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.
Generation details were not recorded for this description.
Original text from hospital filings
HC Kt Orth Merit Sm Fnl Fngr Flxn
Low
$1
Average
$6
Median
$2
High
$36
Each hospital's average Premera rate, under the methodology and billing class chosen below.
34 hospitals; the 90th percentile is 18.0× 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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35 hospital rates
iThe hospitals that file a Premera 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 | MultiCare Auburn Medical Center Auburn, WA percent of total billed charges · outpatientfrom % of charges | 4 | $17 | $17 | $11 | 67% | 14–140 | $4 – $28 |
| 2 | Central Washington Health Services Association Wenatchee, WA percent of total billed charges · bothfrom % of charges | 3 | $19 | $38 | $43 | 113% | — | $2 – $163 |
| 3 | Central Washington Health Services Association Wenatchee, WA percent of total billed charges · outpatientfrom % of charges | 3 | $19 | $18 | $1 | 4% | — | $17 – $19 |
| 4 | Good Samaritan Hospital Puyallup, WA percent of total billed charges · outpatientfrom % of charges | 4 | $17 | $17 | $11 | 67% | — | $4 – $28 |
| 5 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $2 | $2 | $0 | 11% | — | $2 – $3 |
| 6 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | $0 | 11% | — | $1 – $1 |
| 7 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $2 | $2 | $0 | 12% | — | $2 – $2 |
| 8 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | $0 | 12% | — | $1 – $2 |
| 9 | Mary Bridge Children's Hospital Tacoma, WA percent of total billed charges · outpatientfrom % of charges | 4 | $17 | $17 | $11 | 67% | — | $4 – $28 |
| 10 | Mercy Fitzgerald Hospital Darby, PA facility · percent of total billed charges · bothfrom % of charges | 1 | $4 | $4 | $0 | 11% | — | $4 – $5 |
| 11 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | $0 | 12% | — | $1 – $1 |
| 12 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $2 | $2 | $0 | 12% | — | $2 – $2 |
| 13 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | $0 | 10% | — | $1 – $2 |
| 14 | Mishawaka Medical Center Mishawaka, IN facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | $0 | 10% | — | $1 – $1 |
| 15 | MultiCare Capital Medical Center Lacey, WA percent of total billed charges · outpatientfrom % of charges | 4 | $17 | $17 | $11 | 67% | — | $4 – $28 |
| 16 | MultiCare Covington Medical Center Covington, WA percent of total billed charges · outpatientfrom % of charges | 4 | $17 | $17 | $11 | 67% | — | $4 – $28 |
| 17 | MultiCare Deaconess Hospital Spokane, WA percent of total billed charges · outpatientfrom % of charges | 4 | $16 | $15 | $10 | 67% | — | $4 – $25 |
| 18 | MultiCare Valley Hospital Spokane Valley, WA percent of total billed charges · outpatientfrom % of charges | 4 | $16 | $15 | $10 | 67% | — | $4 – $25 |
| 19 | MultiCare Yakima Valley Memorial Hospital Association Union Gap, WA percent of total billed charges · outpatientfrom % of charges | 3 | $10 | $9 | $6 | 67% | — | $2 – $15 |
| 20 | Nazareth Hospital Philadelphia, PA facility · percent of total billed charges · bothfrom % of charges | 1 | $4 | $4 | $0 | 2% | — | $4 – $4 |
| 21 | Plymouth Medical Center Plymouth, IN facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | $0 | 10% | — | $1 – $1 |
| 22 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $3 | $3 | $0 | 11% | — | $3 – $4 |
| 23 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $2 | $3 | $0 | 11% | — | $2 – $3 |
| 24 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $2 | $3 | $0 | 11% | — | $2 – $3 |
| 25 | Samaritan Hospital Troy, NY facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | $0 | 12% | — | $1 – $1 |
← Payers reporting HCPCS A4570 · Snapshot 20261111T120946Z-9134e7f7