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
Rx test prsmv ur w/def conf
56 payers file a negotiated rate for this code. Each is shown once, under the terms the most hospitals file it under; rates under different terms (billing class, payment method, setting) are never blended, so open a payer to see them all. Figures are hospital-level averages; the median is across hospitals.
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Filter by billing class
| # | |||||
|---|---|---|---|---|---|
| 1 | UnitedHealthcare fee schedule · outpatient · +11 other terms | 602 | $114.89 | $124.66 | $40.95 – $1,030 |
| 2 | Aetna fee schedule · outpatient · +9 other terms | 551 | $117.86 | $244.26 | $62.48 – $2,461 |
| 3 | Humana fee schedule · outpatient · +12 other terms | 385 | $114.43 | $188.13 | $81.24 – $1,115 |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +10 other terms | 372 | $150.74 | $239.34 | $1.00 – $1,849 |
| 5 | Cigna fee schedule · outpatient · +8 other terms | 359 | $203.01 | $263.95 | $52.07 – $1,154 |
| 6 | WellCare fee schedule · outpatient · +7 other terms | 247 | $117.86 | $121.84 | $112.60 – $227.72 |
| 7 | Molina fee schedule · outpatient · +8 other terms | 200 | $168.50 | $165.78 | $68.66 – $343.29 |
| 8 | Devoted fee schedule · outpatient · +4 other terms | 193 | $114.43 | $115.77 | $112.14 – $132.35 |
| 9 | Oscar fee schedule · outpatient · +6 other terms | 160 | $221.42 | $246.58 | $112.14 – $350.16 |
| 10 | Anthem fee schedule · outpatient · +8 other terms | 141 | $125.88 | $235.58 | $45.77 – $858.22 |
| 11 | Cigna Healthspring fee schedule · outpatient · +3 other terms | 124 | $119.01 | $116.72 | $114.43 – $123.58 |
| 12 | Kaiser fee schedule · outpatient · +4 other terms | 77 | $116.72 | $158.32 | $91.54 – $427.85 |
| 13 | Ambetter facility · fee schedule · outpatient · +7 other terms | 65 | $201.99 | $215.46 | $114.43 – $291.80 |
| 14 | Superior Healthplan fee schedule · outpatient | 42 | $120.15 | $120.44 | $114.43 – $183.09 |
| 15 | Clover fee schedule · outpatient · +5 other terms | 41 | $116.72 | $117.32 | $114.43 – $120.15 |
| 16 | Optum fee schedule · outpatient · +5 other terms | 41 | $114.43 | $156.79 | $112.14 – $328.41 |
| 17 | Bcbs Tx fee schedule · outpatient · +1 other terms | 32 | $445.51 | $467.61 | $114.43 – $985.24 |
| 18 | Caresource fee schedule · outpatient · +5 other terms | 32 | $132.17 | $138.22 | $114.43 – $223.14 |
| 19 | Regence facility · fee schedule · outpatient · +3 other terms | 24 | $121.30 | $137.19 | $97.27 – $343.29 |
| 20 | First Health fee schedule · outpatient · +2 other terms | 21 | $114.43 | $156.02 | $114.43 – $228.86 |
| 21 | Medica facility · fee schedule · outpatient · +5 other terms | 20 | $114.43 | $114.04 | $38.93 – $295.75 |
| 22 | Amerihealth Caritas fee schedule · outpatient · +2 other terms | 19 | $154.49 | $145.85 | $114.43 – $171.65 |
| 23 | Healthpartners fee schedule · outpatient · +1 other terms | 19 | $345.99 | $339.79 | $116.72 – $388.47 |
| 24 | Medicare fee schedule · outpatient · +2 other terms | 18 | $112.14 | $112.35 | $112.14 – $114.43 |
| 25 | Medical Mutual fee schedule · outpatient · +1 other terms | 17 | $123.58 | $199.41 | $105.00 – $346.72 |
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