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
facility
71 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 · +40 other terms | 618 | $221.50 | $585.45 | $1.00 – $17,881 |
| 2 | Aetna fee schedule · outpatient · +38 other terms | 558 | $228.51 | $962.46 | $1.00 – $26,648 |
| 3 | Blue Cross Blue Shield fee schedule · outpatient · +37 other terms | 448 | $322.56 | $857.41 | $1.00 – $22,145 |
| 4 | Humana fee schedule · outpatient · +33 other terms | 413 | $199.02 | $354.76 | $1.00 – $12,772 |
| 5 | Cigna case rate · outpatient · +36 other terms | 338 | $3,475 | $4,920 | $0.62 – $40,673 |
| 6 | Molina fee schedule · outpatient · +33 other terms | 252 | $171.10 | $218.41 | $1.00 – $6,459 |
| 7 | WellCare fee schedule · outpatient · +25 other terms | 177 | $200.96 | $270.25 | $64.44 – $4,266 |
| 8 | Anthem fee schedule · outpatient · +33 other terms | 146 | $194.31 | $425.78 | $4.14 – $6,285 |
| 9 | Oscar case rate · outpatient · +22 other terms | 136 | $2,636 | $2,698 | $310.69 – $7,454 |
| 10 | MultiPlan fee schedule · outpatient · +24 other terms | 121 | $436.59 | $454.29 | $73.20 – $7,309 |
| 11 | Kaiser fee schedule · outpatient · +26 other terms | 107 | $285.60 | $405.37 | $12.00 – $4,266 |
| 12 | Ambetter facility · fee schedule · outpatient · +22 other terms | 104 | $354.81 | $461.10 | $106.78 – $8,142 |
| 13 | Devoted facility · fee schedule · outpatient · +17 other terms | 83 | $189.82 | $260.85 | $51.99 – $4,876 |
| 14 | Aetna Better Health fee schedule · outpatient · +23 other terms | 81 | $102.50 | $118.92 | $81.77 – $698.50 |
| 15 | Caresource fee schedule · outpatient · +20 other terms | 73 | $215.60 | $341.26 | $1.05 – $4,266 |
| 16 | Optum fee schedule · outpatient · +26 other terms | 72 | $181.82 | $193.07 | $86.51 – $740.60 |
| 17 | Tricare facility · fee schedule · outpatient · +22 other terms | 70 | $201.61 | $683.23 | $47.95 – $6,106 |
| 18 | Highmark facility · fee schedule · outpatient · +21 other terms | 68 | $266.38 | $309.82 | $75.75 – $899.68 |
| 19 | Amerihealth Caritas facility · fee schedule · outpatient · +15 other terms | 52 | $146.53 | $317.22 | $100.55 – $9,463 |
| 20 | First Health fee schedule · outpatient · +24 other terms | 51 | $211.78 | $806.74 | $74.34 – $7,569 |
| 21 | Medica fee schedule · outpatient · +25 other terms | 47 | $209.65 | $282.81 | $38.12 – $731.00 |
| 22 | Medicare facility · fee schedule · outpatient · +19 other terms | 40 | $209.85 | $855.83 | $94.65 – $22,000 |
| 23 | Healthcare Highways case rate · outpatient · +4 other terms | 39 | $5,841 | $6,676 | $2,069 – $14,612 |
| 24 | Superior Healthplan case rate · outpatient · +6 other terms | 38 | $948.00 | $929.36 | $298.53 – $948.00 |
| 25 | Cigna Healthspring fee schedule · outpatient · +11 other terms | 37 | $99.59 | $163.85 | $89.69 – $213.95 |
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