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
Nondisp underpads, all sizes
Low
$0
Average
$12
Median
$8
High
$58
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
52 hospitals; the 90th percentile is 8.8× 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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56 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 | ATHOL MEMORIAL HOSPITAL INCORPORATED Athol, MA fee schedule · outpatient | 3 | $4 | $3 | $0 | 2% | — | $3 – $4 |
| 2 | Adventhealth Ottawa Ottawa, KS fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 3 | Benson Hospital Corporation Benson, AZ facility · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 4 | Beth Israel Deaconess Hospital - Needham Needham, MA fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 5 | Beth Israel Deaconess Hospital - Plymouth Plymouth, MA fee schedule · outpatient | 2 | $4 | $4 | $0 | 3% | — | $4 – $4 |
| 6 | Beth Israel Deaconess Hospital-Milton Inc Milton, MA fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 7 | Beth Israel Deaconess Medical Center Boston, MA fee schedule · outpatient | 2 | $5 | $5 | $0 | 2% | — | $5 – $6 |
| 8 | Covenant Medical Center Inc Saginaw, MI facility · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 9 | Covenant Medical Center Inc Saginaw, MI facility · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 10 | Edward Hospital Plainfield, IL fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 11 | Elmhurst Memorial Hospital Elmhurst, IL fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 12 | Endeavor Health Clinical Operations Skokie, IL fee schedule · outpatient | 3 | $28 | $28 | $2 | 7% | — | $26 – $30 |
| 13 | HENRY HEYWOOD MEMORIAL HOSPITAL Gardner, MA fee schedule · outpatient | 3 | $4 | $4 | $0 | 1% | — | $4 – $4 |
| 14 | Henry Ford Health System West Bloomfield, MI facility · fee schedule · outpatient | 3 | $23 | $25 | $4 | 16% | — | $23 – $31 |
| 15 | Henry Ford Health System Plymouth, MI facility · fee schedule · outpatient | 3 | $45 | $41 | $7 | 16% | — | $31 – $45 |
| 16 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI facility · fee schedule · outpatient | 3 | $20 | $24 | $5 | 23% | — | $20 – $31 |
| 17 | Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI facility · fee schedule · outpatient | 3 | $23 | $26 | $4 | 15% | — | $23 – $31 |
| 18 | HonorHealth Florence Medical Center Florence, AZ facility · fee schedule · outpatient | 1 | $3 | $3 | $1 | 29% | — | $2 – $3 |
| 19 | Honorhealth Deer Valley Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $3 | $3 | $1 | 30% | — | $2 – $3 |
| 20 | Honorhealth Four Peaks Medical Center Mesa, AZ facility · fee schedule · outpatient | 1 | $3 | $3 | $1 | 29% | — | $2 – $3 |
| 21 | Honorhealth John C. Lincoln Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $3 | $3 | $1 | 30% | — | $2 – $3 |
| 22 | Honorhealth Scottsdale Osborn Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $3 | $3 | $1 | 30% | — | $2 – $3 |
| 23 | Honorhealth Scottsdale Shea Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $3 | $3 | $1 | 30% | — | $2 – $3 |
| 24 | Honorhealth Scottsdale Thompson Peak Med Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $3 | $3 | $1 | 30% | — | $2 – $3 |
| 25 | Honorhealth Sonoran Crossing Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $3 | $3 | $1 | 30% | — | $2 – $3 |
← Payers reporting HCPCS A4553 · Snapshot 20261112T181611Z-3fa9fb76