4095115 (OTHER) — raw rate rows

OTHER · raw rates

4095115 — Femoral Head 8777-028-03 28mm +3.5mm

Per-row negotiated rates, exactly as filed by each hospital. Aggregated views below summarize across hospitals; the bottom table shows the underlying rows.

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Typical negotiated price $6,309

Usually $6,258–$6,503 (25th–75th percentile) across 1 hospital · 5 payers.

“Negotiated” is the hospital’s negotiated facility rate for this OTHER 4095115 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.

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This estimate runs on the hospital’s facility charge only. The surgeon’s and anesthesiologist’s fees are billed separately and aren’t in this number — your EOB shows your complete total.

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Out-of-pocket max (assumed — typical plan) Coinsurance % (after deductible)

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Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.

Hospital rates (per row)

Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.

Hospital	Payer	Plan	Negotiated rate	Gross	Cash	Observed	Source
POINTE COUPEE GENERAL HOSPITAL	Anthem Medicare Advantage	—	$3,267.36	$7,049.32	—	2026-07-31	MRF ↗
POINTE COUPEE GENERAL HOSPITAL	Anthem Medigap	—	$6,252.04	$7,049.32	—	2026-07-31	MRF ↗
POINTE COUPEE GENERAL HOSPITAL	Aetna	—	$6,273.89	$7,049.32	—	2026-07-31	MRF ↗
POINTE COUPEE GENERAL HOSPITAL	Self-Pay Rate	—	$6,344.39	$7,049.32	—	2026-07-31	MRF ↗
POINTE COUPEE GENERAL HOSPITAL	Cigna	—	$6,555.87	$7,049.32	—	2026-07-31	MRF ↗
POINTE COUPEE GENERAL HOSPITAL	Humana (Choicecare)	—	$6,696.85	$7,049.32	—	2026-07-31	MRF ↗