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
Litholapaxy Smpl/Sm <2.5 Cm
Low
$425
Average
$4.2k
Median
$3.3k
High
$31.3k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
67 payers; the 90th percentile is 3.7× 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 fee schedule · outpatient · +29 other terms | 416 | $3.4k | $2.9k | $1.4k | 49% | 18–180 | $1 – $12.8k |
| 2 | Blue Cross Blue Shield fee schedule · outpatient · +30 other terms | 418 | $4.4k | $5.8k | $4.1k | 70% | 14–140 | $1 – $25.6k |
| 3 | Aetna fee schedule · outpatient · +33 other terms | 545 | $3.5k | $3.8k | $2.8k | 75% | 13–130 | $1 – $23.6k |
| 4 | UnitedHealthcare fee schedule · outpatient · +33 other terms | 601 | $3.4k | $3.8k | $5.2k | 136% | 11–110 | $1 – $101.4k |
| 5 | Cigna case rate · outpatient · +25 other terms | 349 | $3.2k | $4.1k | $4.5k | 108% | 5–50 | $1 – $30.9k |
| 6 | Anthem fee schedule · outpatient · +27 other terms | 132 | $2.7k | $2.9k | $4.0k | 139% | 2–20 | $81 – $25.8k |
| 7 | Bcbs Al facility · other · outpatient · +5 other terms | 3 | $2.3k | $2.4k | $228 | 10% | 2–20 | $2.2k – $2.7k |
| 8 | Highmark facility · fee schedule · outpatient · +15 other terms | 58 | $3.8k | $3.5k | $3.0k | 86% | 1–10 | $3 – $15.6k |
| 9 | First Health fee schedule · outpatient · +22 other terms | 37 | $3.7k | $3.0k | $2.5k | 82% | 1–10 | $360 – $10.3k |
| 10 | Bcbs La fee schedule · outpatient · +3 other terms | 25 | $6.3k | $6.1k | $1.3k | 22% | 1–10 | $2.0k – $8.6k |
| 11 | Bcbs Id fee schedule · outpatient · +5 other terms | 5 | $7.1k | $6.3k | $2.0k | 31% | 1–10 | $4.0k – $8.8k |
| 12 | Molina fee schedule · outpatient · +28 other terms | 247 | $2.6k | $2.3k | $1.9k | 83% | — | $1 – $12.4k |
| 13 | WellCare fee schedule · outpatient · +18 other terms | 204 | $3.6k | $3.6k | $1.3k | 37% | — | $310 – $8.1k |
| 14 | Oscar case rate · outpatient · +20 other terms | 126 | $6.0k | $5.6k | $2.0k | 36% | — | $2.4k – $10.1k |
| 15 | Kaiser fee schedule · outpatient · +22 other terms | 101 | $4.4k | $5.0k | $4.4k | 87% | — | $35 – $25.2k |
| 16 | Ambetter fee schedule · outpatient · +16 other terms | 99 | $5.5k | $4.6k | $2.6k | 56% | — | $209 – $8.5k |
| 17 | Aetna Better Health fee schedule · outpatient · +11 other terms | 80 | $1.4k | $1.6k | $1.4k | 83% | — | $359 – $17.9k |
| 18 | Devoted fee schedule · outpatient · +10 other terms | 72 | $3.5k | $3.2k | $1.1k | 34% | — | $319 – $3.9k |
| 19 | Healthcare Highways case rate · outpatient · +3 other terms | 70 | $4.2k | $4.2k | $1.0k | 24% | — | $1.1k – $5.5k |
| 20 | Caresource fee schedule · outpatient · +15 other terms | 63 | $2.7k | $2.3k | $1.7k | 73% | — | $1 – $6.2k |
| 21 | Tricare facility · fee schedule · outpatient · +21 other terms | 57 | $4.6k | $5.0k | $3.1k | 62% | — | $167 – $17.4k |
| 22 | Optum fee schedule · outpatient · +23 other terms | 49 | $3.2k | $3.4k | $2.9k | 85% | — | $310 – $13.0k |
| 23 | MultiPlan fee schedule · outpatient · +21 other terms | 46 | $4.8k | $5.2k | $1.3k | 26% | — | $299 – $11.6k |
| 24 | Cigna Healthspring fee schedule · outpatient · +9 other terms | 40 | $2.3k | $2.5k | $1.3k | 53% | — | $310 – $3.8k |
| 25 | Superior Healthplan case rate · outpatient · +4 other terms | 38 | $948 | $1.1k | $735 | 68% | — | $929 – $5.2k |
← Hospitals reporting CPT 52317 · Snapshot 20261111T120946Z-9134e7f7