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
Mod Cs Diff Phys<5Yrs 1St 15
Low
$17
Average
$680
Median
$93
High
$25.0k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
58 hospitals; the 90th percentile is 13.8× 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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74 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 | $71 | $71 | $6 | 8% | — | $66 – $77 |
| 2 | AnMed Health Anderson, SC professional · fee schedule · inpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 3 | AnMed Health Anderson, SC professional · fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 4 | AnMed Health Cannon Pickens, SC professional · fee schedule · inpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 5 | AnMed Health Cannon Pickens, SC professional · fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 6 | AnMed Piedmont Piedmont, SC professional · fee schedule · inpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 7 | AnMed Piedmont Piedmont, SC professional · fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 8 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $50k | $50k | — | — | — | $50k – $50k |
| 9 | Anderson Hospital Maryville, IL professional · other · outpatient | 1 | $83 | $83 | — | — | — | $83 – $83 |
| 10 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 11 | Aspen Valley Hospital District Aspen, CO facility · percent of total billed charges · bothfrom % of charges | 4 | $350 | $411 | $126 | 31% | — | $327 – $649 |
| 12 | Aspirus Wausau Hospital Wausau, WI fee schedule · both | 1 | $75 | $75 | — | — | — | $75 – $75 |
| 13 | Baptist Memorial Hospital-Calhoun Calhoun City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $211 | $211 | — | — | — | $211 – $211 |
| 14 | Beaufort Memorial Hospital Beaufort, SC facility · percent of total billed charges · inpatientfrom % of charges | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 15 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 2 | $521 | $521 | $169 | 32% | — | $353 – $690 |
| 16 | Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient | 1 | $71 | $71 | — | — | — | $71 – $71 |
| 17 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · inpatient | 1 | $75 | $75 | — | — | — | $75 – $75 |
| 18 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · outpatient | 1 | $75 | $75 | — | — | — | $75 – $75 |
| 19 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $163 | $163 | — | — | — | $163 – $163 |
| 20 | Charleston Area Medical Center Charleston, WV percent of total billed charges · outpatientfrom % of charges | 1 | $163 | $163 | — | — | — | $163 – $163 |
| 21 | Coulee Medical Center Grand Coulee, WA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $175 | $175 | — | — | — | $175 – $175 |
| 22 | Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient | 1 | $178 | $178 | — | — | — | $178 – $178 |
| 23 | Dukes Health System LLC Peru, IN facility · fee schedule · outpatient | 1 | $63 | $58 | $7 | 12% | — | $48 – $63 |
| 24 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $205 | $212 | $80 | 38% | — | $133 – $306 |
| 25 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $409 | $409 | — | — | — | $409 – $409 |
← Payers reporting CPT 99155 · Snapshot 20261111T120946Z-9134e7f7