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
Onlay cst base mtl >=3 surfa
Low
$1
Average
$1.3k
Median
$909
High
$4.9k
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Prices here combine facility and professional fees. See them separately →Experimental
Reflects negotiated fee schedule rates with commercial payers.
Showing only prices reported under the fee schedule methodology. Choose another in the filter above to change the chart. 193 hospitals; the 90th percentile is 9.1× 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.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | St. Anthony Shawnee Hospital, Inc Shawnee, OK | $575 | $575 | — | — | — | $575 – $575 |
| 2 | Mayo Regional Hospital Dover Foxcroft, ME | $537 | $588 | $288 | 49% | — | $315 – $1.1k |
| 3 | Baptist Medical Center of the Beaches, INC Beach, FL | $273 | $273 | — | — | — | $273 – $273 |
| 4 | Westfield Memorial Hospital Inc WESTFIELD, NY | $613 | $575 | $139 | 24% | — | $308 – $769 |
| 5 | Gundersen Luthern Medical Center Inc La Crosse, WI | $173 | $994 | $1.7k | 166% | — | $173 – $5.6k |
| 6 | Spohn Hospital Beeville Beeville, TX | $786 | $786 | — | — | — | $786 – $786 |
| 7 | Spohn Hospital Alice Alice, TX | $786 | $786 | — | — | — | $786 – $786 |
| 8 | OSF Saint Francis Medical Center Peoria, IL | $441 | $441 | — | — | — | $441 – $441 |
| 9 | Covenant Medical Center Lubbock, TX | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 10 | Corewell Health Butterworth Hospital Grand Rapids, MI | $431 | $430 | $88 | 21% | — | $311 – $545 |
Ask Claude or any MCP client for HCPCS D6613 pricing at a specific hospital — see how to connect.