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
SURGICAL SUPPLY; MISCELLANEOUS
Custer, SD
See all hospitals reporting HCPCS A4649 →Price type
Monument Health Network Inc’s median price of $526 is 113% above the median hospital's median price ($248), higher than 65% of the 760 hospitals reporting HCPCS A4649. 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, 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 | UnitedHealthcare uhc mcr adv percent of total billed charges · outpatientfrom % of charges | $146 | $146 | $8 | 5% | — | $139 – $154 |
| 2 | Medica medica mcr adv percent of total billed charges · outpatientfrom % of charges | $150 | $150 | $8 | 5% | — | $142 – $157 |
| 3 | Wellmark bcbs wellmark mcr adv percent of total billed charges · outpatientfrom % of charges | $150 | $150 | $8 | 5% | — | $142 – $157 |
| 4 | Medica medica mcaid percent of total billed charges · outpatientfrom % of charges | $194 | $194 | $10 | 5% | — | $184 – $204 |
| 5 | Wellmark bcbs wellmark - all other plans percent of total billed charges · outpatientfrom % of charges | $526 | $526 | $27 | 5% | — | $499 – $553 |
| 6 | Aetna aetna - all plans percent of total billed charges · outpatientfrom % of charges | $555 | $555 | $29 | 5% | — | $526 – $583 |
| 7 | MultiPlan multiplan/phcs - all plans percent of total billed charges · outpatientfrom % of charges | $555 | $555 | $29 | 5% | — | $526 – $583 |
| 8 | Medica medica commercial - all other plans percent of total billed charges · outpatientfrom % of charges | $567 | $567 | $29 | 5% | — | $538 – $596 |
| 9 | UnitedHealthcare uhc - all other plans percent of total billed charges · outpatientfrom % of charges | $567 | $567 | $29 | 5% | — | $538 – $596 |
| 10 | Humana humana commercial - all plans percent of total billed charges · outpatientfrom % of charges | $584 | $584 | $30 | 5% | — | $554 – $614 |
Last updated: Sep 1, 2026
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