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 swedish type pre ots
Low
$204
Average
$260
Median
$252
High
$332
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
21 hospitals; the 90th percentile is 1.5× 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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21 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 | $245 | $245 | — | — | — | $245 – $245 |
| 2 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $294 | $294 | — | — | — | $294 – $294 |
| 3 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $312 | $312 | — | — | — | $312 – $312 |
| 4 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient | 1 | $312 | $312 | — | — | — | $312 – $312 |
| 5 | Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient | 1 | $205 | $205 | — | — | — | $205 – $205 |
| 6 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $294 | $294 | — | — | — | $294 – $294 |
| 7 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $252 | $252 | — | — | — | $252 – $252 |
| 8 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $252 | $252 | — | — | — | $252 – $252 |
| 9 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital City, UT facility · fee schedule · outpatient | 1 | $204 | $204 | — | — | — | $204 – $204 |
| 10 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital Lehi, UT facility · fee schedule · outpatient | 1 | $204 | $204 | — | — | — | $204 – $204 |
| 11 | LECONTE MEDICAL CENTER Sevierville, TN fee schedule · outpatient | 1 | $312 | $312 | — | — | — | $312 – $312 |
| 12 | Little Company of Mary Hospital of Indiana Inc Jasper, IN facility · case rate · outpatient | 1 | $250 | $250 | — | — | — | $250 – $250 |
| 13 | MCLAREN FLINT FLINT, MI fee schedule | 1 | $214 | $214 | — | — | — | $214 – $214 |
| 14 | MCLAREN GREATER LANSING LANSING, MI fee schedule | 1 | $209 | $209 | — | — | — | $209 – $209 |
| 15 | METHODIST MEDICAL CENTER OF OAK RIDGE Oak Ridge, TN fee schedule · outpatient | 1 | $252 | $252 | — | — | — | $252 – $252 |
| 16 | MORRISTOWN HAMBLEN HOSPITAL ASSOCIATION Morristown, TN fee schedule · outpatient | 1 | $252 | $252 | — | — | — | $252 – $252 |
| 17 | Mercy Hospital Ardmore Inc Ardmore, OK facility · fee schedule · outpatient | 1 | $311 | $311 | — | — | — | $311 – $311 |
| 18 | PARKWEST MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $252 | $252 | — | — | — | $252 – $252 |
| 19 | PARKWEST MEDICAL CENTER Louisville, TN fee schedule · outpatient | 1 | $252 | $252 | — | — | — | $252 – $252 |
| 20 | Public Hospital District NO 2 Skagit County Washington Anacortes, WA facility · fee schedule · outpatient | 1 | $332 | $332 | — | — | — | $332 – $332 |
| 21 | ROANE COUNTY MEDICAL CENTER Harriman, TN fee schedule · outpatient | 1 | $252 | $252 | — | — | — | $252 – $252 |
← Payers reporting HCPCS L1850 · Snapshot 20261112T181611Z-3fa9fb76