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
$1
Average
$319
Median
$36
High
$1.4k
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
17 hospitals; the 90th percentile is 1349.0× 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 Medicaid 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 | ADVENTIST HEALTH DELANO Delano, CA fee schedule · outpatient | 1 | $239 | $239 | — | — | — | $239 – $239 |
| 2 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 3 | Childrens Hospital of Los Angeles Angeles, CA facility · other · outpatient | 2 | $2 | $5 | $6 | 107% | — | $1 – $13 |
| 4 | Childrens Hospital of Los Angeles Angeles, CA professional · fee schedule · outpatient | 2 | $2 | $5 | $6 | 107% | — | $1 – $13 |
| 5 | GLENDALE ADVENTIST MEDICAL CENTER Glendale, CA fee schedule · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 6 | Geisinger Bloomsburg Hospital Bloomsburg, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 7 | Geisinger Community Medical Center Scranton, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 8 | Geisinger Jersey Shore Hospital Jersey Shore, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 9 | Geisinger Lewistown Hospital Lewistown, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 10 | Geisinger Medical Center Muncy, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 11 | Geisinger Wyoming Valley Wilkes-Barre, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 12 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $166 | $166 | $5 | 3% | — | $161 – $171 |
| 13 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA fee schedule · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 14 | Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges | 1 | $184 | $193 | $165 | 86% | — | $57 – $654 |
| 15 | MELROSEWAKEFIELD HEALTHCARE Medford, MA percent of total billed charges · bothfrom % of charges | 1 | $273 | $322 | $178 | 55% | — | $63 – $692 |
| 16 | Ste. Genevieve County Memorial Hospital Ste. Genevieve, MO percent of total billed charges · outpatientfrom % of charges | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 17 | Tufts Medical Center BOSTON, MA percent of total billed charges · bothfrom % of charges | 1 | $273 | $290 | $179 | 62% | — | $21 – $692 |
| 18 | WHITE MEMORIAL MEDICAL CENTER MONTEBELLO, CA fee schedule · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
← Payers reporting HCPCS B4087 · Snapshot 20261111T120946Z-9134e7f7