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 DEST LESN MLG TR/LIMB 3.1-4CM
Prices here combine facility and professional fees. See them separately →Experimental
Low
$0
Average
$758
Median
$440
High
$8.1k
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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. 186 hospitals; the 90th percentile is 5.9× 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 | Mayo Clinic Rochester, MN | $492 | $497 | $21 | 4% | 6–60 | $469 – $539 |
| 2 | Samaritan Medical Center Watertown, NY | $294 | $294 | — | — | 4–40 | $294 – $294 |
| 3 | Brigham and Women's Hospital Boston, MA | $470 | $470 | $5 | 1% | 2–20 | $465 – $474 |
| 4 | Mayo Clinic Health System Eau Claire 54703-5270 | $434 | $433 | $9 | 2% | 2–20 | $421 – $442 |
| 5 | Tufts Medical Center BOSTON, MA | $556 | $556 | — | — | 2–20 | $556 – $556 |
| 6 | University of Virginia Medical Center Charlottesville, VA | $408 | $653 | $419 | 64% | 1–10 | $367 – $1.9k |
| 7 | University of Virginia Haymarket Medical Center Haymarket, VA | $421 | $602 | $309 | 51% | — | $421 – $1.2k |
| 8 | OU Health - University of Oklahoma Medical Center Oklahoma City, OK | $397 | $444 | $131 | 30% | — | $389 – $813 |
| 9 | Columbia St. Mary's Hospital Ozaukee, Inc. Mequon, WI | $389 | $545 | $220 | 40% | — | $389 – $856 |
| 10 | Henry Ford Health Novi, MI | $391 | $356 | $99 | 28% | — | $227 – $540 |
Ask Claude or any MCP client for CPT 17264 pricing at a specific hospital — see how to connect.