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
Fee Schedule
Low
$51
Average
$310
Median
$223
High
$717
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
8 hospitals; the 90th percentile is 10.8× 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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8 hospital rates
iThe hospitals that file a Tricare 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 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · outpatient | 1 | $717 | $717 | — | — | — | $717 – $717 |
| 2 | KAPLAN GENERAL HOSPITAL, INC ST, LA percent of total billed charges · outpatientfrom % of charges | 1 | $307 | $307 | — | — | — | $307 – $307 |
| 3 | LAFAYETTE GENERAL MEDICAL CENTER INC Lafayette, LA other · outpatient | 1 | $717 | $717 | — | — | — | $717 – $717 |
| 4 | OCHSNER BAYOU LLC Raceland, LA percent of total billed charges · outpatientfrom % of charges | 1 | $73 | $73 | $4 | 5% | — | $69 – $77 |
| 5 | Ochsner American Legion Hospital, LLC Jennings, LA other · outpatient | 1 | $220 | $220 | — | — | — | $220 – $220 |
| 6 | SOUTHERN REGIONAL MEDICAL CORPORATION Houma, LA other · outpatient | 1 | $166 | $166 | — | — | — | $166 – $166 |
| 7 | ST MARTIN HOSPITAL INC Breaux Bridge, LA percent of total billed charges · outpatientfrom % of charges | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 8 | University Hospital & Clinics, Inc. Lafayette, LA other · outpatient | 1 | $225 | $225 | — | — | — | $225 – $225 |
← Payers reporting HCPCS A7042 · Snapshot 20261112T181611Z-3fa9fb76