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
HC Revasc Intra Lithotrip-Stent
Low
$80
Average
$21.9k
Median
$17.3k
High
$58.1k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
136 hospitals; the 90th percentile is 2.7× 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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144 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 | ROBERT PACKER HOSPITAL Sayre, PA facility · other · outpatient | 2 | $33.7k | $33.7k | — | — | 1–10 | $33.7k – $33.7k |
| 2 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · outpatient | 1 | $16.3k | $16.3k | — | — | — | $16.3k – $16.3k |
| 3 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $58.1k | $58.1k | — | — | — | $58.1k – $58.1k |
| 4 | Beaufort Memorial Hospital Beaufort, SC facility · case rate · outpatient | 1 | $17.7k | $17.7k | — | — | — | $17.7k – $17.7k |
| 5 | Benefis Hospitals Inc Helena, MT other · outpatient | 1 | $18.0k | $18.0k | — | — | — | $18.0k – $18.0k |
| 6 | Bon Secours Community Hospital Jervis, NY facility · fee schedule · outpatient | 1 | $50k | $50k | — | — | — | $50k – $50k |
| 7 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · case rate · outpatient | 1 | $17.3k | $17.3k | — | — | — | $17.3k – $17.3k |
| 8 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $17.8k | $17.8k | — | — | — | $17.8k – $17.8k |
| 9 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 2 | $33.7k | $33.7k | — | — | — | $33.7k – $33.7k |
| 10 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient | 1 | $17.8k | $17.8k | — | — | — | $17.8k – $17.8k |
| 11 | CentraState Medical Center Freehold Township, NJ other · both | 2 | $20.8k | $20.8k | — | — | — | $20.8k – $20.8k |
| 12 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $19.6k | $19.6k | — | — | — | $19.6k – $19.6k |
| 13 | Central Maine Medical Center Lewiston, ME fee schedule · outpatient | 1 | $18.1k | $18.1k | — | — | — | $18.1k – $18.1k |
| 14 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $9.1k | $9.1k | $6.9k | 76% | — | $2.2k – $16.1k |
| 15 | Chilton Medical Center Pompton Plains, NJ other · both | 2 | $20.8k | $20.8k | — | — | — | $20.8k – $20.8k |
| 16 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $19.6k | $19.6k | — | — | — | $19.6k – $19.6k |
| 17 | Clarion Hospital Clarion, PA facility · case rate · outpatient | 1 | $17.3k | $17.3k | — | — | — | $17.3k – $17.3k |
| 18 | Conway Regional Medical Center Conway, AR facility · fee schedule · outpatient | 1 | $34.9k | $34.9k | — | — | — | $34.9k – $34.9k |
| 19 | Dallas Medical Center Dallas, TX fee schedule · outpatient | 1 | $16.0k | $16.0k | — | — | — | $16.0k – $16.0k |
| 20 | Desert Valley Hospital Victorville, CA fee schedule · outpatient | 2 | $23.5k | $23.5k | — | — | — | $23.5k – $23.5k |
| 21 | Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient | 1 | $20.8k | $20.8k | $5 | 0% | — | $20.8k – $20.8k |
| 22 | EAST BATON ROUGE MEDICAL CENTER, LLC Baton Rouge, LA other · outpatient | 1 | $16.5k | $16.5k | — | — | — | $16.5k – $16.5k |
| 23 | Eisenhower Medical Center Rancho Mirage, CA other · both | 3 | $23.6k | $23.6k | — | — | — | $23.6k – $23.6k |
| 24 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $16.6k | $16.6k | — | — | — | $16.6k – $16.6k |
| 25 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · both | 1 | $16.6k | $16.6k | — | — | — | $16.6k – $16.6k |
← Payers reporting HCPCS C9765 · Snapshot 20261111T120946Z-9134e7f7