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
SPLINT ORTHO LG 11IN LT FOREARM WRIST NON-PERFORATED PALMAR/DORSAL STAY HK-LOOP CLOSURE BROWN
Low
$0
Average
$225
Median
$159
High
$916
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
29 hospitals; the 90th percentile is 764.2× 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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30 hospital rates
iThe hospitals that file a Medicaid 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 | Allina Health Systems Shakopee, MN facility · fee schedule · outpatient | 1 | $128 | $159 | $105 | 66% | — | $25 – $279 |
| 2 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · fee schedule · outpatient | 1 | $128 | $159 | $105 | 66% | — | $25 – $279 |
| 3 | Allina Health Systems Owatonna, MN facility · fee schedule · outpatient | 1 | $128 | $159 | $105 | 66% | — | $25 – $279 |
| 4 | Allina Health Systems Ulm, MN facility · other · outpatient | 1 | $49 | $69 | $50 | 73% | — | $10 – $147 |
| 5 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · fee schedule · outpatient | 1 | $128 | $159 | $105 | 66% | — | $25 – $279 |
| 6 | Allina Health Systems Cambridge, MN facility · fee schedule · outpatient | 1 | $128 | $159 | $105 | 66% | — | $25 – $279 |
| 7 | Allina Health Systems River Falls, WI facility · fee schedule · outpatient | 1 | $128 | $159 | $105 | 66% | — | $25 – $279 |
| 8 | Allina Health Systems Minneapolis, MN facility · fee schedule · outpatient | 1 | $128 | $159 | $105 | 66% | — | $25 – $279 |
| 9 | Allina Health Systems Buffalo, MN facility · fee schedule · outpatient | 1 | $128 | $159 | $105 | 66% | — | $25 – $279 |
| 10 | Brookings Health System Brookings, SD fee schedule · outpatient | 1 | $14 | $14 | $0 | 3% | — | $14 – $15 |
| 11 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $236 | $236 | — | — | — | $236 – $236 |
| 12 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CROWN POINT CROWN POINT, IN fee schedule · both | 14 | $274 | $287 | $23 | 8% | — | $274 – $329 |
| 13 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH DYER DYER, IN fee schedule · both | 14 | $274 | $286 | $23 | 8% | — | $274 – $329 |
| 14 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MICHIGAN CITY CITY, IN fee schedule · both | 2 | $302 | $302 | $27 | 9% | — | $274 – $329 |
| 15 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MICHIGAN CITY LAPORTE PORTE, IN fee schedule · both | 2 | $302 | $302 | $27 | 9% | — | $274 – $329 |
| 16 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MUNSTER MUNSTER, IN fee schedule · both | 2 | $302 | $302 | $27 | 9% | — | $274 – $329 |
| 17 | Geisinger Community Medical Center Scranton, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 18 | Geisinger Medical Center Muncy, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 19 | Geisinger Wyoming Valley Wilkes-Barre, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 20 | Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges | 1 | $764 | $764 | — | — | — | $764 – $764 |
| 21 | MELROSEWAKEFIELD HEALTHCARE Medford, MA percent of total billed charges · bothfrom % of charges | 1 | $764 | $764 | — | — | — | $764 – $764 |
| 22 | Mercy Hospital Lincoln Troy, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 23 | Mercy Hospital South Louis, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2 | $2 | $1 | 52% | — | $0 – $2 |
| 24 | Mercy Perry Perryville, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 25 | Mount Carmel Grove City Grove City, OH professional · percent of total billed charges · inpatientfrom % of charges | 1 | $951 | $951 | $225 | 24% | — | $726 – $1.2k |
← Payers reporting HCPCS L3809 · Snapshot 20261111T120946Z-9134e7f7