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 FO WO JT CUSTOM FAB
Low
$0
Average
$249
Median
$244
High
$784
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Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 103 hospitals; the 90th percentile is 4.6× 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.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Froedtert Memorial Lutheran Hospital Inc Milwaukee, WI | $228 | $206 | $38 | 19% | 52–133 | $83 – $244 |
| 2 | Self Regional Healthcare Greenwood, SC | $236 | $246 | $24 | 10% | 23–59 | $224 – $294 |
| 3 | Delta County Memorial Hospital DELTA, CO | $241 | $243 | $4 | 2% | 21–48 | $206 – $504 |
| 4 | Allina Health Systems Cambridge, MN | $309 | $301 | $143 | 48% | 16–52 | $0 – $750 |
| 5 | Allina Health Systems Buffalo, MN | $309 | $301 | $143 | 48% | 16–52 | $0 – $750 |
| 6 | Allina Health Systems Owatonna, MN | $309 | $301 | $143 | 48% | 16–52 | $0 – $750 |
| 7 | Allina Health Systems Faribault, MN | $309 | $301 | $143 | 48% | 16–52 | $0 – $750 |
| 8 | Allina Health Systems Shakopee, MN | $309 | $308 | $87 | 28% | 15–42 | $0 – $750 |
| 9 | Wheeling Hospital, Inc. Wheeling, WV | $245 | $287 | $199 | 69% | 9–90 | $80 – $987 |
| 10 | Fairview Health Services Wyoming, MN | $233 | $276 | $97 | 35% | 6–60 | $219 – $525 |
Ask Claude or any MCP client for HCPCS L3933 pricing at a specific hospital — see how to connect.