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 LAP SUPRACERV HYST>250 G
Low
$751
Average
$8.4k
Median
$8.1k
High
$25.7k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
65 payers; the 90th percentile is 5.4× 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 · +23 other terms | 446 | $10.6k | $11.1k | $7.9k | 71% | — | $79 – $71.2k |
| 2 | UnitedHealthcare case rate · outpatient · +23 other terms | 427 | $11.2k | $11.2k | $5.8k | 52% | — | $1 – $46.7k |
| 3 | Blue Cross Blue Shield fee schedule · outpatient · +21 other terms | 343 | $13.8k | $16.6k | $8.9k | 54% | — | $1 – $75.5k |
| 4 | Cigna case rate · outpatient · +20 other terms | 313 | $11.8k | $13.6k | $9.0k | 66% | — | $2.7k – $71.5k |
| 5 | Humana fee schedule · outpatient · +22 other terms | 291 | $10.4k | $8.9k | $4.1k | 46% | — | $1 – $30.7k |
| 6 | WellCare fee schedule · outpatient · +13 other terms | 155 | $10.8k | $11.0k | $4.0k | 37% | — | $147 – $24.4k |
| 7 | Molina fee schedule · outpatient · +15 other terms | 152 | $10.4k | $10.3k | $6.8k | 66% | — | $1 – $28.8k |
| 8 | Oscar case rate · outpatient · +12 other terms | 137 | $16.3k | $14.8k | $6.2k | 42% | — | $3.5k – $33.7k |
| 9 | Anthem fee schedule · outpatient · +15 other terms | 124 | $7.1k | $8.0k | $12.5k | 156% | — | $758 – $77.8k |
| 10 | Kaiser fee schedule · outpatient · +14 other terms | 94 | $13.2k | $16.1k | $13.0k | 81% | — | $743 – $71.5k |
| 11 | Healthcare Highways case rate · outpatient · +1 other terms | 76 | $8.5k | $8.7k | $1.8k | 21% | — | $3.4k – $11.6k |
| 12 | Devoted fee schedule · outpatient · +5 other terms | 69 | $10.8k | $9.7k | $3.2k | 33% | — | $808 – $11.9k |
| 13 | Ambetter fee schedule · outpatient · +12 other terms | 65 | $17.8k | $14.3k | $8.4k | 59% | — | $1.1k – $25.7k |
| 14 | Caresource fee schedule · outpatient · +11 other terms | 45 | $10.3k | $8.1k | $4.6k | 56% | — | $774 – $18.2k |
| 15 | Superior Healthplan case rate · outpatient · +3 other terms | 38 | $948 | $1.4k | $2.5k | 182% | — | $929 – $15.6k |
| 16 | Optum fee schedule · outpatient · +12 other terms | 35 | $10.2k | $11.6k | $9.6k | 83% | — | $808 – $39.2k |
| 17 | Bcbs Tx fee schedule · outpatient · +2 other terms | 32 | $12.5k | $13.0k | $5.3k | 41% | — | $6.6k – $34.9k |
| 18 | Clover fee schedule · outpatient · +7 other terms | 32 | $11.4k | $11.2k | $674 | 6% | — | $9.6k – $12.3k |
| 19 | Tricare fee schedule · outpatient · +13 other terms | 29 | $9.6k | $8.8k | $2.4k | 27% | — | $264 – $12.6k |
| 20 | Medica case rate · outpatient · +9 other terms | 28 | $6.3k | $7.6k | $3.6k | 48% | — | $2.5k – $16.0k |
| 21 | Bcbs La fee schedule · outpatient · +3 other terms | 25 | $13.2k | $13.2k | $3.7k | 28% | — | $4.9k – $24.0k |
| 22 | First Health fee schedule · outpatient · +17 other terms | 24 | $11.1k | $11.9k | $4.1k | 34% | — | $802 – $21.6k |
| 23 | Medicare fee schedule · outpatient · +10 other terms | 24 | $808 | $2.8k | $3.9k | 138% | — | $743 – $10.6k |
| 24 | MultiPlan fee schedule · outpatient · +15 other terms | 24 | $16.5k | $16.0k | $2.2k | 14% | — | $1.0k – $16.5k |
| 25 | Regence professional · fee schedule · outpatient · +12 other terms | 22 | $418 | $467 | $292 | 63% | — | $132 – $2.1k |
← Hospitals reporting CPT 58543 · Snapshot 20261113T090226Z-3ce6c0b8