Low
$35
Average
$102
Median
$102
High
$170
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2 hospital rates
iThe hospitals that file a Premera 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 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 2 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · bothfrom % of charges | 5 | $164 | $170 | $58 | 34% | — | $98 – $274 |
← Payers reporting HCPCS L3956 · Snapshot 20261113T090226Z-3ce6c0b8