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
HB-Visco Gel Toe Spacer per Each
Low
$0
Average
$192
Median
$266
High
$434
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
16 hospitals; the 90th percentile is 22.3× 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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17 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 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $338 | $338 | — | — | — | $338 – $338 |
| 2 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $434 | $434 | $352 | 81% | — | $82 – $785 |
| 3 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $357 | $357 | $297 | 83% | — | $60 – $655 |
| 4 | Little Company of Mary Hospital of Indiana Inc Jasper, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 5 | Mayo Clinic Health System Sparta, WI professional · percent of total billed charges · outpatientfrom % of charges | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 6 | Mayo Clinic Health System Cannon Falls 55009-5003 facility · percent of total billed charges · bothfrom % of charges | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 7 | Mercy Hospital Healdton Inc Healdton, OK facility · percent of total billed charges · outpatientfrom % of charges | 2 | $56 | $56 | — | — | — | $56 – $56 |
| 8 | Mercy Love County Marietta, OK facility · percent of total billed charges · outpatientfrom % of charges | 1 | $70 | $70 | — | — | — | $70 – $70 |
| 9 | Northside Hospital, Inc. Lawrenceville, GA fee schedule · outpatient | 1 | $282 | $282 | — | — | — | $282 – $282 |
| 10 | Northside Hospital, Inc. Atlanta, GA fee schedule · outpatient | 1 | $282 | $282 | — | — | — | $282 – $282 |
| 11 | Northside Hospital, Inc. Cumming, GA fee schedule · outpatient | 1 | $282 | $282 | — | — | — | $282 – $282 |
| 12 | Northside Hospital, Inc. Duluth, GA fee schedule · outpatient | 1 | $282 | $282 | — | — | — | $282 – $282 |
| 13 | Northside Hospital, Inc. Canton, GA fee schedule · outpatient | 1 | $282 | $282 | — | — | — | $282 – $282 |
| 14 | San Juan Hospital Spanish Valley, UT facility · fee schedule · both | 3 | $65 | $65 | — | — | — | $65 – $65 |
| 15 | University Health Truman Medical Center Kansas City, MO facility · fee schedule · outpatient | 1 | $64 | $64 | $26 | 41% | — | $38 – $90 |
| 16 | Victor Valley Global Medical Center Victorville, CA facility · fee schedule · outpatient | 1 | $288 | $288 | — | — | — | $288 – $288 |
| 17 | Victor Valley Global Medical Center Victorville, CA professional · fee schedule · outpatient | 1 | $212 | $212 | — | — | — | $212 – $212 |
← Payers reporting HCPCS L2999 · Snapshot 20261111T120946Z-9134e7f7