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
Add ue prost a/e acrylic
Prices here combine facility and professional fees. See them separately →Experimental
Low
$379
Average
$974
Median
$688
High
$2.9k
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Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 7 hospitals; the 90th percentile is 3.8× 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.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Nationwide Children's Hospital Columbus, OH | $512 | $512 | — | — | — | $512 – $512 |
| 2 | Montefiore Mount Vernon Hospital Mount Vernon, NY | $700 | $700 | — | — | — | $700 – $700 |
| 3 | University of New Mexico Hospital | UNM Sandoval Regional Medical Center - A Campus of UNM Hospital Albuquerque, NM | $688 | $946 | $382 | 40% | — | $619 – $1.7k |
| 4 | Nationwide Children's Hospital Toledo, Llc Toledo, OH | $380 | $379 | $2 | 0% | — | $377 – $380 |
| 5 | Arkansas Childrens Hospital Little Rock, AR | $688 | $688 | — | — | — | $688 – $688 |
| 6 | Arkansas Childrens Northwest Springdale, AR | $668 | $668 | — | — | — | $668 – $668 |
| 7 | Montefiore New Rochelle Hospital New Rochelle, NY | $3.0k | $2.9k | $191 | 7% | — | $2.6k – $3.0k |
Ask Claude or any MCP client for HCPCS L7404 pricing at a specific hospital — see how to connect.