Low
$7
Average
$69
Median
$45
High
$155
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4 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 | Garfield County, a political subdivision of the State of Utah, DBA Intermountain Health Garfield Memorial Hospital Panguitch, UT facility · percent of total billed charges · inpatientfrom % of charges | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 2 | Garfield County, a political subdivision of the State of Utah, DBA Intermountain Health Garfield Memorial Hospital Panguitch, UT facility · percent of total billed charges · outpatientfrom % of charges | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 3 | Pennsylvania Hospital of the University of Pennsylvania Health System Philadelphia, PA facility · fee schedule · outpatient | 1 | $45 | $45 | — | — | — | $45 – $45 |
| 4 | The Chester County Hospital West Chester, PA facility · fee schedule · outpatient | 1 | $155 | $155 | — | — | — | $155 – $155 |
← Payers reporting HCPCS G9876 · Snapshot 20261112T181611Z-3fa9fb76