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
facility
Low
$1
Average
$5.4k
Median
$23
High
$50k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
72 hospitals; the 90th percentile is 1022.5× 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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75 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 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 2 | Bon Secours Community Hospital Jervis, NY facility · fee schedule · outpatient | 1 | $50k | $50k | — | — | — | $50k – $50k |
| 3 | Boston Medical Center Boston, MA other · both | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 4 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 5 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 6 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 2 | $6 | $6 | — | — | — | $6 – $6 |
| 7 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 8 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $8.6k | $8.6k | $1.7k | 20% | — | $6.9k – $10.3k |
| 9 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 10 | Conway Regional Medical Center Conway, AR facility · fee schedule · outpatient | 1 | $24.4k | $24.4k | $4.9k | 20% | — | $19.5k – $29.2k |
| 11 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 12 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 13 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 14 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 15 | Good Samaritan Hospital Suffern, NY facility · fee schedule · outpatient | 1 | $50k | $50k | — | — | — | $50k – $50k |
| 16 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $24.4k | $24.4k | $4.9k | 20% | — | $19.5k – $29.3k |
| 17 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · inpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 18 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 19 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $20.7k | $20.7k | $4.1k | 20% | — | $16.6k – $24.9k |
| 20 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital City, UT facility · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 21 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital Lehi, UT facility · fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 22 | Kaleida Health Buffalo, NY fee schedule · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 23 | LECONTE MEDICAL CENTER Sevierville, TN fee schedule · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 24 | Lake Charles Memorial Hospital Charles., LA fee schedule · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 25 | Little Company of Mary Hospital of Indiana Inc Jasper, IN facility · case rate · outpatient | 1 | $20 | $20 | — | — | — | $20 – $20 |
← Payers reporting HCPCS J0741 · Snapshot 20261111T120946Z-9134e7f7