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 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.
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79 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · inpatient | 2 | $294.31 | $0.03 – $8,784 |
| 2 | ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA Missouri Valley, IA fee schedule · inpatient | 2 | $279.60 | $0.03 – $8,345 |
| 3 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · inpatientfrom % of charges | 1 | $42,872 | $42,872 – $42,872 |
| 4 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · outpatientfrom % of charges | 1 | $42,872 | $42,872 – $42,872 |
| 5 | Avera Heart Hospital Sioux Falls, SD case rate · outpatient | 2 | $185.60 | $185.60 – $185.60 |
| 6 | Avera Holy Family Hospital Estherville, IA percent of total billed charges · inpatientfrom % of charges | 2 | $53.59 | $53.59 – $53.59 |
| 7 | Avera McKennan Hospital Sioux Falls, SD case rate · outpatient | 2 | $173.86 | $173.86 – $173.86 |
| 8 | Avera St. Benedicts Parkston, SD outpatient | 1 | $63.14 | $63.14 – $63.14 |
| 9 | Avera St. Benedicts Parkston, SD percent of total billed charges · inpatientfrom % of charges | 1 | $62.76 | $62.76 – $62.76 |
| 10 | Avera St. Benedicts Parkston, SD percent of total billed charges · outpatientfrom % of charges | 1 | $62.76 | $62.76 – $62.76 |
| 11 | Avera St. Luke's Aberdeen, SD outpatient | 1 | $223.08 | $223.08 – $223.08 |
| 12 | Avera St. Luke's Aberdeen, SD case rate · outpatient | 1 | $223.08 | $223.08 – $223.08 |
| 13 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · outpatient | 2 | $18,691 | $10,678 – $26,704 |
| 14 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · other · outpatient | 1 | $17,490 | $9,992 – $24,988 |
| 15 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $228.66 | $0.01 – $7,785 |
| 16 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · outpatient | 2 | $15,008 | $3,312 – $26,704 |
| 17 | Covenant Medical Center Inc Waterloo, IA facility · other · outpatient | 1 | $13,978 | $3,085 – $24,871 |
| 18 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · case rate · both | 2 | $107.00 | $107.00 – $107.00 |
| 19 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · percent of total billed charges · inpatientfrom % of charges | 1 | $88.81 | $88.81 – $88.81 |
| 20 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $55.11 | $54.57 – $55.64 |
| 21 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $417.69 | $0.03 – $15,350 |
| 22 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763.00 | $763.00 – $763.00 |
| 23 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 1 | $84.28 | $22.75 – $107.60 |
| 24 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $356.81 | $0.02 – $15,068 |
| 25 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $316.26 | $0.02 – $14,370 |
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