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
L150CM BALLOON L100MM DIA2MM SHEATH 4FR GUIDEWIRE 0.014IN RATED BURST PRESSURE 14ATM OTW LOW COMPLIANT NON SCORED
Low
$136
Average
$884
Median
$722
High
$2.9k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
44 hospitals; the 90th percentile is 6.4× 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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54 hospital rates
iThe hospitals that file a Wellmark 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 | Avera Heart Hospital Sioux Falls, SD case rate · outpatient | 2 | $1.8k | $1.8k | — | — | 206 | $1.8k – $1.8k |
| 2 | Avera McKennan Hospital Sioux Falls, SD case rate · outpatient | 2 | $1.3k | $1.3k | — | — | 48 | $1.3k – $1.3k |
| 3 | Avera St. Luke's Aberdeen, SD outpatient | 1 | $600 | $600 | — | — | 15 | $600 – $600 |
| 4 | Avera St. Luke's Aberdeen, SD case rate · outpatient | 1 | $600 | $600 | — | — | 15 | $600 – $600 |
| 5 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · inpatient | 2 | $494 | $919 | $1.4k | 154% | — | $11 – $14.4k |
| 6 | ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA Missouri Valley, IA fee schedule · inpatient | 2 | $469 | $874 | $1.3k | 154% | — | $10 – $13.7k |
| 7 | Avera St. Anthony's Hospital O'Neill, NE percent of total billed charges · inpatientfrom % of charges | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 8 | Avera St. Anthony's Hospital O'Neill, NE percent of total billed charges · outpatientfrom % of charges | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 9 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $254 | $614 | $758 | 124% | — | $0 – $7.8k |
| 10 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $476 | $1.1k | $1.5k | 127% | — | $0 – $15.4k |
| 11 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763 | $763 | — | — | — | $763 – $763 |
| 12 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $399 | $995 | $1.4k | 141% | — | $0 – $15.1k |
| 13 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $352 | $915 | $1.3k | 146% | — | $0 – $14.4k |
| 14 | Mercy Fitzgerald Hospital Darby, PA facility · percent of total billed charges · bothfrom % of charges | 1 | $968 | $2.5k | $3.7k | 147% | — | $0 – $39.5k |
| 15 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $433 | $640 | $677 | 106% | — | $0 – $7.0k |
| 16 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $451 | $1.1k | $1.3k | 118% | — | $0 – $11.1k |
| 17 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $318 | $572 | $653 | 114% | — | $0 – $6.9k |
| 18 | Mercy Hospital of Franciscan Sisters Inc Oelwein, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $202 | $485 | $598 | 123% | — | $17 – $6.1k |
| 19 | Mercy Medical Center - Dyersville Dyersville, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $274 | $661 | $816 | 124% | — | $0 – $8.4k |
| 20 | Mercy Medical Center - New Hampton New Hampton, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $244 | $451 | $528 | 117% | — | $0 – $5.7k |
| 21 | MercyOne Genesis Aledo Medical Center Aledo, IL facility · case rate · both | 1 | $300 | $683 | $1.2k | 170% | — | $34 – $12.9k |
| 22 | MercyOne Genesis Aledo Medical Center Aledo, IL facility · case rate · outpatient | 1 | $282 | $282 | — | — | — | $282 – $282 |
| 23 | MercyOne Genesis Aledo Medical Center Aledo, IL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $174 | $396 | $672 | 170% | — | $20 – $7.5k |
| 24 | MercyOne Genesis Aledo Medical Center Aledo, IL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $141 | $321 | $545 | 170% | — | $16 – $6.1k |
| 25 | MercyOne Genesis DeWitt Medical Center DeWitt, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $150 | $342 | $580 | 170% | — | $17 – $6.5k |
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