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
$53
Average
$251
Median
$214
High
$487
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
50 payers; the 90th percentile is 2.1× 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 | UnitedHealthcare fee schedule · outpatient · +6 other terms | 545 | $200 | $216 | $114 | 53% | — | $1 – $1.8k |
| 2 | Aetna fee schedule · outpatient · +4 other terms | 508 | $201 | $244 | $146 | 60% | — | $1 – $1.9k |
| 3 | Humana fee schedule · outpatient · +3 other terms | 369 | $199 | $209 | $60 | 29% | — | $1 – $795 |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +4 other terms | 340 | $203 | $224 | $203 | 91% | — | $0 – $1.6k |
| 5 | WellCare fee schedule · outpatient · +2 other terms | 247 | $205 | $212 | $33 | 16% | — | $196 – $395 |
| 6 | Molina fee schedule · outpatient · +2 other terms | 202 | $293 | $285 | $123 | 43% | — | $1 – $596 |
| 7 | Devoted fee schedule · outpatient · +1 other terms | 193 | $199 | $201 | $6 | 3% | — | $195 – $230 |
| 8 | Cigna fee schedule · outpatient · +3 other terms | 172 | $205 | $275 | $121 | 44% | — | $129 – $730 |
| 9 | Oscar fee schedule · outpatient · +1 other terms | 159 | $385 | $429 | $143 | 33% | — | $195 – $608 |
| 10 | Cigna Healthspring fee schedule · outpatient | 124 | $207 | $203 | $6 | 3% | — | $199 – $215 |
← Hospitals reporting CPT 0457U · Snapshot 20261113T090226Z-3ce6c0b8