CPT 0457U
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
Pfas 9 cmpnd lcms/ms pls/sr
Low
$6
Average
$188
Median
$199
High
$555
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
32 payers; the 90th percentile is 5.8× 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 | Aetna case rate · outpatient · +1 other terms | 38 | $203 | $188 | $50 | 27% | — | $15 – $206 |
| 2 | Molina facility · case rate · outpatient · +2 other terms | 38 | $17 | $100 | $126 | 126% | — | $6 – $407 |
| 3 | UnitedHealthcare case rate · outpatient · +1 other terms | 38 | $205 | $190 | $54 | 29% | — | $12 – $225 |
| 4 | Humana case rate · outpatient · +1 other terms | 26 | $207 | $205 | $5 | 2% | — | $199 – $209 |
| 5 | Caresource facility · case rate · outpatient · +1 other terms | 20 | $18 | $104 | $143 | 137% | — | $11 – $397 |
| 6 | Anthem facility · case rate · outpatient · +1 other terms | 19 | $17 | $63 | $78 | 124% | — | $11 – $199 |
| 7 | Optum facility · case rate · outpatient | 14 | $15 | $40 | $63 | 158% | — | $6 – $203 |
| 8 | WellCare case rate · outpatient · +1 other terms | 14 | $201 | $206 | $8 | 4% | — | $199 – $219 |
| 9 | Ambetter case rate · outpatient · +1 other terms | 12 | $288 | $296 | $13 | 4% | — | $288 – $318 |
| 10 | Wellmark case rate · outpatient | 12 | $203 | $202 | $1 | 1% | — | $199 – $203 |
← Hospitals reporting CPT 0457U · Snapshot 20261113T090226Z-3ce6c0b8