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
TUBE ARGYLE SALEM SUMP SNTNL LINE SNTNL EYE 12FR 2 LUMEN #8888266114E
Low
$1
Average
$3
Median
$2
High
$57
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
96 hospitals; the 90th percentile is 2.2× 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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109 hospital rates
iThe hospitals that file a Anthem 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 Hospital Bangor, ME facility · fee schedule · outpatient | 2 | $2 | $2 | $0 | 12% | — | $2 – $2 |
| 2 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 3 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 4 | Ascension St. Vincent Heart Center Carmel, IN fee schedule · both | 3 | $2 | $2 | — | — | — | $2 – $2 |
| 5 | Ascension St. Vincent Heart Center Carmel, IN fee schedule · outpatient | 8 | $1 | $1 | $1 | 52% | — | $0 – $2 |
| 6 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 2 | $1 | $1 | $1 | 62% | — | $0 – $2 |
| 7 | Boulder Community Health Lafayette, CO facility · case rate · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 8 | Boulder Community Health Lafayette, CO facility · fee schedule · outpatient | 2 | $2 | $3 | $1 | 47% | — | $2 – $6 |
| 9 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 2 | $2 | $2 | — | — | — | $2 – $2 |
| 10 | CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 11 | CATHOLIC HEALTH INITIATIVES COLORADO Pueblo, CO fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 12 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 13 | CATHOLIC HEALTH INITIATIVES COLORADO Frisco, CO fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 14 | CATHOLIC HEALTH INITIATIVES COLORADO Durango, CO fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 15 | CATHOLIC HEALTH INITIATIVES COLORADO Lakewood, CO fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 16 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 17 | CATHOLIC HEALTH INITIATIVES COLORADO Fort Morgan, CO fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 18 | Carmel AmbSurg Carmel, IN fee schedule · both | 3 | $2 | $2 | — | — | — | $2 – $2 |
| 19 | Carmel AmbSurg Carmel, IN fee schedule · outpatient | 8 | $1 | $1 | $1 | 52% | — | $0 – $2 |
| 20 | Central Georgia Rehabilitation LLC Macon, GA fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 21 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 2 | $1 | $1 | $1 | 62% | — | $0 – $2 |
| 22 | Cheshire Medical Center Keene, NH facility · fee schedule · outpatient | 6 | $3 | $3 | $0 | 14% | — | $3 – $4 |
| 23 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 2 | $4 | $4 | $2 | 47% | — | $2 – $6 |
| 24 | Community Memorial Hospital of Menomonee Falls Inc Menomonee Falls, WI case rate · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 25 | Covenant Medical Center Inc Saginaw, MI facility · fee schedule · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
← Payers reporting HCPCS B4083 · Snapshot 20261111T120946Z-9134e7f7