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
Pediarix PFS
Low
$0
Average
$112
Median
$104
High
$546
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
127 hospitals; the 90th percentile is 3.3× 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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143 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 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient | 4 | $110 | $110 | — | — | — | $110 – $110 |
| 2 | AnMed Health Anderson, SC professional · fee schedule · outpatient | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 3 | AnMed Piedmont Piedmont, SC professional · fee schedule · inpatient | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 4 | AnMed Piedmont Piedmont, SC professional · fee schedule · outpatient | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 5 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $107 | $107 | — | — | — | $107 – $107 |
| 6 | Anderson Hospital Maryville, IL professional · other · outpatient | 1 | $109 | $109 | — | — | — | $109 – $109 |
| 7 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $110 | $110 | — | — | — | $110 – $110 |
| 8 | Aspirus Divine Savior Hospital Portage, WI fee schedule · both | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 9 | Aspirus Keweenaw Hospital Laurium, MI fee schedule · both | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 10 | Aspirus Medford Hospital Medford, WI fee schedule · both | 1 | $110 | $110 | — | — | — | $110 – $110 |
| 11 | Aspirus Rhinelander Hospital Rhinelander, WI fee schedule · both | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 12 | Aspirus St. Luke’s Hospital Duluth, MN fee schedule · both | 1 | $110 | $110 | — | — | — | $110 – $110 |
| 13 | Aspirus Wausau Hospital Wausau, WI fee schedule · both | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 14 | Aspirus Wisconsin Rapids Hospital Wisconsin Rapids, WI fee schedule · both | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 15 | Bay Park Community Hospital Oregon, OH facility · fee schedule · outpatient | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 16 | Bay Park Community Hospital Oregon, OH professional · fee schedule · outpatient | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 17 | Bluffton Health System LLC Bluffton, IN facility · fee schedule · outpatient | 1 | $0 | $35 | $49 | 141% | — | $0 – $104 |
| 18 | Brandon HMA LLC Brandon, MS facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 19 | COLUMBIA MEMORIAL HOSPITAL Hudson, NY professional · fee schedule · outpatient | 4 | $110 | $110 | — | — | — | $110 – $110 |
| 20 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 2 | $147 | $147 | — | — | — | $147 – $147 |
| 21 | Calhoun Liberty Hospital Association Inc Blountstown, FL percent of total billed charges · bothfrom % of charges | 1 | $81 | $81 | $7 | 9% | — | $73 – $88 |
| 22 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $83 | $83 | — | — | — | $83 – $83 |
| 23 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $171 | $171 | — | — | — | $171 – $171 |
| 24 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $83 | $83 | — | — | — | $83 – $83 |
| 25 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $53 | $53 | — | — | — | $53 – $53 |
← Payers reporting CPT 90723 · Snapshot 20261111T120946Z-9134e7f7