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
PROPHYLACTIC TX ULNA
Low
$946
Average
$9.6k
Median
$9.1k
High
$37.3k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
62 payers; the 90th percentile is 5.6× 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 fee schedule · outpatient · +20 other terms | 476 | $12.2k | $11.7k | $14.8k | 126% | — | $98 – $378.1k |
| 2 | Aetna fee schedule · outpatient · +18 other terms | 445 | $12.8k | $12.4k | $9.4k | 76% | — | $79 – $88.0k |
| 3 | Humana fee schedule · outpatient · +19 other terms | 348 | $12.5k | $10.2k | $5.1k | 50% | — | $1 – $37.1k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +19 other terms | 345 | $16.0k | $20.5k | $12.4k | 60% | — | $1 – $96.5k |
| 5 | Cigna case rate · outpatient · +15 other terms | 308 | $6.4k | $7.3k | $5.6k | 78% | — | $1.1k – $40.7k |
| 6 | Molina fee schedule · outpatient · +13 other terms | 214 | $8.2k | $9.0k | $5.8k | 65% | — | $1 – $34.8k |
| 7 | WellCare fee schedule · outpatient · +8 other terms | 157 | $13.0k | $13.4k | $4.9k | 37% | — | $129 – $30.2k |
| 8 | Oscar case rate · outpatient · +12 other terms | 137 | $9.7k | $8.6k | $3.3k | 38% | — | $3.5k – $20.1k |
| 9 | Anthem fee schedule · outpatient · +15 other terms | 123 | $9.1k | $9.5k | $15.3k | 162% | — | $729 – $93.9k |
| 10 | Kaiser fee schedule · outpatient · +9 other terms | 94 | $16.3k | $20.6k | $17.7k | 86% | — | $658 – $102.6k |
| 11 | Healthcare Highways case rate · outpatient · +1 other terms | 76 | $6.4k | $7.1k | $1.2k | 17% | — | $2.0k – $8.6k |
| 12 | Ambetter fee schedule · outpatient · +6 other terms | 73 | $19.7k | $15.0k | $10.8k | 72% | — | $978 – $31.0k |
| 13 | Devoted fee schedule · outpatient · +5 other terms | 69 | $13.1k | $11.8k | $4.0k | 34% | — | $729 – $14.5k |
| 14 | Aetna Better Health fee schedule · outpatient · +9 other terms | 64 | $7.9k | $7.7k | $1.8k | 23% | — | $561 – $12.1k |
| 15 | Caresource fee schedule · outpatient · +9 other terms | 43 | $12.5k | $10.4k | $4.8k | 46% | — | $6.4k – $21.9k |
| 16 | Superior Healthplan case rate · outpatient · +4 other terms | 38 | $948 | $1.5k | $3.2k | 211% | — | $929 – $19.3k |
| 17 | Optum fee schedule · outpatient · +8 other terms | 35 | $12.4k | $14.0k | $11.7k | 84% | — | $729 – $47.4k |
| 18 | MultiPlan case rate · outpatient · +13 other terms | 34 | $5.7k | $6.5k | $2.5k | 39% | — | $965 – $11.5k |
| 19 | Amerihealth Caritas case rate · outpatient · +5 other terms | 33 | $567 | $7.4k | $6.6k | 88% | — | $536 – $16.0k |
| 20 | Bcbs Tx fee schedule · outpatient · +2 other terms | 33 | $17.4k | $17.1k | $8.0k | 47% | — | $6.3k – $49.4k |
| 21 | First Health fee schedule · outpatient · +13 other terms | 32 | $13.4k | $10.5k | $5.1k | 49% | — | $716 – $26.1k |
| 22 | Clover fee schedule · outpatient · +5 other terms | 31 | $14.1k | $13.6k | $886 | 7% | — | $11.6k – $15.2k |
| 23 | Medica case rate · outpatient · +8 other terms | 28 | $4.0k | $5.8k | $3.4k | 58% | — | $1.6k – $12.9k |
| 24 | Cigna Healthspring fee schedule · outpatient · +3 other terms | 27 | $6.6k | $9.4k | $3.1k | 33% | — | $6.6k – $13.5k |
| 25 | Tricare fee schedule · outpatient · +9 other terms | 27 | $11.6k | $16.3k | $14.7k | 90% | — | $6.8k – $50k |
← Hospitals reporting CPT 25491 · Snapshot 20261113T090226Z-3ce6c0b8