CPT 0104A
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
Fee Schedule
Low
$17
Average
$110
Median
$29
High
$1.1k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
14 payers; the 90th percentile is 4.2× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Molina facility · case rate · outpatient · +2 other terms | 27 | $25 | $25 | $10 | 41% | — | $11 – $57 |
| 2 | UnitedHealthcare facility · case rate · outpatient · +1 other terms | 19 | $17 | $29 | $42 | 144% | — | $11 – $212 |
| 3 | Anthem facility · case rate · outpatient · +1 other terms | 15 | $15 | $17 | $4 | 23% | — | $11 – $26 |
| 4 | Caresource facility · case rate · outpatient | 15 | $16 | $17 | $4 | 23% | — | $11 – $27 |
| 5 | Optum facility · case rate · outpatient | 13 | $15 | $18 | $5 | 27% | — | $13 – $26 |
| 6 | Humana facility · case rate · outpatient | 8 | $27 | $28 | $1 | 5% | — | $27 – $30 |
| 7 | Oscar facility · case rate · outpatient | 8 | $1.1k | $1.1k | $100 | 9% | — | $904 – $1.1k |
| 8 | Aetna Better Health facility · case rate · outpatient | 7 | $33 | $32 | $1 | 3% | — | $29 – $33 |
| 9 | Amerihealth Caritas facility · case rate · outpatient · +1 other terms | 7 | $30 | $30 | $1 | 3% | — | $30 – $33 |
| 10 | Aetna facility · case rate · outpatient · +1 other terms | 6 | $36 | $81 | $110 | 136% | — | $27 – $350 |
← Hospitals reporting CPT 0104A · Snapshot 20261113T090226Z-3ce6c0b8