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
PR REVISION, PPM DEVICE POCKET
Low
$0
Average
$5.0k
Median
$3.2k
High
$27.0k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
67 payers; the 90th percentile is 16.2× 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 case rate · outpatient · +29 other terms | 457 | $2.1k | $2.4k | $4.4k | 186% | 3–30 | $1 – $70.1k |
| 2 | Aetna fee schedule · outpatient · +32 other terms | 451 | $709 | $3.2k | $5.7k | 180% | — | $1 – $40.8k |
| 3 | Blue Cross Blue Shield fee schedule · outpatient · +26 other terms | 333 | $1.3k | $2.2k | $3.2k | 146% | — | $1 – $45.5k |
| 4 | Humana fee schedule · outpatient · +26 other terms | 281 | $630 | $1.6k | $3.5k | 216% | — | $1 – $29.5k |
| 5 | Cigna case rate · outpatient · +25 other terms | 236 | $7.2k | $10.2k | $8.4k | 82% | — | $1 – $40.7k |
| 6 | Molina fee schedule · outpatient · +24 other terms | 144 | $792 | $896 | $883 | 99% | — | $1 – $7.3k |
| 7 | WellCare fee schedule · outpatient · +16 other terms | 139 | $662 | $814 | $581 | 71% | — | $526 – $4.3k |
| 8 | Oscar case rate · outpatient · +18 other terms | 130 | $3.0k | $2.6k | $1.1k | 42% | — | $967 – $7.5k |
| 9 | Anthem fee schedule · outpatient · +27 other terms | 111 | $683 | $1.2k | $5.4k | 446% | — | $0 – $111.8k |
| 10 | Kaiser fee schedule · outpatient · +20 other terms | 97 | $1.0k | $2.0k | $3.4k | 170% | — | $1 – $33.0k |
| 11 | Ambetter facility · fee schedule · outpatient · +16 other terms | 87 | $1.2k | $1.4k | $1.1k | 79% | — | $574 – $18.2k |
| 12 | Healthcare Highways case rate · outpatient · +5 other terms | 73 | $2.2k | $1.9k | $506 | 26% | — | $1.2k – $3.4k |
| 13 | Devoted facility · fee schedule · outpatient · +10 other terms | 64 | $629 | $695 | $646 | 93% | — | $111 – $8.9k |
| 14 | MultiPlan fee schedule · outpatient · +16 other terms | 62 | $2.2k | $5.6k | $9.7k | 173% | — | $581 – $109.0k |
| 15 | Optum fee schedule · outpatient · +21 other terms | 54 | $628 | $4.5k | $6.4k | 143% | — | $428 – $45.5k |
| 16 | Caresource fee schedule · outpatient · +13 other terms | 41 | $961 | $1.2k | $924 | 79% | — | $1 – $4.3k |
| 17 | Superior Healthplan case rate · outpatient · +5 other terms | 38 | $948 | $940 | $9 | 1% | — | $929 – $948 |
| 18 | First Health fee schedule · outpatient · +14 other terms | 36 | $809 | $9.2k | $12.8k | 139% | — | $581 – $96.6k |
| 19 | Clover fee schedule · outpatient · +6 other terms | 32 | $690 | $984 | $1.0k | 102% | — | $566 – $4.4k |
| 20 | Tricare fee schedule · outpatient · +13 other terms | 30 | $604 | $10.2k | $18.0k | 177% | — | $466 – $50k |
| 21 | Highmark facility · fee schedule · outpatient · +14 other terms | 29 | $999 | $882 | $1.3k | 151% | — | $15 – $9.1k |
| 22 | Medicare fee schedule · outpatient · +13 other terms | 29 | $628 | $832 | $799 | 96% | — | $1 – $4.2k |
| 23 | Medica case rate · outpatient · +18 other terms | 28 | $1.8k | $1.7k | $646 | 38% | — | $585 – $2.9k |
| 24 | Bcbs Tx fee schedule · outpatient · +4 other terms | 26 | $910 | $961 | $434 | 45% | — | $492 – $2.6k |
| 25 | Baylor Scott White Health Plan facility · fee schedule · outpatient · +1 other terms | 25 | $796 | $794 | $159 | 20% | — | $599 – $1.0k |
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