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Payers and negotiated rates for CPT 90422 | medprice.ai

Donnatal Elixer 5cc

Payers reporting CPT 90422

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Payer pricing summary

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Low

$57

Average

$62

Median

$61

High

$72

Payer rate distribution

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1	Aetna percent of total billed charges · outpatientfrom % of charges	1	$61	$61	—	—	—	$61 – $61
2	Blue Cross Blue Shield percent of total billed charges · outpatientfrom % of charges	1	$57	$57	$10	17%	—	$43 – $65
3	Cigna percent of total billed charges · outpatientfrom % of charges	1	$58	$58	—	—	—	$58 – $58
4	MultiPlan percent of total billed charges · outpatientfrom % of charges	1	$72	$72	—	—	—	$72 – $72
5	Phcs percent of total billed charges · outpatientfrom % of charges	1	$65	$65	—	—	—	$65 – $65
6	Superior Healthplan fee schedule · outpatient	1	$61	$61	$10	16%	—	$51 – $71

← Hospitals reporting CPT 90422 · Snapshot 20261111T120946Z-9134e7f7