Every billing code / CPT 85097 / St Elizabeth Hospital
CPT 85097 at St Elizabeth Hospital
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St Elizabeth Hospital, Enumclaw
This name is the CMS category the code belongs to (CMS's Restructured BETOS Classification System), shared with similar codes. The official CPT description belongs to the American Medical Association and isn't shown.
What St Elizabeth Hospital publishes for this code: as an outpatient
St Elizabeth Hospital’s prices for CPT 85097, as an outpatient| Who pays | Hospital’s fee (lowest – highest) | Doctor’s fee the hospital lists |
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| Commercial insuranceInsurer rates | $75.62 – $3,63915 plans | — |
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| Medicare AdvantageInsurer rates | $187 – $22912 plans | — |
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| Medicaid managed careInsurer rates | $177 – $2155 plans | — |
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| Cash pricePaying yourself, without insurance | $367 | — |
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| List priceBefore any discount; few people pay it | $1,039 | — |
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Lowest and highest amounts St Elizabeth Hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. Its price file is dated 2026-02-28. This is one line of a bill; most care brings several.
What St Elizabeth Hospital publishes for this code: during a hospital stay
St Elizabeth Hospital’s prices for CPT 85097, during a hospital stay| Who pays | Hospital’s fee (lowest – highest) | Doctor’s fee the hospital lists |
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| Commercial insuranceInsurer rates | $416 – $9355 plans | — |
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| Medicaid managed careInsurer rates | $291 – $3455 plans | — |
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| Cash pricePaying yourself, without insurance | $367 | — |
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| List priceBefore any discount; few people pay it | $1,039 | — |
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Lowest and highest amounts St Elizabeth Hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. Its price file is dated 2026-02-28. This is one line of a bill; most care brings several.
Bills to expect
The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in Seattle (King County) for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.
Bills to expect for CPT 85097 at St Elizabeth Hospital| Bill | What it’s for | Original Medicare allows | Private plan estimate |
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| Hospital's feeThe hospital | The service | — | The price above |
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Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.
Compare CPT 85097 at every Washington hospital, with Medicare’s reference amounts.