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 HLTH BHV IVNTJ GRP EA ADDL 15
Low
$4
Average
$1.3k
Median
$4
High
$25.0k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
19 hospitals; the 90th percentile is 12.0× 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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27 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 | $4 | $4 | $0 | 10% | — | $4 – $5 |
| 2 | AnMed Health Anderson, SC professional · fee schedule · inpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 3 | AnMed Health Anderson, SC professional · fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 4 | AnMed Health Cannon Pickens, SC professional · fee schedule · inpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 5 | AnMed Health Cannon Pickens, SC professional · fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 6 | AnMed Piedmont Piedmont, SC professional · fee schedule · inpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 7 | AnMed Piedmont Piedmont, SC professional · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 8 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $50k | $50k | — | — | — | $50k – $50k |
| 9 | Anderson Hospital Maryville, IL professional · other · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 10 | Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 11 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $8 | $8 | $0 | 4% | — | $7 – $8 |
| 12 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $5 | $5 | $2 | 47% | — | $2 – $7 |
| 13 | Columbia Lutheran Charities Astoria, OR professional · fee schedule · both | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 14 | Craig Hospital Englewood, CO facility · percent of total billed charges · inpatientfrom % of charges | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 15 | Craig Hospital Englewood, CO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 16 | GLENS FALLS HOSPITAL INC Falls, NY professional · fee schedule · outpatient | 4 | $4 | $4 | $0 | 10% | — | $4 – $5 |
| 17 | Kaweah Health Medical Center Visalia, CA facility · fee schedule · outpatient | 1 | $26 | $26 | $17 | 65% | — | $9 – $43 |
| 18 | Kaweah Health Mental Health Hospital Visalia, CA facility · fee schedule · outpatient | 1 | $26 | $26 | $17 | 65% | — | $9 – $43 |
| 19 | Little Company of Mary Hospital of Indiana Inc Jasper, IN facility · case rate · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 20 | Mayo Clinic Health System Sparta, WI professional · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 21 | Nationwide Children's Hospital Columbus, OH professional · fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 22 | Newark-Wayne Community Hospital Newark, NY facility · fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 23 | San Juan Hospital Spanish Valley, UT facility · fee schedule · outpatient | 3 | $4 | $4 | — | — | — | $4 – $4 |
| 24 | San Juan Hospital Spanish Valley, UT professional · fee schedule · outpatient | 3 | $4 | $4 | — | — | — | $4 – $4 |
| 25 | University Health Truman Medical Center Kansas City, MO facility · fee schedule · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
← Payers reporting CPT 96165 · Snapshot 20261111T120946Z-9134e7f7