CPT 22103
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
Remove extra spine segment
Low
$88
Average
$2.3k
Median
$1.0k
High
$11.5k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
58 payers; the 90th percentile is 42.6× 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 case rate · outpatient · +19 other terms | 375 | $1.7k | $1.9k | $1.6k | 87% | — | $1 – $22.4k |
| 2 | Cigna case rate · outpatient · +16 other terms | 320 | $9.2k | $11.0k | $7.2k | 65% | — | $127 – $40.8k |
| 3 | Aetna case rate · outpatient · +19 other terms | 262 | $3.9k | $4.2k | $2.5k | 60% | — | $118 – $25.2k |
| 4 | Oscar case rate · outpatient · +12 other terms | 122 | $2.6k | $2.6k | $715 | 27% | — | $990 – $7.5k |
| 5 | Blue Cross Blue Shield fee schedule · outpatient · +18 other terms | 105 | $1.5k | $5.2k | $7.4k | 143% | — | $0 – $58.9k |
| 6 | Humana fee schedule · outpatient · +18 other terms | 102 | $128 | $1.6k | $3.2k | 201% | — | $104 – $14.4k |
| 7 | Molina case rate · outpatient · +13 other terms | 88 | $2.3k | $2.6k | $1.9k | 71% | — | $115 – $15.7k |
| 8 | Anthem fee schedule · outpatient · +14 other terms | 86 | $211 | $616 | $1.7k | 271% | — | $115 – $13.7k |
| 9 | Healthcare Highways case rate · outpatient | 42 | $5.8k | $8.1k | $5.3k | 66% | — | $2.1k – $14.6k |
| 10 | Kaiser fee schedule · outpatient · +10 other terms | 40 | $128 | $140 | $45 | 32% | — | $23 – $322 |
| 11 | Superior Healthplan case rate · outpatient · +2 other terms | 33 | $948 | $944 | $8 | 1% | — | $929 – $948 |
| 12 | WellCare fee schedule · both · +9 other terms | 30 | $109 | $117 | $50 | 43% | — | $0 – $227 |
| 13 | Medica case rate · outpatient · +8 other terms | 26 | $1.3k | $1.1k | $677 | 60% | — | $320 – $2.9k |
| 14 | Devoted fee schedule · outpatient · +5 other terms | 21 | $128 | $127 | $1 | 1% | — | $125 – $128 |
| 15 | Regence professional · fee schedule · outpatient · +5 other terms | 21 | $21 | $47 | $76 | 162% | — | $21 – $334 |
| 16 | Caresource facility · case rate · outpatient · +10 other terms | 20 | $3.3k | $2.8k | $1.8k | 65% | — | $117 – $6.0k |
| 17 | Bcbs La fee schedule · outpatient · +1 other terms | 19 | $11.2k | $10.8k | $2.9k | 27% | — | $0 – $15.4k |
| 18 | Medicare fee schedule · outpatient · +7 other terms | 18 | $126 | $124 | $3 | 2% | — | $115 – $128 |
| 19 | Optum professional · fee schedule · outpatient · +6 other terms | 16 | $105 | $85 | $41 | 48% | — | $14 – $137 |
| 20 | Ambetter case rate · outpatient · +7 other terms | 14 | $3.3k | $3.6k | $2.6k | 73% | — | $0 – $10.1k |
| 21 | Wellmark fee schedule · both · +4 other terms | 13 | $233 | $233 | $69 | 30% | — | $118 – $302 |
| 22 | Aetna Better Health fee schedule · outpatient · +8 other terms | 12 | $133 | $129 | $5 | 4% | — | $123 – $133 |
| 23 | Amerihealth Caritas case rate · outpatient · +6 other terms | 12 | $3.3k | $3.2k | $141 | 4% | — | $3.1k – $3.6k |
| 24 | Baylor Scott White Health Plan facility · percent of total billed charges · outpatientfrom % of charges | 12 | $2.0k | $1.7k | $448 | 26% | — | $614 – $2.1k |
| 25 | Bcbs Mn fee schedule · outpatient · +4 other terms | 12 | $3.0k | $1.9k | $1.6k | 87% | — | $0 – $3.7k |
← Hospitals reporting CPT 22103 · Snapshot 20261113T090226Z-3ce6c0b8