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
Hdr I192 Tx Source
Low
$279
Average
$792
Median
$342
High
$24.5k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
118 hospitals; the 90th percentile is 1.2× 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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121 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 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $367 | $367 | — | — | — | $367 – $367 |
| 2 | Benefis Hospitals Inc Helena, MT other · outpatient | 1 | $342 | $342 | — | — | — | $342 – $342 |
| 3 | Boston Medical Center Boston, MA other · both | 1 | $325 | $325 | — | — | — | $325 – $325 |
| 4 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $342 | $342 | — | — | — | $342 – $342 |
| 5 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $340 | $340 | — | — | — | $340 – $340 |
| 6 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 1 | $7.0k | $7.0k | — | — | — | $7.0k – $7.0k |
| 7 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient | 1 | $340 | $340 | — | — | — | $340 – $340 |
| 8 | Campbell County HMA, LLC LaFollette, TN facility · fee schedule · outpatient | 1 | $340 | $340 | — | — | — | $340 – $340 |
| 9 | CentraState Medical Center Freehold Township, NJ other · both | 2 | $342 | $342 | — | — | — | $342 – $342 |
| 10 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $342 | $342 | — | — | — | $342 – $342 |
| 11 | Central Maine Medical Center Lewiston, ME fee schedule · outpatient | 1 | $356 | $356 | — | — | — | $356 – $356 |
| 12 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $436 | $436 | $18 | 4% | — | $418 – $454 |
| 13 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $342 | $342 | — | — | — | $342 – $342 |
| 14 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $342 | $342 | — | — | — | $342 – $342 |
| 15 | Cocke County HMA, LLC Newport, TN facility · fee schedule · outpatient | 1 | $340 | $340 | — | — | — | $340 – $340 |
| 16 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $302 | $302 | — | — | — | $302 – $302 |
| 17 | EAST BATON ROUGE MEDICAL CENTER, LLC Baton Rouge, LA other · outpatient | 1 | $342 | $342 | — | — | — | $342 – $342 |
| 18 | Eisenhower Medical Center Rancho Mirage, CA other · both | 3 | $357 | $357 | — | — | — | $357 – $357 |
| 19 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $317 | $317 | — | — | — | $317 – $317 |
| 20 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · both | 1 | $317 | $317 | — | — | — | $317 – $317 |
| 21 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient | 1 | $372 | $372 | — | — | — | $372 – $372 |
| 22 | Garfield County, a political subdivision of the State of Utah, DBA Intermountain Health Garfield Memorial Hospital Panguitch, UT facility · percent of total billed charges · inpatientfrom % of charges | 1 | $26.6k | $26.6k | — | — | — | $26.6k – $26.6k |
| 23 | Garfield County, a political subdivision of the State of Utah, DBA Intermountain Health Garfield Memorial Hospital Panguitch, UT facility · percent of total billed charges · outpatientfrom % of charges | 1 | $22.4k | $22.4k | — | — | — | $22.4k – $22.4k |
| 24 | Gerald Champion Regional Medical Center Alamogordo, NM fee schedule · outpatient | 5 | $347 | $347 | — | — | — | $347 – $347 |
| 25 | Hackettstown Medical Center Hackettstown, NJ other · outpatient | 2 | $342 | $342 | — | — | — | $342 – $342 |
← Payers reporting HCPCS C1717 · Snapshot 20261111T120946Z-9134e7f7