CPT 95904
Low
$16
Average
$2.0k
Median
$122
High
$33.5k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
27 payers; the 90th percentile is 83.8× 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 · +10 other terms | 28 | $174 | $225 | $116 | 52% | — | $13 – $707 |
| 2 | Anthem facility · fee schedule · outpatient · +2 other terms | 5 | $88 | $379 | $843 | 223% | — | $26 – $2.8k |
| 3 | First Health fee schedule · both · +9 other terms | 5 | $35 | $35 | $13 | 37% | — | $21 – $53 |
| 4 | MultiPlan professional · percent of total billed charges · bothfrom % of charges · +6 other terms | 5 | $63 | $64 | $26 | 41% | — | $26 – $100 |
| 5 | Aetna facility · fee schedule · outpatient · +11 other terms | 3 | $76 | $4.7k | $6.6k | 140% | — | $31 – $13.9k |
| 6 | Ambetter professional · percent of total billed charges · inpatientfrom % of charges · +2 other terms | 3 | $78 | $64 | $21 | 33% | — | $34 – $78 |
| 7 | Cigna other · both · +6 other terms | 3 | $346 | $364 | $98 | 27% | — | $156 – $410 |
| 8 | Medcost professional · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 3 | $209 | $170 | $56 | 33% | — | $91 – $209 |
| 9 | Phcs professional · percent of total billed charges · inpatientfrom % of charges · +2 other terms | 3 | $230 | $186 | $61 | 33% | — | $100 – $230 |
| 10 | UnitedHealthcare facility · per diem · outpatient · +8 other terms | 3 | $779 | $942 | $286 | 30% | — | $697 – $1.4k |
← Hospitals reporting CPT 95904 · Snapshot 20261113T090226Z-3ce6c0b8