RC 489
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 CT Heart W/WO Dye Funct
Low
$108
Average
$652
Median
$338
High
$3.0k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
9 hospitals; the 90th percentile is 4.2× 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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12 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 | Austin Center for Outpatient Surgery LP, DBA Northwest Hills Surgical Hospital Austin, TX percent of total billed charges · bothfrom % of charges | 1 | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 2 | Austin Center for Outpatient Surgery LP, DBA Northwest Hills Surgical Hospital Austin, TX percent of total billed charges · outpatientfrom % of charges | 1 | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 3 | Doylestown Hospital Doylestown, PA facility · fee schedule · outpatient | 1 | $672 | $560 | $158 | 28% | — | $336 – $672 |
| 4 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $547 | $547 | $278 | 51% | — | $270 – $825 |
| 5 | NEMOURS CHILDREN'S HOSPITAL STE 100 LAKE MARY, FL other · outpatient | 1 | $407 | $407 | $250 | 61% | — | $157 – $657 |
| 6 | San Juan Hospital Spanish Valley, UT facility · fee schedule · both | 3 | $108 | $108 | — | — | — | $108 – $108 |
| 7 | University of Virginia Culpeper Medical Center Culpeper, VA fee schedule · both | 1 | $179 | $338 | $290 | 86% | — | $155 – $840 |
| 8 | University of Virginia Haymarket Medical Center Haymarket, VA fee schedule · both | 1 | $179 | $338 | $290 | 86% | — | $155 – $840 |
| 9 | University of Virginia Medical Center Charlottesville, VA fee schedule · both | 1 | $180 | $339 | $289 | 85% | — | $155 – $840 |
| 10 | University of Virginia Medical Center Charlottesville, VA fee schedule · outpatient | 1 | $168 | $168 | $13 | 7% | — | $155 – $180 |
| 11 | University of Virginia Prince William Medical Center Manassas, VA fee schedule · both | 1 | $179 | $338 | $290 | 86% | — | $155 – $840 |
| 12 | University of Virginia Prince William Medical Center Manassas, VA fee schedule · outpatient | 1 | $177 | $177 | — | — | — | $177 – $177 |
← Payers reporting RC 489 · Snapshot 20261111T120946Z-9134e7f7