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
$15
Average
$211
Median
$137
High
$989
Each hospital's average Magellan rate, under the methodology and billing class chosen below.
30 hospitals; the 90th percentile is 7.1× 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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35 hospital rates
iThe hospitals that file a Magellan 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 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL per diem · inpatient | 1 | $900 | $900 | — | — | — | $900 – $900 |
| 2 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · outpatientfrom % of charges | 1 | $174 | $174 | — | — | — | $174 – $174 |
| 3 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · outpatientfrom % of charges | 1 | $137 | $137 | — | — | — | $137 – $137 |
| 4 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $137 | $137 | — | — | — | $137 – $137 |
| 5 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $137 | $137 | — | — | — | $137 – $137 |
| 6 | Carolinas Medical Center Davidson, NC percent of total billed charges · outpatientfrom % of charges | 1 | $137 | $137 | — | — | — | $137 – $137 |
| 7 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $137 | $137 | — | — | — | $137 – $137 |
| 8 | DIGNITY COMMUNITY CARE Woodland, CA fee schedule · inpatient | 1 | $239 | $239 | — | — | — | $239 – $239 |
| 9 | DIGNITY COMMUNITY CARE Woodland, CA fee schedule · outpatient | 1 | $239 | $239 | — | — | — | $239 – $239 |
| 10 | Gerald Champion Regional Medical Center Alamogordo, NM fee schedule · outpatient | 1 | $234 | $234 | — | — | — | $234 – $234 |
| 11 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 12 | Mercy Fitzgerald Hospital Darby, PA facility · percent of total billed charges · bothfrom % of charges | 1 | $95 | $95 | — | — | — | $95 – $95 |
| 13 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $69 | $69 | — | — | — | $69 – $69 |
| 14 | Morristown Medical Center Morristown, NJ fee schedule · both | 1 | $957 | $957 | — | — | — | $957 – $957 |
| 15 | Morristown Medical Center Morristown, NJ fee schedule · outpatient | 1 | $957 | $957 | — | — | — | $957 – $957 |
| 16 | Northwestern Medicine Central DuPage Hospital Winfield, IL percent of total billed charges · outpatientfrom % of charges | 1 | $237 | $237 | — | — | — | $237 – $237 |
| 17 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC percent of total billed charges · bothfrom % of charges | 1 | $148 | $148 | — | — | — | $148 – $148 |
| 18 | Palos Community Hospital Palos Heights, IL percent of total billed charges · outpatientfrom % of charges | 1 | $236 | $236 | — | — | — | $236 – $236 |
| 19 | Penn Medicine Princeton Medical Center Princeton, NJ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $989 | $989 | — | — | — | $989 – $989 |
| 20 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $52 | $52 | $27 | 51% | — | $25 – $78 |
| 21 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · fee schedule · both | 1 | $197 | $197 | — | — | — | $197 – $197 |
| 22 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 23 | Saint Alphonsus Medical Center - Ontario Ontario, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $35 | $35 | $18 | 51% | — | $17 – $54 |
| 24 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · fee schedule · both | 1 | $197 | $197 | — | — | — | $197 – $197 |
| 25 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $17 | $17 | — | — | — | $17 – $17 |
← Payers reporting HCPCS L3933 · Snapshot 20261111T120946Z-9134e7f7