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
Steqeyma
Low
$2
Average
$427
Median
$103
High
$2.2k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
24 hospitals; the 90th percentile is 225.4× 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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24 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 | Boston Medical Center Boston, MA other · both | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 2 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 3 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 2 | $1.3k | $1.3k | $962 | 75% | — | $313 – $2.2k |
| 4 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 5 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient | 1 | $313 | $313 | — | — | — | $313 – $313 |
| 6 | Little Company of Mary Hospital of Indiana Inc Jasper, IN facility · case rate · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 7 | Mayo Clinic Health System Cannon Falls 55009-5003 facility · percent of total billed charges · bothfrom % of charges | 1 | $537 | $537 | — | — | — | $537 – $537 |
| 8 | MedStar Franklin Square Medical Center Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $64 | $44 | $29 | 66% | — | $3 – $64 |
| 9 | MedStar Good Samaritan Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $184 | $126 | $83 | 66% | — | $9 – $184 |
| 10 | MedStar Harbor Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $151 | $103 | $68 | 65% | — | $8 – $151 |
| 11 | MedStar Montgomery Medical Center Olney, MD percent of total billed charges · outpatientfrom % of charges | 1 | $84 | $57 | $37 | 65% | — | $4 – $84 |
| 12 | MedStar Southern Hospital Center Clinton, MD percent of total billed charges · outpatientfrom % of charges | 1 | $120 | $82 | $54 | 66% | — | $6 – $120 |
| 13 | MedStar St. Mary's Hospital Leonardtown, MD percent of total billed charges · outpatientfrom % of charges | 1 | $76 | $52 | $34 | 65% | — | $4 – $76 |
| 14 | MedStar Union Memorial Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $149 | $102 | $67 | 66% | — | $8 – $149 |
| 15 | Mercy Hospital Ardmore Inc Ardmore, OK facility · other · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 16 | Mercy Hospital Berryville Berryville, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $531 | $531 | $2 | 0% | — | $529 – $532 |
| 17 | Mercy Hospital Lincoln Troy, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $524 | $524 | $1 | 0% | — | $523 – $525 |
| 18 | Mercy Hospital Oklahoma City Inc City, OK facility · other · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 19 | Mercy Perry Perryville, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $740 | $740 | $2 | 0% | — | $738 – $742 |
| 20 | Mid Hudson Regional Hospital Poughkeepsie, NY facility · fee schedule · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 21 | ROBERT PACKER HOSPITAL Sayre, PA facility · other · outpatient | 2 | $1.3k | $1.3k | $962 | 75% | — | $313 – $2.2k |
| 22 | TROY COMMUNITY HOSPITAL INCORPORATED Troy, PA facility · other · outpatient | 1 | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 23 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania Philadelphia, PA facility · fee schedule · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 24 | Westchester Medical Center Valhalla, NY facility · fee schedule · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
← Payers reporting HCPCS Q5099 · Snapshot 20261111T120946Z-9134e7f7