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
Rcnstj Pst Tibl Tdn W/Exc Accessory Tarsl Navclr|RIGHT SIDE
Low
$193
Average
$8.1k
Median
$6.5k
High
$27.1k
Each hospital's average Carefirst rate, under the methodology and billing class chosen below.
23 hospitals; the 90th percentile is 27.6× 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 Carefirst 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 | Inova Alexandria Hospital Alexandria, VA other · both | 1 | $10.3k | $10.3k | $2.1k | 20% | 2–20 | $8.3k – $12.4k |
| 2 | Inova Fairfax Hospital Falls Church, VA other · both | 1 | $10.3k | $10.3k | $2.1k | 20% | 2–20 | $8.3k – $12.4k |
| 3 | Children's National Hospital Washington, DC professional · fee schedule · both | 3 | $577 | $564 | $33 | 6% | — | $519 – $596 |
| 4 | Inova Alexandria Hospital Alexandria, VA fee schedule · both | 1 | $10.4k | $10.4k | $2.1k | 20% | — | $8.4k – $12.5k |
| 5 | Inova Fair Oaks Hospital Fairfax, VA fee schedule · both | 2 | $10.4k | $10.4k | $2.1k | 20% | — | $8.3k – $12.5k |
| 6 | Inova Fairfax Hospital Falls Church, VA fee schedule · both | 1 | $10.4k | $10.4k | $2.1k | 20% | — | $8.4k – $12.5k |
| 7 | Inova Loudoun Hospital Leesburg, VA fee schedule · both | 2 | $10.4k | $10.4k | $2.1k | 20% | — | $8.3k – $12.5k |
| 8 | Inova Mount Vernon Hospital Alexandria, VA fee schedule · both | 2 | $10.4k | $10.4k | $2.1k | 20% | — | $8.3k – $12.5k |
| 9 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · outpatient | 1 | $5.1k | $5.1k | — | — | — | $5.1k – $5.1k |
| 10 | Mercy Health Saint Marys Rockford, MI facility · fee schedule · outpatient | 1 | $5.2k | $5.2k | — | — | — | $5.2k – $5.2k |
| 11 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · inpatient | 3 | $306 | $282 | $114 | 40% | — | $146 – $393 |
| 12 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 3 | $306 | $282 | $114 | 40% | — | $146 – $393 |
| 13 | Mishawaka Medical Center Mishawaka, IN facility · other · outpatient | 1 | $27.1k | $27.1k | — | — | — | $27.1k – $27.1k |
| 14 | Mount Carmel New Albany Surgical Hospital New Albany, OH facility · other · outpatient | 1 | $26.1k | $26.1k | — | — | — | $26.1k – $26.1k |
| 15 | Mount Carmel St Ann's Lewis Center, OH facility · other · outpatient | 1 | $26.1k | $26.1k | — | — | — | $26.1k – $26.1k |
| 16 | Nazareth Hospital Philadelphia, PA facility · fee schedule · outpatient | 1 | $2.9k | $2.9k | — | — | — | $2.9k – $2.9k |
| 17 | Potomac Hospital Corporation of Prince William Lake Ridge, VA facility · fee schedule · outpatient | 2 | $6.8k | $6.8k | $474 | 7% | — | $6.3k – $7.3k |
| 18 | RESTON HOSPITAL CENTER Reston, VA case rate · outpatient | 2 | $7.0k | $7.0k | — | — | — | $7.0k – $7.0k |
| 19 | STONESPRINGS HOSPITAL CENTER Dulles, VA case rate · outpatient | 2 | $7.0k | $7.0k | — | — | — | $7.0k – $7.0k |
| 20 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · inpatient | 3 | $106 | $186 | $185 | 100% | — | $24 – $494 |
| 21 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · outpatient | 3 | $130 | $200 | $179 | 90% | — | $34 – $494 |
| 22 | Samaritan Hospital Troy, NY facility · other · outpatient | 2 | $6.2k | $5.9k | $535 | 9% | — | $4.9k – $6.2k |
| 23 | St Joseph Mercy Livingston Hospital | Trinity Health Medical Center - Brighton Brighton, MI facility · fee schedule · outpatient | 1 | $7.2k | $7.2k | — | — | — | $7.2k – $7.2k |
| 24 | St Joseph Mercy Livingston Hospital | Trinity Health Medical Center - Brighton Brighton, MI professional · fee schedule · inpatient | 3 | $306 | $285 | $109 | 38% | — | $157 – $393 |
| 25 | St Joseph Mercy Livingston Hospital | Trinity Health Medical Center - Brighton Brighton, MI professional · fee schedule · outpatient | 3 | $306 | $285 | $109 | 38% | — | $157 – $393 |
← Payers reporting CPT 28238 · Snapshot 20261112T181611Z-3fa9fb76