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
HC EXC, BEN LES INCL MARG, EXCPT SKN TG, TRNK ARMS LGS, DIA 3.1-4.0 CM
Low
$0
Average
$2.3k
Median
$1.8k
High
$35k
Filter by billing methodology
Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 414 hospitals; the 90th percentile is 8.7× 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.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Froedtert Memorial Lutheran Hospital Inc Milwaukee, WI | $1.3k | $1.7k | $1.2k | 74% | 26–260 | $562 – $4.3k |
| 2 | Triad of Alabama LLC Dothan, AL | $1.6k | $4.3k | $7.2k | 168% | 15 | $1.6k – $27.9k |
| 3 | St Peters Hospital Albany, NY | $3.8k | $8.1k | $7.5k | 93% | 11–110 | $2.0k – $21.2k |
| 4 | Brigham and Women's Hospital Boston, MA | $1.9k | $1.7k | $270 | 16% | 10–100 | $1.2k – $1.9k |
| 5 | Community Memorial Hospital of Menomonee Falls Inc Menomonee Falls, WI | $1.1k | $1.2k | $616 | 53% | 8–80 | $567 – $2.0k |
| 6 | Samaritan Hospital Troy, NY | $3.6k | $3.4k | $1.1k | 33% | 8–80 | $2.0k – $9.0k |
| 7 | Fairview Health Services Edina, MN | $2.3k | $2.3k | $801 | 35% | 6–60 | $1.3k – $3.3k |
| 8 | Mayo Clinic Health System Mankato 56001-4752 | $2.0k | $2.0k | $106 | 5% | 6–60 | $1.9k – $2.3k |
| 9 | Fairview Health Services Minneapolis, MN | $1.2k | $1.2k | $512 | 44% | 6–60 | $656 – $1.7k |
| 10 | Mayo Clinic Rochester, MN | $2.0k | $2.0k | $84 | 4% | 6–60 | $1.9k – $2.2k |
Ask Claude or any MCP client for CPT 11404 pricing at a specific hospital — see how to connect.