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.
Generation details were not recorded for this description.
Original text from hospital filings
FERN TEST NONL
Low
$4
Average
$10
Median
$10
High
$30
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
103 hospitals; the 90th percentile is 1.2× 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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107 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 | AnMed Piedmont Piedmont, SC professional · fee schedule · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 2 | Ascension Seton Austin, TX fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 3 | Ascension Seton Bastrop, TX fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 4 | Bay Park Community Hospital Oregon, OH facility · fee schedule · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 5 | Bay Park Community Hospital Oregon, OH professional · fee schedule · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 6 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 7 | Boston Medical Center Boston, MA fee schedule · both | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 8 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 9 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 10 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 11 | Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 12 | Central Maine Medical Center Lewiston, ME fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 13 | Chino Valley Medical Center Chino, CA fee schedule · outpatient | 2 | $10 | $10 | — | — | — | $10 – $10 |
| 14 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 15 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 16 | Dallas Medical Center Dallas, TX fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 17 | Dallas Regional Medical Center Mesquite, TX fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 18 | Desert Valley Hospital Victorville, CA fee schedule · outpatient | 2 | $10 | $10 | — | — | — | $10 – $10 |
| 19 | EAST BATON ROUGE MEDICAL CENTER, LLC Baton Rouge, LA fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 20 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 21 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 22 | Garden Grove Hospital Medical Center Grove, CA fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 23 | Gouverneur Hospital Gouverneur, NY facility · fee schedule · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 24 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 25 | Huntington Beach Hospital Beach, CA fee schedule · outpatient | 2 | $10 | $10 | — | — | — | $10 – $10 |
← Payers reporting HCPCS Q0114 · Snapshot 20261111T120946Z-9134e7f7