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
Mra Pelvis W&W/O Contrast
Low
$79
Average
$554
Median
$347
High
$5.8k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
152 hospitals; the 90th percentile is 2.5× 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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159 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 | Affinity Hospital LLC Birmingham, AL facility · fee schedule · outpatient | 1 | $303 | $303 | — | — | — | $303 – $303 |
| 2 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $340 | $340 | — | — | — | $340 – $340 |
| 3 | Ascension Cedar Park Park, TX fee schedule · outpatient | 1 | $439 | $439 | — | — | — | $439 – $439 |
| 4 | Ascension Seton Austin, TX fee schedule · outpatient | 1 | $439 | $439 | — | — | — | $439 – $439 |
| 5 | Ascension Seton Austin, TX fee schedule · outpatient | 1 | $439 | $439 | — | — | — | $439 – $439 |
| 6 | Ascension Seton Austin, TX fee schedule · outpatient | 1 | $439 | $439 | — | — | — | $439 – $439 |
| 7 | Ascension Seton Luling, TX fee schedule · outpatient | 1 | $439 | $439 | — | — | — | $439 – $439 |
| 8 | Ascension Seton Burnet, TX fee schedule · outpatient | 1 | $439 | $439 | — | — | — | $439 – $439 |
| 9 | Ascension Seton Smithville, TX fee schedule · outpatient | 1 | $439 | $439 | — | — | — | $439 – $439 |
| 10 | Ascension Seton Bastrop, TX fee schedule · outpatient | 1 | $439 | $439 | — | — | — | $439 – $439 |
| 11 | Ascension Seton Austin, TX fee schedule · outpatient | 1 | $439 | $439 | — | — | — | $439 – $439 |
| 12 | Baptist Memorial Hospital-Calhoun Calhoun City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 13 | Beaufort Memorial Hospital Beaufort, SC facility · case rate · outpatient | 1 | $352 | $352 | — | — | — | $352 – $352 |
| 14 | Boston Medical Center Boston, MA other · both | 1 | $403 | $403 | — | — | — | $403 – $403 |
| 15 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · case rate · outpatient | 1 | $344 | $344 | — | — | — | $344 – $344 |
| 16 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · both | 1 | $339 | $339 | — | — | — | $339 – $339 |
| 17 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 2 | $3.6k | $3.6k | $3.2k | 88% | — | $423 – $6.9k |
| 18 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · both | 1 | $339 | $339 | — | — | — | $339 – $339 |
| 19 | Campbell County HMA, LLC LaFollette, TN facility · fee schedule · outpatient | 1 | $309 | $309 | — | — | — | $309 – $309 |
| 20 | Centinela Hospital Medical Center Inglewood, CA fee schedule · outpatient | 1 | $447 | $447 | — | — | — | $447 – $447 |
| 21 | CentraState Medical Center Freehold Township, NJ fee schedule · both | 2 | $291 | $291 | $15 | 5% | — | $275 – $306 |
| 22 | CentraState Medical Center Freehold Township, NJ fee schedule · outpatient | 2 | $291 | $291 | $15 | 5% | — | $275 – $306 |
| 23 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 24 | Chilton Medical Center Pompton Plains, NJ fee schedule · both | 2 | $288 | $288 | $6 | 2% | — | $283 – $294 |
| 25 | Chilton Medical Center Pompton Plains, NJ fee schedule · outpatient | 2 | $288 | $288 | $6 | 2% | — | $283 – $294 |
← Payers reporting HCPCS C8920 · Snapshot 20261111T120946Z-9134e7f7