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
INTRDCR SHTH ANSEL3 6FX45CM .018/.038 HYDROPHILIC COATING
The hospitals that file a Premera 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.
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34 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | COMMONSPIRIT OREGON Roseburg, OR fee schedule · inpatient | 1 | $447.04 | $6.56 – $6,724 |
| 2 | COMMONSPIRIT OREGON Roseburg, OR fee schedule · outpatient | 1 | $475.70 | $6.98 – $7,155 |
| 3 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · outpatient | 1 | $18,691 | $10,678 – $26,704 |
| 4 | Central Washington Health Services Association Wenatchee, WA percent of total billed charges · bothfrom % of charges | 3 | $505.13 | $13.40 – $3,525 |
| 5 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · outpatient | 1 | $15,008 | $3,312 – $26,704 |
| 6 | ENUMCLAW REGIONAL HOSPITAL ASSOCIATION Enumclaw, WA fee schedule · outpatient | 1 | $177.18 | $8.23 – $1,842 |
| 7 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $417.69 | $0.03 – $15,350 |
| 8 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763.00 | $763.00 – $763.00 |
| 9 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $84.28 | $22.75 – $107.60 |
| 10 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $356.81 | $0.02 – $15,068 |
| 11 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $316.26 | $0.02 – $14,370 |
| 12 | Mercy Fitzgerald Hospital Darby, PA facility · percent of total billed charges · bothfrom % of charges | 1 | $873.86 | $0.06 – $39,518 |
| 13 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $227.36 | $0.02 – $7,010 |
| 14 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $378.25 | $0.03 – $11,054 |
| 15 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $224.62 | $0.02 – $6,949 |
| 16 | Nazareth Hospital Philadelphia, PA facility · percent of total billed charges · bothfrom % of charges | 1 | $876.86 | $0.06 – $39,518 |
| 17 | PORTLAND ADVENTIST MEDICAL CENTER Portland, OR percent of total billed charges · outpatientfrom % of charges | 1 | $930.48 | $16.00 – $25,309 |
| 18 | Public Hospital Dis No 1 Skagit dba Skagit Valley Hospital Vernon, WA fee schedule · both | 1 | $14,757 | $14,757 – $14,757 |
| 19 | Public Hospital Dist No 1 Skagit dba Cascade Valley Hospital Arlington, WA fee schedule · both | 1 | $12,059 | $12,059 – $12,059 |
| 20 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $389.20 | $0.04 – $13,234 |
| 21 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $316.99 | $0.04 – $10,738 |
| 22 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $323.76 | $0.04 – $10,738 |
| 23 | Samaritan Hospital Troy, NY facility · percent of total billed charges · bothfrom % of charges | 1 | $218.13 | $0.02 – $9,879 |
| 24 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $169.54 | $0.01 – $5,176 |
| 25 | St Joseph Mercy Chelsea Chelsea, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $117.66 | $1.48 – $2,853 |
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