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
PR PESSARY KIT NON-RUBBER
Low
$28
Average
$93
Median
$73
High
$351
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
43 hospitals; the 90th percentile is 3.6× 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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47 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 | $64 | $64 | — | — | — | $64 – $64 |
| 2 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $338 | $351 | $50 | 14% | — | $338 – $545 |
| 3 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 4 | Covenant Medical Center Inc Waterloo, IA professional · percent of total billed charges · bothfrom % of charges | 1 | $147 | $147 | — | — | — | $147 – $147 |
| 5 | Dukes Health System LLC Peru, IN facility · fee schedule · outpatient | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 6 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 7 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $73 | $73 | — | — | — | $73 – $73 |
| 8 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $73 | $73 | — | — | — | $73 – $73 |
| 9 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $112 | $120 | $16 | 13% | — | $106 – $142 |
| 10 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $81 | $86 | $10 | 12% | — | $78 – $104 |
| 11 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 12 | Kaweah Health Medical Center Visalia, CA facility · fee schedule · outpatient | 1 | $263 | $263 | — | — | — | $263 – $263 |
| 13 | Kaweah Health Mental Health Hospital Visalia, CA facility · fee schedule · outpatient | 1 | $263 | $263 | — | — | — | $263 – $263 |
| 14 | Kaweah Health Rehabilitation Hospital Visalia, CA facility · fee schedule · outpatient | 1 | $255 | $255 | — | — | — | $255 – $255 |
| 15 | Little Company of Mary Hospital of Indiana Inc Jasper, IN facility · case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 16 | MCLAREN BAY REGION CITY, MI fee schedule | 1 | $70 | $70 | — | — | — | $70 – $70 |
| 17 | MCLAREN CENTRAL MICHIGAN PLEASANT, MI fee schedule | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 18 | MCLAREN FLINT FLINT, MI fee schedule | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 19 | MCLAREN GREATER LANSING LANSING, MI fee schedule | 1 | $66 | $66 | — | — | — | $66 – $66 |
| 20 | MCLAREN LAPEER REGION LAPEER, MI fee schedule | 1 | $66 | $66 | — | — | — | $66 – $66 |
| 21 | MCLAREN MACOMB CLEMENS, MI fee schedule | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 22 | MCLAREN NORTHERN MICHIGAN PETOSKEY, MI fee schedule | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 23 | MCLAREN OAKLAND PONTIAC, MI fee schedule | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 24 | METHODIST MEDICAL CENTER OF OAK RIDGE Oak Ridge, TN fee schedule · outpatient | 1 | $73 | $73 | — | — | — | $73 – $73 |
| 25 | MORRISTOWN HAMBLEN HOSPITAL ASSOCIATION Morristown, TN fee schedule · outpatient | 1 | $73 | $73 | — | — | — | $73 – $73 |
← Payers reporting HCPCS A4562 · Snapshot 20261111T120946Z-9134e7f7