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
SLEEVE ORTHO CTI SPORT LG 15-18IN MID-PATELLA KNEE
Low
$21
Average
$86
Median
$91
High
$153
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
25 hospitals; the 90th percentile is 3.0× 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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42 hospital rates
iThe hospitals that file a Wellmark 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 | Allen Memorial Hospital Corporation Waterloo, IA case rate · outpatient | 1 | $77 | $77 | — | — | — | $77 – $77 |
| 2 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 3 | $96 | $96 | — | — | — | $96 – $96 |
| 3 | Avera Creighton Hospital Creighton, NE percent of total billed charges · inpatientfrom % of charges | 1 | $143 | $143 | — | — | — | $143 – $143 |
| 4 | Avera Creighton Hospital Creighton, NE percent of total billed charges · outpatientfrom % of charges | 1 | $143 | $143 | — | — | — | $143 – $143 |
| 5 | Avera Gregory Hospital Gregory, SD percent of total billed charges · inpatientfrom % of charges | 1 | $59 | $59 | $2 | 3% | — | $56 – $61 |
| 6 | Avera Gregory Hospital Gregory, SD percent of total billed charges · outpatientfrom % of charges | 1 | $59 | $59 | $2 | 3% | — | $56 – $61 |
| 7 | Avera Sacred Heart Hospital Yankton, SD percent of total billed charges · inpatientfrom % of charges | 1 | $59 | $59 | $2 | 3% | — | $56 – $61 |
| 8 | Avera Sacred Heart Hospital Yankton, SD percent of total billed charges · outpatientfrom % of charges | 1 | $59 | $59 | $2 | 3% | — | $56 – $61 |
| 9 | Avera St. Anthony's Hospital O'Neill, NE percent of total billed charges · inpatientfrom % of charges | 1 | $41 | $41 | $1 | 3% | — | $40 – $42 |
| 10 | Avera St. Anthony's Hospital O'Neill, NE percent of total billed charges · outpatientfrom % of charges | 1 | $41 | $41 | $1 | 3% | — | $40 – $42 |
| 11 | Central Iowa Hospital Corporation Des Moines, IA case rate · outpatient | 1 | $77 | $77 | — | — | — | $77 – $77 |
| 12 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 3 | $96 | $96 | — | — | — | $96 – $96 |
| 13 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 3 | $96 | $96 | — | — | — | $96 – $96 |
| 14 | Grinnell Regional Medical Center Grinnell, IA case rate · outpatient | 1 | $100 | $100 | — | — | — | $100 – $100 |
| 15 | Grinnell Regional Medical Center Grinnell, IA fee schedule · both | 3 | $96 | $96 | — | — | — | $96 – $96 |
| 16 | Northwest Iowa Hospital Corporation Sioux City, IA case rate · outpatient | 1 | $77 | $77 | — | — | — | $77 – $77 |
| 17 | Northwest Iowa Hospital Corporation Sioux City, IA fee schedule · both | 3 | $96 | $96 | — | — | — | $96 – $96 |
| 18 | Sanford Chamberlain Medical Center Chamberlain, SD percent of total billed charges · inpatientfrom % of charges | 1 | $54 | $191 | $193 | 101% | — | $54 – $464 |
| 19 | Sanford Chamberlain Medical Center Chamberlain, SD percent of total billed charges · outpatientfrom % of charges | 2 | $53 | $134 | $156 | 116% | — | $23 – $458 |
| 20 | Sanford Clear Lake Medical Center Clear Lake, SD percent of total billed charges · inpatientfrom % of charges | 1 | $124 | $124 | — | — | — | $124 – $124 |
| 21 | Sanford Clear Lake Medical Center Clear Lake, SD percent of total billed charges · outpatientfrom % of charges | 2 | $101 | $101 | $22 | 22% | — | $79 – $123 |
| 22 | Sanford Jackson Hospital Jackson, MN percent of total billed charges · outpatientfrom % of charges | 1 | $19 | $21 | $5 | 24% | — | $19 – $32 |
| 23 | Sanford Sheldon Medical Center Sheldon, IA percent of total billed charges · inpatientfrom % of charges | 2 | $47 | $41 | $9 | 21% | — | $29 – $49 |
| 24 | Sanford Tracy Hospital Tracy, MN percent of total billed charges · outpatientfrom % of charges | 1 | $40 | $33 | $12 | 35% | — | $17 – $44 |
| 25 | Sanford Westbrook Hospital Westbrook, MN percent of total billed charges · outpatientfrom % of charges | 1 | $44 | $36 | $13 | 35% | — | $18 – $49 |
← Payers reporting HCPCS L1812 · Snapshot 20261111T120946Z-9134e7f7