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/O Jnt Prefab Custom by Expertise Tier1
Low
$1
Average
$156
Median
$100
High
$8.8k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
678 hospitals; the 90th percentile is 3.5× 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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920 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | Mercy Hospital Springfield Ozark, MO facility · percent of total billed charges · outpatientfrom % of charges | 5 | $80 | $88 | $44 | 50% | 15–150 | $29 – $179 |
| 2 | PRISMA HEALTH BAPTIST PARKRIDGE HOSPITAL COLUMBIA, SC percent of total billed charges · bothfrom % of charges | 3 | $173 | $192 | $52 | 27% | 15–33 | $139 – $263 |
| 3 | PRISMA HEALTH RICHLAND HOSPITAL COLUMBIA, SC percent of total billed charges · bothfrom % of charges | 3 | $173 | $192 | $52 | 27% | 15–33 | $139 – $263 |
| 4 | The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges | 2 | $58 | $49 | $12 | 25% | 14–140 | $25 – $58 |
| 5 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges | 4 | $27 | $25 | $14 | 56% | 12–120 | $6 – $48 |
| 6 | Mercy Hospital Springfield Springfield, MO facility · percent of total billed charges · outpatientfrom % of charges | 5 | $104 | $102 | $45 | 44% | 8–80 | $29 – $179 |
| 7 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · percent of total billed charges · bothfrom % of charges | 2 | $75 | $80 | $27 | 34% | 6–60 | $31 – $111 |
| 8 | North Carolina Baptist Hospital Winston Salem, NC percent of total billed charges · outpatientfrom % of charges | 4 | $27 | $26 | $4 | 17% | 4–40 | $19 – $30 |
| 9 | Virtua_West_Jersey_Health_System_Inc Marlton, NJ percent of total billed charges · outpatientfrom % of charges | 2 | $273 | $273 | — | — | 4–40 | $273 – $273 |
| 10 | Virtua_West_Jersey_Health_System_Inc Voorhees, NJ percent of total billed charges · outpatientfrom % of charges | 2 | $273 | $273 | — | — | 4–40 | $273 – $273 |
| 11 | FHN Memorial Hospital Freeport, IL percent of total billed charges · outpatientfrom % of charges | 1 | $106 | $124 | $31 | 25% | 3–30 | $99 – $167 |
| 12 | Self Regional Healthcare Greenwood, SC facility · other · outpatient | 2 | $140 | $140 | $44 | 32% | 2–20 | $96 – $184 |
| 13 | Allina Health Systems Shakopee, MN facility · other · outpatient | 5 | $126 | $132 | $43 | 33% | 1–10 | $60 – $186 |
| 14 | Allina Health Systems Owatonna, MN facility · other · outpatient | 5 | $126 | $132 | $43 | 33% | 1–10 | $60 – $186 |
| 15 | Allina Health Systems Cambridge, MN facility · other · outpatient | 5 | $126 | $132 | $43 | 33% | 1–10 | $60 – $186 |
| 16 | Allina Health Systems Faribualt, MN facility · other · outpatient | 5 | $126 | $132 | $43 | 33% | 1–10 | $60 – $186 |
| 17 | Allina Health Systems Buffalo, MN facility · other · outpatient | 5 | $126 | $132 | $43 | 33% | 1–10 | $60 – $186 |
| 18 | Arkansas Childrens Northwest Springdale, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $85 | $85 | — | — | 1–10 | $85 – $85 |
| 19 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · outpatientfrom % of charges | 2 | $37 | $37 | $0 | 0% | 1–10 | $37 – $37 |
| 20 | Lexington Medical Center Lexington, NC other · outpatient | 1 | $96 | $96 | — | — | 1–10 | $96 – $96 |
| 21 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 4 | $86 | $79 | $19 | 24% | — | $47 – $96 |
| 22 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 4 | $86 | $73 | $30 | 42% | — | $21 – $98 |
| 23 | ADVENTIST HEALTH TULARE Tulare, CA case rate · outpatient | 2 | $54 | $54 | $8 | 15% | — | $44 – $65 |
| 24 | ADVENTIST HEALTH TULARE Tulare, CA other · outpatient | 2 | $96 | $96 | — | — | — | $96 – $96 |
| 25 | ADVENTIST HEALTH TULARE Tulare, CA percent of total billed charges · outpatientfrom % of charges | 2 | $41 | $42 | $9 | 21% | — | $31 – $56 |
← Payers reporting HCPCS L3923 · Snapshot 20261111T120946Z-9134e7f7