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
HC Add Le Lamin/Prepreg Carbon Graphite P/Seg T1
Low
$80
Average
$155
Median
$157
High
$225
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
28 hospitals; the 90th percentile is 1.1× 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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29 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 | $158 | $158 | — | — | — | $158 – $158 |
| 2 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $154 | $154 | — | — | — | $154 – $154 |
| 3 | Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient | 1 | $141 | $141 | — | — | — | $141 – $141 |
| 4 | Central Maine Medical Center Lewiston, ME fee schedule · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 5 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $154 | $154 | — | — | — | $154 – $154 |
| 6 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $161 | $161 | — | — | — | $161 – $161 |
| 7 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $161 | $161 | — | — | — | $161 – $161 |
| 8 | 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 | $245 | $245 | — | — | — | $245 – $245 |
| 9 | 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 | $206 | $206 | — | — | — | $206 – $206 |
| 10 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital City, UT facility · fee schedule · outpatient | 1 | $159 | $159 | — | — | — | $159 – $159 |
| 11 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital Lehi, UT facility · fee schedule · outpatient | 1 | $159 | $159 | — | — | — | $159 – $159 |
| 12 | Jefferson Health - Northeast Langhorne, PA facility · fee schedule · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 13 | Jefferson Health - Northeast Philadelphia, PA facility · fee schedule · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 14 | Jefferson Health - Northeast Philadelphia, PA facility · fee schedule · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 15 | Kennedy University Hospital, Inc Turnersville, NJ facility · fee schedule · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 16 | Kennedy University Hospital, Inc Cherry Hill, NJ facility · fee schedule · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 17 | Kennedy University Hospital, Inc Stratford, NJ facility · fee schedule · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 18 | Lansdale Hospital Corp Lansdale, PA facility · fee schedule · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 19 | Little Company of Mary Hospital of Indiana Inc Jasper, IN facility · case rate · outpatient | 1 | $159 | $159 | — | — | — | $159 – $159 |
| 20 | METHODIST MEDICAL CENTER OF OAK RIDGE Oak Ridge, TN fee schedule · outpatient | 1 | $161 | $161 | — | — | — | $161 – $161 |
| 21 | MORRISTOWN HAMBLEN HOSPITAL ASSOCIATION Morristown, TN fee schedule · outpatient | 1 | $161 | $161 | — | — | — | $161 – $161 |
| 22 | Mercy Hospital Healdton Inc Healdton, OK facility · percent of total billed charges · outpatientfrom % of charges | 2 | $80 | $80 | — | — | — | $80 – $80 |
| 23 | Mercy Hospital Oklahoma City Inc City, OK facility · fee schedule · outpatient | 1 | $158 | $158 | — | — | — | $158 – $158 |
| 24 | Mercy Love County Marietta, OK facility · percent of total billed charges · outpatientfrom % of charges | 1 | $100 | $100 | — | — | — | $100 – $100 |
| 25 | PARKWEST MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $161 | $161 | — | — | — | $161 – $161 |
← Payers reporting HCPCS L2755 · Snapshot 20261111T120946Z-9134e7f7