Smooth low-profile rectangular tissue expander, 160-320 cc at Saint Alphonsus Medical Center - Ontario

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

EXPANDER TISS TALL CPX4 450ML W/SUTURE TABS

Ontario, OR

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How this price compares nationally

Saint Alphonsus Medical Center - Ontario’s median price of $984 is 52% below the median hospital's median price ($2.1k), higher than 17% of the 1,315 hospitals reporting HCPCS C1789. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS C1789 at Saint Alphonsus Medical Center - Ontario

Negotiated rates from the hospital’s own file: 19 payers, 26 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	Aetna medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
2	Amerihealth Caritas medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
3	Anthem medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
4	Blue Cross Blue Shield medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
5	Carefirst medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
6	Caresource medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
7	Cigna medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
8	Excellus medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
9	First Health medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
10	Highmark medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
11	Humana medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
12	Kaiser medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
13	Magellan medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
14	Medicaid medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
15	Molina medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
16	Ucare medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
17	UnitedHealthcare medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
18	WellCare medicaid facility · percent of total billed charges · bothfrom % of charges	$964.54	$902.90	$7.50 – $1,363
19	Blue Cross Blue Shield blue cross of idaho connected care facility · percent of total billed charges · bothfrom % of charges	$2,476	$2,317	$19.25 – $3,497
20	Blue Cross Blue Shield bci hmo facility · percent of total billed charges · bothfrom % of charges	$2,733	$2,558	$21.25 – $3,861
21	Humana humana facility · percent of total billed charges · bothfrom % of charges	$2,829	$2,649	$22.00 – $3,997
22	Phcs multiplan facility · percent of total billed charges · bothfrom % of charges	$2,894	$2,709	$22.50 – $4,088
23	Cigna cigna facility · percent of total billed charges · bothfrom % of charges	$3,022	$2,829	$23.50 – $4,270
24	Aetna aetna facility · percent of total billed charges · bothfrom % of charges	$3,045	$2,850	$23.68 – $4,301
25	First Health first health facility · percent of total billed charges · bothfrom % of charges	$3,054	$2,859	$23.75 – $4,315

Page 1 of 2 · 26 rates

Last updated: Mar 31, 2026

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