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
PWC gp3 xhd mult pow opt s/b
Devils Lake, ND
See all hospitals reporting HCPCS K0864 →Price type
Altru Hospital Devils Lake’s median price of $2.2k is 7% below the median hospital's median price ($2.3k), higher than 13% of the 570 hospitals reporting HCPCS K0864. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 2 payers, 6 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Medica medicaid managed care plan facility · fee schedule · outpatient | $735 | $735 | — | — | — | $735 – $735 |
| 2 | Medica medicaid managed care plan – hmo facility · fee schedule · outpatient | $735 | $735 | — | — | — | $735 – $735 |
| 3 | Medica medicare managed care plan facility · fee schedule · outpatient | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 4 | Medica all commercial plans facility · fee schedule · outpatient | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 5 | Blue Cross Blue Shield all commercial plans facility · fee schedule · outpatient | $22.7k | $22.7k | — | — | — | $22.7k – $22.7k |
| 6 | Blue Cross Blue Shield medicaid managed care plan facility · fee schedule · outpatient | $22.7k | $22.7k | — | — | — | $22.7k – $22.7k |
Last updated: Mar 1, 2026
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