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
INSJ STABLJ DEV W/O DCMPRN
Low
$391
Average
$11.1k
Median
$10.6k
High
$36.7k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
61 payers; the 90th percentile is 4.3× 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 | Aetna fee schedule · outpatient · +26 other terms | 453 | $12.8k | $12.6k | $9.4k | 75% | — | $68 – $88.0k |
| 2 | UnitedHealthcare case rate · outpatient · +26 other terms | 434 | $12.3k | $11.3k | $6.8k | 60% | — | $1 – $57.8k |
| 3 | Blue Cross Blue Shield fee schedule · outpatient · +23 other terms | 336 | $16.9k | $21.0k | $13.6k | 65% | — | $1 – $96.5k |
| 4 | Humana fee schedule · outpatient · +24 other terms | 314 | $12.6k | $10.8k | $5.3k | 49% | — | $1 – $37.1k |
| 5 | Cigna case rate · outpatient · +19 other terms | 230 | $7.2k | $12.3k | $8.2k | 67% | — | $1 – $40.7k |
| 6 | WellCare fee schedule · outpatient · +13 other terms | 157 | $13.0k | $13.4k | $4.8k | 36% | — | $74 – $30.2k |
| 7 | Molina fee schedule · outpatient · +20 other terms | 147 | $12.9k | $12.7k | $8.3k | 66% | — | $1 – $34.8k |
| 8 | Oscar case rate · outpatient · +14 other terms | 128 | $10.6k | $9.9k | $3.6k | 37% | — | $3.5k – $20.1k |
| 9 | Anthem fee schedule · outpatient · +22 other terms | 126 | $8.8k | $8.9k | $15.2k | 171% | — | $111 – $93.9k |
| 10 | Kaiser fee schedule · outpatient · +13 other terms | 94 | $16.3k | $20.3k | $17.7k | 87% | — | $387 – $102.6k |
| 11 | Devoted fee schedule · outpatient · +7 other terms | 72 | $13.0k | $11.6k | $4.2k | 36% | — | $419 – $14.3k |
| 12 | Ambetter fee schedule · outpatient · +11 other terms | 65 | $22.2k | $18.7k | $9.0k | 48% | — | $544 – $31.0k |
| 13 | Healthcare Highways case rate · outpatient · +2 other terms | 63 | $5.8k | $8.3k | $5.2k | 62% | — | $2.1k – $14.6k |
| 14 | Caresource fee schedule · outpatient · +11 other terms | 57 | $13.0k | $15.9k | $6.8k | 43% | — | $526 – $26.1k |
| 15 | Superior Healthplan case rate · outpatient · +4 other terms | 46 | $2.4k | $2.8k | $2.6k | 95% | — | $2.3k – $19.3k |
| 16 | Optum fee schedule · outpatient · +13 other terms | 37 | $11.6k | $13.4k | $11.5k | 86% | — | $419 – $47.4k |
| 17 | Amerihealth Caritas case rate · outpatient · +5 other terms | 31 | $496 | $7.4k | $6.8k | 91% | — | $468 – $14.4k |
| 18 | Clover fee schedule · outpatient · +6 other terms | 31 | $14.1k | $13.6k | $886 | 7% | — | $11.6k – $15.2k |
| 19 | Bcbs Tx fee schedule · outpatient · +1 other terms | 30 | $17.4k | $18.0k | $7.8k | 43% | — | $9.3k – $49.4k |
| 20 | Medica case rate · outpatient · +11 other terms | 28 | $6.3k | $8.1k | $3.7k | 46% | — | $2.5k – $16.0k |
| 21 | Bcbs La fee schedule · outpatient · +2 other terms | 25 | $6.1k | $11.2k | $12.2k | 109% | — | $3.8k – $48.5k |
| 22 | First Health fee schedule · outpatient · +12 other terms | 25 | $13.4k | $11.5k | $6.2k | 54% | — | $413 – $26.1k |
| 23 | Regence professional · fee schedule · outpatient · +7 other terms | 25 | $201 | $520 | $421 | 81% | — | $67 – $1.3k |
| 24 | Medicare fee schedule · outpatient · +12 other terms | 24 | $419 | $3.1k | $5.1k | 166% | — | $387 – $12.8k |
| 25 | MultiPlan fee schedule · outpatient · +14 other terms | 24 | $21.1k | $20.4k | $3.0k | 15% | — | $386 – $21.1k |
← Hospitals reporting CPT 22869 · Snapshot 20261113T090226Z-3ce6c0b8