna ppo facility · percent of total billed charges · outpatientfrom % of charges | $54 | $54 | — | — | — | $54 – $54 |
| 9 | MultiPlan multiplan facility · percent of total billed charges · inpatientfrom % of charges | $54 | $54 | — | — | — | $54 – $54 |
| 10 | MultiPlan multiplan facility · percent of total billed charges · outpatientfrom % of charges | $58 | $58 | — | — | — | $58 – $58 |
| 11 | Phcs phcs facility · percent of total billed charges · inpatientfrom % of charges | $65 | $65 | — | — | — | $65 – $65 |
| 12 | Phcs phcs facility · percent of total billed charges · outpatientfrom % of charges | $65 | $65 | — | — | — | $65 – $65 |
| 13 | Tricare tricare facility · fee schedule · outpatient | $77 | $77 | — | — | — | $77 – $77 |
| 14 | UnitedHealthcare uhc medicare facility · per diem · outpatient | $242 | $242 | — | — | — | $242 – $242 |
| 15 | UnitedHealthcare uhc compass facility · per diem · outpatient | $249 | $339 | $180 | 53% | — | $249 – $700 |
| 16 | UnitedHealthcare uhc exchange facility · per diem · outpatient | $249 | $339 | $180 | 53% | — | $249 – $700 |
| 17 | UnitedHealthcare uhc commercial facility · per diem · outpatient | $249 | $364 | $230 | 63% | — | $249 – $824 |
| 18 | UnitedHealthcare uhc empire facility · per diem · outpatient | $249 | $364 | $230 | 63% | — | $249 – $824 |
Last updated: Jul 28, 2026
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