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
Spherocylinder 4.00d/4.25-6d
Devils Lake, ND
See all hospitals reporting HCPCS V2105 →Price type
Altru Hospital Devils Lake’s median price of $58 is about the same as the median hospital's median price ($58), higher than 45% of the 731 hospitals reporting HCPCS V2105. 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 | $20 | $20 | — | — | — | $20 – $20 |
| 2 | Medica medicaid managed care plan – hmo facility · fee schedule · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 3 | Medica medicare managed care plan facility · fee schedule · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 4 | Aetna medicare managed care plan facility · fee schedule · outpatient | $50 | $50 | — | — | — | $50 – $50 |
| 5 | Blue Cross Blue Shield all commercial plans facility · fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 6 | Blue Cross Blue Shield medicaid managed care plan facility · fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 7 | Medica all commercial plans facility · fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 8 | Sanford Health Plan all commercial plans facility · fee schedule · outpatient | $69 | $69 | $10 | 15% | — | $59 – $79 |
| 9 | Aetna all commercial plans facility · fee schedule · outpatient | $72 | $72 | $19 | 26% | — | $53 – $90 |
| 10 | UnitedHealthcare all commercial plans facility · fee schedule · outpatient | $98 | $98 | — | — | — | $98 – $98 |
Last updated: Mar 1, 2026
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