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
COLON CA SCRN NOT HI RSK IND
The 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.
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303 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · outpatient | 1 | $828.67 | $828.67 – $828.67 |
| 2 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient | 4 | $224.02 | $145.19 – $313.55 |
| 3 | Affinity Hospital LLC Birmingham, AL facility · fee schedule · outpatient | 1 | $808.09 | $808.09 – $808.09 |
| 4 | AnMed Health Anderson, SC professional · fee schedule · inpatient | 1 | $130.50 | $87.00 – $174.00 |
| 5 | AnMed Health Anderson, SC professional · fee schedule · outpatient | 1 | $130.50 | $87.00 – $174.00 |
| 6 | AnMed Health Cannon Pickens, SC professional · fee schedule · inpatient | 1 | $130.50 | $87.00 – $174.00 |
| 7 | AnMed Health Cannon Pickens, SC professional · fee schedule · outpatient | 1 | $130.50 | $87.00 – $174.00 |
| 8 | AnMed Piedmont Piedmont, SC professional · fee schedule · inpatient | 1 | $130.50 | $87.00 – $174.00 |
| 9 | AnMed Piedmont Piedmont, SC professional · fee schedule · outpatient | 1 | $238.55 | $159.03 – $318.06 |
| 10 | Aspirus Rhinelander Hospital Rhinelander, WI fee schedule · both | 1 | $165.57 | $165.57 – $165.57 |
| 11 | Aspirus Wisconsin Rapids Hospital Wisconsin Rapids, WI fee schedule · both | 1 | $165.57 | $165.57 – $165.57 |
| 12 | BERTRAND CHAFFEE HOSPITAL SPRINGVILLE, NY fee schedule · both | 3 | $167.09 | $159.64 – $170.82 |
| 13 | Baptist Medical Center-Attala Kosciusko, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $859.85 | $859.85 – $859.85 |
| 14 | Baptist Medical Center-Yazoo Yazoo City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $835.28 | $835.28 – $835.28 |
| 15 | Baptist Memorial Hospital - Leake Carthage, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $835.28 | $835.28 – $835.28 |
| 16 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $898.34 | $898.34 – $898.34 |
| 17 | Benefis Hospitals Inc Helena, MT other · outpatient | 1 | $911.71 | $911.71 – $911.71 |
| 18 | Bluffton Health System LLC Bluffton, IN facility · fee schedule · outpatient | 1 | $934.71 | $934.71 – $934.71 |
| 19 | Bon Secours Community Hospital Jervis, NY facility · fee schedule · outpatient | 1 | $6,220 | $6,220 – $6,220 |
| 20 | Brandon HMA LLC Brandon, MS facility · fee schedule · outpatient | 1 | $797.64 | $797.64 – $797.64 |
| 21 | Bullhead City Hospital Corporation City, AZ facility · fee schedule · outpatient | 1 | $992.34 | $992.34 – $992.34 |
| 22 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $877.08 | $877.08 – $877.08 |
| 23 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $903.63 | $903.63 – $903.63 |
| 24 | COLUMBIA MEMORIAL HOSPITAL Hudson, NY professional · fee schedule · outpatient | 4 | $254.91 | $163.54 – $358.75 |
| 25 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 2 | $1,054 | $1,029 – $1,079 |
← Payers reporting HCPCS G0121 · Snapshot 20261108T203506Z-bb90dbab