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
POWDER HEMOSTATIC 5G AMP W/2.8MMX230CM DELIVERY SYS
Troy, NY
See all hospitals reporting HCPCS C1052 →Price type
Samaritan Hospital’s median price of $2.6k is 21% below the median hospital's median price ($3.3k), higher than 40% of the 939 hospitals reporting HCPCS C1052. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 13 payers, 24 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 essential plan medicaid facility · percent of total billed charges · bothfrom % of charges | $1.7k | $1.6k | $277 | 17% | — | $1.2k – $1.9k |
| 2 | UnitedHealthcare united healthcare medicaid harp chip facility · percent of total billed charges · bothfrom % of charges | $1.7k | $1.6k | $277 | 17% | — | $1.2k – $1.9k |
| 3 | Blue Cross Blue Shield blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $2.4k | $2.3k | $380 | 17% | — | $1.7k – $2.6k |
| 4 | Blue Cross Blue Shield blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $2.4k | $2.3k | $380 | 17% | — | $1.7k – $2.6k |
| 5 | Carefirst blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $2.4k | $2.3k | $380 | 17% | — | $1.7k – $2.6k |
| 6 | Carefirst blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $2.4k | $2.3k | $380 | 17% | — | $1.7k – $2.6k |
| 7 | Excellus blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $2.4k | $2.3k | $380 | 17% | — | $1.7k – $2.6k |
| 8 | Highmark blue shield of ne new york ascend facility · percent of total billed charges · bothfrom % of charges | $2.4k | $2.3k | $380 | 17% | — | $1.7k – $2.6k |
| 9 | Highmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $2.4k | $2.3k | $380 | 17% | — | $1.7k – $2.6k |
| 10 | Highmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $2.4k | $2.3k | $380 | 17% | — | $1.7k – $2.6k |
| 11 | Premera blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $2.4k | $2.3k | $380 | 17% | — | $1.7k – $2.6k |
| 12 | Regence blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $2.4k | $2.3k | $380 | 17% | — | $1.7k – $2.6k |
| 13 | Wellmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $2.4k | $2.3k | $380 | 17% | — | $1.7k – $2.6k |
| 14 | Wellmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $2.4k | $2.3k | $380 | 17% | — | $1.7k – $2.6k |
| 15 | UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges | $2.9k | $3.2k | $1.1k | 34% | — | $1.7k – $4.8k |
| 16 | First Health first health facility · percent of total billed charges · bothfrom % of charges | $3.5k | $3.3k | $553 | 17% | — | $2.5k – $3.8k |
| 17 | Cigna cigna facility · percent of total billed charges · bothfrom % of charges | $3.7k | $3.5k | $588 | 17% | — | $2.6k – $4.0k |
| 18 | MultiPlan beech street facility · percent of total billed charges · bothfrom % of charges | $3.9k | $3.7k | $622 | 17% | — | $2.8k – $4.3k |
| 19 | MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges | $3.9k | $3.7k | $622 | 17% | — | $2.8k – $4.3k |
| 20 | Phcs multiplan facility · percent of total billed charges · bothfrom % of charges | $3.9k | $3.7k | $622 | 17% | — | $2.8k – $4.3k |
| 21 | Anthem empire medicaid facility · percent of total billed charges · bothfrom % of charges | $4.3k | $4.1k | $692 | 17% | — | $3.1k – $4.8k |
| 22 | Anthem empire medicaid essential 1 2 3 4 facility · percent of total billed charges · bothfrom % of charges | $4.3k | $4.1k | $692 | 17% | — | $3.1k – $4.8k |
| 23 | Excellus empire medicaid facility · percent of total billed charges · bothfrom % of charges | $4.3k | $4.1k | $692 | 17% | — | $3.1k – $4.8k |
| 24 | Excellus empire medicaid essential 1 2 3 4 facility · percent of total billed charges · bothfrom % of charges | $4.3k | $4.1k | $692 | 17% | — | $3.1k – $4.8k |
Last updated: Mar 31, 2026
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