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 Miro3d per Cubic Cm
Low
$73
Average
$204
Median
$215
High
$351
Each hospital's average Ambetter rate, under the methodology and billing class chosen below.
70 hospitals; the 90th percentile is 2.3× 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
71 hospital rates
iThe hospitals that file a Ambetter 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 | Brunswick Community Hospital, LLC Bolivia, NC fee schedule · outpatient | 1 | $300 | $300 | — | — | — | $300 – $300 |
| 2 | Good Samaritan Hospital Puyallup, WA fee schedule · outpatient | 1 | $285 | $285 | — | — | — | $285 – $285 |
| 3 | Hardin County General Hospital Savannah, TN facility · fee schedule · outpatient | 1 | $181 | $181 | — | — | — | $181 – $181 |
| 4 | Hendrick Medical Center Brownwood, TX facility · case rate · outpatient | 1 | $284 | $284 | — | — | — | $284 – $284 |
| 5 | High Point Regional Health High Point, NC percent of total billed charges · outpatientfrom % of charges | 1 | $119 | $149 | $73 | 49% | — | $93 – $303 |
| 6 | HonorHealth Florence Medical Center Florence, AZ facility · fee schedule · outpatient | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 7 | Honorhealth Four Peaks Medical Center Mesa, AZ facility · fee schedule · outpatient | 1 | $189 | $189 | — | — | — | $189 – $189 |
| 8 | Indiana University Health Arnett Inc. Lafayette, IN fee schedule · outpatient | 1 | $218 | $218 | — | — | — | $218 – $218 |
| 9 | Indiana University Health Ball Memorial Hospital Inc. Muncie, IN fee schedule · outpatient | 1 | $218 | $218 | — | — | — | $218 – $218 |
| 10 | Indiana University Health Bloomington Inc. Bloomington, IN fee schedule · outpatient | 1 | $218 | $218 | — | — | — | $218 – $218 |
| 11 | Indiana University Health Inc. Martinsville, IN fee schedule · outpatient | 1 | $218 | $218 | — | — | — | $218 – $218 |
| 12 | Indiana University Health North Hospital Inc. Carmel, IN fee schedule · outpatient | 1 | $218 | $218 | — | — | — | $218 – $218 |
| 13 | Indiana University Health West Hospital Inc. Avon, IN fee schedule · outpatient | 1 | $218 | $218 | — | — | — | $218 – $218 |
| 14 | Inspira Medical Center Mullica Hill Hill, NJ fee schedule · outpatient | 1 | $287 | $287 | — | — | — | $287 – $287 |
| 15 | Inspira Medical Center Vineland Vineland, NJ fee schedule · outpatient | 1 | $287 | $287 | — | — | — | $287 – $287 |
| 16 | Lexington Medical Center Lexington, NC percent of total billed charges · outpatientfrom % of charges | 1 | $106 | $133 | $65 | 49% | — | $83 – $271 |
| 17 | Mercy Hospital Ardmore Inc Ardmore, OK facility · other · outpatient | 1 | $172 | $172 | — | — | — | $172 – $172 |
| 18 | Mercy Hospital Jefferson Imperial, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $99 | $99 | $27 | 27% | — | $73 – $126 |
| 19 | Mercy Hospital Joplin dba Mercy Hospital Joplin Joplin, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $114 | $114 | $30 | 27% | — | $83 – $144 |
| 20 | Mercy Hospital Oklahoma City Inc City, OK facility · other · outpatient | 1 | $172 | $172 | — | — | — | $172 – $172 |
| 21 | Mercy Hospital Pittsburg Inc Pittsburg, KS facility · other · outpatient | 1 | $216 | $216 | — | — | — | $216 – $216 |
| 22 | Mercy Hospital Rogers dba Mercy Hospital Northwest Arkansas Rogers, AR facility · other · outpatient | 1 | $178 | $178 | — | — | — | $178 – $178 |
| 23 | Mercy Hospital South Louis, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $60 | $73 | $32 | 43% | — | $47 – $125 |
| 24 | Mercy Hospital Springfield Ozark, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $97 | $100 | $34 | 34% | — | $56 – $150 |
| 25 | Mercy Hospital Springfield Springfield, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $97 | $100 | $34 | 34% | — | $56 – $150 |
← Payers reporting HCPCS A2025 · Snapshot 20261111T120946Z-9134e7f7