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
Trluml Dilat Aqueous O/F Can W/Retention Dev/St
Low
$878
Average
$5.5k
Median
$4.9k
High
$16.3k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
62 payers; the 90th percentile is 4.8× 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 · +21 other terms | 430 | $9.2k | $8.8k | $4.7k | 53% | 2–20 | $1 – $36.5k |
| 2 | Aetna fee schedule · outpatient · +19 other terms | 428 | $5.5k | $6.8k | $5.3k | 78% | — | $79 – $53.3k |
| 3 | Blue Cross Blue Shield fee schedule · outpatient · +19 other terms | 327 | $7.3k | $8.2k | $4.8k | 59% | — | $1 – $38.3k |
| 4 | Cigna case rate · outpatient · +15 other terms | 308 | $7.3k | $8.8k | $5.8k | 65% | — | $1.1k – $40.7k |
| 5 | Humana fee schedule · outpatient · +17 other terms | 281 | $5.2k | $4.8k | $2.3k | 49% | — | $1 – $32.5k |
| 6 | WellCare fee schedule · outpatient · +10 other terms | 148 | $5.3k | $5.6k | $1.9k | 33% | — | $120 – $12.1k |
| 7 | Molina fee schedule · outpatient · +14 other terms | 137 | $5.2k | $5.8k | $2.8k | 49% | — | $1 – $12.3k |
| 8 | Oscar case rate · outpatient · +13 other terms | 127 | $6.6k | $7.6k | $4.3k | 56% | — | $3.3k – $17.8k |
| 9 | Anthem fee schedule · outpatient · +15 other terms | 120 | $5.2k | $5.0k | $6.2k | 123% | — | $699 – $38.9k |
| 10 | Kaiser fee schedule · outpatient · +10 other terms | 95 | $6.8k | $8.2k | $5.9k | 71% | — | $170 – $31.4k |
| 11 | Healthcare Highways case rate · outpatient · +1 other terms | 76 | $6.4k | $7.0k | $1.1k | 16% | — | $3.4k – $8.6k |
| 12 | Devoted fee schedule · outpatient · +5 other terms | 67 | $5.2k | $4.8k | $1.5k | 31% | — | $699 – $5.9k |
| 13 | Ambetter fee schedule · outpatient · +6 other terms | 63 | $9.0k | $7.6k | $3.7k | 49% | — | $886 – $12.8k |
| 14 | Caresource fee schedule · outpatient · +9 other terms | 39 | $5.1k | $4.7k | $1.7k | 35% | — | $3.5k – $9.1k |
| 15 | Superior Healthplan case rate · outpatient · +3 other terms | 38 | $948 | $1.2k | $1.2k | 102% | — | $929 – $7.8k |
| 16 | Optum fee schedule · outpatient · +11 other terms | 35 | $5.1k | $5.9k | $4.7k | 80% | — | $699 – $19.6k |
| 17 | Bcbs Tx fee schedule · outpatient · +2 other terms | 32 | $5.7k | $5.9k | $2.4k | 40% | — | $3.0k – $15.8k |
| 18 | Amerihealth Caritas case rate · outpatient · +6 other terms | 31 | $700 | $7.7k | $6.7k | 88% | — | $662 – $16.0k |
| 19 | Clover fee schedule · outpatient · +6 other terms | 31 | $5.6k | $5.5k | $312 | 6% | — | $4.8k – $6.1k |
| 20 | Medica case rate · outpatient · +8 other terms | 28 | $4.0k | $4.9k | $2.2k | 46% | — | $1.6k – $10.6k |
| 21 | Tricare fee schedule · outpatient · +8 other terms | 27 | $4.8k | $11.5k | $16.6k | 145% | — | $3.3k – $50k |
| 22 | Bcbs La fee schedule · outpatient · +2 other terms | 25 | $8.3k | $8.3k | $1.7k | 21% | — | $2.5k – $11.4k |
| 23 | Medicare fee schedule · outpatient · +8 other terms | 24 | $699 | $1.6k | $1.8k | 112% | — | $636 – $5.3k |
| 24 | MultiPlan fee schedule · outpatient · +12 other terms | 23 | $8.4k | $8.2k | $760 | 9% | — | $835 – $8.4k |
| 25 | Regence professional · fee schedule · outpatient · +9 other terms | 21 | $544 | $576 | $410 | 71% | — | $111 – $1.8k |
← Hospitals reporting CPT 66175 · Snapshot 20261112T181611Z-3fa9fb76