CPT 81458
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
So gsap dna cpy nmbr&mcrstl
Low
$179
Average
$559
Median
$502
High
$1.0k
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
5 hospitals; the 90th percentile is 5.5× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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5 hospital rates
iThe hospitals that file a Medicaid rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $889 | $889 | — | — | — | $889 – $889 |
| 2 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $179 | $179 | — | — | — | $179 – $179 |
| 3 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 4 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $179 | $179 | — | — | — | $179 – $179 |
| 5 | The Chester County Hospital West Chester, PA facility · fee schedule · outpatient | 1 | $502 | $502 | — | — | — | $502 – $502 |
← Payers reporting CPT 81458 · Snapshot 20261113T090226Z-3ce6c0b8