RC 404
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
POSITRON EMISSION TOMOGRAPHY
Low
$664
Average
$2.4k
Median
$1.4k
High
$17.4k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
200 hospitals; the 90th percentile is 4.8× 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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221 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 | ROBERT PACKER HOSPITAL Sayre, PA facility · other · outpatient | 2 | $3.9k | $5.3k | $4.1k | 78% | 50–68 | $1.5k – $13.6k |
| 2 | Mercy Hospital Springfield Ozark, MO facility · other · outpatient | 1 | $1.4k | $1.5k | $301 | 20% | 32–50 | $1.3k – $2.2k |
| 3 | Mercy Hospital Springfield Springfield, MO facility · other · outpatient | 1 | $1.4k | $1.5k | $301 | 20% | 32–50 | $1.3k – $2.2k |
| 4 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 2 | $3.8k | $5.1k | $3.6k | 72% | 27–36 | $1.7k – $11.1k |
| 5 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient | 1 | $2.2k | $4.0k | $3.0k | 76% | 17 | $1.8k – $9.9k |
| 6 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS other · outpatient | 1 | $1.3k | $1.3k | $53 | 4% | 15–42 | $1.2k – $1.3k |
| 7 | Mercy Hospital Fort Smith Smith, AR facility · other · outpatient | 1 | $1.4k | $1.5k | $336 | 22% | 4–40 | $1.2k – $2.1k |
| 8 | Mercy Hospital Fort Smith Smith, AR facility · other · outpatient | 1 | $1.4k | $1.5k | $336 | 22% | 4–40 | $1.2k – $2.1k |
| 9 | PRISMA HEALTH BAPTIST COLUMBIA HOSPITAL COLUMBIA, SC other · both | 1 | $1.3k | $1.3k | $57 | 4% | 3–30 | $1.2k – $1.3k |
| 10 | Mercy Hospital Rogers dba Mercy Hospital Northwest Arkansas Rogers, AR facility · other · outpatient | 1 | $1.3k | $1.5k | $306 | 21% | 2–20 | $1.3k – $2.0k |
| 11 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC other · both | 1 | $1.4k | $1.3k | $53 | 4% | 2–20 | $1.2k – $1.4k |
| 12 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC other · both | 1 | $1.4k | $1.3k | $53 | 4% | 2–20 | $1.2k – $1.4k |
| 13 | PRISMA HEALTH TUOMEY HOSPITAL SUMTER, SC other · both | 1 | $1.4k | $1.3k | $57 | 4% | 2–20 | $1.2k – $1.4k |
| 14 | Benefis Hospitals Inc Helena, MT other · outpatient | 1 | $1.5k | $1.5k | — | — | 1–10 | $1.5k – $1.5k |
| 15 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $2.0k | $1.9k | $325 | 17% | 1–10 | $1.4k – $2.2k |
| 16 | Massachusetts General Hospital Boston, MA other · both | 1 | $2.5k | $2.5k | — | — | 1–10 | $2.5k – $2.5k |
| 17 | Mississippi Baptist Medical Center Jackson, MS facility · other · outpatient | 1 | $1.3k | $1.3k | — | — | 1–10 | $1.3k – $1.3k |
| 18 | ONEIDA HEALTH ONEIDA, NY other · outpatient | 1 | $1.8k | $1.8k | — | — | 1–10 | $1.8k – $1.8k |
| 19 | PRISMA HEALTH PATEWOOD HOSPITAL GREENVILLE, SC other · both | 1 | $1.4k | $1.3k | $50 | 4% | 1–10 | $1.2k – $1.4k |
| 20 | Affinity Hospital LLC Birmingham, AL facility · fee schedule · outpatient | 1 | $1.2k | $1.2k | $47 | 4% | — | $1.1k – $1.2k |
| 21 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 22 | Anderson Hospital Maryville, IL professional · other · outpatient | 1 | $1.4k | $1.4k | $0 | 0% | — | $1.4k – $1.4k |
| 23 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 24 | Ascension Calumet Hospital, Inc. Chilton, WI percent of total billed charges · bothfrom % of charges | 1 | $2.1k | $2.1k | $459 | 22% | — | $1.5k – $2.6k |
| 25 | Ascension Calumet Hospital, Inc. Chilton, WI percent of total billed charges · outpatientfrom % of charges | 1 | $2.1k | $2.1k | $459 | 22% | — | $1.5k – $2.6k |
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