RC 623
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 DRESSING MEPITEL T2
Low
$0
Average
$227
Median
$41
High
$1.2k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
75 hospitals; the 90th percentile is 120.4× 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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99 hospital rates
iThe hospitals that file a Molina 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 | Public Hospital District No 1 of Mason County Shelton, WA fee schedule · both | 1 | $19 | $18 | $1 | 8% | 11–110 | $16 – $19 |
| 2 | Aurora BayCare Medical Center Green Bay, WI percent of total billed charges · outpatientfrom % of charges | 1 | $26 | $41 | $37 | 92% | 1–10 | $6 – $144 |
| 3 | Aurora Sinai Medical Center of Aurora Health Care Metro Inc Milwaukee, WI percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $41 | $36 | 89% | 1–10 | $6 – $144 |
| 4 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $12 | $12 | $3 | 21% | — | $10 – $15 |
| 5 | Allen Memorial Hospital Corporation Waterloo, IA case rate · outpatient | 1 | $20 | $20 | $10 | 48% | — | $10 – $30 |
| 6 | Aurora Lakeland Medical Center Elkhorn, WI percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $39 | $31 | 81% | — | $6 – $102 |
| 7 | Aurora Medical Center Bay Area Marinette, WI percent of total billed charges · outpatientfrom % of charges | 1 | $18 | $27 | $28 | 102% | — | $6 – $87 |
| 8 | Aurora Medical Center Burlington Burlington, WI percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $47 | $44 | 94% | — | $6 – $171 |
| 9 | Aurora Medical Center Fond du Lac Fond Du Lac, WI percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $47 | $44 | 94% | — | $6 – $171 |
| 10 | Aurora Medical Center Grafton Grafton, WI percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $47 | $44 | 94% | — | $6 – $171 |
| 11 | Aurora Medical Center Kenosha Kenosha, WI percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $48 | $44 | 92% | — | $6 – $171 |
| 12 | Aurora Medical Center Manitowoc Two Rivers, WI percent of total billed charges · outpatientfrom % of charges | 1 | $26 | $38 | $31 | 84% | — | $6 – $102 |
| 13 | Aurora Medical Center Mount Pleasant Mount Pleasant, WI percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $48 | $44 | 92% | — | $6 – $171 |
| 14 | Aurora Medical Center Oshkosh Oshkosh, WI percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $47 | $44 | 94% | — | $6 – $171 |
| 15 | Aurora Medical Center Sheboygan County Sheboygan, WI percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $43 | $40 | 94% | — | $6 – $171 |
| 16 | Aurora Medical Center Summit Summit, WI percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $45 | $37 | 83% | — | $6 – $144 |
| 17 | Aurora Medical Center Washington County Hartford, WI percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $47 | $44 | 94% | — | $6 – $171 |
| 18 | Aurora Psychiatric Hospital Wauwatosa, WI percent of total billed charges · outpatientfrom % of charges | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 19 | Aurora St Lukes Medical Center of Aurora Health Care Metro Inc Milwaukee, WI percent of total billed charges · outpatientfrom % of charges | 1 | $30 | $48 | $44 | 91% | — | $6 – $171 |
| 20 | Aurora St Lukes South Shore of Aurora Health Care Metro Inc Cudahy, WI percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $46 | $43 | 94% | — | $6 – $171 |
| 21 | Aurora West Allis Medical Center West Allis, WI percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $43 | $37 | 86% | — | $6 – $144 |
| 22 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE other · outpatient | 1 | $33 | $41 | $28 | 68% | — | $2 – $75 |
| 23 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE percent of total billed charges · outpatientfrom % of charges | 1 | $30 | $172 | $388 | 225% | — | $12 – $1.2k |
| 24 | Bronson LakeView Hospital Paw Paw, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $6 | $9 | $8 | 81% | — | $3 – $24 |
| 25 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
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