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
STATIC OR DYNAMI AFO PRE OTS
Low
$1
Average
$232
Median
$231
High
$349
Each hospital's average Premera rate, under the methodology and billing class chosen below.
21 hospitals; the 90th percentile is 235.5× 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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21 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 | ENUMCLAW REGIONAL HOSPITAL ASSOCIATION Enumclaw, WA fee schedule · outpatient | 2 | $128 | $128 | $88 | 69% | — | $40 – $216 |
| 2 | FRANCISCAN HEALTH SYSTEM Gig Harbor, WA fee schedule · outpatient | 2 | $216 | $216 | — | — | — | $216 – $216 |
| 3 | FRANCISCAN HEALTH SYSTEM Tacoma, WA fee schedule · outpatient | 2 | $216 | $216 | — | — | — | $216 – $216 |
| 4 | Good Samaritan Hospital Puyallup, WA fee schedule · outpatient | 4 | $341 | $349 | $44 | 12% | — | $295 – $417 |
| 5 | HARRISON MEDICAL CENTER Silverdale, WA fee schedule · outpatient | 2 | $216 | $216 | — | — | — | $216 – $216 |
| 6 | HIGHLINE MEDICAL CENTER Burien, WA fee schedule · outpatient | 2 | $216 | $216 | — | — | — | $216 – $216 |
| 7 | Mary Bridge Children's Hospital Tacoma, WA fee schedule · outpatient | 4 | $341 | $349 | $44 | 12% | — | $295 – $417 |
| 8 | MultiCare Auburn Medical Center Auburn, WA fee schedule · outpatient | 4 | $341 | $349 | $44 | 12% | — | $295 – $417 |
| 9 | MultiCare Capital Medical Center Lacey, WA fee schedule · outpatient | 4 | $351 | $337 | $24 | 7% | — | $295 – $351 |
| 10 | MultiCare Covington Medical Center Covington, WA fee schedule · outpatient | 4 | $341 | $349 | $44 | 12% | — | $295 – $417 |
| 11 | MultiCare Deaconess Hospital Spokane, WA fee schedule · outpatient | 4 | $237 | $252 | $25 | 10% | — | $237 – $295 |
| 12 | MultiCare Valley Hospital Spokane Valley, WA fee schedule · outpatient | 4 | $237 | $252 | $25 | 10% | — | $237 – $295 |
| 13 | MultiCare Yakima Valley Memorial Hospital Association Union Gap, WA fee schedule · outpatient | 3 | $294 | $294 | — | — | — | $294 – $294 |
| 14 | SAINT CLARE HOSPITAL Lakewood, WA fee schedule · outpatient | 2 | $216 | $216 | — | — | — | $216 – $216 |
| 15 | ST FRANCIS COMMUNITY HOSPITAL Federal Way, WA fee schedule · outpatient | 2 | $216 | $216 | — | — | — | $216 – $216 |
| 16 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · bothfrom % of charges | 5 | $237 | $231 | $39 | 17% | — | $188 – $289 |
| 17 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 18 | St Joseph Mercy Chelsea Chelsea, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 19 | St Joseph Mercy Livingston Hospital | Trinity Health Medical Center - Brighton Brighton, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 20 | Tacoma General Allenmore Hospital Bremerton, WA fee schedule · outpatient | 4 | $341 | $349 | $44 | 12% | — | $295 – $417 |
| 21 | Virginia Mason Medical Center Seattle, WA facility · fee schedule · outpatient | 2 | $349 | $349 | $155 | 44% | — | $194 – $504 |
← Payers reporting HCPCS L4397 · Snapshot 20261111T120946Z-9134e7f7