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
HC GIARDIA DFA
Low
$6
Average
$46
Median
$28
High
$495
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
60 payers; the 90th percentile is 5.5× 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.
Filter by billing methodology
Filter by billing class
| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Aetna Better Health fee schedule · outpatient · +11 other terms | 85 | $12 | $13 | $1 | 8% | 1–10 | $7 – $14 |
| 2 | UnitedHealthcare fee schedule · outpatient · +24 other terms | 654 | $14 | $14 | $8 | 53% | — | $5 – $145 |
| 3 | Aetna fee schedule · outpatient · +19 other terms | 620 | $15 | $57 | $410 | 715% | — | $0 – $8.4k |
| 4 | Humana fee schedule · outpatient · +21 other terms | 437 | $14 | $29 | $33 | 115% | — | $7 – $160 |
| 5 | Cigna fee schedule · outpatient · +20 other terms | 430 | $25 | $31 | $21 | 67% | — | $5 – $137 |
| 6 | Blue Cross Blue Shield fee schedule · outpatient · +22 other terms | 425 | $19 | $29 | $23 | 82% | — | $0 – $210 |
| 7 | WellCare fee schedule · outpatient · +13 other terms | 275 | $14 | $15 | $3 | 18% | — | $10 – $43 |
| 8 | Molina fee schedule · outpatient · +18 other terms | 246 | $15 | $16 | $7 | 43% | — | $2 – $59 |
| 9 | Devoted fee schedule · outpatient · +7 other terms | 198 | $14 | $14 | $0 | 3% | — | $13 – $16 |
| 10 | Oscar fee schedule · outpatient · +11 other terms | 163 | $26 | $29 | $10 | 33% | — | $13 – $42 |
| 11 | Anthem fee schedule · outpatient · +16 other terms | 160 | $20 | $24 | $24 | 99% | — | $6 – $102 |
| 12 | Cigna Healthspring fee schedule · outpatient · +5 other terms | 129 | $14 | $14 | $1 | 6% | — | $8 – $15 |
| 13 | Ambetter fee schedule · outpatient · +9 other terms | 108 | $22 | $20 | $6 | 32% | — | $9 – $37 |
| 14 | Kaiser fee schedule · outpatient · +15 other terms | 83 | $14 | $18 | $11 | 59% | — | $5 – $64 |
| 15 | Caresource fee schedule · outpatient · +9 other terms | 62 | $14 | $15 | $3 | 20% | — | $13 – $27 |
| 16 | Superior Healthplan fee schedule · outpatient · +5 other terms | 51 | $14 | $27 | $30 | 110% | — | $11 – $127 |
| 17 | Clover fee schedule · outpatient · +6 other terms | 42 | $14 | $14 | $0 | 3% | — | $13 – $14 |
| 18 | Optum fee schedule · outpatient · +14 other terms | 41 | $14 | $19 | $8 | 43% | — | $13 – $39 |
| 19 | Amerihealth Caritas fee schedule · outpatient · +8 other terms | 35 | $16 | $15 | $4 | 27% | — | $2 – $27 |
| 20 | First Health fee schedule · outpatient · +10 other terms | 35 | $14 | $16 | $11 | 69% | — | $11 – $64 |
| 21 | Tricare fee schedule · outpatient · +13 other terms | 34 | $14 | $13 | $1 | 5% | — | $11 – $15 |
| 22 | Bcbs Tx fee schedule · outpatient · +1 other terms | 33 | $49 | $52 | $25 | 48% | — | $14 – $117 |
| 23 | Healthcare Highways fee schedule · outpatient · +1 other terms | 29 | $32 | $32 | $5 | 17% | — | $18 – $36 |
| 24 | Highmark fee schedule · outpatient · +12 other terms | 26 | $14 | $15 | $8 | 51% | — | $6 – $64 |
| 25 | Regence facility · fee schedule · outpatient · +8 other terms | 26 | $14 | $17 | $7 | 44% | — | $12 – $41 |
← Hospitals reporting CPT 87269 · Snapshot 20261112T181611Z-3fa9fb76