CPT 21401
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
Closed tx orbit w/manipulj
Low
$435
Average
$2.0k
Median
$1.8k
High
$5.3k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
61 payers; the 90th percentile is 6.2× 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 | UnitedHealthcare fee schedule · outpatient · +27 other terms | 485 | $1.5k | $2.1k | $2.4k | 112% | — | $1 – $43.5k |
| 2 | Aetna fee schedule · outpatient · +23 other terms | 441 | $1.7k | $2.8k | $3.4k | 124% | — | $1 – $37.3k |
| 3 | Humana fee schedule · outpatient · +22 other terms | 350 | $1.5k | $1.4k | $1.0k | 70% | — | $1 – $12.8k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +20 other terms | 341 | $2.6k | $3.2k | $2.7k | 84% | — | $1 – $39.1k |
| 5 | Cigna case rate · outpatient · +22 other terms | 310 | $6.3k | $7.4k | $6.3k | 85% | — | $1 – $40.7k |
| 6 | Molina fee schedule · outpatient · +17 other terms | 225 | $890 | $966 | $718 | 74% | — | $1 – $3.6k |
| 7 | WellCare fee schedule · outpatient · +12 other terms | 160 | $1.5k | $1.6k | $616 | 38% | — | $56 – $4.4k |
| 8 | Oscar case rate · outpatient · +11 other terms | 137 | $3.2k | $2.6k | $1.1k | 42% | — | $1.4k – $7.5k |
| 9 | Anthem fee schedule · outpatient · +19 other terms | 128 | $1.4k | $1.5k | $1.9k | 123% | — | $300 – $11.4k |
| 10 | Kaiser fee schedule · outpatient · +14 other terms | 94 | $1.9k | $2.5k | $1.9k | 77% | — | $294 – $10.9k |
| 11 | Healthcare Highways case rate · outpatient · +1 other terms | 76 | $2.2k | $2.0k | $718 | 36% | — | $1.2k – $4.3k |
| 12 | Ambetter fee schedule · outpatient · +10 other terms | 71 | $2.6k | $2.3k | $1.0k | 46% | — | $639 – $3.9k |
| 13 | Devoted fee schedule · outpatient · +7 other terms | 69 | $1.5k | $1.4k | $393 | 28% | — | $328 – $1.7k |
| 14 | Aetna Better Health fee schedule · outpatient · +9 other terms | 64 | $693 | $693 | $162 | 23% | — | $311 – $1.4k |
| 15 | Caresource fee schedule · outpatient · +11 other terms | 42 | $1.5k | $1.4k | $880 | 63% | — | $1 – $4.4k |
| 16 | Tricare fee schedule · outpatient · +9 other terms | 39 | $1.5k | $1.8k | $1.3k | 72% | — | $666 – $5.2k |
| 17 | Superior Healthplan case rate · outpatient · +3 other terms | 38 | $948 | $970 | $176 | 18% | — | $929 – $2.2k |
| 18 | Optum fee schedule · outpatient · +11 other terms | 35 | $1.5k | $1.7k | $1.3k | 77% | — | $328 – $5.7k |
| 19 | MultiPlan case rate · outpatient · +18 other terms | 34 | $5.7k | $6.5k | $2.5k | 39% | — | $965 – $11.5k |
| 20 | Amerihealth Caritas case rate · outpatient · +5 other terms | 33 | $567 | $2.2k | $1.6k | 72% | — | $359 – $4.0k |
| 21 | Bcbs Tx fee schedule · outpatient · +2 other terms | 33 | $2.0k | $1.9k | $923 | 48% | — | $549 – $5.6k |
| 22 | Clover fee schedule · outpatient · +6 other terms | 32 | $1.6k | $1.9k | $800 | 43% | — | $1.4k – $4.5k |
| 23 | Cigna Healthspring fee schedule · outpatient · +3 other terms | 29 | $576 | $1.1k | $466 | 43% | — | $576 – $1.6k |
| 24 | Medica case rate · outpatient · +10 other terms | 28 | $2.3k | $2.3k | $712 | 31% | — | $977 – $3.2k |
| 25 | First Health fee schedule · outpatient · +15 other terms | 26 | $1.6k | $2.5k | $3.3k | 130% | — | $485 – $10.2k |
← Hospitals reporting CPT 21401 · Snapshot 20261113T090226Z-3ce6c0b8