APC N804
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
Mammography Services
Low
$90
Average
$148
Median
$113
High
$368
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
30 hospitals; the 90th percentile is 2.1× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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30 hospital rates
iThe hospitals that file a Tricare rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Aspirus Divine Savior Hospital Portage, WI other · outpatient | 1 | $108 | $108 | — | — | 14 | $108 – $108 |
| 2 | Aspirus Eagle River Hospital Eagle River, WI other · outpatient | 1 | $207 | $207 | — | — | 1–10 | $207 – $207 |
| 3 | Aspirus Keweenaw Hospital Laurium, MI other · outpatient | 1 | $190 | $190 | — | — | 1–10 | $190 – $190 |
| 4 | Aspirus Langlade Hospital Antigo, WI other · outpatient | 1 | $177 | $177 | — | — | 14 | $177 – $177 |
| 5 | Aspirus Medford Hospital Medford, WI other · outpatient | 1 | $189 | $189 | — | — | 1–10 | $189 – $189 |
| 6 | Aspirus Merrill Hospital Merrill, WI other · outpatient | 1 | $187 | $187 | — | — | 12 | $187 – $187 |
| 7 | Aspirus Rhinelander Hospital Rhinelander, WI other · outpatient | 1 | $108 | $108 | — | — | 17 | $108 – $108 |
| 8 | Aspirus St. Luke’s Hospital Duluth, MN other · outpatient | 1 | $119 | $119 | — | — | 34 | $119 – $119 |
| 9 | Aspirus Stanley Hospital Stanley, WI other · outpatient | 1 | $284 | $284 | — | — | 1–10 | $284 – $284 |
| 10 | Aspirus Stevens Point Hospital Stevens Point, WI other · outpatient | 1 | $108 | $108 | — | — | 1–10 | $108 – $108 |
| 11 | Aspirus Tomahawk Hospital Tomahawk, WI other · outpatient | 1 | $164 | $164 | — | — | 1–10 | $164 – $164 |
| 12 | Aspirus Wausau Hospital Wausau, WI other · outpatient | 1 | $108 | $108 | — | — | 46 | $108 – $108 |
| 13 | Aspirus Wisconsin Rapids Hospital Wisconsin Rapids, WI other · outpatient | 1 | $108 | $108 | — | — | 1–10 | $108 – $108 |
| 14 | Canton-Potsdam Hospital Potsdam, NY facility · other · outpatient | 1 | $107 | $107 | — | — | 35 | $107 – $107 |
| 15 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · other · outpatient | 1 | $110 | $110 | — | — | 1–10 | $110 – $110 |
| 16 | El Camino Hospital Los Gatos, CA other · outpatient | 1 | $162 | $162 | — | — | 1–10 | $162 – $162 |
| 17 | Gouverneur Hospital Gouverneur, NY facility · other · outpatient | 1 | $161 | $161 | — | — | 18 | $161 – $161 |
| 18 | Howard Young Medical Center Woodruff, WI other · outpatient | 1 | $108 | $108 | — | — | 1–10 | $108 – $108 |
| 19 | Logan Health - Cut Bank Cut Bank, MT other · outpatient | 1 | $368 | $368 | — | — | 1–10 | $368 – $368 |
| 20 | Logan Health - Whitefish Whitefish, MT other · outpatient | 1 | $163 | $163 | — | — | 27 | $163 – $163 |
| 21 | Logan Health Medical Center Kalispell, MT other · outpatient | 1 | $116 | $116 | — | — | 39 | $116 – $116 |
| 22 | Massena Hospital Inc Massena, NY facility · other · outpatient | 1 | $245 | $245 | — | — | 1–10 | $245 – $245 |
| 23 | Metrohealth System Parma, OH facility · other · outpatient | 1 | $103 | $103 | — | — | 17 | $103 – $103 |
| 24 | Newark-Wayne Community Hospital Newark, NY facility · other · outpatient | 1 | $107 | $107 | — | — | 1–10 | $107 – $107 |
| 25 | Rochester General Hospital Rochester, NY facility · other · outpatient | 1 | $107 | $107 | — | — | 33 | $107 – $107 |
← Payers reporting APC N804 · Snapshot 20261111T120946Z-9134e7f7