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
SEAL PROTECTIVE STOMA 4.2X35MM
Low
$1
Average
$18
Median
$7
High
$101
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
15 hospitals; the 90th percentile is 17.3× 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.
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15 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 | Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 2 | Central Maine Medical Center Lewiston, ME fee schedule · outpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 3 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $101 | $101 | — | — | — | $101 – $101 |
| 4 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 5 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 6 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 7 | HSA PGH LLC Hialeah, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $91 | $91 | — | — | — | $91 – $91 |
| 8 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 9 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 10 | Little Company of Mary Hospital of Indiana Inc Jasper, IN facility · case rate · outpatient | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 11 | METHODIST MEDICAL CENTER OF OAK RIDGE Oak Ridge, TN fee schedule · outpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 12 | MORRISTOWN HAMBLEN HOSPITAL ASSOCIATION Morristown, TN fee schedule · outpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 13 | PARKWEST MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 14 | PARKWEST MEDICAL CENTER Louisville, TN fee schedule · outpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 15 | ROANE COUNTY MEDICAL CENTER Harriman, TN fee schedule · outpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
← Payers reporting HCPCS A4385 · Snapshot 20261111T120946Z-9134e7f7