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  5. /Percent of billed charges
CPT L4387

HC PREFAB NON-PNMTC BOOT OTS

Reported by 65 hospitals in the network under the percent of billed charges methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a negotiated percentage of total billed charges.

National pricing summary

Low

$50

Average

$161

Median

$164

High

$362

Hospitals reporting this code

#HospitalLocationApproximate number of payer billing records behind this hospital’s price. CMS privacy rules cap small counts as a range (e.g. “1–10”) rather than an exact number — more samples means a more reliable price.
1IHC Health Services Inc., DBA Intermountain Health Intermountain Medical CenterMurray, UT$192$174$50—$3$239
2IHC Health Services Inc., DBA Intermountain Health Utah Valley HospitalProvo, UT$192$176$48—$4$239
3IHC Health Services Inc., DBA Intermountain Health McKay-Dee HospitalOgden, UT$192$176$50—$3$266
4IHC Health Services Inc., DBA Intermountain Health St George Regional HospitalSt. George, UT$176$167$31—$4$186
5IHC Health Services Inc., DBA Intermountain Health LDS HospitalSalt Lake City, UT$192$175$49—$3$239
6Scl Health - Montana, Dba Intermountain Health St. Vincent HealthcareBillings, MT$221$218$34—$149$258
7Saint Joseph Hospital, Inc. Dba Intermountain Nhealth Saint Joseph HospitalDENVER, CO$362$357$153—$117$633
8IHC Health Services Inc., DBA Intermountain Health Logan Regional HospitalLogan, UT$175$164$38—$4$198
9St. Mary's Hospital & Medical Center, Inc. Dba Intermountain Health St. Mary's Regional HospitalJUNCTION, CO$234$207$48—$97$272
10IHC Health Services Inc., DBA Intermountain Health American Fork HospitalAmerican Fork, UT$189$175$47—$5$239
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