RC 483
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
HC Tte F-Up or Lmtd - Tte Limited W/ Contrast
Low
$0
Average
$848
Median
$531
High
$6.3k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
284 hospitals; the 90th percentile is 5.0× 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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322 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 | PRISMA HEALTH BAPTIST PARKRIDGE HOSPITAL COLUMBIA, SC other · both | 1 | $515 | $601 | $261 | 43% | 249–321 | $227 – $1.5k |
| 2 | PRISMA HEALTH RICHLAND HOSPITAL COLUMBIA, SC other · both | 1 | $515 | $601 | $261 | 43% | 249–321 | $227 – $1.5k |
| 3 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS other · outpatient | 1 | $493 | $549 | $115 | 21% | 200–245 | $315 – $708 |
| 4 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient | 1 | $695 | $977 | $863 | 88% | 190–208 | $104 – $4.7k |
| 5 | ROBERT PACKER HOSPITAL Sayre, PA facility · other · outpatient | 2 | $868 | $1.3k | $1.1k | 85% | 170–224 | $99 – $4.7k |
| 6 | Mercy Hospital Lebanon dba Mercy Hospital Lebanon Rolla, MO facility · other · outpatient | 1 | $575 | $535 | $169 | 32% | 102–111 | $251 – $825 |
| 7 | Mercy Hospital Springfield Ozark, MO facility · other · outpatient | 1 | $537 | $527 | $196 | 37% | 85–121 | $234 – $770 |
| 8 | Mercy Hospital Springfield Springfield, MO facility · other · outpatient | 1 | $537 | $527 | $196 | 37% | 85–121 | $234 – $770 |
| 9 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 2 | $933 | $1.5k | $1.4k | 94% | 81–135 | $66 – $5.7k |
| 10 | Mercy Hospital Rogers dba Mercy Hospital Northwest Arkansas Rogers, AR facility · other · outpatient | 1 | $500 | $466 | $191 | 41% | 78–96 | $218 – $718 |
| 11 | NEMOURS CHILDREN'S HOSPITAL Philadelphia, PA case rate · outpatient | 1 | $574 | $532 | $143 | 27% | 63–99 | $253 – $827 |
| 12 | ROBERT PACKER HOSPITAL Doing Business As: ROBERT PACKER HOSPITAL, TOWANDA CAMPUS Towanda, PA facility · other · outpatient | 2 | $868 | $1.4k | $1.4k | 97% | 53–89 | $80 – $5.3k |
| 13 | NEMOURS CHILDREN'S HOSPITAL STE 100 LAKE MARY, FL other · outpatient | 1 | $550 | $489 | $123 | 25% | 50–95 | $243 – $550 |
| 14 | Southern Baptist Hospital of Florida, INC FL 32222; 461 Outlet Mall Blvd St. Augustine, FL facility · other · outpatient | 1 | $777 | $715 | $321 | 45% | 50–113 | $221 – $1.3k |
| 15 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC other · both | 1 | $511 | $571 | $259 | 45% | 48–75 | $225 – $1.4k |
| 16 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC other · both | 1 | $511 | $571 | $259 | 45% | 48–75 | $225 – $1.4k |
| 17 | The Children's Hospital of Alabama Birmingham, AL facility · other · outpatient | 1 | $474 | $386 | $125 | 32% | 36 | $209 – $474 |
| 18 | The Children's Hospital of Alabama Birmingham, AL facility · other · outpatient | 1 | $474 | $474 | — | — | 36 | $474 – $474 |
| 19 | Wentworth Douglass Hospital Dover, NH other · both | 1 | $573 | $445 | $157 | 35% | 35–71 | $253 – $573 |
| 20 | Massachusetts General Hospital Boston, MA other · both | 1 | $446 | $446 | $173 | 39% | 28–55 | $273 – $619 |
| 21 | Mercy Hospital Fort Smith Smith, AR facility · other · outpatient | 1 | $519 | $509 | $199 | 39% | 26–44 | $227 – $745 |
| 22 | Mercy Hospital Fort Smith Smith, AR facility · other · outpatient | 1 | $519 | $509 | $199 | 39% | 26–44 | $227 – $745 |
| 23 | PRISMA HEALTH GREER MEMORIAL HOSPITAL GREER, SC other · both | 1 | $510 | $608 | $274 | 45% | 26–35 | $225 – $1.4k |
| 24 | Brigham and Women's Hospital Boston, MA other · both | 1 | $619 | $503 | $163 | 32% | 25–70 | $273 – $619 |
| 25 | PRISMA HEALTH HILLCREST HOSPITAL SIMPSONVILLE, SC other · both | 1 | $510 | $608 | $274 | 45% | 24–51 | $225 – $1.4k |
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