HCPCS C1052
Hemostatic agent, gastrointestinal, topical
Current code39 hospitals with prices
What Washington hospitals publish for this code
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | — | $3,912 | $9,780 |
| Cascade Valley Hospital | $3,998 | $3,198 | $3,998 |
| Deaconess Medical Center | — | $3,912 | $9,780 |
| Harborview Medical Center | — | $5,266 | $7,524 |
| Highline Medical Center | — | $2,601 – $4,396 | $8,518 – $14,396 |
| Kadlec Regional Medical Center | — | $1,777 – $4,095 | $2,538 – $5,850 |
| Mary Bridge Children's Hospital | — | $3,912 | $9,780 |
| MultiCare Auburn Medical Center | — | $3,912 – $5,280 | $9,780 – $13,200 |
| MultiCare Covington Medical Center | — | $3,912 | $9,780 |
| MultiCare Good Samaritan Hospital | — | $3,912 – $5,280 | $9,780 – $13,200 |
| MultiCare Valley Hospital | — | $3,912 | $9,780 |
| Olympic Medical Center | — | $3,200 | $4,000 |
| Overlake Hospital Medical Center & Clinics | — | $3,413 | $6,825 |
| PeaceHealth Southwest Medical Cente | — | $56.30 | $86.61 |
| PeaceHealth St John Medical Center | — | $3,536 | $5,440 |
| PeaceHealth St Joseph Medical Center | — | $1,845 | $2,838 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $1,791 – $5,514 | $2,559 – $7,877 |
| Providence Centralia Hospital | — | $2,890 – $8,931 | $5,557 – $17,175 |
| Providence Holy Family Hospital | — | $1,791 – $5,514 | $2,559 – $7,877 |
| Providence Mount Carmel Hospital | — | $1,709 – $5,268 | $2,441 – $7,525 |
| Providence Regional Medical Center Everett | — | $3,062 – $7,501 | $5,888 – $14,425 |
| Providence St Joseph Hospital | — | $1,709 – $5,268 | $2,441 – $7,525 |
| Providence St Mary Medical Center | — | $1,787 – $4,708 | $2,553 – $6,725 |
| Providence St Peter Hospital | — | $2,890 – $8,931 | $5,557 – $17,175 |
| Skagit Valley Hospital | — | $3,198 – $4,359 | $3,998 – $5,449 |
| St Anthony Hospital | — | $2,591 – $4,378 | $8,518 – $14,396 |
| St Clare Hospital | — | $2,455 – $4,149 | $8,518 – $14,396 |
| St Elizabeth Hospital | $1,533 – $3,167 | $3,010 – $5,087 | $8,518 – $14,396 |
| St Francis Community Hospital | — | $2,673 – $4,518 | $8,518 – $14,396 |
| St Joseph Medical Center | — | $2,821 – $4,768 | $8,518 – $14,396 |
| St Michael Medical Center | — | $3,760 – $6,354 | $8,518 – $14,396 |
| Swedish Edmonds Hospital | — | $1,856 – $5,256 | $3,868 – $10,950 |
| Swedish Issaquah | — | $1,856 – $5,256 | $3,868 – $10,950 |
| Swedish Medical Center | — | $1,856 – $5,256 | $3,868 – $10,950 |
| Swedish Medical Center / Cherry Hill | — | $1,856 – $5,256 | $3,868 – $10,950 |
| Tacoma General Allenmore Hospital | — | $3,912 – $5,280 | $9,780 – $13,200 |
| University of Washington Medical Ctr | — | $4,681 | $6,687 |
| Virginia Mason Medical Center | — | $2,989 – $3,978 | $5,860 – $7,800 |
| Yakima Valley Memorial | — | $1,728 – $1,944 | $4,320 – $4,860 |
Medicare (traditional) reference
CMS publishes no national amount for this code.