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
AQUAPORIN-4 ANTB CBA EACH
Low
$12
Average
$160
Median
$21
High
$1.5k
Each hospital's average Premera rate, under the methodology and billing class chosen below.
25 hospitals; the 90th percentile is 36.5× 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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28 hospital rates
iThe hospitals that file a Premera 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 | COMMONSPIRIT OREGON Roseburg, OR fee schedule · inpatient | 1 | $566 | $566 | — | — | — | $566 – $566 |
| 2 | COMMONSPIRIT OREGON Roseburg, OR fee schedule · outpatient | 1 | $602 | $602 | — | — | — | $602 – $602 |
| 3 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · inpatient | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 4 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · outpatient | 1 | $39 | $39 | — | — | — | $39 – $39 |
| 5 | ENUMCLAW REGIONAL HOSPITAL ASSOCIATION Enumclaw, WA fee schedule · outpatient | 1 | $22 | $22 | $0 | 0% | — | $22 – $22 |
| 6 | Good Samaritan Hospital Puyallup, WA fee schedule · outpatient | 4 | $12 | $13 | $1 | 10% | — | $12 – $15 |
| 7 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $808 | $895 | $628 | 70% | — | $31 – $2.0k |
| 8 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · case rate · both | 1 | $183 | $183 | — | — | — | $183 – $183 |
| 9 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $1.1k | $1.5k | $664 | 45% | — | $1.1k – $2.8k |
| 10 | Mary Bridge Children's Hospital Tacoma, WA fee schedule · outpatient | 4 | $12 | $13 | $1 | 10% | — | $12 – $15 |
| 11 | Mercy Fitzgerald Hospital Darby, PA facility · fee schedule · both | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 12 | MultiCare Auburn Medical Center Auburn, WA fee schedule · outpatient | 4 | $12 | $13 | $1 | 10% | — | $12 – $15 |
| 13 | MultiCare Capital Medical Center Lacey, WA fee schedule · outpatient | 4 | $15 | $14 | $1 | 9% | — | $12 – $15 |
| 14 | MultiCare Covington Medical Center Covington, WA fee schedule · outpatient | 4 | $12 | $13 | $1 | 10% | — | $12 – $15 |
| 15 | MultiCare Deaconess Hospital Spokane, WA fee schedule · outpatient | 4 | $15 | $14 | $1 | 9% | — | $12 – $15 |
| 16 | MultiCare Valley Hospital Spokane Valley, WA fee schedule · outpatient | 4 | $15 | $14 | $1 | 9% | — | $12 – $15 |
| 17 | MultiCare Yakima Valley Memorial Hospital Association Union Gap, WA fee schedule · outpatient | 3 | $15 | $15 | — | — | — | $15 – $15 |
| 18 | Nazareth Hospital Philadelphia, PA facility · fee schedule · both | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 19 | Public Hospital District NO 2 Skagit County Washington Anacortes, WA facility · fee schedule · both | 2 | $292 | $292 | $279 | 95% | — | $14 – $571 |
| 20 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $105 | $105 | — | — | — | $105 – $105 |
| 21 | Saint Alphonsus Medical Center - Nampa Nampa, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $85 | $85 | — | — | — | $85 – $85 |
| 22 | Saint Alphonsus Medical Center - Ontario Ontario, OR facility · fee schedule · both | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 23 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · percent of total billed charges · bothfrom % of charges | 1 | $85 | $85 | — | — | — | $85 – $85 |
| 24 | St Josephs Hospital Health Center Syracuse, NY facility · fee schedule · both | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 25 | St Mary Medical Center Langhorne, PA facility · fee schedule · both | 1 | $21 | $21 | — | — | — | $21 – $21 |
← Payers reporting CPT 86052 · Snapshot 20261112T124536Z-e251e855