RC 964
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
ADMINISTRATION ANESTHESIA - PERINEUM,Not Medical Necessity without ABN, Monitored anesthesia care
Low
$20
Average
$231
Median
$109
High
$1.6k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
31 hospitals; the 90th percentile is 19.8× 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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43 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 | Mercy Perry Perryville, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $206 | $194 | $86 | 44% | 2–20 | $23 – $379 |
| 2 | Ascension Seton Luling, TX percent of total billed charges · bothfrom % of charges | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 3 | Ascension Seton Luling, TX percent of total billed charges · outpatientfrom % of charges | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 4 | Ascension Seton Burnet, TX percent of total billed charges · bothfrom % of charges | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 5 | Ascension Seton Burnet, TX percent of total billed charges · outpatientfrom % of charges | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 6 | Ascension Seton Smithville, TX percent of total billed charges · bothfrom % of charges | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 7 | Ascension Seton Smithville, TX percent of total billed charges · outpatientfrom % of charges | 2 | $35 | $35 | $27 | 77% | — | $8 – $63 |
| 8 | Calhoun Liberty Hospital Association Inc Blountstown, FL percent of total billed charges · bothfrom % of charges | 1 | $62 | $93 | $67 | 72% | — | $39 – $208 |
| 9 | Columbia Lutheran Charities Astoria, OR professional · fee schedule · both | 1 | $176 | $168 | $114 | 68% | — | $16 – $448 |
| 10 | Coulee Medical Center Grand Coulee, WA facility · percent of total billed charges · bothfrom % of charges | 1 | $98 | $117 | $59 | 51% | — | $40 – $245 |
| 11 | Coulee Medical Center Grand Coulee, WA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $188 | $399 | $403 | 101% | — | $33 – $1.8k |
| 12 | DELTA COUNTY MEMORIAL HOSPITAL DELTA, CO other · outpatient | 1 | $328 | $326 | $212 | 65% | — | $83 – $830 |
| 13 | GRITMAN MEDICAL CENTER INC Moscow, ID facility · fee schedule · both | 1 | $93 | $130 | $113 | 87% | — | $26 – $491 |
| 14 | HOULTON REGIONAL HOSPITAL HOULTON, ME percent of total billed charges · outpatientfrom % of charges | 1 | $10 | $101 | $156 | 155% | — | $6 – $747 |
| 15 | KAPLAN GENERAL HOSPITAL, INC ST, LA other · outpatient | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 16 | Mayo Clinic Health System Cannon Falls 55009-5003 facility · other · both | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 17 | Mayo Clinic Health System Cannon Falls 55009-5003 facility · percent of total billed charges · bothfrom % of charges | 1 | $403 | $302 | $153 | 51% | — | $86 – $416 |
| 18 | Mercy Hospital Aurora Aurora, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $127 | $132 | $89 | 68% | — | $19 – $280 |
| 19 | Mercy Hospital Berryville Berryville, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $99 | $100 | $76 | 76% | — | $15 – $230 |
| 20 | Mercy Hospital Carthage Carthage, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $125 | $129 | $84 | 65% | — | $17 – $243 |
| 21 | Mercy Hospital Kingfisher, Inc Kingfisher, OK facility · fee schedule · outpatient | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 22 | Mercy Hospital Lincoln Troy, MO facility · fee schedule · outpatient | 1 | $57 | $62 | $11 | 18% | — | $53 – $83 |
| 23 | Mercy Hospital Lincoln Troy, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $140 | $158 | $78 | 50% | — | $86 – $340 |
| 24 | Mercy Hospital Watonga Inc Watonga, OK facility · fee schedule · outpatient | 1 | $80 | $80 | — | — | — | $80 – $80 |
| 25 | Monument Health Rapid City Hospital Inc City, SD fee schedule · outpatient | 1 | $48 | $48 | $10 | 20% | — | $39 – $58 |
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