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
Microcapillary tube sealant
Low
$1
Average
$290
Median
$17
High
$2.5k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
24 hospitals; the 90th percentile is 122.1× 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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27 hospital rates
iThe hospitals that file a Molina 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 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 2 | Avita Ontario Hospital Ontario, OH per diem · both | 2 | $4.6k | $4.6k | $1.1k | 23% | — | $3.5k – $5.6k |
| 3 | Avita Ontario Hospital Ontario, OH percent of total billed charges · bothfrom % of charges | 3 | $23 | $27 | $8 | 30% | — | $16 – $37 |
| 4 | Bucyrus Community Hospital Bucyrus, OH per diem · both | 2 | $4.6k | $4.6k | $1.1k | 23% | — | $3.5k – $5.6k |
| 5 | Bucyrus Community Hospital Bucyrus, OH percent of total billed charges · bothfrom % of charges | 3 | $23 | $27 | $8 | 30% | — | $16 – $37 |
| 6 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 7 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 8 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 9 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 10 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 11 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 12 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 13 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 14 | GRITMAN MEDICAL CENTER INC Moscow, ID facility · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 15 | Galion Community Hospital S., OH per diem · both | 2 | $4.9k | $4.9k | $744 | 15% | — | $4.1k – $5.6k |
| 16 | Galion Community Hospital S., OH percent of total billed charges · bothfrom % of charges | 2 | $32 | $32 | $7 | 23% | — | $24 – $39 |
| 17 | Gerald Champion Regional Medical Center Alamogordo, NM fee schedule · outpatient | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 18 | LODI COMMUNITY HOSPITAL Lodi, OH facility · case rate · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 19 | LUTHERAN HOSPITAL Cleveland, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 20 | MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · case rate · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 21 | MEDINA HOSPITAL Medina, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 22 | NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC Toledo, OH facility · other · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 23 | Nationwide Children's Hospital Columbus, OH facility · other · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 24 | St. Vincent Regional Medical Center Santa Fe, NM fee schedule · outpatient | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 25 | THE UNION HOSPITAL ASSOCIATION Dover, OH facility · case rate · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
← Payers reporting HCPCS A4652 · Snapshot 20261112T124536Z-e251e855