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
HB Fna Bx W/US Gdn Ea Addl
The hospitals that file a Wellmark 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.
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102 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 4 | $81.14 | $45.95 – $103.20 |
| 2 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · inpatientfrom % of charges | 1 | $2,669 | $2,669 – $2,669 |
| 3 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · outpatientfrom % of charges | 1 | $2,669 | $2,669 – $2,669 |
| 4 | Avera McKennan Hospital Sioux Falls, SD case rate · outpatient | 2 | $559.87 | $559.87 – $559.87 |
| 5 | Avera Queen of Peace Mitchell, SD fee schedule · both | 1 | $107.40 | $107.40 – $107.40 |
| 6 | Avera St. Anthony's Hospital O'Neill, NE percent of total billed charges · inpatientfrom % of charges | 1 | $1,001 | $1,001 – $1,001 |
| 7 | Avera St. Anthony's Hospital O'Neill, NE percent of total billed charges · outpatientfrom % of charges | 1 | $1,001 | $1,001 – $1,001 |
| 8 | Avera St. Luke's Aberdeen, SD outpatient | 1 | $3,469 | $3,469 – $3,469 |
| 9 | Avera St. Luke's Aberdeen, SD case rate · outpatient | 1 | $3,469 | $3,469 – $3,469 |
| 10 | Avera St. Mary's Hospital Pierre, SD outpatient | 1 | $627.25 | $627.25 – $627.25 |
| 11 | Avera St. Mary's Hospital Pierre, SD case rate · outpatient | 1 | $627.25 | $627.25 – $627.25 |
| 12 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 3 | $79.62 | $39.89 – $103.20 |
| 13 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 4 | $81.14 | $45.95 – $103.20 |
| 14 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 4 | $81.14 | $45.95 – $103.20 |
| 15 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both | 3 | $79.62 | $39.89 – $103.20 |
| 16 | Floyd Valley Healthcare Le Mars, IA fee schedule · both | 2 | $95.45 | $87.70 – $103.20 |
| 17 | Floyd Valley Healthcare Le Mars, IA percent of total billed charges · inpatientfrom % of charges | 2 | $209.88 | $209.88 – $209.88 |
| 18 | Grinnell Regional Medical Center Grinnell, IA fee schedule · both | 4 | $81.14 | $45.95 – $103.20 |
| 19 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · case rate · outpatient | 2 | $1,620 | $1,544 – $1,695 |
| 20 | HAWARDEN REGIONAL HEALTHCARE HARWARDEN, IA other · outpatient | 2 | $363.73 | $363.73 – $363.73 |
| 21 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $831.06 | $831.06 – $831.06 |
| 22 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · both | 2 | $58.14 | $45.22 – $64.60 |
| 23 | Holy Cross Hospital-Silver Spring Silver Spring, MD professional · percent of total billed charges · bothfrom % of charges | 1 | $105.00 | $105.00 – $105.00 |
| 24 | Johnson Memorial Hospital Stafford Springs, CT facility · case rate · both | 1 | $6,585 | $6,585 – $6,585 |
| 25 | Mercy Fitzgerald Hospital Darby, PA facility · fee schedule · both | 1 | $1,631 | $1,631 – $1,631 |
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