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
Br-Hmii Belt Modular Lrg
Low
$39
Average
$421
Median
$372
High
$901
Each hospital's average Ambetter rate, under the methodology and billing class chosen below.
129 hospitals; the 90th percentile is 2.5× 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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133 hospital rates
iThe hospitals that file a Ambetter 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 | Advocate Childrens Hospital Oak Lawn Oak Lawn, IL facility · case rate · outpatient | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 2 | Advocate Childrens Hospital Park Ridge Park Ridge, IL facility · case rate · outpatient | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 3 | Advocate Christ Medical Center Oak Lawn, IL facility · case rate · outpatient | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 4 | Advocate Condell Medical Center Libertyville, IL case rate · outpatient | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 5 | Advocate Good Samaritan Hospital Downers Grove, IL case rate · outpatient | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 6 | Advocate Good Shepherd Hospital Barrington, IL case rate · outpatient | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 7 | Advocate Illinois Masonic Medical Center Chicago, IL case rate · outpatient | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 8 | Advocate Lutheran General Hospital Park Ridge, IL case rate · outpatient | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 9 | Advocate Sherman Hospital Elgin, IL case rate · outpatient | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 10 | Advocate South Suburban Hospital Hazel Crest, IL case rate · outpatient | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 11 | Advocate Trinity Hospital Chicago, IL case rate · outpatient | 1 | $292 | $292 | — | — | — | $292 – $292 |
| 12 | Bartow Regional Medical Center Bartow, FL facility · fee schedule · outpatient | 2 | $456 | $456 | — | — | — | $456 – $456 |
| 13 | Baycare Hospital Wesley Chapel Chapel, FL facility · fee schedule · outpatient | 2 | $486 | $486 | $30 | 6% | — | $456 – $517 |
| 14 | Bayhealth Hospital, Sussex Campus Milton, DE fee schedule · outpatient | 1 | $301 | $301 | — | — | — | $301 – $301 |
| 15 | Bayhealth Medical Center, Kent Campus Dover, DE fee schedule · outpatient | 1 | $301 | $301 | — | — | — | $301 – $301 |
| 16 | Baylor Scott & White All Saints Medical Center - Fort Worth Fort Worth, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $733 | $901 | $331 | 37% | — | $634 – $1.6k |
| 17 | Baylor Scott & White Heart and Vascular Hospital - Dallas Dallas, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $733 | $901 | $331 | 37% | — | $634 – $1.6k |
| 18 | Baylor Scott & White Medical Center - Centennial Frisco, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $733 | $901 | $331 | 37% | — | $634 – $1.6k |
| 19 | Baylor Scott & White Medical Center - Frisco at PGA Parkway Frisco, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $733 | $901 | $331 | 37% | — | $634 – $1.6k |
| 20 | Baylor Scott & White Medical Center - Grapevine Grapevine, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $733 | $901 | $331 | 37% | — | $634 – $1.6k |
| 21 | Baylor Scott & White Medical Center - Irving Irving, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $733 | $901 | $331 | 37% | — | $634 – $1.6k |
| 22 | Baylor Scott & White Medical Center - Lake Pointe Rowlett, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $733 | $901 | $331 | 37% | — | $634 – $1.6k |
| 23 | Baylor Scott & White Medical Center - McKinney McKinney, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $733 | $901 | $331 | 37% | — | $634 – $1.6k |
| 24 | Baylor Scott & White Medical Center - Plano Plano, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $733 | $901 | $331 | 37% | — | $634 – $1.6k |
| 25 | Baylor Scott & White Medical Center at Waxahachie Waxahachie, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $733 | $901 | $331 | 37% | — | $634 – $1.6k |
← Payers reporting HCPCS Q0499 · Snapshot 20261111T120946Z-9134e7f7