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.
Generation details were not recorded for this description.
Original text from hospital filings
DEVICE HEMOSTATIC SYSTEM FIBRIN SEALANT STANDARD SYRINGE FROZEN STERILE DISPOSABLE PRIMA 2ML
Low
$126
Average
$311
Median
$153
High
$1.4k
Each hospital's average Amerihealth Caritas rate, under the methodology and billing class chosen below.
26 hospitals; the 90th percentile is 4.4× 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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28 hospital rates
iThe hospitals that file a Amerihealth Caritas 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 | Henry Ford Health System West Bloomfield, MI facility · fee schedule · outpatient | 1 | $140 | $140 | — | — | — | $140 – $140 |
| 2 | Henry Ford Health System Plymouth, MI facility · fee schedule · outpatient | 1 | $140 | $140 | — | — | — | $140 – $140 |
| 3 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI facility · fee schedule · outpatient | 1 | $140 | $140 | — | — | — | $140 – $140 |
| 4 | Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI facility · fee schedule · outpatient | 1 | $140 | $140 | — | — | — | $140 – $140 |
| 5 | Lancaster General Health Lancaster, PA facility · fee schedule · outpatient | 1 | $145 | $145 | — | — | — | $145 – $145 |
| 6 | Lancaster General Health Lancaster, PA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 7 | MedStar Franklin Square Medical Center Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $250 | $250 | $14 | 6% | — | $236 – $264 |
| 8 | MedStar Good Samaritan Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $722 | $722 | $40 | 6% | — | $682 – $762 |
| 9 | MedStar Harbor Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $592 | $592 | $33 | 6% | — | $559 – $625 |
| 10 | MedStar Montgomery Medical Center Olney, MD percent of total billed charges · outpatientfrom % of charges | 1 | $327 | $327 | $18 | 6% | — | $309 – $345 |
| 11 | MedStar Southern Hospital Center Clinton, MD percent of total billed charges · outpatientfrom % of charges | 1 | $469 | $469 | $26 | 6% | — | $443 – $495 |
| 12 | MedStar St. Mary's Hospital Leonardtown, MD percent of total billed charges · outpatientfrom % of charges | 1 | $263 | $263 | $15 | 6% | — | $249 – $278 |
| 13 | MedStar Union Memorial Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $584 | $584 | $32 | 6% | — | $552 – $617 |
| 14 | Penn State Health Hampden Medical Center Enola, PA fee schedule · both | 2 | $126 | $126 | $10 | 8% | — | $115 – $136 |
| 15 | Penn State Health Lancaster Medical Center Lancaster, PA fee schedule · both | 2 | $126 | $126 | $10 | 8% | — | $116 – $136 |
| 16 | Penn State Health Milton S. Hershey Medical Center Hershey, PA fee schedule · both | 2 | $136 | $136 | $11 | 8% | — | $125 – $147 |
| 17 | Rex Hospital, Inc. Holly Springs, NC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $197 | $197 | — | — | — | $197 – $197 |
| 18 | St Joseph Regional Health Network Reading, PA fee schedule · both | 2 | $131 | $131 | $11 | 8% | — | $120 – $141 |
| 19 | UPMC Altoona Altoona, PA facility · fee schedule · outpatient | 1 | $153 | $153 | — | — | — | $153 – $153 |
| 20 | UPMC Childrens Hospital of Pittsburgh Pittsburgh, PA facility · fee schedule · outpatient | 1 | $153 | $153 | — | — | — | $153 – $153 |
| 21 | UPMC Childrens Hospital of Pittsburgh Pittsburgh, PA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $967 | $967 | $64 | 7% | — | $903 – $1.0k |
| 22 | UPMC Cole Coudersport, PA facility · percent of total billed charges · outpatientfrom % of charges | 3 | $172 | $171 | $2 | 1% | — | $168 – $172 |
| 23 | UPMC Hamot Erie, PA facility · fee schedule · outpatient | 1 | $153 | $153 | — | — | — | $153 – $153 |
| 24 | UPMC Magee-Womens Hospital Pittsburgh, PA facility · fee schedule · outpatient | 1 | $153 | $153 | — | — | — | $153 – $153 |
| 25 | UPMC Mercy Pittsburgh, PA facility · fee schedule · outpatient | 1 | $153 | $153 | — | — | — | $153 – $153 |
← Payers reporting HCPCS C9250 · Snapshot 20261111T120946Z-9134e7f7