RC 290
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
BUTTON, BALLOON MINIONE AMT 14FRX4.4CM
Low
$0
Average
$82
Median
$46
High
$383
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
8 hospitals; the 90th percentile is 22.5× 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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8 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 | Conway Regional Medical Center Conway, AR facility · fee schedule · outpatient | 1 | $53 | $383 | $1.5k | 380% | — | $3 – $9.2k |
| 2 | GRITMAN MEDICAL CENTER INC Moscow, ID facility · fee schedule · both | 1 | $66 | $66 | — | — | — | $66 – $66 |
| 3 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $58 | $58 | — | — | — | $58 – $58 |
| 4 | Lancaster General Health Lancaster, PA facility · fee schedule · outpatient | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 5 | Little Company of Mary Hospital of Indiana Inc Jasper, IN professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 6 | Presence Chicago Hospitals Network Chicago, IL percent of total billed charges · outpatientfrom % of charges | 2 | $11 | $11 | — | — | — | $11 – $11 |
| 7 | San Juan Hospital Spanish Valley, UT facility · fee schedule · both | 3 | $34 | $34 | — | — | — | $34 – $34 |
| 8 | University Health Truman Medical Center Kansas City, MO facility · fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
← Payers reporting RC 290 · Snapshot 20261111T120946Z-9134e7f7