HCPCS 87653

HC SMR PRIM SRC WET MOUNT NFCT AGT LAB - as described in hospitals' own price files.

20hospitals publishing a price

$167median cash price

-median typical insurance price

Hospital	Location	Cash price	Typical insurance	List price	Negotiated range
Saint John'S Health Center	Santa Monica, CA	$23.80	-	$68.00	-
Providence St. Mary Medical Center	Walla Walla, WA	$97.30	-	$139	-
Providence Centralia Hospital	Centralia, WA	$107	-	$206	-
Providence St. Peter Hospital	Olympia, WA	$107	-	$206	-
Providence St. Joseph Hospital	Chewelah, WA	$116	-	$165	-
Providence Mount Carmel Hospital	Colville, WA	$135	-	$193	-
Covenant Medical Center	Lubbock, TX	$147	-	$349	-
Swedish Edmonds Hospital	Edmonds, WA	$163	-	$339	-
Swedish Medical Center / Cherry Hill	Seattle, WA	$163	-	$339	-
Swedish Issaquah	Issaquah, WA	$163	-	$339	-
Providence Little Co Of Mary Med Ctr San Pedro	San Pedro, CA	$172	-	$490	-
Providence Little Company Of Mary Med Ctr Torrance	Torrance, CA	$172	-	$490	-
Providence Regional Medical Center Everett	Everett, WA	$176	-	$339	-
Providence Alaska Medical Center	Anchorage, AK	$200	-	$257	-
Covenant Hospital Levelland	Levelland, TX	$213	-	$508	-
Providence Holy Family Hospital	Spokane, WA	$216	-	$308	-
St. Patrick Hospital	Missoula, MT	$218	-	$273	-
Providence St. Joseph Medical Center	Polson, MT	$238	-	$297	-
Covenant Hospital Plainview	Plainview, TX	$244	-	$580	-
Kadlec Regional Medical Center	Richland, WA	$262	-	$374	-

Prices are from each hospital's own machine-readable price file. Cash price is the published discounted cash price; typical insurance price is the median of the per-plan negotiated rates in the file; list price is the gross charge.