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
HDR RDNCL NTRSTL/ICAV BRCHTX
Low
$327
Average
$1.9k
Median
$1.5k
High
$5.7k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
66 payers; the 90th percentile is 5.7× 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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Filter by billing class
| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Wellmark case rate · outpatient · +14 other terms | 13 | $661 | $1.0k | $713 | 71% | 82 | $652 – $2.7k |
| 2 | Medicare other · both · +16 other terms | 29 | $668 | $785 | $401 | 51% | 21–30 | $635 – $3.2k |
| 3 | Humana fee schedule · outpatient · +29 other terms | 321 | $734 | $1.3k | $1.7k | 130% | 5–50 | $1 – $12.0k |
| 4 | UnitedHealthcare fee schedule · outpatient · +35 other terms | 376 | $714 | $1.1k | $1.6k | 149% | 2–20 | $1 – $20.4k |
| 5 | Cigna fee schedule · outpatient · +30 other terms | 308 | $1.3k | $1.8k | $1.9k | 105% | 2–20 | $240 – $15.6k |
| 6 | Blue Cross Blue Shield fee schedule · outpatient · +31 other terms | 367 | $1.3k | $1.5k | $1.2k | 75% | 1–10 | $1 – $8.2k |
| 7 | Molina fee schedule · outpatient · +27 other terms | 134 | $822 | $808 | $475 | 59% | 1–10 | $1 – $3.8k |
| 8 | Anthem fee schedule · outpatient · +29 other terms | 130 | $1.6k | $1.1k | $1.0k | 89% | 1–10 | $17 – $8.9k |
| 9 | Aetna fee schedule · outpatient · +33 other terms | 516 | $869 | $1.6k | $3.0k | 183% | — | $1 – $96.7k |
| 10 | WellCare fee schedule · outpatient · +21 other terms | 145 | $700 | $746 | $267 | 36% | — | $185 – $1.6k |
| 11 | Ambetter facility · fee schedule · outpatient · +18 other terms | 86 | $1.2k | $1.4k | $652 | 47% | — | $645 – $7.2k |
| 12 | Kaiser fee schedule · outpatient · +22 other terms | 75 | $991 | $1.3k | $941 | 75% | — | $352 – $6.3k |
| 13 | Devoted facility · fee schedule · outpatient · +16 other terms | 67 | $673 | $760 | $493 | 65% | — | $634 – $4.9k |
| 14 | Caresource fee schedule · outpatient · +20 other terms | 56 | $717 | $924 | $349 | 38% | — | $1 – $2.9k |
| 15 | Oscar facility · fee schedule · outpatient · +23 other terms | 54 | $1000 | $988 | $209 | 21% | — | $634 – $1.3k |
| 16 | MultiPlan fee schedule · outpatient · +20 other terms | 53 | $1.9k | $2.9k | $3.6k | 125% | — | $336 – $13.9k |
| 17 | Optum fee schedule · outpatient · +21 other terms | 48 | $674 | $3.1k | $4.2k | 137% | — | $222 – $15.3k |
| 18 | Highmark facility · fee schedule · outpatient · +18 other terms | 39 | $983 | $1.0k | $681 | 68% | — | $150 – $3.1k |
| 19 | Tricare fee schedule · outpatient · +16 other terms | 39 | $673 | $693 | $121 | 17% | — | $198 – $891 |
| 20 | Clover fee schedule · outpatient · +12 other terms | 33 | $758 | $741 | $50 | 7% | — | $629 – $840 |
| 21 | Bcbs Tx fee schedule · outpatient · +4 other terms | 26 | $1.8k | $1.9k | $740 | 40% | — | $651 – $3.2k |
| 22 | Amerihealth Caritas facility · fee schedule · outpatient · +15 other terms | 25 | $580 | $775 | $624 | 81% | — | $337 – $3.0k |
| 23 | Baylor Scott White Health Plan facility · fee schedule · outpatient · +1 other terms | 25 | $884 | $882 | $176 | 20% | — | $665 – $1.2k |
| 24 | Medica facility · fee schedule · outpatient · +21 other terms | 23 | $710 | $665 | $140 | 21% | — | $255 – $754 |
| 25 | Aetna Better Health fee schedule · outpatient · +19 other terms | 22 | $523 | $689 | $323 | 47% | — | $421 – $1.8k |
← Hospitals reporting CPT 77771 · Snapshot 20261112T124536Z-e251e855