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
Special casting material
Low
$0
Average
$112
Median
$35
High
$474
Each hospital's average Ambetter rate, under the methodology and billing class chosen below.
13 hospitals; the 90th percentile is 23738.3× 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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17 hospital rates
iThe hospitals that file a Ambetter 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 | The University of Kansas Health System Great Bend Campus Bend, KS percent of total billed charges · bothfrom % of charges | 1 | $35 | $35 | $9 | 25% | 21 | $25 – $64 |
| 2 | The University of Kansas Health System Great Bend Campus Bend, KS percent of total billed charges · outpatientfrom % of charges | 1 | $35 | $35 | $9 | 24% | 21 | $25 – $64 |
| 3 | Central Washington Health Services Association Wenatchee, WA percent of total billed charges · bothfrom % of charges | 1 | $75 | $74 | $23 | 32% | — | $40 – $106 |
| 4 | Central Washington Health Services Association Wenatchee, WA percent of total billed charges · outpatientfrom % of charges | 1 | $50 | $57 | $32 | 55% | — | $21 – $108 |
| 5 | Covenant Medical Center Inc Waterloo, IA facility · other · outpatient | 1 | $474 | $474 | $22 | 5% | — | $452 – $496 |
| 6 | Deaconess Health System Gibson General Hospital Princeton, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 7 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 8 | Deaconess Hospital, Inc Newburgh, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 9 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $226 | $228 | $145 | 63% | — | $76 – $383 |
| 10 | Little Company of Mary Hospital of Indiana Inc Jasper, IN professional · percent of total billed charges · bothfrom % of charges | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 11 | Ste. Genevieve County Memorial Hospital Ste. Genevieve, MO percent of total billed charges · outpatientfrom % of charges | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 12 | The Methodist Hospitals, Inc. Gary, IN facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 13 | The University of Kansas Health System Great Bend Campus Bend, KS percent of total billed charges · inpatientfrom % of charges | 1 | $35 | $36 | $2 | 6% | — | $35 – $40 |
| 14 | University Hospitals Health System Geneva, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $157 | $153 | $12 | 8% | — | $139 – $172 |
| 15 | University Hospitals Health System Conneaut, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $243 | $237 | $19 | 8% | — | $216 – $266 |
| 16 | University Hospitals Health System Cleveland, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $244 | $238 | $19 | 8% | — | $217 – $267 |
| 17 | University Hospitals Health System Cleveland, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $244 | $238 | $19 | 8% | — | $217 – $267 |
← Payers reporting HCPCS A4590 · Snapshot 20261111T120946Z-9134e7f7