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 SPACER WITHOUT MASK
Low
$0
Average
$33
Median
$24
High
$168
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
70 hospitals; the 90th percentile is 4.2× 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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82 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | Mayo Clinic Health System Mankato 56001-4752 professional · percent of total billed charges · outpatientfrom % of charges | 9 | $27 | $23 | $9 | 38% | 1–10 | $5 – $30 |
| 2 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient | 6 | $88 | $77 | $19 | 25% | — | $51 – $94 |
| 3 | Adventhealth Ottawa Ottawa, KS fee schedule · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 4 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 2 | $19 | $19 | — | — | — | $19 – $19 |
| 5 | Altru Hospital Grand Forks, ND facility · fee schedule · outpatient | 2 | $19 | $19 | — | — | — | $19 – $19 |
| 6 | Altru Hospital Devils Lake Devils Lake, ND facility · fee schedule · outpatient | 2 | $19 | $19 | — | — | — | $19 – $19 |
| 7 | Benefis Community Hospitals, Inc Choteau, MT percent of total billed charges · bothfrom % of charges | 3 | $67 | $69 | $6 | 9% | — | $64 – $78 |
| 8 | Benefis Hospitals Inc Helena, MT fee schedule · outpatient | 2 | $31 | $31 | $4 | 14% | — | $26 – $35 |
| 9 | Benefis Hospitals Inc Helena, MT percent of total billed charges · bothfrom % of charges | 3 | $61 | $61 | $0 | 1% | — | $60 – $61 |
| 10 | Benefis Hospitals Inc Helena, MT percent of total billed charges · inpatientfrom % of charges | 3 | $57 | $56 | $2 | 3% | — | $53 – $58 |
| 11 | Benefis Hospitals Inc Helena, MT percent of total billed charges · outpatientfrom % of charges | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 12 | Benefis Teton Medical Center Choteau, MT fee schedule · outpatient | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 13 | Benefis Teton Medical Center Choteau, MT percent of total billed charges · bothfrom % of charges | 3 | $60 | $57 | $10 | 18% | — | $43 – $67 |
| 14 | Benefis Teton Medical Center Choteau, MT percent of total billed charges · inpatientfrom % of charges | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 15 | Benson Hospital Corporation Benson, AZ facility · fee schedule · outpatient | 1 | $168 | $168 | — | — | — | $168 – $168 |
| 16 | Blessing Hospital Quincy, IL professional · fee schedule · both | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 17 | Covenant Medical Center Inc Saginaw, MI facility · fee schedule · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 18 | Covenant Medical Center Inc Saginaw, MI facility · fee schedule · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 19 | Deaconess Health System Henderson Hospital Henderson, KY professional · fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 20 | Edward Hospital Plainfield, IL fee schedule · outpatient | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 21 | Elmhurst Memorial Hospital Elmhurst, IL fee schedule · outpatient | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 22 | Endeavor Health Clinical Operations Skokie, IL fee schedule · outpatient | 3 | $87 | $88 | $6 | 7% | — | $81 – $95 |
| 23 | Essentia Health Duluth Duluth, MN facility · fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 24 | Essentia Health Fargo 3000 32nd Ave S Fargo, ND facility · fee schedule · outpatient | 2 | $18 | $18 | — | — | — | $18 – $18 |
| 25 | Essentia Health St. Joseph's Medical Center Brainerd, MN facility · fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
← Payers reporting HCPCS S8100 · Snapshot 20261111T120946Z-9134e7f7