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
Dextranomer-Hyaluronate-NaCl 50-15 mg/mL (4) Syringe gel 1 mL SYRINGE
Low
$0
Average
$1.9k
Median
$904
High
$18.4k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
284 hospitals; the 90th percentile is 4.2× 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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300 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | Mayo Clinic Arizona Phoenix, AZ professional · percent of total billed charges · outpatientfrom % of charges | 5 | $2.2k | $2.3k | $191 | 8% | 1–10 | $2.2k – $2.6k |
| 2 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · case rate · outpatient | 4 | $1.7k | $2.2k | $810 | 37% | — | $1.4k – $3.2k |
| 3 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · fee schedule · outpatient | 1 | $844 | $844 | — | — | — | $844 – $844 |
| 4 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 1 | $887 | $887 | — | — | — | $887 – $887 |
| 5 | AdventHealth Avista Louisville, CO fee schedule · outpatient | 1 | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 6 | AdventHealth Castle Rock Castle Rock, CO fee schedule · outpatient | 1 | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 7 | AdventHealth Littleton Littleton, CO fee schedule · outpatient | 1 | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 8 | AdventHealth Parker Aurora, CO fee schedule · outpatient | 1 | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 9 | AdventHealth Porter Denver, CO fee schedule · outpatient | 1 | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 10 | Adventhealth Ottawa Ottawa, KS fee schedule · outpatient | 1 | $726 | $726 | — | — | — | $726 – $726 |
| 11 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 12 | Altru Hospital Grand Forks, ND facility · fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 13 | Altru Hospital Devils Lake Devils Lake, ND facility · fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 14 | BELTON REGIONAL MEDICAL CENTER Kansas City, MO fee schedule · outpatient | 3 | $869 | $872 | $4 | 0% | — | $869 – $878 |
| 15 | Benson Hospital Corporation Benson, AZ facility · fee schedule · outpatient | 1 | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 16 | Berger Hospital Circleville, OH fee schedule · outpatient | 3 | $9.5k | $9.5k | — | — | — | $9.5k – $9.5k |
| 17 | Bexar County Hospital District San Antonio, TX fee schedule · outpatient | 1 | $887 | $887 | — | — | — | $887 – $887 |
| 18 | Blessing Hospital Quincy, IL professional · fee schedule · both | 1 | $477 | $477 | — | — | — | $477 – $477 |
| 19 | CENTERPOINT MEDICAL CENTER Independence, MO fee schedule · outpatient | 3 | $869 | $872 | $4 | 0% | — | $869 – $878 |
| 20 | CHRISTUS Good Shepherd Hospital - Northpark Longview, TX fee schedule · outpatient | 1 | $869 | $869 | — | — | — | $869 – $869 |
| 21 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · case rate · inpatient | 1 | $861 | $861 | — | — | — | $861 – $861 |
| 22 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · fee schedule · inpatient | 4 | $3.4k | $3.3k | $1.1k | 34% | — | $1.6k – $4.8k |
| 23 | COLUMBIA MEMORIAL HOSPITAL Hudson, NY facility · case rate · outpatient | 3 | $2.6k | $2.2k | $566 | 26% | — | $1.4k – $2.6k |
| 24 | COLUMBIA MEMORIAL HOSPITAL Hudson, NY facility · fee schedule · outpatient | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 25 | Carle BroMenn Medical Center Normal, IL case rate · outpatient | 1 | $882 | $882 | — | — | — | $882 – $882 |
← Payers reporting HCPCS L8605 · Snapshot 20261111T120946Z-9134e7f7