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
PR INJ PERFLUTREN LIP MICROS,ML
Low
$39
Average
$404
Median
$376
High
$2.5k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
72 hospitals; the 90th percentile is 20.2× 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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78 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 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $270 | $300 | $43 | 14% | 2–20 | $270 – $361 |
| 2 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $174 | $174 | — | — | — | $174 – $174 |
| 3 | Anderson Hospital Maryville, IL professional · other · outpatient | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 4 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $466 | $466 | — | — | — | $466 – $466 |
| 5 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 1 | $378 | $378 | $183 | 48% | — | $195 – $561 |
| 6 | CentraState Medical Center Freehold Township, NJ other · outpatient | 2 | $874 | $874 | — | — | — | $874 – $874 |
| 7 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $258 | $258 | $40 | 15% | — | $218 – $298 |
| 8 | Chilton Medical Center Pompton Plains, NJ other · outpatient | 2 | $917 | $917 | — | — | — | $917 – $917 |
| 9 | Conway Regional Medical Center Conway, AR facility · fee schedule · outpatient | 1 | $665 | $665 | $50 | 7% | — | $615 – $714 |
| 10 | Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient | 1 | $414 | $414 | — | — | — | $414 – $414 |
| 11 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $490 | $490 | — | — | — | $490 – $490 |
| 12 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $126 | $182 | $97 | 54% | — | $126 – $351 |
| 13 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $118 | $171 | $91 | 54% | — | $118 – $329 |
| 14 | GLENS FALLS HOSPITAL INC Falls, NY professional · fee schedule · outpatient | 4 | $42 | $42 | — | — | — | $42 – $42 |
| 15 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient | 1 | $387 | $387 | $192 | 50% | — | $195 – $579 |
| 16 | Garfield County, a political subdivision of the State of Utah, DBA Intermountain Health Garfield Memorial Hospital Panguitch, UT facility · percent of total billed charges · inpatientfrom % of charges | 1 | $321 | $321 | — | — | — | $321 – $321 |
| 17 | Garfield County, a political subdivision of the State of Utah, DBA Intermountain Health Garfield Memorial Hospital Panguitch, UT facility · percent of total billed charges · outpatientfrom % of charges | 1 | $270 | $270 | — | — | — | $270 – $270 |
| 18 | HOULTON REGIONAL HOSPITAL HOULTON, ME percent of total billed charges · bothfrom % of charges | 1 | $312 | $312 | — | — | — | $312 – $312 |
| 19 | HOULTON REGIONAL HOSPITAL HOULTON, ME percent of total billed charges · outpatientfrom % of charges | 1 | $86 | $86 | — | — | — | $86 – $86 |
| 20 | HSA CGH LLC Coral Gables, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $649 | $750 | $309 | 41% | — | $432 – $1.2k |
| 21 | HSA PGH LLC Hialeah, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $541 | $619 | $351 | 57% | — | $226 – $1.2k |
| 22 | Hackettstown Medical Center Hackettstown, NJ other · outpatient | 2 | $863 | $863 | — | — | — | $863 – $863 |
| 23 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $810 | $810 | $24 | 3% | — | $786 – $834 |
| 24 | Hospital Service District #1, Parish of Terrebonne, State of Louisiana dba Terrebonne General Health System Houma, LA facility · fee schedule · outpatient | 1 | $2.5k | $2.5k | $14 | 1% | — | $2.4k – $2.5k |
| 25 | Kaweah Health Medical Center Visalia, CA facility · fee schedule · outpatient | 1 | $376 | $376 | $0 | 0% | — | $376 – $376 |
← Payers reporting HCPCS Q9957 · Snapshot 20261111T120946Z-9134e7f7