Custom shape cover bk cost at US hospitals
Custom shape cover BK · HCPCS L5704
$479.45
lowest cash price
$1,062.75
national median
$1,600.60
highest cash price
11
hospitals with a published cash price
Middle half of hospitals (25th–75th percentile) against the full range. The same procedure varies $479.45–$1,600.60 — the variation is the story.
Most expensive published cash price
$1,600.60
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) — Milwaukee, WIMedian cash price over time
Jan 1, 2026 ($1,600.60) → Jun 1, 2026 ($1,062.75)
By state
| State | Hospitals | Lowest cash | Median | Highest |
|---|---|---|---|---|
| Alaska | 1 | not published by hospital | not published by hospital | not published by hospital |
| California | 7 | $702.53 | $717.62 | $926.65 |
| Colorado | 8 | not published by hospital | not published by hospital | not published by hospital |
| Florida | 10 | not published by hospital | not published by hospital | not published by hospital |
| Georgia | 2 | not published by hospital | not published by hospital | not published by hospital |
| Illinois | 10 | not published by hospital | not published by hospital | not published by hospital |
| Iowa | 11 | not published by hospital | not published by hospital | not published by hospital |
| Kansas | 1 | not published by hospital | not published by hospital | not published by hospital |
| Maine | 7 | not published by hospital | not published by hospital | not published by hospital |
| Michigan | 12 | $1,062.75 | $1,062.75 | $1,062.75 |
| Minnesota | 2 | not published by hospital | not published by hospital | not published by hospital |
| Missouri | 1 | not published by hospital | not published by hospital | not published by hospital |
| New Hampshire | 1 | not published by hospital | not published by hospital | not published by hospital |
| New Jersey | 18 | not published by hospital | not published by hospital | not published by hospital |
| New York | 7 | not published by hospital | not published by hospital | not published by hospital |
| North Carolina | 11 | not published by hospital | not published by hospital | not published by hospital |
| North Dakota | 2 | not published by hospital | not published by hospital | not published by hospital |
| Ohio | 22 | $479.45 | $479.45 | $479.45 |
| Oklahoma | 3 | not published by hospital | not published by hospital | not published by hospital |
| South Carolina | 2 | not published by hospital | not published by hospital | not published by hospital |
| South Dakota | 2 | not published by hospital | not published by hospital | not published by hospital |
| Texas | 6 | not published by hospital | not published by hospital | not published by hospital |
| Virginia | 8 | not published by hospital | not published by hospital | not published by hospital |
| Washington | 5 | not published by hospital | not published by hospital | not published by hospital |
| Wisconsin | 4 | $1,600.60 | $1,600.60 | $1,600.60 |
All hospitals
| Hospital | Location | Cash price | Negotiated range |
|---|---|---|---|
| Sanford Medical Center Bismarck | Bismarck, ND | not published | $675.19 – $746.27 |
| Atrium Health Mercy | Charlotte, NC | not published | $656.22 – $804.19 |
| Sanford Worthington Medical Center | Worthington, MN | not published | $700.44 – $884.78 |
| Sanford Bemidji Medical Center | Bemidji, MN | not published | $713.05 – $884.78 |
| HCA HOUSTON NORTHWEST | SPRING, TX | not published | $643.05 – $1,410.77 |
| HCA HOUSTON KINGWOOD | HUMBLE, TX | not published | $643.05 – $1,410.77 |
| TRICITIES HOSPITAL | HOPEWELL, VA | not published | $611.26 – $970.83 |
| STONESPRINGS HOSPITAL CENTER | Dulles, VA | not published | $539.35 – $769.47 |
| SPOTSYLVANIA REGIONAL MEDICAL CENTER | Fredericksburg, VA | not published | $697.56 – $769.47 |
