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
DRSNG SILVERLON ISLAND 4X14"
Low
$1
Average
$80
Median
$3
High
$620
Each hospital's average First Health rate, under the methodology and billing class chosen below.
26 hospitals; the 90th percentile is 175.4× 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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43 hospital rates
iThe hospitals that file a First Health 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 | Bexar County Hospital District San Antonio, TX fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 2 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 3 | CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER Houston, TX fee schedule · inpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 4 | CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER Houston, TX fee schedule · outpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 5 | Davis Medical Center Elkins, WV professional · fee schedule · both | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 6 | GRMC, Inc. Oakland, MD percent of total billed charges · bothfrom % of charges | 1 | $568 | $568 | $133 | 23% | — | $435 – $701 |
| 7 | H. Lee Moffitt Cancer Center and Research Institute Hospital, Inc. Tampa, FL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $128 | $128 | — | — | — | $128 – $128 |
| 8 | H. Lee Moffitt Cancer Center and Research Institute Hospital, Inc. Tampa, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $128 | $128 | — | — | — | $128 – $128 |
| 9 | ST LUKE'S LAKESIDE HOSPITAL, LLC The Woodlands, TX fee schedule · inpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 10 | ST LUKE'S LAKESIDE HOSPITAL, LLC The Woodlands, TX fee schedule · outpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 11 | ST LUKES COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND Sugar Land, TX fee schedule · inpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 12 | ST LUKES COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND Sugar Land, TX fee schedule · outpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 13 | ST. LUKE'S COMMUNITY HEALTH SERVICES The Woodlands, TX fee schedule · inpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 14 | ST. LUKE'S COMMUNITY HEALTH SERVICES The Woodlands, TX fee schedule · outpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 15 | ST. LUKE'S COMMUNITY HEALTH SERVICES Spring, TX fee schedule · inpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 16 | ST. LUKE'S COMMUNITY HEALTH SERVICES Spring, TX fee schedule · outpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 17 | ST. LUKES HOSPITAL AT THE VINTAGE Houston, TX fee schedule · inpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 18 | ST. LUKES HOSPITAL AT THE VINTAGE Houston, TX fee schedule · outpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 19 | Southcoast Hospitals Group, Inc. Bedford, MA percent of total billed charges · outpatientfrom % of charges | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 20 | Southcoast Hospitals Group, Inc. Wareham, MA percent of total billed charges · outpatientfrom % of charges | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 21 | Southcoast Hospitals Group, Inc. River, MA percent of total billed charges · outpatientfrom % of charges | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 22 | SwedishAmerican Hospital IL 61104; 1625 S State St Belvidere, IL percent of total billed charges · bothfrom % of charges | 1 | $620 | $620 | — | — | — | $620 – $620 |
| 23 | Texas Children's Hospital The Woodlands, TX facility · percent of total billed charges · inpatientfrom % of charges | 2 | $1 | $1 | $0 | 32% | — | $0 – $1 |
| 24 | Texas Children's Hospital The Woodlands, TX facility · percent of total billed charges · outpatientfrom % of charges | 3 | $0 | $1 | $0 | 48% | — | $0 – $1 |
| 25 | Texas Children's Hospital - Austin Austin, TX facility · percent of total billed charges · inpatientfrom % of charges | 2 | $1 | $1 | $0 | 32% | — | $0 – $1 |
← Payers reporting HCPCS A6255 · Snapshot 20261111T120946Z-9134e7f7