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
PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE
The hospitals that file a Magellan 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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52 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL per diem · inpatient | 1 | $900.00 | $900.00 – $900.00 |
| 2 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · outpatientfrom % of charges | 1 | $716.80 | $716.80 – $716.80 |
| 3 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · outpatientfrom % of charges | 1 | $1,551 | $1,551 – $1,551 |
| 4 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $1,551 | $1,551 – $1,551 |
| 5 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $1,551 | $1,551 – $1,551 |
| 6 | Carolinas Medical Center Davidson, NC percent of total billed charges · outpatientfrom % of charges | 1 | $1,551 | $1,551 – $1,551 |
| 7 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $1,551 | $1,551 – $1,551 |
| 8 | Childrens Hospital of Orange County - Profit Orange, CA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $1,193 | $1,193 – $1,193 |
| 9 | DIGNITY COMMUNITY CARE Woodland, CA fee schedule · inpatient | 1 | $1,194 | $1,171 – $1,217 |
| 10 | DIGNITY COMMUNITY CARE Woodland, CA fee schedule · outpatient | 1 | $1,194 | $1,171 – $1,217 |
| 11 | Gerald Champion Regional Medical Center Alamogordo, NM fee schedule · outpatient | 2 | $637.44 | $480.64 – $794.23 |
| 12 | Holyoke Medical Center Holyoke, MA facility · percent of total billed charges · inpatientfrom % of charges | 2 | $359.80 | $359.80 – $359.80 |
| 13 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1,583 | $1,583 – $1,583 |
| 14 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL professional · fee schedule · outpatient | 1 | $76.24 | $76.24 – $76.24 |
| 15 | Lake Charles Memorial Hospital Charles., LA percent of total billed charges · outpatientfrom % of charges | 1 | $23.30 | $23.30 – $23.30 |
| 16 | Lancaster General Health Lancaster, PA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $1,924 | $1,859 – $1,989 |
| 17 | Lancaster General Health Lancaster, PA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1,924 | $1,859 – $1,989 |
| 18 | Lovelace Health System, LLC Albuquerque, NM facility · percent of total billed charges · bothfrom % of charges | 1 | $1,160 | $1,160 – $1,160 |
| 19 | Lovelace Health System, LLC Albuquerque, NM facility · percent of total billed charges · bothfrom % of charges | 1 | $1,123 | $1,123 – $1,123 |
| 20 | MedStar Harbor Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $2,802 | $2,802 – $2,802 |
| 21 | MedStar Montgomery Medical Center Olney, MD percent of total billed charges · outpatientfrom % of charges | 1 | $815.15 | $815.15 – $815.15 |
| 22 | MedStar Southern Hospital Center Clinton, MD percent of total billed charges · outpatientfrom % of charges | 1 | $3,925 | $3,925 – $3,925 |
| 23 | Mercy Fitzgerald Hospital Darby, PA facility · percent of total billed charges · bothfrom % of charges | 1 | $3,390 | $3,013 – $4,520 |
| 24 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $891.00 | $792.00 – $1,188 |
| 25 | Morristown Medical Center Morristown, NJ other · both | 1 | $768.81 | $768.81 – $768.81 |
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