CPT 90875
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
90875
Low
$5
Average
$144
Median
$106
High
$631
Filter by billing methodology
Filter by billing class
270 hospital rates
iThe hospitals that file a Cigna 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 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 1 | $81 | $81 | — | — | — | $81 – $81 |
| 2 | AKRON GENERAL MEDICAL CENTER Akron, OH professional · fee schedule · outpatient | 2 | $81 | $81 | $7 | 8% | — | $74 – $87 |
| 3 | ALBANY GENERAL HOSPITAL Albany, OR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $114 | $114 | — | — | — | $114 – $114 |
| 4 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient | 4 | $95 | $95 | $9 | 10% | — | $86 – $105 |
| 5 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · inpatient | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 6 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 7 | Advocate Childrens Hospital Park Ridge Park Ridge, IL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $165 | $165 | $20 | 12% | — | $146 – $185 |
| 8 | Alexian Brothers Behavioral Health Hospital Estates, IL other · both | 3 | $245 | $245 | — | — | — | $245 – $245 |
| 9 | Alexian Brothers Medical Center Village, IL other · both | 4 | $245 | $243 | $4 | 2% | — | $236 – $245 |
| 10 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 1 | $141 | $141 | — | — | — | $141 – $141 |
| 11 | Allina Health Systems Minneapolis, MN facility · other · outpatient | 1 | $193 | $193 | — | — | — | $193 – $193 |
| 12 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $199 | $199 | — | — | — | $199 – $199 |
| 13 | AnMed Health Anderson, SC professional · fee schedule · inpatient | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 14 | AnMed Health Anderson, SC professional · fee schedule · outpatient | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 15 | AnMed Health Cannon Pickens, SC professional · fee schedule · inpatient | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 16 | AnMed Health Cannon Pickens, SC professional · fee schedule · outpatient | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 17 | AnMed Piedmont Piedmont, SC professional · fee schedule · inpatient | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 18 | AnMed Piedmont Piedmont, SC professional · fee schedule · outpatient | 1 | $95 | $95 | — | — | — | $95 – $95 |
| 19 | BOCA RATON REGIONAL HOSPITAL Delray Beach, FL percent of total billed charges · bothfrom % of charges | 2 | $46 | $46 | — | — | — | $46 – $46 |
| 20 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $130 | $130 | $1 | 1% | — | $130 – $131 |
| 21 | Boston Children's Hospital Boston, MA fee schedule · both | 1 | $379 | $379 | — | — | — | $379 – $379 |
| 22 | Boston Children's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 2 | $328 | $330 | $8 | 3% | — | $322 – $342 |
| 23 | Boston Children's Hospital Waltham, MA fee schedule · both | 1 | $379 | $379 | — | — | — | $379 – $379 |
| 24 | Boston Children's Hospital Waltham, MA percent of total billed charges · bothfrom % of charges | 2 | $328 | $330 | $8 | 3% | — | $322 – $342 |
| 25 | Boston Children's Hospital Needham, MA fee schedule · both | 1 | $379 | $379 | — | — | — | $379 – $379 |
← Payers reporting CPT 90875 · Snapshot 20261113T090226Z-3ce6c0b8