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
$0
Average
$130
Median
$42
High
$1.4k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
148 hospitals; the 90th percentile is 14.1× 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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174 hospital rates
iThe hospitals that file a Molina 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 | MultiCare Yakima Valley Memorial Hospital Association Union Gap, WA other · outpatient | 1 | $141 | $141 | — | — | 102 | $141 – $141 |
| 2 | University of New Mexico Hospital | UNM Sandoval Regional Medical Center - A Campus of UNM Hospital Rio Rancho, NM facility · other · outpatient | 2 | $82 | $67 | $18 | 26% | 8–80 | $46 – $82 |
| 3 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 4 | Adena Fayette Medical Center Washington Court House, OH facility · case rate · outpatient | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 5 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $86 | $86 | — | — | — | $86 – $86 |
| 6 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 2 | $65 | $65 | $22 | 34% | — | $42 – $87 |
| 7 | Advocate Childrens Hospital Oak Lawn Oak Lawn, IL facility · case rate · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 8 | Advocate Childrens Hospital Park Ridge Park Ridge, IL facility · case rate · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 9 | Advocate Christ Medical Center Oak Lawn, IL facility · case rate · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 10 | Advocate Condell Medical Center Libertyville, IL case rate · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 11 | Advocate Good Samaritan Hospital Downers Grove, IL case rate · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 12 | Advocate Good Shepherd Hospital Barrington, IL case rate · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 13 | Advocate Illinois Masonic Medical Center Chicago, IL case rate · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 14 | Advocate Lutheran General Hospital Park Ridge, IL case rate · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 15 | Advocate Sherman Hospital Elgin, IL case rate · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 16 | Advocate South Suburban Hospital Hazel Crest, IL case rate · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 17 | Advocate Trinity Hospital Chicago, IL case rate · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 18 | Allen Memorial Hospital Corporation Waterloo, IA case rate · outpatient | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 19 | Aurora Medical Center Bay Area Marinette, WI percent of total billed charges · outpatientfrom % of charges | 1 | $81 | $81 | — | — | — | $81 – $81 |
| 20 | Aurora Medical Center Kenosha Kenosha, WI percent of total billed charges · outpatientfrom % of charges | 1 | $225 | $225 | — | — | — | $225 – $225 |
| 21 | Aurora Medical Center Mount Pleasant Mount Pleasant, WI percent of total billed charges · outpatientfrom % of charges | 1 | $225 | $225 | — | — | — | $225 – $225 |
| 22 | Aurora Medical Center Sheboygan County Sheboygan, WI percent of total billed charges · outpatientfrom % of charges | 1 | $81 | $81 | — | — | — | $81 – $81 |
| 23 | Aurora Medical Center Summit Summit, WI percent of total billed charges · outpatientfrom % of charges | 1 | $225 | $225 | — | — | — | $225 – $225 |
| 24 | Aurora St Lukes Medical Center of Aurora Health Care Metro Inc Milwaukee, WI percent of total billed charges · outpatientfrom % of charges | 1 | $225 | $225 | — | — | — | $225 – $225 |
| 25 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE fee schedule · outpatient | 1 | $48 | $48 | — | — | — | $48 – $48 |
← Payers reporting HCPCS B4087 · Snapshot 20261111T120946Z-9134e7f7