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
$32
Average
$1.1k
Median
$41
High
$15.9k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
17 hospitals; the 90th percentile is 12.8× 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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18 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 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 2 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 3 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 4 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $146 | $298 | $203 | 68% | — | $125 – $684 |
| 5 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 6 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $357 | $357 | — | — | — | $357 – $357 |
| 7 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 8 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $166 | $166 | $5 | 3% | — | $161 – $171 |
| 9 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital City, UT facility · fee schedule · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 10 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital Lehi, UT facility · fee schedule · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 11 | Little Company of Mary Hospital of Indiana Inc Jasper, IN facility · case rate · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 12 | Mayo Clinic Health System Sparta, WI professional · percent of total billed charges · outpatientfrom % of charges | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 13 | Mayo Clinic Health System Cannon Falls 55009-5003 facility · percent of total billed charges · bothfrom % of charges | 1 | $277 | $277 | — | — | — | $277 – $277 |
| 14 | McLeod Health Cheraw, SC percent of total billed charges · bothfrom % of charges | 1 | $15.9k | $15.9k | — | — | — | $15.9k – $15.9k |
| 15 | The Children's Hospital of Alabama Birmingham, AL facility · fee schedule · outpatient | 1 | $439 | $499 | $277 | 56% | — | $92 – $1.0k |
| 16 | The Children's Hospital of Alabama Birmingham, AL facility · other · inpatient | 1 | $439 | $499 | $277 | 56% | — | $92 – $1.0k |
| 17 | University Health Truman Medical Center Kansas City, MO facility · fee schedule · outpatient | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 18 | University of Texas MD Anderson Cancer Center The University of Texas M D Anderson Cancer Center Houston, TX facility · percent of total billed charges · bothfrom % of charges | 1 | $227 | $223 | $134 | 60% | — | $39 – $464 |
← Payers reporting HCPCS B4087 · Snapshot 20261111T120946Z-9134e7f7