CPT 90484
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
IMM CNSL NOT ADMN SM>20
Low
$24
Average
$2.4k
Median
$42
High
$50k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
22 payers; the 90th percentile is 25.9× 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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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield fee schedule · outpatient · +3 other terms | 28 | $144 | $127 | $41 | 32% | — | $79 – $229 |
| 2 | Humana fee schedule · outpatient · +2 other terms | 26 | $41 | $50 | $19 | 37% | — | $41 – $93 |
| 3 | Aetna fee schedule · outpatient · +3 other terms | 23 | $41 | $55 | $20 | 37% | — | $41 – $91 |
| 4 | Medicare fee schedule · outpatient | 18 | $41 | $41 | — | — | — | $41 – $41 |
| 5 | UnitedHealthcare facility · fee schedule · outpatient · +3 other terms | 18 | $40 | $34 | $8 | 24% | — | $21 – $40 |
| 6 | Molina facility · fee schedule · outpatient · +2 other terms | 17 | $40 | $37 | $13 | 35% | — | $21 – $82 |
| 7 | Anthem fee schedule · outpatient · +2 other terms | 15 | $41 | $54 | $21 | 39% | — | $41 – $89 |
| 8 | Cigna facility · fee schedule · outpatient · +2 other terms | 14 | $40 | $31 | $12 | 40% | — | $14 – $40 |
| 9 | Kaiser fee schedule · outpatient | 13 | $41 | $41 | — | — | — | $41 – $41 |
| 10 | WellCare facility · fee schedule · outpatient · +1 other terms | 12 | $40 | $40 | $0 | 0% | — | $40 – $40 |
← Hospitals reporting CPT 90484 · Snapshot 20261113T090226Z-3ce6c0b8