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
Fulphila PFS
Low
$76
Average
$1.9k
Median
$104
High
$18.4k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
128 hospitals; the 90th percentile is 88.4× 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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138 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 | Mercy Hospital Springfield Ozark, MO facility · other · outpatient | 1 | $97 | $97 | — | — | 1–10 | $97 – $97 |
| 2 | Mercy Hospital Springfield Springfield, MO facility · other · outpatient | 1 | $97 | $97 | — | — | 1–10 | $97 – $97 |
| 3 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · outpatient | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 4 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $5.3k | $5.3k | $4.7k | 90% | — | $542 – $10.0k |
| 5 | Aspen Valley Hospital District Aspen, CO facility · percent of total billed charges · bothfrom % of charges | 4 | $2.5k | $3.0k | $920 | 30% | — | $2.5k – $4.6k |
| 6 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 7 | Boston Medical Center Boston, MA other · both | 1 | $99 | $99 | — | — | — | $99 – $99 |
| 8 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $99 | $99 | — | — | — | $99 – $99 |
| 9 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $94 | $94 | — | — | — | $94 – $94 |
| 10 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 2 | $8.9k | $8.9k | $7.6k | 86% | — | $1.2k – $16.5k |
| 11 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient | 1 | $94 | $94 | — | — | — | $94 – $94 |
| 12 | Cary Medical Center Caribou, ME case rate · outpatient | 1 | $91 | $91 | — | — | — | $91 – $91 |
| 13 | CentraState Medical Center Freehold Township, NJ other · both | 2 | $104 | $104 | — | — | — | $104 – $104 |
| 14 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $104 | $104 | — | — | — | $104 – $104 |
| 15 | Central Maine Medical Center Lewiston, ME fee schedule · outpatient | 1 | $80 | $80 | — | — | — | $80 – $80 |
| 16 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $2.2k | $2.2k | $1.1k | 50% | — | $1.1k – $3.2k |
| 17 | Chilton Medical Center Pompton Plains, NJ other · both | 2 | $104 | $104 | — | — | — | $104 – $104 |
| 18 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $104 | $104 | — | — | — | $104 – $104 |
| 19 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $99 | $99 | — | — | — | $99 – $99 |
| 20 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $4.9k | $4.9k | — | — | — | $4.9k – $4.9k |
| 21 | Conway Regional Medical Center Conway, AR facility · fee schedule · outpatient | 1 | $18.4k | $18.4k | $450 | 2% | — | $18.0k – $18.9k |
| 22 | Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient | 1 | $5.9k | $5.9k | — | — | — | $5.9k – $5.9k |
| 23 | Eisenhower Medical Center Rancho Mirage, CA other · both | 3 | $99 | $99 | — | — | — | $99 – $99 |
| 24 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · both | 1 | $88 | $88 | — | — | — | $88 – $88 |
| 25 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $88 | $88 | — | — | — | $88 – $88 |
← Payers reporting HCPCS Q5108 · Snapshot 20261111T120946Z-9134e7f7