Reported by 3 hospitals in the network.
Filter by billing methodology
Low
$14
Average
$38
Median
$50
High
$50
| # | Hospital | Location | Approximate 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. | |||||
|---|---|---|---|---|---|---|---|---|
| 1 | St Joseph’s Health Services Inc | Hillsboro, WI | $50 | $50 | — | — | $50 | $50 |
| 2 | Memorial Hospital of Boscobel | Boscobel, WI | $50 | $50 | — | — | $50 | $50 |
| 3 | Nationwide Children's Hospital Toledo, Llc | Toledo, OH | $14 | $14 | — | — | $14 | $14 |
Ask Claude or any MCP client for HCPCS 84490TC pricing at a specific hospital — see how to connect.