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 HFO W JT CUSTOM FAB
Low
$0
Average
$354
Median
$369
High
$1.2k
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Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 71 hospitals; the 90th percentile is 5.6× 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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| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Froedtert Memorial Lutheran Hospital Inc Milwaukee, WI | $242 | $242 | $102 | 42% | 4–40 | $125 – $367 |
| 2 | Wheeling Hospital, Inc. Wheeling, WV | $368 | $460 | $293 | 64% | 2–20 | $228 – $1.5k |
| 3 | Holy Family Memorial Inc Manitowoc, WI | $275 | $275 | — | — | 1–10 | $138 – $453 |
| 4 | Covenant Medical Center Inc Saginaw, MI | $352 | $352 | — | — | 1–10 | $100 – $671 |
| 5 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN | $511 | $509 | $212 | 42% | — | $68 – $1.1k |
| 6 | Portland Adventist Medical Center Portland, OR | $364 | $490 | $223 | 45% | — | $268 – $1.5k |
| 7 | Sonora Community Hospital Sonora, CA | $344 | $383 | $96 | 25% | — | $264 – $619 |
| 8 | Glendale Adventist Medical Center Glendale, CA | $351 | $422 | $131 | 31% | — | $129 – $789 |
| 9 | Adventist Health Tulare Tulare, CA | $344 | $457 | $165 | 36% | — | $216 – $1.5k |
| 10 | Rideout Memorial Hospital Marysville, CA | $351 | $407 | $112 | 27% | — | $198 – $1.8k |
Ask Claude or any MCP client for HCPCS L3921 pricing at a specific hospital — see how to connect.