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 SUPPLIES UNLISTED
Low
$2
Average
$257
Median
$110
High
$699
Each hospital's average MultiPlan rate, under the methodology and billing class chosen below.
67 hospitals; the 90th percentile is 26.2× 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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100 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 | Boston Children's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 2 | $281 | $281 | $5 | 2% | — | $276 – $285 |
| 2 | Boston Children's Hospital Lexington, MA percent of total billed charges · bothfrom % of charges | 2 | $281 | $281 | $5 | 2% | — | $276 – $285 |
| 3 | Boston Children's Hospital Brookline, MA percent of total billed charges · bothfrom % of charges | 2 | $281 | $281 | $5 | 2% | — | $276 – $285 |
| 4 | Boston Children's Hospital Dartmouth, MA percent of total billed charges · bothfrom % of charges | 2 | $281 | $281 | $5 | 2% | — | $276 – $285 |
| 5 | Boston Children's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 2 | $281 | $281 | $5 | 2% | — | $276 – $285 |
| 6 | Boston Children's Hospital Peabody, MA percent of total billed charges · bothfrom % of charges | 2 | $281 | $281 | $5 | 2% | — | $276 – $285 |
| 7 | Boston Children's Hospital Waltham, MA percent of total billed charges · bothfrom % of charges | 2 | $281 | $281 | $5 | 2% | — | $276 – $285 |
| 8 | Boston Children's Hospital Needham, MA percent of total billed charges · bothfrom % of charges | 2 | $281 | $281 | $5 | 2% | — | $276 – $285 |
| 9 | Boston Children's Hospital Weymouth, MA percent of total billed charges · bothfrom % of charges | 2 | $281 | $281 | $5 | 2% | — | $276 – $285 |
| 10 | Bronson Battle Creek Hospital Battle Creek, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 11 | EAST BATON ROUGE MEDICAL CENTER, LLC Baton Rouge, LA other · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 12 | GLENCOE REGIONAL HEALTH SERVICES Glencoe, MN facility · fee schedule · both | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 13 | GLENCOE REGIONAL HEALTH SERVICES Glencoe, MN professional · fee schedule · outpatient | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 14 | Geisinger Medical Center Muncy, PA percent of total billed charges · inpatientfrom % of charges | 2 | $94 | $94 | — | — | — | $94 – $94 |
| 15 | Geisinger Medical Center Muncy, PA percent of total billed charges · outpatientfrom % of charges | 2 | $94 | $94 | — | — | — | $94 – $94 |
| 16 | Good Samaritan Hospital Puyallup, WA percent of total billed charges · inpatientfrom % of charges | 1 | $67 | $93 | $123 | 132% | — | $33 – $668 |
| 17 | Good Samaritan Hospital Puyallup, WA percent of total billed charges · outpatientfrom % of charges | 1 | $67 | $93 | $123 | 132% | — | $33 – $668 |
| 18 | Greenbrier Valley Medical Center Ronceverte, WV percent of total billed charges · bothfrom % of charges | 2 | $163 | $196 | $81 | 41% | — | $119 – $349 |
| 19 | Indiana University Health Arnett Inc. Lafayette, IN percent of total billed charges · outpatientfrom % of charges | 2 | $200 | $699 | $731 | 104% | — | $162 – $1.8k |
| 20 | Indiana University Health Ball Memorial Hospital Inc. Muncie, IN percent of total billed charges · outpatientfrom % of charges | 2 | $200 | $699 | $731 | 104% | — | $162 – $1.8k |
| 21 | Indiana University Health Bedford Inc. Bedford, IN percent of total billed charges · outpatientfrom % of charges | 2 | $200 | $699 | $731 | 104% | — | $162 – $1.8k |
| 22 | Indiana University Health Bloomington Inc. Bloomington, IN percent of total billed charges · outpatientfrom % of charges | 2 | $200 | $699 | $731 | 104% | — | $162 – $1.8k |
| 23 | Indiana University Health Frankfort Inc. Frankfort, IN percent of total billed charges · outpatientfrom % of charges | 2 | $200 | $699 | $731 | 104% | — | $162 – $1.8k |
| 24 | Indiana University Health Inc. Martinsville, IN percent of total billed charges · outpatientfrom % of charges | 2 | $200 | $699 | $731 | 104% | — | $162 – $1.8k |
| 25 | Indiana University Health Jay Inc. Portland, IN percent of total billed charges · outpatientfrom % of charges | 2 | $200 | $699 | $731 | 104% | — | $162 – $1.8k |
← Payers reporting HCPCS Q4050 · Snapshot 20261111T120946Z-9134e7f7