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
Fo W/O Joint Custom T1
Low
$1
Average
$300
Median
$240
High
$8.9k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
650 hospitals; the 90th percentile is 3.3× 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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906 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 | Spaulding Rehabilitation Hospital Boston Charlestown, MA percent of total billed charges · outpatientfrom % of charges | 1 | $314 | $314 | — | — | 199 | $314 – $314 |
| 2 | Self Regional Healthcare Greenwood, SC facility · other · outpatient | 2 | $231 | $231 | $5 | 2% | 20–29 | $226 – $235 |
| 3 | Virtua_West_Jersey_Health_System_Inc Marlton, NJ percent of total billed charges · outpatientfrom % of charges | 2 | $652 | $652 | — | — | 18–27 | $652 – $652 |
| 4 | Virtua_West_Jersey_Health_System_Inc Voorhees, NJ percent of total billed charges · outpatientfrom % of charges | 2 | $652 | $652 | — | — | 18–27 | $652 – $652 |
| 5 | West Virginia University Hospitals, Inc. Morgantown, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $60 | $60 | — | — | 18 | $60 – $60 |
| 6 | The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges | 2 | $127 | $133 | $18 | 13% | 16 | $120 – $172 |
| 7 | Allina Health Systems Shakopee, MN facility · other · outpatient | 5 | $278 | $292 | $95 | 33% | 14–32 | $133 – $411 |
| 8 | Allina Health Systems Owatonna, MN facility · other · outpatient | 5 | $278 | $292 | $95 | 33% | 14–32 | $133 – $411 |
| 9 | Allina Health Systems Cambridge, MN facility · other · outpatient | 5 | $278 | $292 | $95 | 33% | 14–32 | $133 – $411 |
| 10 | Allina Health Systems Faribualt, MN facility · other · outpatient | 5 | $278 | $292 | $95 | 33% | 14–32 | $133 – $411 |
| 11 | Allina Health Systems Buffalo, MN facility · other · outpatient | 5 | $278 | $292 | $95 | 33% | 14–32 | $133 – $411 |
| 12 | Spaulding Rehabilitation Hospital Cape Cod Sandwich, MA percent of total billed charges · outpatientfrom % of charges | 1 | $353 | $353 | — | — | 13 | $353 – $353 |
| 13 | NYU Langone New York, NY percent of total billed charges · bothfrom % of charges | 50 | $70 | $70 | — | — | 5–50 | $70 – $70 |
| 14 | NYU Langone Brooklyn, NY percent of total billed charges · bothfrom % of charges | 50 | $70 | $70 | — | — | 5–50 | $70 – $70 |
| 15 | North Carolina Baptist Hospital Winston Salem, NC percent of total billed charges · outpatientfrom % of charges | 4 | $66 | $63 | $11 | 17% | 4–40 | $45 – $74 |
| 16 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges | 4 | $66 | $63 | $11 | 17% | 4–40 | $45 – $74 |
| 17 | Novant Health Matthews Medical Center LLC Matthews, NC percent of total billed charges · outpatientfrom % of charges | 3 | $232 | $189 | $62 | 33% | 3–30 | $101 – $232 |
| 18 | PRISMA HEALTH BAPTIST PARKRIDGE HOSPITAL COLUMBIA, SC percent of total billed charges · bothfrom % of charges | 3 | $123 | $136 | $37 | 27% | 3–30 | $98 – $186 |
| 19 | PRISMA HEALTH RICHLAND HOSPITAL COLUMBIA, SC percent of total billed charges · bothfrom % of charges | 3 | $123 | $136 | $37 | 27% | 3–30 | $98 – $186 |
| 20 | Stanford Health Care Stanford, CA fee schedule · both | 1 | $532 | $532 | — | — | 3–30 | $532 – $532 |
| 21 | Covenant Medical Center Inc Saginaw, MI professional · other · both | 1 | $234 | $234 | — | — | 2–20 | $234 – $234 |
| 22 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · percent of total billed charges · bothfrom % of charges | 2 | $41 | $41 | $1 | 2% | 2–20 | $37 – $41 |
| 23 | Samaritan Hospital Troy, NY facility · percent of total billed charges · bothfrom % of charges | 2 | $22 | $22 | $1 | 5% | 2–20 | $21 – $24 |
| 24 | MVHS, Inc. Utica, NY percent of total billed charges · bothfrom % of charges | 1 | $286 | $286 | — | — | 1–10 | $286 – $286 |
| 25 | Martha's Vineyard Hospital Bluffs, MA percent of total billed charges · outpatientfrom % of charges | 1 | $121 | $121 | — | — | 1–10 | $121 – $121 |
← Payers reporting HCPCS L3933 · Snapshot 20261111T120946Z-9134e7f7