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
Rep cast part frame man
Low
$156
Average
$156
Median
$156
High
$156
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1 hospital rate
iThe hospitals that file a Bcbs Vt 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 | Mary Hitchcock Memorial Hospital Lebanon, NH professional · fee schedule · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
← Payers reporting HCPCS D5621 · Snapshot 20261112T181611Z-3fa9fb76