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
Hiv 1/2 Scrn
Low
$10
Average
$13
Median
$12
High
$116
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
79 hospitals; the 90th percentile is 1.3× 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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79 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 | Affinity Hospital LLC Birmingham, AL facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 2 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 3 | Brandon HMA LLC Brandon, MS facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 4 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 5 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 6 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 7 | Campbell County HMA, LLC LaFollette, TN facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 8 | Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 9 | Carlsbad Medical Center LLC Carlsbad, NM facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 10 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 11 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · fee schedule · outpatient | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 12 | Cocke County HMA, LLC Newport, TN facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 13 | Crestview Hospital Corporation Crestview, FL facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 14 | Dallas Regional Medical Center Mesquite, TX fee schedule · outpatient | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 15 | EAST BATON ROUGE MEDICAL CENTER, LLC Baton Rouge, LA fee schedule · outpatient | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 16 | East Georgia Regional Medical Center LLC Statesboro, GA facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 17 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $116 | $116 | $103 | 89% | — | $13 – $219 |
| 18 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 19 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 20 | Foley Hospital Company LLC Foley, AL facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 21 | Gadsden Regional Medical Center LLC Gadsden, AL facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 22 | Garden Grove Hospital Medical Center Grove, CA fee schedule · outpatient | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 23 | Gouverneur Hospital Gouverneur, NY facility · fee schedule · outpatient | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 24 | Granbury Hospital Corporation Granbury, TX facility · fee schedule · outpatient | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 25 | HMA Santa Rosa Medical Center LLC Milton, FL facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
← Payers reporting HCPCS G0435 · Snapshot 20261111T120946Z-9134e7f7