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 GASTROSTOMY FEEDING 26FR BALLOON 7-10ML SILICONE TAPERED RECESSED DISTAL TIP RADIOPAQUE STRIPE SECUR LOK EXTERNAL RETENTION RING WITH CONNECTOR
Low
$4
Average
$160
Median
$37
High
$1.4k
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
182 hospitals; the 90th percentile is 27.6× 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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250 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 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 4 | $101 | $215 | $228 | 106% | 46–460 | $12 – $908 |
| 2 | ADVENTIST HEALTH DELANO Delano, CA fee schedule · outpatient | 1 | $34 | $34 | — | — | — | $34 – $34 |
| 3 | ADVENTIST HEALTH DELANO Delano, CA percent of total billed charges · outpatientfrom % of charges | 1 | $199 | $199 | — | — | — | $199 – $199 |
| 4 | Acadia Hospital Bangor, ME facility · fee schedule · outpatient | 2 | $25 | $25 | $3 | 12% | — | $22 – $29 |
| 5 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 6 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · inpatientfrom % of charges | 3 | $127 | $119 | $19 | 16% | — | $92 – $137 |
| 7 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · outpatientfrom % of charges | 4 | $115 | $106 | $32 | 31% | — | $55 – $138 |
| 8 | Adena Health System Chillicothe, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $134 | $134 | — | — | — | $134 – $134 |
| 9 | Adena Health System Chillicothe, OH facility · percent of total billed charges · outpatientfrom % of charges | 5 | $118 | $116 | $16 | 13% | — | $96 – $134 |
| 10 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 11 | Alta Newport Hospital, LLC Tustin, CA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $380 | $394 | $138 | 35% | — | $235 – $583 |
| 12 | Ascension St. Vincent Heart Center Carmel, IN fee schedule · outpatient | 8 | $23 | $19 | $10 | 52% | — | $3 – $26 |
| 13 | Aurora Medical Center Bay Area Marinette, WI percent of total billed charges · inpatientfrom % of charges | 1 | $95 | $95 | — | — | — | $95 – $95 |
| 14 | Aurora Medical Center Bay Area Marinette, WI percent of total billed charges · outpatientfrom % of charges | 3 | $81 | $84 | $6 | 8% | — | $78 – $93 |
| 15 | Aurora Medical Center Kenosha Kenosha, WI percent of total billed charges · inpatientfrom % of charges | 1 | $319 | $319 | — | — | — | $319 – $319 |
| 16 | Aurora Medical Center Kenosha Kenosha, WI percent of total billed charges · outpatientfrom % of charges | 3 | $244 | $263 | $41 | 15% | — | $225 – $319 |
| 17 | Aurora Medical Center Mount Pleasant Mount Pleasant, WI percent of total billed charges · inpatientfrom % of charges | 1 | $319 | $319 | — | — | — | $319 – $319 |
| 18 | Aurora Medical Center Mount Pleasant Mount Pleasant, WI percent of total billed charges · outpatientfrom % of charges | 3 | $244 | $263 | $41 | 15% | — | $225 – $319 |
| 19 | Aurora Medical Center Sheboygan County Sheboygan, WI percent of total billed charges · inpatientfrom % of charges | 1 | $115 | $115 | — | — | — | $115 – $115 |
| 20 | Aurora Medical Center Sheboygan County Sheboygan, WI percent of total billed charges · outpatientfrom % of charges | 3 | $88 | $95 | $15 | 15% | — | $81 – $115 |
| 21 | Aurora Medical Center Summit Summit, WI percent of total billed charges · inpatientfrom % of charges | 1 | $319 | $319 | — | — | — | $319 – $319 |
| 22 | Aurora Medical Center Summit Summit, WI percent of total billed charges · outpatientfrom % of charges | 3 | $244 | $263 | $41 | 15% | — | $225 – $319 |
| 23 | Aurora St Lukes Medical Center of Aurora Health Care Metro Inc Milwaukee, WI percent of total billed charges · inpatientfrom % of charges | 1 | $319 | $319 | — | — | — | $319 – $319 |
| 24 | Aurora St Lukes Medical Center of Aurora Health Care Metro Inc Milwaukee, WI percent of total billed charges · outpatientfrom % of charges | 3 | $244 | $263 | $41 | 15% | — | $225 – $319 |
| 25 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 2 | $20 | $16 | $10 | 61% | — | $3 – $26 |
← Payers reporting HCPCS B4087 · Snapshot 20261111T120946Z-9134e7f7