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
$40
Average
$458
Median
$272
High
$1.5k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
14 hospitals; the 90th percentile is 18.7× 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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16 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 | Aspen Valley Hospital District Aspen, CO facility · percent of total billed charges · bothfrom % of charges | 4 | $71 | $71 | $27 | 37% | — | $46 – $131 |
| 2 | Conway Regional Medical Center Conway, AR facility · fee schedule · outpatient | 1 | $311 | $311 | $8 | 2% | — | $303 – $319 |
| 3 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $1.1k | $1.1k | $45 | 4% | — | $1.0k – $1.1k |
| 4 | 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 | $56 | $56 | — | — | — | $56 – $56 |
| 5 | 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 | $47 | $47 | — | — | — | $47 – $47 |
| 6 | Glenwood Regional Medical Center - HSA West Monroe, LA facility · fee schedule · outpatient | 1 | $1.9k | $1.5k | $1.1k | 75% | — | $52 – $3.0k |
| 7 | HOULTON REGIONAL HOSPITAL HOULTON, ME percent of total billed charges · bothfrom % of charges | 1 | $34 | $37 | $18 | 49% | — | $17 – $62 |
| 8 | HOULTON REGIONAL HOSPITAL HOULTON, ME percent of total billed charges · outpatientfrom % of charges | 1 | $33 | $42 | $33 | 78% | — | $10 – $120 |
| 9 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $26 | $95 | $110 | 116% | — | $25 – $277 |
| 10 | Hospital Service District #1, Parish of Terrebonne, State of Louisiana dba Terrebonne General Health System Houma, LA facility · fee schedule · outpatient | 1 | $493 | $929 | $1.0k | 110% | — | $31 – $3.8k |
| 11 | KAPLAN GENERAL HOSPITAL, INC ST, LA percent of total billed charges · outpatientfrom % of charges | 1 | $441 | $574 | $405 | 71% | — | $240 – $1.4k |
| 12 | Mid Hudson Regional Hospital Poughkeepsie, NY facility · fee schedule · outpatient | 1 | $534 | $624 | $616 | 99% | — | $19 – $1.8k |
| 13 | OCHSNER BAYOU LLC Raceland, LA percent of total billed charges · outpatientfrom % of charges | 1 | $103 | $233 | $204 | 88% | — | $23 – $587 |
| 14 | ST MARTIN HOSPITAL INC Breaux Bridge, LA percent of total billed charges · outpatientfrom % of charges | 1 | $186 | $226 | $204 | 90% | — | $13 – $727 |
| 15 | VALLEY REGIONAL HOSPITAL CLAREMONT, NH percent of total billed charges · bothfrom % of charges | 1 | $45 | $62 | $41 | 67% | — | $16 – $144 |
| 16 | Westchester Medical Center Valhalla, NY facility · fee schedule · outpatient | 1 | $534 | $624 | $616 | 99% | — | $19 – $1.8k |
← Payers reporting HCPCS J3535 · Snapshot 20261111T120946Z-9134e7f7