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
SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-CAC
Low
$0
Average
$344
Median
$185
High
$16.8k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
371 hospitals; the 90th percentile is 6.5× 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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464 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 | ROBERT PACKER HOSPITAL Sayre, PA facility · other · outpatient | 2 | $247 | $285 | $95 | 33% | 4–40 | $218 – $511 |
| 2 | Benefis Hospitals Inc Helena, MT other · outpatient | 1 | $199 | $199 | — | — | 3–30 | $199 – $199 |
| 3 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 2 | $235 | $152 | $96 | 63% | 3–30 | $41 – $235 |
| 4 | Aspen Valley Hospital District Aspen, CO facility · percent of total billed charges · bothfrom % of charges | 4 | $280 | $278 | $165 | 59% | 2–20 | $118 – $632 |
| 5 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · outpatient | 1 | $20 | $20 | — | — | 1–10 | $20 – $20 |
| 6 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $119 | $103 | $37 | 36% | 1–10 | $38 – $141 |
| 7 | DELTA COUNTY MEMORIAL HOSPITAL DELTA, CO other · outpatient | 1 | $212 | $212 | — | — | 1–10 | $212 – $212 |
| 8 | OKTIBBEHA COUNTY HOSPITAL STARKVILLE, MS other · outpatient | 1 | $173 | $173 | — | — | 1–10 | $173 – $173 |
| 9 | ONEIDA HEALTH ONEIDA, NY other · outpatient | 1 | $250 | $250 | — | — | 1–10 | $250 – $250 |
| 10 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · both | 1 | $35 | $35 | — | — | 1–10 | $35 – $35 |
| 11 | Springhill Memorial Hospital Mobile, AL other · outpatient | 1 | $20 | $20 | — | — | 1–10 | $20 – $20 |
| 12 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · outpatient | 1 | $181 | $181 | — | — | — | $181 – $181 |
| 13 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient | 4 | $58 | $59 | $22 | 36% | — | $35 – $87 |
| 14 | Affinity Hospital LLC Birmingham, AL facility · fee schedule · outpatient | 1 | $174 | $174 | — | — | — | $174 – $174 |
| 15 | AnMed Health Anderson, SC professional · fee schedule · inpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 16 | AnMed Health Anderson, SC professional · fee schedule · outpatient | 1 | $43 | $58 | $21 | 37% | — | $43 – $88 |
| 17 | AnMed Health Cannon Pickens, SC professional · fee schedule · inpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 18 | AnMed Health Cannon Pickens, SC professional · fee schedule · outpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 19 | AnMed Piedmont Piedmont, SC professional · fee schedule · inpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 20 | AnMed Piedmont Piedmont, SC professional · fee schedule · outpatient | 1 | $88 | $88 | — | — | — | $88 – $88 |
| 21 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $3.0k | $3.0k | $2.7k | 93% | — | $209 – $5.7k |
| 22 | Anderson Hospital Maryville, IL professional · other · outpatient | 1 | $90 | $90 | — | — | — | $90 – $90 |
| 23 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $195 | $195 | — | — | — | $195 – $195 |
| 24 | Ascension Cedar Park Park, TX fee schedule · outpatient | 1 | $114 | $114 | — | — | — | $114 – $114 |
| 25 | Ascension Providence Waco, TX other · inpatient | 1 | $195 | $195 | — | — | — | $195 – $195 |
← Payers reporting CPT 12001 · Snapshot 20261111T120946Z-9134e7f7