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
Colles Splint Lg Rt Unpad
Low
$2
Average
$861
Median
$190
High
$3.8k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
32 hospitals; the 90th percentile is 729.3× 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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32 hospital rates
iThe hospitals that file a Tricare 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 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
| 2 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 3 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
| 4 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $116 | $116 | — | — | — | $116 – $116 |
| 5 | Dukes Health System LLC Peru, IN facility · fee schedule · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 6 | GRITMAN MEDICAL CENTER INC Moscow, ID facility · fee schedule · both | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 7 | Hackettstown Medical Center Hackettstown, NJ other · outpatient | 2 | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
| 8 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 9 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 10 | Mayo Clinic Health System Sparta, WI professional · percent of total billed charges · outpatientfrom % of charges | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 11 | Mayo Clinic Health System Cannon Falls 55009-5003 facility · percent of total billed charges · bothfrom % of charges | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 12 | Mercy Hospital Cassville Knob, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 13 | Mercy Hospital Healdton Inc Healdton, OK facility · percent of total billed charges · outpatientfrom % of charges | 2 | $124 | $124 | $78 | 63% | — | $46 – $202 |
| 14 | Mercy Hospital Lincoln Troy, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 15 | Mercy Hospital Waldron Waldron, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 16 | Mercy Love County Marietta, OK facility · percent of total billed charges · outpatientfrom % of charges | 1 | $155 | $155 | $97 | 63% | — | $57 – $252 |
| 17 | Morristown Medical Center Morristown, NJ other · outpatient | 2 | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
| 18 | Newton Medical Center Newton, NJ other · outpatient | 2 | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
| 19 | Northside Hospital, Inc. Lawrenceville, GA fee schedule · outpatient | 1 | $350 | $350 | $132 | 38% | — | $218 – $482 |
| 20 | Northside Hospital, Inc. Atlanta, GA fee schedule · outpatient | 1 | $350 | $350 | $132 | 38% | — | $218 – $482 |
| 21 | Northside Hospital, Inc. Cumming, GA fee schedule · outpatient | 1 | $350 | $350 | $132 | 38% | — | $218 – $482 |
| 22 | Northside Hospital, Inc. Duluth, GA fee schedule · outpatient | 1 | $350 | $350 | $132 | 38% | — | $218 – $482 |
| 23 | Northside Hospital, Inc. Canton, GA fee schedule · outpatient | 1 | $350 | $350 | $132 | 38% | — | $218 – $482 |
| 24 | Overlook Medical Center Summit, NJ other · outpatient | 2 | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
| 25 | Penn Medicine Princeton Medical Center Princeton, NJ facility · fee schedule · outpatient | 1 | $426 | $426 | — | — | — | $426 – $426 |
← Payers reporting HCPCS L3999 · Snapshot 20261111T120946Z-9134e7f7