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
THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG FAC
Low
$0
Average
$1.0k
Median
$87
High
$11.8k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
118 hospitals; the 90th percentile is 57.2× 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.
Filter by billing methodology
Filter by billing class
130 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 | Springhill Memorial Hospital Mobile, AL other · outpatient | 1 | $69 | $69 | $57 | 83% | 38–47 | $12 – $125 |
| 2 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient | 1 | $204 | $204 | — | — | 18 | $204 – $204 |
| 3 | ROBERT PACKER HOSPITAL Sayre, PA facility · other · outpatient | 1 | $404 | $404 | — | — | 4–40 | $404 – $404 |
| 4 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $73 | $73 | — | — | 1–10 | $73 – $73 |
| 5 | Mercy Hospital Ozark Ozark, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $55 | $55 | — | — | 1–10 | $55 – $55 |
| 6 | Mercy Perry Perryville, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $69 | $69 | — | — | 1–10 | $69 – $69 |
| 7 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient | 4 | $13 | $13 | $1 | 8% | — | $12 – $14 |
| 8 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $322 | $16.9k | $23.4k | 139% | — | $322 – $50k |
| 9 | Anderson Hospital Maryville, IL professional · other · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 10 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $288 | $288 | — | — | — | $288 – $288 |
| 11 | Aspen Valley Hospital District Aspen, CO facility · percent of total billed charges · bothfrom % of charges | 4 | $78 | $95 | $29 | 30% | — | $78 – $145 |
| 12 | Baptist Medical Center-Attala Kosciusko, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 13 | Baptist Medical Center-Yazoo Yazoo City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 14 | Baptist Memorial Hospital - Leake Carthage, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 15 | Baptist Memorial Hospital-Calhoun Calhoun City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $95 | $95 | — | — | — | $95 – $95 |
| 16 | Bay Park Community Hospital Oregon, OH facility · fee schedule · outpatient | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 17 | Bay Park Community Hospital Oregon, OH professional · fee schedule · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 18 | Beaufort Memorial Hospital Beaufort, SC facility · percent of total billed charges · inpatientfrom % of charges | 1 | $98 | $89 | $13 | 14% | — | $71 – $98 |
| 19 | Benefis Community Hospitals, Inc Choteau, MT other · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 20 | Bon Secours Community Hospital Jervis, NY facility · fee schedule · outpatient | 1 | $787 | $10.6k | $19.7k | 185% | — | $787 – $50k |
| 21 | CLEVELAND AREA HOSPITAL CLEVELAND, OK percent of total billed charges · outpatientfrom % of charges | 1 | $28 | $28 | $4 | 15% | — | $24 – $32 |
| 22 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 1 | $360 | $285 | $143 | 50% | — | $39 – $380 |
| 23 | Calhoun Liberty Hospital Association Inc Blountstown, FL percent of total billed charges · bothfrom % of charges | 1 | $3 | $10 | $10 | 94% | — | $3 – $24 |
| 24 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $48 | $48 | — | — | — | $48 – $48 |
| 25 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $242 | $242 | — | — | — | $242 – $242 |
← Payers reporting CPT 96376 · Snapshot 20261111T120946Z-9134e7f7