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
Laps Gstr Rstcv Px W/Byp Roux-en-Y Limb <150 Cm
The hospitals that file a Premera 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.
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61 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · fee schedule · outpatient | 1 | $135.93 | $135.93 – $135.93 |
| 2 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA professional · fee schedule · both | 1 | $268.77 | $268.77 – $268.77 |
| 3 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA professional · fee schedule · inpatient | 1 | $1,680 | $1,680 – $1,680 |
| 4 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA professional · fee schedule · outpatient | 1 | $1,680 | $1,680 – $1,680 |
| 5 | ENUMCLAW REGIONAL HOSPITAL ASSOCIATION Enumclaw, WA case rate · outpatient | 1 | $43,564 | $43,564 – $43,564 |
| 6 | FRANCISCAN HEALTH SYSTEM Gig Harbor, WA case rate · outpatient | 2 | $29,138 | $23,829 – $34,446 |
| 7 | FRANCISCAN HEALTH SYSTEM Tacoma, WA case rate · outpatient | 2 | $29,138 | $23,829 – $34,446 |
| 8 | Good Samaritan Hospital Puyallup, WA fee schedule · outpatient | 4 | $34,823 | $15,960 – $47,264 |
| 9 | HARRISON MEDICAL CENTER Silverdale, WA case rate · outpatient | 2 | $42,547 | $40,424 – $44,669 |
| 10 | HIGHLINE MEDICAL CENTER Burien, WA case rate · outpatient | 2 | $29,401 | $27,589 – $31,213 |
| 11 | Holy Cross Hospital-Silver Spring Silver Spring, MD professional · percent of total billed charges · bothfrom % of charges | 1 | $2,186 | $603.04 – $3,769 |
| 12 | Mary Bridge Children's Hospital Tacoma, WA fee schedule · outpatient | 4 | $34,823 | $15,960 – $47,264 |
| 13 | Mercy Fitzgerald Hospital Darby, PA professional · fee schedule · both | 1 | $430.63 | $156.59 – $978.71 |
| 14 | Mercy Fitzgerald Hospital Darby, PA professional · fee schedule · inpatient | 1 | $978.71 | $978.71 – $978.71 |
| 15 | Mercy Fitzgerald Hospital Darby, PA professional · fee schedule · outpatient | 1 | $978.71 | $978.71 – $978.71 |
| 16 | Mount Carmel East Reynoldsburg, OH professional · percent of total billed charges · inpatientfrom % of charges | 1 | $2,240 | $603.04 – $3,986 |
| 17 | Mount Carmel East Reynoldsburg, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $3,349 | $560.32 – $7,450 |
| 18 | Mount Carmel Grove City Grove City, OH facility · fee schedule · outpatient | 1 | $21,745 | $21,745 – $21,745 |
| 19 | MultiCare Auburn Medical Center Auburn, WA fee schedule · outpatient | 4 | $34,823 | $15,960 – $47,264 |
| 20 | MultiCare Capital Medical Center Lacey, WA fee schedule · outpatient | 4 | $24,279 | $15,960 – $27,052 |
| 21 | MultiCare Covington Medical Center Covington, WA fee schedule · outpatient | 4 | $34,823 | $15,960 – $47,264 |
| 22 | MultiCare Deaconess Hospital Spokane, WA fee schedule · outpatient | 4 | $26,319 | $15,488 – $29,929 |
| 23 | MultiCare Valley Hospital Spokane Valley, WA fee schedule · outpatient | 4 | $24,193 | $15,059 – $27,237 |
| 24 | MultiCare Yakima Valley Memorial Hospital Association Union Gap, WA fee schedule · outpatient | 3 | $33,605 | $32,038 – $34,389 |
| 25 | SAINT CLARE HOSPITAL Lakewood, WA case rate · outpatient | 2 | $29,138 | $23,829 – $34,446 |
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