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
Fractional Abl Lsr Fenestration First 100 Sqcm
Low
$179
Average
$664
Median
$587
High
$6.2k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
55 hospitals; the 90th percentile is 2.2× 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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66 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 | METHODIST LEBONHEUR CHILDRENS HOSP TN 38301; 7691 POPLAR AVE. MEMPHIS, TN other · outpatient | 1 | $562 | $562 | — | — | 1–10 | $562 – $562 |
| 2 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · outpatient | 1 | $556 | $556 | — | — | — | $556 – $556 |
| 3 | AnMed Health Anderson, SC professional · fee schedule · inpatient | 1 | $256 | $256 | — | — | — | $256 – $256 |
| 4 | AnMed Health Anderson, SC professional · fee schedule · outpatient | 1 | $256 | $256 | — | — | — | $256 – $256 |
| 5 | AnMed Health Cannon Pickens, SC professional · fee schedule · inpatient | 1 | $256 | $256 | — | — | — | $256 – $256 |
| 6 | AnMed Health Cannon Pickens, SC professional · fee schedule · outpatient | 1 | $256 | $256 | — | — | — | $256 – $256 |
| 7 | AnMed Piedmont Piedmont, SC professional · fee schedule · inpatient | 1 | $256 | $256 | — | — | — | $256 – $256 |
| 8 | AnMed Piedmont Piedmont, SC professional · fee schedule · outpatient | 1 | $336 | $336 | — | — | — | $336 – $336 |
| 9 | Ascension Providence Waco, TX other · inpatient | 1 | $600 | $600 | — | — | — | $600 – $600 |
| 10 | Ascension Providence Waco, TX other · outpatient | 1 | $600 | $600 | — | — | — | $600 – $600 |
| 11 | Ascension Seton Austin, TX other · inpatient | 1 | $593 | $593 | — | — | — | $593 – $593 |
| 12 | Ascension Seton Austin, TX other · inpatient | 1 | $593 | $593 | — | — | — | $593 – $593 |
| 13 | Ascension Seton Bastrop, TX other · inpatient | 1 | $593 | $593 | — | — | — | $593 – $593 |
| 14 | Ascension Seton Austin, TX other · inpatient | 1 | $593 | $593 | — | — | — | $593 – $593 |
| 15 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $603 | $603 | — | — | — | $603 – $603 |
| 16 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $589 | $589 | — | — | — | $589 – $589 |
| 17 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $718 | $718 | — | — | — | $718 – $718 |
| 18 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient | 1 | $718 | $718 | — | — | — | $718 – $718 |
| 19 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $589 | $589 | — | — | — | $589 – $589 |
| 20 | EAST BATON ROUGE MEDICAL CENTER, LLC Baton Rouge, LA other · outpatient | 1 | $563 | $563 | — | — | — | $563 – $563 |
| 21 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $6.2k | $6.2k | — | — | — | $6.2k – $6.2k |
| 22 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $671 | $671 | — | — | — | $671 – $671 |
| 23 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $671 | $671 | — | — | — | $671 – $671 |
| 24 | Gerald Champion Regional Medical Center Alamogordo, NM fee schedule · outpatient | 5 | $598 | $598 | — | — | — | $598 – $598 |
| 25 | HOSPITAL SERVICE DISTRICT NO. 1 OF THE PARISH OF ST. CHARLES, STATE OF LOUISIANA LULING, LA other · outpatient | 1 | $377 | $377 | $157 | 42% | — | $220 – $534 |
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