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
$42
Median
$38
High
$70
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Aetna facility · percent of total billed charges · outpatientfrom % of charges · +4 other terms | 20 | $39 | $35 | $15 | 44% | — | $23 – $76 |
| 2 | Blue Cross Blue Shield facility · percent of total billed charges · outpatientfrom % of charges · +3 other terms | 20 | $51 | $47 | $12 | 25% | — | $26 – $70 |
| 3 | Humana facility · percent of total billed charges · outpatientfrom % of charges · +4 other terms | 18 | $55 | $53 | $14 | 26% | — | $31 – $78 |
| 4 | MultiPlan facility · percent of total billed charges · inpatientfrom % of charges · +5 other terms | 18 | $65 | $65 | $4 | 7% | — | $57 – $78 |
| 5 | Molina facility · percent of total billed charges · outpatientfrom % of charges · +3 other terms | 16 | $44 | $42 | $9 | 23% | — | $17 – $69 |
| 6 | Cigna facility · percent of total billed charges · outpatientfrom % of charges · +5 other terms | 13 | $42 | $41 | $7 | 17% | — | $31 – $54 |
| 7 | UnitedHealthcare facility · percent of total billed charges · outpatientfrom % of charges · +5 other terms | 12 | $44 | $45 | $8 | 19% | — | $30 – $70 |
| 8 | Oscar facility · percent of total billed charges · outpatientfrom % of charges · +1 other terms | 8 | $30 | $37 | $11 | 30% | — | $30 – $57 |
| 9 | First Health professional · percent of total billed charges · bothfrom % of charges | 6 | $34 | $36 | $4 | 10% | — | $34 – $44 |
| 10 | Caresource professional · percent of total billed charges · bothfrom % of charges | 4 | $17 | $17 | — | — | — | $17 – $17 |
← Hospitals reporting CPT 0104A · Snapshot 20261113T090226Z-3ce6c0b8