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
BRACE ANKLE ADULT UNIVERSAL GEL AIR LINER ANATOMICALLY SHAPE HOOK LOOP STRAP CS/25EA
Low
$0
Average
$245
Median
$113
High
$3.8k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
127 hospitals; the 90th percentile is 19.0× 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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135 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 | Massachusetts General Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $78 | $78 | $2 | 3% | 2–20 | $76 – $81 |
| 2 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $115 | $115 | — | — | — | $115 – $115 |
| 3 | Ascension Seton Austin, TX fee schedule · outpatient | 1 | $82 | $82 | — | — | — | $82 – $82 |
| 4 | Ascension Seton Austin, TX fee schedule · outpatient | 1 | $82 | $82 | — | — | — | $82 – $82 |
| 5 | Ascension Seton Austin, TX fee schedule · outpatient | 1 | $82 | $82 | — | — | — | $82 – $82 |
| 6 | Ascension Seton Luling, TX fee schedule · outpatient | 1 | $82 | $82 | — | — | — | $82 – $82 |
| 7 | Ascension Seton Burnet, TX fee schedule · outpatient | 1 | $82 | $82 | — | — | — | $82 – $82 |
| 8 | Ascension Seton Bastrop, TX fee schedule · outpatient | 1 | $82 | $82 | — | — | — | $82 – $82 |
| 9 | Ascension Seton Austin, TX fee schedule · outpatient | 1 | $82 | $82 | — | — | — | $82 – $82 |
| 10 | Aspen Valley Hospital District Aspen, CO facility · percent of total billed charges · bothfrom % of charges | 4 | $78 | $85 | $28 | 33% | — | $62 – $145 |
| 11 | Bay Park Community Hospital Oregon, OH facility · fee schedule · outpatient | 1 | $113 | $113 | — | — | — | $113 – $113 |
| 12 | Bay Park Community Hospital Oregon, OH professional · fee schedule · outpatient | 1 | $113 | $113 | — | — | — | $113 – $113 |
| 13 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 14 | Brandon HMA LLC Brandon, MS facility · fee schedule · outpatient | 1 | $92 | $92 | — | — | — | $92 – $92 |
| 15 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $113 | $113 | — | — | — | $113 – $113 |
| 16 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 2 | $725 | $725 | — | — | — | $725 – $725 |
| 17 | Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient | 1 | $92 | $92 | — | — | — | $92 – $92 |
| 18 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
| 19 | Central Maine Medical Center Lewiston, ME fee schedule · outpatient | 1 | $119 | $119 | — | — | — | $119 – $119 |
| 20 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $224 | $224 | — | — | — | $224 – $224 |
| 21 | Chilton Medical Center Pompton Plains, NJ fee schedule · both | 2 | $99 | $99 | $2 | 2% | — | $97 – $101 |
| 22 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
| 23 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $113 | $113 | — | — | — | $113 – $113 |
| 24 | Crestview Hospital Corporation Crestview, FL facility · fee schedule · outpatient | 1 | $115 | $115 | — | — | — | $115 – $115 |
| 25 | Dukes Health System LLC Peru, IN facility · fee schedule · outpatient | 1 | $41 | $41 | — | — | — | $41 – $41 |
← Payers reporting HCPCS L4350 · Snapshot 20261111T120946Z-9134e7f7