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
$58
Average
$103
Median
$83
High
$294
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59 hospital rates
iThe hospitals that file a Optum 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 · case rate · outpatient | 1 | $97 | $97 | — | — | — | $97 – $97 |
| 2 | AKRON GENERAL MEDICAL CENTER Akron, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $280 | $280 | — | — | — | $280 – $280 |
| 3 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 2 | $58 | $58 | $1 | 1% | — | $58 – $59 |
| 4 | Boston Children's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 3 | $315 | $294 | $34 | 12% | — | $246 – $322 |
| 5 | Boston Children's Hospital Waltham, MA percent of total billed charges · bothfrom % of charges | 3 | $315 | $294 | $34 | 12% | — | $246 – $322 |
| 6 | Boston Children's Hospital Needham, MA percent of total billed charges · bothfrom % of charges | 3 | $315 | $294 | $34 | 12% | — | $246 – $322 |
| 7 | CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO fee schedule · outpatient | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 8 | CATHOLIC HEALTH INITIATIVES COLORADO Pueblo, CO fee schedule · outpatient | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 9 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 10 | CATHOLIC HEALTH INITIATIVES COLORADO Frisco, CO fee schedule · outpatient | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 11 | CATHOLIC HEALTH INITIATIVES COLORADO Durango, CO fee schedule · outpatient | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 12 | CATHOLIC HEALTH INITIATIVES COLORADO Lakewood, CO fee schedule · outpatient | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 13 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 14 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $170 | $170 | — | — | — | $170 – $170 |
| 15 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 16 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $106 | $106 | — | — | — | $106 – $106 |
| 17 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $111 | $111 | — | — | — | $111 – $111 |
| 18 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 19 | Fairview Bethesda Hospital St. Paul, MN fee schedule · both | 1 | $59 | $59 | $1 | 2% | — | $58 – $61 |
| 20 | Fairview Health Services Edina, MN fee schedule · both | 1 | $59 | $59 | $1 | 2% | — | $58 – $61 |
| 21 | Fairview Health Services Minneapolis, MN fee schedule · both | 1 | $59 | $59 | $1 | 2% | — | $58 – $61 |
| 22 | Fairview Health Services Princeton, MN fee schedule · both | 1 | $59 | $59 | $1 | 2% | — | $58 – $61 |
| 23 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $100 | $100 | — | — | — | $100 – $100 |
| 24 | Fisher-Titus Medical Center Norwalk, OH facility · fee schedule · outpatient | 1 | $59 | $59 | — | — | — | $59 – $59 |
| 25 | HealthEast St John's Hospital Maplewood, MN fee schedule · both | 1 | $59 | $59 | $1 | 2% | — | $58 – $61 |
← Payers reporting CPT 90875 · Snapshot 20261113T090226Z-3ce6c0b8