RC 302
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
HB Ref Aquaporin-4 Antibody (Nmo-Igg), Elisa (Q)
Low
$0
Average
$77
Median
$35
High
$2.0k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
308 hospitals; the 90th percentile is 15.6× 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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442 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 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 2 | $36 | $147 | $443 | 301% | 777–1,479 | $7 – $6.2k |
| 2 | ROBERT PACKER HOSPITAL Doing Business As: ROBERT PACKER HOSPITAL, TOWANDA CAMPUS Towanda, PA facility · other · outpatient | 2 | $146 | $339 | $798 | 235% | 311–1,094 | $4 – $6.2k |
| 3 | Massachusetts General Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $152 | $193 | $227 | 117% | 239–716 | $71 – $1.6k |
| 4 | Brigham and Women's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $145 | $163 | $92 | 57% | 234–639 | $82 – $719 |
| 5 | Salem Hospital Salem, MA percent of total billed charges · bothfrom % of charges | 1 | $118 | $131 | $60 | 46% | 223–646 | $35 – $400 |
| 6 | The Children's Hospital of Alabama Birmingham, AL facility · other · outpatient | 1 | $148 | $161 | $114 | 71% | 121 | $34 – $311 |
| 7 | The Children's Hospital of Alabama Birmingham, AL facility · other · outpatient | 1 | $311 | $311 | — | — | 121 | $311 – $311 |
| 8 | ROBERT PACKER HOSPITAL Sayre, PA facility · other · outpatient | 2 | $190 | $381 | $779 | 204% | 119–731 | $4 – $6.2k |
| 9 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient | 1 | $171 | $202 | $137 | 68% | 74–110 | $13 – $653 |
| 10 | Newton Wellesley Hospital Newton, MA percent of total billed charges · bothfrom % of charges | 1 | $115 | $138 | $101 | 73% | 62–377 | $58 – $693 |
| 11 | Wentworth Douglass Hospital Dover, NH other · both | 1 | $95 | $152 | $134 | 88% | 57–84 | $41 – $376 |
| 12 | St. Charles Prineville Prineville, OR percent of total billed charges · bothfrom % of charges | 1 | $28 | $41 | $48 | 116% | 56–461 | $3 – $368 |
| 13 | Mercy Perry Perryville, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $47 | $59 | $81 | 139% | 47–317 | $9 – $1.3k |
| 14 | Brigham and Women's Hospital Boston, MA other · both | 1 | $60 | $83 | $44 | 53% | 44–62 | $44 – $145 |
| 15 | Massachusetts General Hospital Boston, MA other · both | 1 | $103 | $111 | $61 | 55% | 33–60 | $44 – $193 |
| 16 | Anderson Hospital Maryville, IL professional · other · outpatient | 1 | $13 | $19 | $32 | 164% | 32–194 | $3 – $308 |
| 17 | Mercy Hospital Springfield Ozark, MO facility · other · outpatient | 1 | $58 | $134 | $113 | 85% | 27–63 | $28 – $352 |
| 18 | Mercy Hospital Springfield Springfield, MO facility · other · outpatient | 1 | $149 | $152 | $117 | 77% | 27–63 | $28 – $352 |
| 19 | St. Charles Prineville Prineville, OR percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $29 | $15 | 54% | 20–101 | $7 – $80 |
| 20 | Mercy Hospital Waldron Waldron, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $35 | $44 | $42 | 96% | 17 | $7 – $444 |
| 21 | St. Charles Bend Bend, OR other · outpatient | 1 | $189 | $212 | $142 | 67% | 17–35 | $42 – $398 |
| 22 | St. Charles Redmond Redmond, OR other · outpatient | 1 | $189 | $212 | $142 | 67% | 17–35 | $42 – $398 |
| 23 | ONEIDA HEALTH ONEIDA, NY fee schedule · outpatient | 1 | $14 | $35 | $79 | 223% | 12 | $5 – $437 |
| 24 | Mayo Clinic Health System Cannon Falls 55009-5003 facility · percent of total billed charges · bothfrom % of charges | 1 | $72 | $86 | $52 | 61% | 7–70 | $21 – $464 |
| 25 | OKTIBBEHA COUNTY HOSPITAL STARKVILLE, MS other · outpatient | 1 | $51 | $63 | $28 | 44% | 7–70 | $32 – $100 |
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