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
Ko Elas W/ Condyle Pads Ots
Low
$109
Average
$219
Median
$233
High
$458
Each hospital's average First Health rate, under the methodology and billing class chosen below.
15 hospitals; the 90th percentile is 2.6× 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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24 hospital rates
iThe hospitals that file a First Health 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 | Bexar County Hospital District San Antonio, TX fee schedule · outpatient | 1 | $162 | $162 | — | — | — | $162 – $162 |
| 2 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $109 | $109 | — | — | — | $109 – $109 |
| 3 | Davis Medical Center Elkins, WV professional · fee schedule · both | 1 | $109 | $109 | — | — | — | $109 – $109 |
| 4 | Fairview Bethesda Hospital St. Paul, MN percent of total billed charges · inpatientfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 5 | Fairview Bethesda Hospital St. Paul, MN percent of total billed charges · outpatientfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 6 | Fairview Health Services Edina, MN percent of total billed charges · inpatientfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 7 | Fairview Health Services Edina, MN percent of total billed charges · outpatientfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 8 | Fairview Health Services Minneapolis, MN percent of total billed charges · inpatientfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 9 | Fairview Health Services Minneapolis, MN percent of total billed charges · outpatientfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 10 | Fairview Health Services Burnsville, MN percent of total billed charges · inpatientfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 11 | Fairview Health Services Burnsville, MN percent of total billed charges · outpatientfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 12 | Fairview Health Services Wyoming, MN percent of total billed charges · inpatientfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 13 | Fairview Health Services Wyoming, MN percent of total billed charges · outpatientfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 14 | Fairview Health Services Princeton, MN percent of total billed charges · inpatientfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 15 | Fairview Health Services Princeton, MN percent of total billed charges · outpatientfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 16 | HealthEast St John's Hospital Maplewood, MN percent of total billed charges · inpatientfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 17 | HealthEast St John's Hospital Maplewood, MN percent of total billed charges · outpatientfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 18 | HealthEast Woodwinds Hospital Woodbury, MN percent of total billed charges · inpatientfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 19 | HealthEast Woodwinds Hospital Woodbury, MN percent of total billed charges · outpatientfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 20 | Mayo Clinic Arizona Phoenix, AZ professional · percent of total billed charges · outpatientfrom % of charges | 1 | $158 | $158 | — | — | — | $158 – $158 |
| 21 | OREGON HEALTH & SCIENCE UNIVERSITY PORTLAND, OR percent of total billed charges · outpatientfrom % of charges | 1 | $458 | $458 | — | — | — | $458 – $458 |
| 22 | UNIVERSITY OF MICHIGAN HEALTH Ann Arbor, MI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $323 | $323 | — | — | — | $323 – $323 |
| 23 | UNIVERSITY OF MICHIGAN HEALTH Ann Arbor, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $323 | $323 | — | — | — | $323 – $323 |
| 24 | Webster Memorial Hospital Inc Cowen, WV professional · fee schedule · both | 1 | $109 | $109 | — | — | — | $109 – $109 |
← Payers reporting HCPCS L1821 · Snapshot 20261111T120946Z-9134e7f7