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 (SUP SHELL A4390) DRAINABLE PCH EX WEAR CONVEX
Low
$0
Average
$16
Median
$8
High
$70
Each hospital's average First Health rate, under the methodology and billing class chosen below.
10 hospitals; the 90th percentile is 116.3× 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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12 hospital rates
iThe hospitals that file a First Health 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 | Bexar County Hospital District San Antonio, TX fee schedule · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 2 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 3 | Davis Medical Center Elkins, WV professional · fee schedule · both | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 4 | Duncan Regional Hospital Duncan, OK percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $26 | $11 | 44% | — | $13 – $38 |
| 5 | Jefferson County Hospital OK Waurika, OK percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $26 | $11 | 44% | — | $13 – $38 |
| 6 | Penn State Health Milton S. Hershey Medical Center Hershey, PA percent of total billed charges · bothfrom % of charges | 1 | $70 | $70 | — | — | — | $70 – $70 |
| 7 | RAPIDES REGIONAL MEDICAL CENTER ALEXANDRIA, LA percent of total billed charges · outpatientfrom % of charges | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 8 | Texas Children's Hospital The Woodlands, TX facility · percent of total billed charges · inpatientfrom % of charges | 2 | $0 | $0 | $0 | 3% | — | $0 – $0 |
| 9 | Texas Children's Hospital The Woodlands, TX facility · percent of total billed charges · outpatientfrom % of charges | 3 | $0 | $0 | $0 | 33% | — | $0 – $0 |
| 10 | Texas Children's Hospital - Austin Austin, TX facility · percent of total billed charges · inpatientfrom % of charges | 2 | $0 | $0 | $0 | 3% | — | $0 – $0 |
| 11 | Texas Children's Hospital - Austin Austin, TX facility · percent of total billed charges · outpatientfrom % of charges | 3 | $0 | $0 | $0 | 33% | — | $0 – $0 |
| 12 | Webster Memorial Hospital Inc Cowen, WV professional · fee schedule · both | 1 | $8 | $8 | — | — | — | $8 – $8 |
← Payers reporting HCPCS A4390 · Snapshot 20261111T120946Z-9134e7f7