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
Casiri and imdev repeat
Low
$451
Average
$912
Median
$605
High
$2.1k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
10 hospitals; the 90th percentile is 3.6× 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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10 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 | Baptist Medical Center-Attala Kosciusko, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $505 | $505 | — | — | — | $505 – $505 |
| 2 | Baptist Medical Center-Yazoo Yazoo City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $490 | $490 | — | — | — | $490 – $490 |
| 3 | Baptist Memorial Hospital - Leake Carthage, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $490 | $490 | — | — | — | $490 – $490 |
| 4 | Baptist Memorial Hospital-Calhoun Calhoun City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $645 | $645 | — | — | — | $645 – $645 |
| 5 | Gerald Champion Regional Medical Center Alamogordo, NM fee schedule · outpatient | 5 | $451 | $451 | — | — | — | $451 – $451 |
| 6 | Lompoc Valley Medical Center Lompoc, CA fee schedule · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 7 | Penn Medicine Princeton Medical Center Princeton, NJ facility · fee schedule · outpatient | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 8 | Shasta Regional Medical Center Redding, CA fee schedule · outpatient | 2 | $564 | $564 | — | — | — | $564 – $564 |
| 9 | The Chester County Hospital West Chester, PA facility · fee schedule · outpatient | 1 | $755 | $755 | — | — | — | $755 – $755 |
| 10 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania Philadelphia, PA facility · fee schedule · outpatient | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
← Payers reporting HCPCS M0240 · Snapshot 20261112T181611Z-3fa9fb76