| RESTON HOSPITAL CENTER | VIENNA, VA | not published | $697.56 – $769.47 |
| HCA HOUSTON CONROE | CONROE, TX | not published | $643.05 – $1,410.77 |
| Newark Beth Israel Medical Center | Newark, NJ | not published | $331.68 – $1,358.53 |
| HCA HealthONE PRESBYTERIAN ST. LUKE'S REHABILITATION, A PART OF SPALDING REHABILITATION | Denver, CO | not published | $717.69 – $761.19 |
| Swedish Issaquah | Issaquah, WA | not published | $746.54 – $1,657.32 |
| HCA HOUSTON MEDICAL CENTER | Houston, TX | not published | $643.05 – $1,410.77 |
| HCA HOUSTON CLEAR LAKE | FRIENDSWOOD, TX | not published | $643.05 – $1,410.77 |
| LEWISGALE MEDICAL CENTER | ROANOKE, VA | not published | $611.26 – $769.47 |
| Clara Maass Medical Center | Belleville, NJ | not published | $682.68 – $1,358.53 |
| Community Medical Center | Toms River, NJ | not published | $682.68 – $1,358.53 |
| HCA HealthONE MOUNTAIN RIDGE | Thornton, CO | not published | $717.69 – $761.19 |
| Atrium Health Anson | Wadesboro, NC | not published | $656.22 – $677.51 |
| UnityPoint Health - St. Luke's Hospital | Cedar Rapids, IA | not published | $372.28 – $947.35 |
| UnityPoint Health - Trinity Regional Medical Center | Fort Dodge, IA | not published | $372.28 – $947.35 |
| UnityPoint Health - Trinity Muscatine | Muscatine, IA | not published | $372.28 – $1,348.24 |
| Berger Hospital | Circleville, OH | not published | $770.11 – $770.11 |
| UnityPoint Health - Trinity Moline | Rock Island, IL | not published | $372.28 – $1,208.02 |
| UnityPoint Health - Trinity Bettendorf | Bettendorf, IA | not published | $372.28 – $1,193.95 |
| UnityPoint Health - St. Lukes Downtown | Sioux City, IA | not published | $372.28 – $947.35 |
| UnityPoint Health - Meriter Hospital | Madison, WI | not published | $376.66 – $770.81 |
| UnityPoint Health - Marshalltown | Marshalltown, IA | not published | $372.28 – $947.35 |
| UnityPoint Health - Jones Regional Medical Center | Anamosa, IA | not published | $372.28 – $947.35 |
| UnityPoint Health - Iowa Lutheran Hospital | Des Moines, IA | not published | $372.28 – $947.35 |
| Advocate Good Samaritan Hospital | Downers Grove, IL | not published | $1,094.76 – $2,665.42 |
| Providence St Luke's Rehabilitation Medical Center | Spokane, WA | not published | $746.54 – $821.19 |
| UnityPoint Health - Grinnell Regional Medical Center | Grinnell, IA | not published | $372.28 – $947.35 |
| UnityPoint Health - Finley Hospital | Dubuque, IA | not published | $372.28 – $947.35 |
| SSM Health St. Anthony Hospital - Midwest | Midwest City, OK | not published | $656.17 – $1,404.20 |
| Advocate Condell Medical Center | Libertyville, IL | not published | $1,094.76 – $1,641.97 |
| Advocate Christ Medical Center | Oak Lawn, IL | not published | $1,094.76 – $2,603.79 |
| Swedish Medical Center - First Hill Campus | Seattle, WA | not published | $746.54 – $2,267.99 |
| HCA HOUSTON PEARLAND | Pearland, TX | not published | $643.05 – $1,410.77 |
| Providence Sacred Heart Medical Center and Children's Hospital | Spokane, WA | not published | $746.54 – $1,899.94 |
| Adventhealth Ottawa | Ottawa, KS | not published | $657.66 – $1,293.94 |
| Trinitas Regional Medical Center | Elizabeth, NJ | not published | $322.21 – $1,358.53 |
| Lincoln Health | Damariscotta, ME | not published | $563.30 – $1,494.32 |
| Wellstar Windy Hill Hospital | Marietta, GA | not published | $628.27 – $1,231.41 |
| Stephens Memorial Hospital | Norway, ME | not published | $563.30 – $1,494.32 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE, FL | not published | $524.98 – $787.46 |
| Corewell Health Wayne | Wayne, MI | not published | $528.98 – $1,039.65 |
| Corewell Health Troy | Troy, MI | not published | $528.98 – $1,039.65 |