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
PROF CL TX NASAL FX WO MAN
Low
$49
Average
$10.2k
Median
$215
High
$50k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
32 hospitals; the 90th percentile is 585.2× 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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34 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 | Ascension Cedar Park Park, TX fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 2 | Ascension Seton Austin, TX fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 3 | Ascension Seton Austin, TX fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 4 | Ascension Seton Austin, TX fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 5 | Ascension Seton Luling, TX fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 6 | Ascension Seton Burnet, TX fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 7 | Ascension Seton Smithville, TX fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 8 | Ascension Seton Bastrop, TX fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 9 | Ascension Seton Austin, TX fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 10 | Ascension Via Christi Hospital Manhattan, Inc. Manhattan, KS fee schedule · both | 1 | $78 | $78 | — | — | — | $78 – $78 |
| 11 | Aspen Valley Hospital District Aspen, CO facility · percent of total billed charges · bothfrom % of charges | 4 | $294 | $330 | $104 | 32% | — | $250 – $544 |
| 12 | Austin Center for Outpatient Surgery LP, DBA Northwest Hills Surgical Hospital Austin, TX fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 13 | Beaufort Memorial Hospital Beaufort, SC facility · percent of total billed charges · inpatientfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 14 | CLEVELAND AREA HOSPITAL CLEVELAND, OK percent of total billed charges · outpatientfrom % of charges | 1 | $81 | $81 | $49 | 60% | — | $32 – $130 |
| 15 | Conway Regional Medical Center Conway, AR facility · fee schedule · outpatient | 1 | $605 | $605 | — | — | — | $605 – $605 |
| 16 | Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient | 1 | $429 | $429 | — | — | — | $429 – $429 |
| 17 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $202 | $282 | $236 | 84% | — | $75 – $651 |
| 18 | HSA CGH LLC Coral Gables, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $35k | $35k | — | — | — | $35k – $35k |
| 19 | HSA PGH LLC Hialeah, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $35k | $35k | — | — | — | $35k – $35k |
| 20 | Hemet Global Medical Center Hemet, CA facility · fee schedule · outpatient | 1 | $528 | $528 | — | — | — | $528 – $528 |
| 21 | Hemet Global Medical Center Hemet, CA professional · fee schedule · outpatient | 1 | $123 | $123 | — | — | — | $123 – $123 |
| 22 | Monroe Hospital Bloomington, IN fee schedule · outpatient | 1 | $212 | $212 | — | — | — | $212 – $212 |
| 23 | Northside Hospital, Inc. Lawrenceville, GA fee schedule · outpatient | 1 | $50k | $50k | — | — | — | $50k – $50k |
| 24 | Northside Hospital, Inc. Atlanta, GA fee schedule · outpatient | 1 | $50k | $50k | — | — | — | $50k – $50k |
| 25 | Northside Hospital, Inc. Cumming, GA fee schedule · outpatient | 1 | $50k | $50k | — | — | — | $50k – $50k |
← Payers reporting CPT 21310 · Snapshot 20261112T181611Z-3fa9fb76