RC 424
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.
Generation details were not recorded for this description.
Original text from hospital filings
HC PT EVAL LOW COMPLEX 20 MIN
Low
$0
Average
$153
Median
$88
High
$1.0k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
260 hospitals; the 90th percentile is 3.7× 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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294 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 | 1 | $90 | $85 | $12 | 14% | 140–158 | $66 – $95 |
| 2 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS fee schedule · outpatient | 1 | $91 | $84 | $12 | 15% | 88–97 | $62 – $91 |
| 3 | Wentworth Douglass Hospital Dover, NH fee schedule · both | 1 | $99 | $99 | — | — | 84 | $99 – $99 |
| 4 | Massachusetts General Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $594 | $594 | — | — | 64–73 | $594 – $594 |
| 5 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · fee schedule · outpatient | 1 | $95 | $88 | $13 | 15% | 63–72 | $66 – $97 |
| 6 | ROBERT PACKER HOSPITAL Sayre, PA facility · other · outpatient | 1 | $87 | $83 | $12 | 14% | 63–81 | $65 – $94 |
| 7 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $149 | $131 | $47 | 36% | 54–72 | $14 – $169 |
| 8 | OUR LADY OF LOURDES MEMORIAL HOSPITAL INC. Doing Business As: LOURDES Binghamton, NY facility · fee schedule · outpatient | 1 | $91 | $78 | $26 | 33% | 30–48 | $32 – $101 |
| 9 | DELTA COUNTY MEMORIAL HOSPITAL DELTA, CO fee schedule · outpatient | 1 | $101 | $94 | $14 | 14% | 6–60 | $70 – $101 |
| 10 | OKTIBBEHA COUNTY HOSPITAL STARKVILLE, MS fee schedule · outpatient | 1 | $91 | $84 | $12 | 15% | 4–40 | $62 – $91 |
| 11 | Newton Wellesley Hospital Newton, MA percent of total billed charges · bothfrom % of charges | 1 | $429 | $429 | — | — | 3–30 | $429 – $429 |
| 12 | CLEVELAND AREA HOSPITAL CLEVELAND, OK percent of total billed charges · outpatientfrom % of charges | 1 | $130 | $122 | $20 | 17% | 2–20 | $88 – $138 |
| 13 | ROBERT PACKER HOSPITAL Doing Business As: ROBERT PACKER HOSPITAL, TOWANDA CAMPUS Towanda, PA facility · other · outpatient | 1 | $234 | $295 | $221 | 75% | 2–20 | $89 – $621 |
| 14 | Brigham and Women's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $594 | $594 | — | — | 1–10 | $594 – $594 |
| 15 | Craig Hospital Englewood, CO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $837 | $1.0k | $377 | 37% | 1–10 | $563 – $1.7k |
| 16 | Massachusetts Eye and Ear Boston, MA fee schedule · both | 1 | $109 | $109 | — | — | 1–10 | $109 – $109 |
| 17 | ONEIDA HEALTH ONEIDA, NY fee schedule · outpatient | 1 | $95 | $80 | $24 | 30% | 1–10 | $32 – $95 |
| 18 | Salem Hospital Salem, MA percent of total billed charges · bothfrom % of charges | 1 | $429 | $429 | — | — | 1–10 | $429 – $429 |
| 19 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY fee schedule · outpatient | 1 | $97 | $90 | $13 | 14% | — | $67 – $97 |
| 20 | Affinity Hospital LLC Birmingham, AL facility · fee schedule · outpatient | 1 | $87 | $80 | $12 | 15% | — | $59 – $87 |
| 21 | Anderson Hospital Maryville, IL facility · fee schedule · outpatient | 1 | $92 | $85 | $13 | 15% | — | $63 – $92 |
| 22 | Anderson Hospital Maryville, IL professional · other · outpatient | 1 | $94 | $87 | $13 | 15% | — | $65 – $94 |
| 23 | Armstrong County Memorial Hospital Kittanning, PA facility · fee schedule · outpatient | 1 | $94 | $87 | $13 | 15% | — | $65 – $94 |
| 24 | Ascension Calumet Hospital, Inc. Chilton, WI percent of total billed charges · bothfrom % of charges | 1 | $199 | $193 | $54 | 28% | — | $115 – $261 |
| 25 | Ascension Calumet Hospital, Inc. Chilton, WI percent of total billed charges · outpatientfrom % of charges | 1 | $199 | $193 | $54 | 28% | — | $115 – $261 |
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