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
Cast Supply Shrt Leg Ad P
Low
$10
Average
$71
Median
$72
High
$344
Each hospital's average MultiPlan rate, under the methodology and billing class chosen below.
58 hospitals; the 90th percentile is 5.3× 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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89 hospital rates
iThe hospitals that file a MultiPlan 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 | Bexar County Hospital District San Antonio, TX fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 2 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 3 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 4 | Covenant Medical Center Inc Saginaw, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 5 | Covenant Medical Center Inc Saginaw, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 6 | EAST BATON ROUGE MEDICAL CENTER, LLC Baton Rouge, LA other · outpatient | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 7 | FHN Memorial Hospital Freeport, IL percent of total billed charges · outpatientfrom % of charges | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 8 | GLENCOE REGIONAL HEALTH SERVICES Glencoe, MN facility · fee schedule · both | 1 | $344 | $344 | — | — | — | $344 – $344 |
| 9 | GLENCOE REGIONAL HEALTH SERVICES Glencoe, MN professional · fee schedule · outpatient | 1 | $344 | $344 | — | — | — | $344 – $344 |
| 10 | Geisinger Jersey Shore Hospital Jersey Shore, PA percent of total billed charges · inpatientfrom % of charges | 1 | $143 | $143 | — | — | — | $143 – $143 |
| 11 | Geisinger Jersey Shore Hospital Jersey Shore, PA percent of total billed charges · outpatientfrom % of charges | 1 | $143 | $143 | — | — | — | $143 – $143 |
| 12 | Geisinger Lewistown Hospital Lewistown, PA percent of total billed charges · inpatientfrom % of charges | 1 | $152 | $152 | — | — | — | $152 – $152 |
| 13 | Geisinger Lewistown Hospital Lewistown, PA percent of total billed charges · outpatientfrom % of charges | 1 | $152 | $152 | — | — | — | $152 – $152 |
| 14 | Geisinger Medical Center Muncy, PA percent of total billed charges · inpatientfrom % of charges | 2 | $152 | $152 | — | — | — | $152 – $152 |
| 15 | Geisinger Medical Center Muncy, PA percent of total billed charges · outpatientfrom % of charges | 2 | $152 | $152 | — | — | — | $152 – $152 |
| 16 | Geisinger Wyoming Valley Wilkes-Barre, PA percent of total billed charges · inpatientfrom % of charges | 2 | $153 | $153 | — | — | — | $153 – $153 |
| 17 | Geisinger Wyoming Valley Wilkes-Barre, PA percent of total billed charges · outpatientfrom % of charges | 2 | $153 | $153 | — | — | — | $153 – $153 |
| 18 | Good Samaritan Hospital Puyallup, WA percent of total billed charges · inpatientfrom % of charges | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 19 | Good Samaritan Hospital Puyallup, WA percent of total billed charges · outpatientfrom % of charges | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 20 | HMH HOSPITALS CORPORATION North Bergen, NJ facility · fee schedule · outpatient | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 21 | Kemper CAH, Inc. DeKalb, MS percent of total billed charges · outpatientfrom % of charges | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 22 | Laird Hospital, Inc. Union, MS percent of total billed charges · outpatientfrom % of charges | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 23 | Marshfield Medical Center - Beaver Dam Beaver Dam, WI facility · percent of total billed charges · inpatientfrom % of charges | 2 | $92 | $92 | $1 | 1% | — | $91 – $93 |
| 24 | Marshfield Medical Center - Beaver Dam Beaver Dam, WI facility · percent of total billed charges · outpatientfrom % of charges | 2 | $92 | $92 | $1 | 1% | — | $91 – $93 |
| 25 | Marshfield Medical Center - Dickinson Iron Mountain, MI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $23 | $23 | — | — | — | $23 – $23 |
← Payers reporting HCPCS Q4037 · Snapshot 20261111T120946Z-9134e7f7