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
FOAM DRG >16<=48 SQ IN W/BDR
Low
$5
Average
$10
Median
$10
High
$16
Each hospital's average Amerihealth Caritas rate, under the methodology and billing class chosen below.
17 hospitals; the 90th percentile is 2.3× 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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18 hospital rates
iThe hospitals that file a Amerihealth Caritas 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 | St. Frances Cabrini Hospital Alexandria, LA percent of total billed charges · outpatientfrom % of charges | 1 | $8 | $8 | — | — | 1–10 | $8 – $8 |
| 2 | VALLEY REGIONAL HOSPITAL CLAREMONT, NH percent of total billed charges · bothfrom % of charges | 1 | $10 | $15 | $8 | 51% | 1–10 | $10 – $26 |
| 3 | ANGEL MEDICAL CENTER Franklin, NC percent of total billed charges · outpatientfrom % of charges | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 4 | BLUE RIDGE REGIONAL HOSPITAL Spruce Pine, NC percent of total billed charges · outpatientfrom % of charges | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 5 | BRFHH MONROE, LLC Monroe, LA other · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 6 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 7 | Children's Hospital of the King's Daughters Norfolk, VA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $15 | $16 | $6 | 34% | — | $11 – $29 |
| 8 | HIGHLANDS-CASHIERS HOSPITAL Highlands, NC percent of total billed charges · outpatientfrom % of charges | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 9 | MELROSEWAKEFIELD HEALTHCARE Medford, MA percent of total billed charges · bothfrom % of charges | 1 | $17 | $16 | $6 | 37% | — | $5 – $21 |
| 10 | MISSION HOSPITAL Arden, NC percent of total billed charges · outpatientfrom % of charges | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 11 | MISSION HOSPITAL MCDOWELL Marion, NC percent of total billed charges · outpatientfrom % of charges | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 12 | Mary Hitchcock Memorial Hospital Lebanon, NH professional · fee schedule · outpatient | 2 | $10 | $10 | $0 | 1% | — | $10 – $10 |
| 13 | OCHSNER LSU HEALTH SHREVEPORT - ST. MARY MEDICAL CENTER, LLC Shreveport, LA other · outpatient | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 14 | TRANSYLVANIA REGIONAL HOSPITAL Brevard, NC percent of total billed charges · outpatientfrom % of charges | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 15 | The New London Hospital Association, Inc. London, NH professional · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 16 | Tufts Medical Center BOSTON, MA percent of total billed charges · bothfrom % of charges | 1 | $6 | $10 | $7 | 70% | — | $4 – $21 |
| 17 | UNIVERSITY HEALTH SHREVEPORT, LLC Shreveport, LA other · outpatient | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 18 | VALLEY REGIONAL HOSPITAL CLAREMONT, NH fee schedule · both | 1 | $10 | $10 | — | — | — | $10 – $10 |
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