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
Spherocylindr 4.00d/12-2.00d
Devils Lake, ND
See all hospitals reporting HCPCS V2103 →Price type
Altru Hospital Devils Lake’s median price of $52 is 8% above the median hospital's median price ($48), higher than 61% of the 730 hospitals reporting HCPCS V2103. 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 | $16 | $16 | — | — | — | $16 – $16 |
| 2 | Medica medicaid managed care plan – hmo facility · fee schedule · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 3 | Medica medicare managed care plan facility · fee schedule · outpatient | $29 | $29 | — | — | — | $29 – $29 |
| 4 | Blue Cross Blue Shield all commercial plans facility · fee schedule · outpatient | $47 | $47 | — | — | — | $47 – $47 |
| 5 | Blue Cross Blue Shield medicaid managed care plan facility · fee schedule · outpatient | $47 | $47 | — | — | — | $47 – $47 |
| 6 | Medica all commercial plans facility · fee schedule · outpatient | $47 | $47 | — | — | — | $47 – $47 |
| 7 | Aetna medicare managed care plan facility · fee schedule · outpatient | $52 | $52 | — | — | — | $52 – $52 |
| 8 | Sanford Health Plan all commercial plans facility · fee schedule · outpatient | $70 | $70 | $10 | 15% | — | $60 – $81 |
| 9 | Aetna all commercial plans facility · fee schedule · outpatient | $73 | $73 | $19 | 26% | — | $54 – $93 |
| 10 | UnitedHealthcare all commercial plans facility · fee schedule · outpatient | $101 | $101 | — | — | — | $101 – $101 |
Last updated: Mar 1, 2026
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