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
$11
Average
$127
Median
$44
High
$490
Each hospital's average Medical Mutual rate, under the methodology and billing class chosen below.
86 hospitals; the 90th percentile is 23.1× 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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134 hospital rates
iThe hospitals that file a Medical Mutual 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 | The Toledo Hospital Maumee, OH facility · other · outpatient | 1 | $299 | $299 | — | — | 1–10 | $299 – $299 |
| 2 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 1 | $490 | $490 | — | — | — | $490 – $490 |
| 3 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $333 | $333 | — | — | — | $333 – $333 |
| 4 | Bay Park Community Hospital Oregon, OH facility · other · outpatient | 1 | $299 | $299 | — | — | — | $299 – $299 |
| 5 | Bay Park Community Hospital Oregon, OH professional · fee schedule · outpatient | 1 | $117 | $117 | — | — | — | $117 – $117 |
| 6 | Bethesda Hospital Inc. Lebanon, OH facility · fee schedule · outpatient | 1 | $285 | $285 | — | — | — | $285 – $285 |
| 7 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · outpatient | 1 | $490 | $490 | — | — | — | $490 – $490 |
| 8 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $18 | $18 | $6 | 31% | — | $13 – $24 |
| 9 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $18 | $18 | $6 | 31% | — | $13 – $24 |
| 10 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $39 | $39 | $12 | 31% | — | $27 – $51 |
| 11 | Covenant Medical Center Inc Waterloo, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $48 | $48 | $15 | 31% | — | $33 – $62 |
| 12 | Defiance Hospital Inc Defiance, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $191 | $191 | — | — | — | $191 – $191 |
| 13 | Defiance Hospital Inc Defiance, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $191 | $191 | — | — | — | $191 – $191 |
| 14 | Defiance Hospital Inc Defiance, OH professional · fee schedule · outpatient | 1 | $168 | $168 | — | — | — | $168 – $168 |
| 15 | Diley Ridge Medical Center Canal Winchester, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $32 | $32 | $10 | 31% | — | $22 – $42 |
| 16 | Fisher-Titus Medical Center Norwalk, OH facility · fee schedule · outpatient | 1 | $274 | $274 | — | — | — | $274 – $274 |
| 17 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $272 | $272 | $5 | 2% | — | $267 – $277 |
| 18 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $185 | $185 | $4 | 2% | — | $181 – $188 |
| 19 | Fisher-Titus Medical Center Norwalk, OH professional · percent of total billed charges · inpatientfrom % of charges | 1 | $160 | $160 | — | — | — | $160 – $160 |
| 20 | Fisher-Titus Medical Center Norwalk, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $109 | $109 | — | — | — | $109 – $109 |
| 21 | Fostoria Hospital Association Fostoria, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $180 | $180 | — | — | — | $180 – $180 |
| 22 | Fostoria Hospital Association Fostoria, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $180 | $180 | — | — | — | $180 – $180 |
| 23 | Fostoria Hospital Association Fostoria, OH professional · fee schedule · outpatient | 1 | $169 | $169 | — | — | — | $169 – $169 |
| 24 | GROVE CITY MEDICAL CENTER GROVE CITY, PA fee schedule · outpatient | 1 | $490 | $490 | — | — | — | $490 – $490 |
| 25 | JEFFERSON REGIONAL MEDICAL CENTER JEFFERSON HILLS, PA fee schedule · outpatient | 1 | $490 | $490 | — | — | — | $490 – $490 |
← Payers reporting HCPCS L3809 · Snapshot 20261111T120946Z-9134e7f7