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
Tlso trnk sj-t9 pre cst
Devils Lake, ND
See all hospitals reporting HCPCS L0454 →Price type
Altru Hospital Devils Lake’s median price of $431 is 1% below the median hospital's median price ($437), higher than 42% of the 849 hospitals reporting HCPCS L0454. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 10 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 | $142 | $142 | — | — | — | $142 – $142 |
| 2 | Medica medicaid managed care plan – hmo facility · fee schedule · outpatient | $142 | $142 | — | — | — | $142 – $142 |
| 3 | Medica medicare managed care plan facility · fee schedule · outpatient | $257 | $257 | — | — | — | $257 – $257 |
| 4 | Blue Cross Blue Shield all commercial plans facility · fee schedule · outpatient | $418 | $418 | — | — | — | $418 – $418 |
| 5 | Blue Cross Blue Shield medicaid managed care plan facility · fee schedule · outpatient | $418 | $418 | — | — | — | $418 – $418 |
| 6 | Medica all commercial plans facility · fee schedule · outpatient | $418 | $418 | — | — | — | $418 – $418 |
| 7 | Aetna medicare managed care plan facility · fee schedule · outpatient | $431 | $431 | — | — | — | $431 – $431 |
| 8 | Sanford Health Plan all commercial plans facility · fee schedule · outpatient | $589 | $589 | $86 | 15% | — | $503 – $675 |
| 9 | Aetna all commercial plans facility · fee schedule · outpatient | $614 | $614 | $162 | 26% | — | $452 – $776 |
| 10 | UnitedHealthcare all commercial plans facility · fee schedule · outpatient | $844 | $844 | — | — | — | $844 – $844 |
Last updated: Mar 1, 2026
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