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
BRACE ORTHO PLAYMAKER SLEEVE STD LG 21-23.5IN THIGH KNEE HINGED POPLITEAL CUTOUT DRYTEX
Low
$115
Average
$1.2k
Median
$556
High
$7.9k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
66 hospitals; the 90th percentile is 7.1× 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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73 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 | $156 | $189 | $57 | 30% | — | $156 – $288 |
| 2 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $542 | $542 | — | — | — | $542 – $542 |
| 3 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $669 | $669 | — | — | — | $669 – $669 |
| 4 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $797 | $797 | — | — | — | $797 – $797 |
| 5 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 2 | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 6 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · both | 1 | $797 | $797 | — | — | — | $797 – $797 |
| 7 | Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient | 1 | $453 | $453 | — | — | — | $453 – $453 |
| 8 | CentraState Medical Center Freehold Township, NJ fee schedule · both | 2 | $466 | $466 | $25 | 5% | — | $442 – $491 |
| 9 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $7.9k | $7.9k | — | — | — | $7.9k – $7.9k |
| 10 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $2.0k | $2.0k | $1.6k | 80% | — | $389 – $3.6k |
| 11 | Chilton Medical Center Pompton Plains, NJ fee schedule · both | 2 | $481 | $481 | $10 | 2% | — | $471 – $491 |
| 12 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $8.3k | $8.3k | — | — | — | $8.3k – $8.3k |
| 13 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $669 | $669 | — | — | — | $669 – $669 |
| 14 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $556 | $556 | — | — | — | $556 – $556 |
| 15 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · both | 1 | $556 | $556 | — | — | — | $556 – $556 |
| 16 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 17 | 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 | $189 | $189 | — | — | — | $189 – $189 |
| 18 | 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 | $159 | $159 | — | — | — | $159 – $159 |
| 19 | HOULTON REGIONAL HOSPITAL HOULTON, ME percent of total billed charges · outpatientfrom % of charges | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 20 | Hackettstown Medical Center Hackettstown, NJ fee schedule · both | 2 | $481 | $481 | $10 | 2% | — | $471 – $491 |
| 21 | Hackettstown Medical Center Hackettstown, NJ other · outpatient | 2 | $7.9k | $7.9k | — | — | — | $7.9k – $7.9k |
| 22 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $299 | $607 | $527 | 87% | — | $174 – $1.3k |
| 23 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $219 | $490 | $450 | 92% | — | $128 – $1.1k |
| 24 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital City, UT facility · fee schedule · outpatient | 1 | $452 | $452 | — | — | — | $452 – $452 |
| 25 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital Lehi, UT facility · fee schedule · outpatient | 1 | $452 | $452 | — | — | — | $452 – $452 |
← Payers reporting HCPCS L1833 · Snapshot 20261111T120946Z-9134e7f7