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
$533
Average
$2.2k
Median
$1.6k
High
$6.3k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
21 payers; the 90th percentile is 4.0× 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 | Humana other · outpatient · +4 other terms | 41 | $2.0k | $1.9k | $837 | 45% | — | $969 – $5.7k |
| 2 | Tricare other · outpatient · +1 other terms | 13 | $1.3k | $1.1k | $368 | 33% | — | $533 – $1.4k |
| 3 | Aetna other · both · +3 other terms | 11 | $1.5k | $1.2k | $571 | 49% | — | $332 – $1.7k |
| 4 | Blue Cross Blue Shield other · both · +3 other terms | 9 | $1.5k | $1.1k | $485 | 46% | — | $512 – $1.6k |
| 5 | Oscar other · both · +1 other terms | 9 | $1k | $1k | — | — | — | $1k – $1k |
| 6 | Molina facility · other · outpatient · +2 other terms | 8 | $443 | $1.5k | $2.8k | 183% | — | $334 – $10.3k |
| 7 | UnitedHealthcare facility · other · outpatient · +4 other terms | 8 | $1.2k | $1.3k | $1.0k | 78% | — | $334 – $5.0k |
| 8 | Cigna other · outpatient · +2 other terms | 7 | $7.5k | $5.9k | $3.0k | 51% | — | $1.1k – $8.7k |
| 9 | Devoted other · both · +1 other terms | 6 | $1.5k | $1.5k | $39 | 3% | — | $1.5k – $1.6k |
| 10 | WellCare other · both · +1 other terms | 6 | $1.6k | $1.6k | $41 | 3% | — | $1.5k – $1.7k |
| 11 | Caresource other · outpatient · +1 other terms | 5 | $6.5k | $7.4k | $1.6k | 21% | — | $5.8k – $9.4k |
| 12 | Kaiser other · both · +1 other terms | 5 | $5.1k | $5.1k | $1.0k | 20% | — | $4.1k – $6.1k |
| 13 | MultiPlan other · outpatient · +1 other terms | 5 | $1.4k | $1.4k | $175 | 12% | — | $1.2k – $1.7k |
| 14 | Phcs other · outpatient | 4 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 15 | Anthem facility · other · outpatient · +1 other terms | 3 | $453 | $1.1k | $1.1k | 92% | — | $337 – $2.6k |
| 16 | First Health other · outpatient | 3 | $2.0k | $1.9k | $101 | 5% | — | $1.7k – $2.0k |
| 17 | Regence other · outpatient | 2 | $1.7k | $1.7k | $28 | 2% | — | $1.7k – $1.7k |
| 18 | Ambetter facility · other · outpatient | 1 | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 19 | Bcbs Al other · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 20 | Medicare professional · other · outpatient | 1 | $533 | $533 | — | — | — | $533 – $533 |
| 21 | Optum facility · other · outpatient | 1 | $5.5k | $5.5k | — | — | — | $5.5k – $5.5k |
← Hospitals reporting CPT 21401 · Snapshot 20261113T090226Z-3ce6c0b8