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/mdi Optichamber
Springfield, VT
See all hospitals reporting HCPCS A4627 →Price type
Springfield Hospital’s median price of $21 is 16% below the median hospital's median price ($25), higher than 40% of the 490 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: 7 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 | Anthem anthem exchange fee schedule · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 2 | Anthem medicare advantage fee schedule · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 3 | UnitedHealthcare medicare advantage fee schedule · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 4 | WellCare medicare advantage fee schedule · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 5 | Anthem commercial percent of total billed charges · outpatientfrom % of charges | $17 | $17 | — | — | — | $17 – $17 |
| 6 | Cigna commercial percent of total billed charges · outpatientfrom % of charges | $18 | $18 | — | — | — | $18 – $18 |
| 7 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $22 | $22 | — | — | — | $22 – $22 |
| 8 | UnitedHealthcare commercial percent of total billed charges · outpatientfrom % of charges | $23 | $23 | — | — | — | $23 – $23 |
| 9 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $25 | $25 | — | — | — | $25 – $25 |
| 10 | Blue Cross Blue Shield medicare advantage percent of total billed charges · outpatientfrom % of charges | $26 | $26 | — | — | — | $26 – $26 |
| 11 | Cigna medicare advantage percent of total billed charges · outpatientfrom % of charges | $27 | $27 | — | — | — | $27 – $27 |
Last updated: Aug 27, 2026
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