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
Spacer Bag/reservoir
Hudson, WI
See all hospitals reporting HCPCS A4627 →Price type
Hudson Hospital’s median price of $20 is 19% below the median hospital's median price ($25), higher than 39% of the 495 hospitals reporting HCPCS A4627. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 11 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 | UnitedHealthcare uhc [50131] facility · fee schedule · both | $9 | $9 | — | — | — | $9 – $9 |
| 2 | Blue Cross Blue Shield bcbs pmap [95296] facility · percent of total billed charges · bothfrom % of charges | $12 | $12 | — | — | — | $12 – $12 |
| 3 | Blue Cross Blue Shield bcbs medicare advantage [50299] facility · percent of total billed charges · bothfrom % of charges | $19 | $19 | — | — | — | $19 – $19 |
| 4 | UnitedHealthcare uhc medicare advantage ppo [50275] facility · percent of total billed charges · bothfrom % of charges | $19 | $19 | — | — | — | $19 – $19 |
| 5 | Ucare ucare pmap [50283] facility · percent of total billed charges · bothfrom % of charges | $19 | $19 | — | — | — | $19 – $19 |
| 6 | Medica medica government advantage [50316] facility · percent of total billed charges · bothfrom % of charges | $20 | $20 | — | — | — | $20 – $20 |
| 7 | Medica medica choice care pmap [50314] facility · percent of total billed charges · bothfrom % of charges | $21 | $21 | — | — | — | $21 – $21 |
| 8 | Blue Cross Blue Shield bcbs out of state [91008] facility · percent of total billed charges · bothfrom % of charges | $44 | $44 | — | — | — | $44 – $44 |
| 9 | Medica medica choice [90156] facility · percent of total billed charges · bothfrom % of charges | $45 | $45 | — | — | — | $45 – $45 |
| 10 | First Health first health network [95334] facility · percent of total billed charges · bothfrom % of charges | $51 | $51 | — | — | — | $51 – $51 |
| 11 | Healthpartners hp self insured [91021] facility · fee schedule · both | $70 | $70 | — | — | — | $70 – $70 |
Last updated: Mar 31, 2026
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