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
XENFORM, 6 * 10CM
Low
$0
Average
$4.0k
Median
$2.1k
High
$40.9k
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Reflects negotiated fee schedule rates with commercial payers.
Showing only prices reported under the fee schedule methodology. Choose another in the filter above to change the chart. 392 hospitals; the 90th percentile is 32.8× 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.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Public Hospital Dis No 1 Skagit dba Skagit Valley Hospital Vernon, WA | $8.3k | $8.3k | $4.5k | 54% | 96–960 | $118 – $14.8k |
| 2 | Dignity Health Phoenix, AZ | $1.9k | $5.0k | $6.6k | 134% | 58–580 | $11 – $30.6k |
| 3 | Avera McKennan Hospital Sioux Falls, SD | $0 | $1.4k | $2.0k | 141% | 24–240 | $0 – $10.9k |
| 4 | Public Hospital District No 1 of Mason County Shelton, WA | $1.6k | $1.6k | — | — | 4–40 | $1.6k – $1.6k |
| 5 | Hutchinson Regional Medical Center, Inc. Hutchinson, KS | $291 | $291 | — | — | 1–10 | $291 – $798 |
| 6 | VHS Acquisition Subsidiary Number 9 Inc Natick, MA | $1.5k | $2.4k | $2.7k | 114% | — | $13 – $10.7k |
| 7 | VHS Acquisition Subsidiary Number 9 Inc Framingham, MA | $1.5k | $2.4k | $2.7k | 114% | — | $13 – $10.7k |
| 8 | Dukes Health System LLC Peru, IN | $1.6k | $2.1k | $2.0k | 96% | — | $18 – $16.4k |
| 9 | Northwest Texas Healthcare System, Inc. Amarillo, TX | $5.6k | $8.4k | $11.1k | 132% | — | $3 – $86.0k |
| 10 | Wellington Regional Medical Center Wellington, FL | $1.6k | $1.4k | $410 | 30% | — | $44 – $1.6k |
Ask Claude or any MCP client for HCPCS C1763 pricing at a specific hospital — see how to connect.