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 A4416) OST PCH CLSD W BARRIER/FILTR
Low
$0
Average
$5
Median
$4
High
$25
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
261 hospitals; the 90th percentile is 1.8× 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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280 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 2 | ALEGENT CREIGHTON HEALTH Plainview, NE fee schedule · inpatient | 2 | $5 | $5 | $0 | 3% | — | $5 – $5 |
| 3 | ALEGENT CREIGHTON HEALTH Plainview, NE fee schedule · outpatient | 3 | $5 | $4 | $1 | 18% | — | $3 – $5 |
| 4 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 5 | ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA Missouri Valley, IA fee schedule · inpatient | 2 | $5 | $5 | $0 | 3% | — | $5 – $5 |
| 6 | ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA Missouri Valley, IA fee schedule · outpatient | 2 | $5 | $5 | $0 | 3% | — | $5 – $5 |
| 7 | ALEGENT HEALTH MEMORIAL HOSPITAL, SCHUYLER Schuyler, NE fee schedule · inpatient | 2 | $5 | $5 | $0 | 3% | — | $5 – $5 |
| 8 | ALEGENT HEALTH MEMORIAL HOSPITAL, SCHUYLER Schuyler, NE fee schedule · outpatient | 3 | $5 | $4 | $1 | 25% | — | $3 – $5 |
| 9 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 10 | Adventhealth Ottawa Ottawa, KS fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 11 | Advocate Childrens Hospital Oak Lawn Oak Lawn, IL facility · fee schedule · outpatient | 2 | $18 | $18 | $1 | 5% | — | $16 – $19 |
| 12 | Advocate Childrens Hospital Park Ridge Park Ridge, IL facility · fee schedule · outpatient | 2 | $18 | $18 | $1 | 5% | — | $17 – $19 |
| 13 | Advocate Christ Medical Center Oak Lawn, IL facility · fee schedule · outpatient | 2 | $17 | $17 | $1 | 5% | — | $16 – $18 |
| 14 | Advocate Condell Medical Center Libertyville, IL fee schedule · outpatient | 2 | $11 | $11 | $1 | 5% | — | $10 – $12 |
| 15 | Advocate Good Samaritan Hospital Downers Grove, IL fee schedule · outpatient | 2 | $18 | $18 | $1 | 5% | — | $17 – $19 |
| 16 | Advocate Good Shepherd Hospital Barrington, IL fee schedule · outpatient | 2 | $18 | $18 | $1 | 5% | — | $17 – $19 |
| 17 | Advocate Illinois Masonic Medical Center Chicago, IL fee schedule · outpatient | 2 | $18 | $18 | $1 | 5% | — | $17 – $19 |
| 18 | Advocate Lutheran General Hospital Park Ridge, IL fee schedule · outpatient | 2 | $18 | $18 | $1 | 5% | — | $16 – $19 |
| 19 | Advocate Sherman Hospital Elgin, IL fee schedule · outpatient | 2 | $8 | $8 | $0 | 5% | — | $8 – $9 |
| 20 | Advocate South Suburban Hospital Hazel Crest, IL fee schedule · outpatient | 2 | $18 | $18 | $1 | 5% | — | $17 – $19 |
| 21 | Advocate Trinity Hospital Chicago, IL fee schedule · outpatient | 2 | $18 | $18 | $1 | 5% | — | $17 – $19 |
| 22 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 23 | Altru Hospital Grand Forks, ND facility · fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 24 | Altru Hospital Devils Lake Devils Lake, ND facility · fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 25 | Amisub of South Carolina, Inc. Fort Mill, SC fee schedule · outpatient | 3 | $1 | $1 | $0 | 46% | — | $0 – $1 |
← Payers reporting HCPCS A4416 · Snapshot 20261112T124536Z-e251e855