CPT 95904
Low
$38
Average
$1.4k
Median
$93
High
$17.2k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
14 payers; the 90th percentile is 10.3× 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.
Filter by billing methodology
Filter by billing class
| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield fee schedule · outpatient · +3 other terms | 28 | $174 | $225 | $116 | 52% | — | $13 – $707 |
| 2 | Anthem facility · fee schedule · outpatient · +1 other terms | 5 | $88 | $379 | $843 | 223% | — | $26 – $2.8k |
| 3 | First Health fee schedule · both · +2 other terms | 5 | $35 | $35 | $13 | 37% | — | $21 – $53 |
| 4 | Aetna facility · fee schedule · outpatient · +3 other terms | 3 | $76 | $4.7k | $6.6k | 140% | — | $31 – $13.9k |
| 5 | Aetna Better Health fee schedule · inpatient | 2 | $165 | $165 | — | — | — | $165 – $165 |
| 6 | Humana fee schedule · outpatient · +1 other terms | 2 | $6.1k | $6.3k | $1.5k | 23% | — | $5.0k – $8.3k |
| 7 | Kaiser fee schedule · both | 2 | $71 | $71 | $13 | 18% | — | $58 – $84 |
| 8 | Tricare facility · fee schedule · outpatient | 2 | $270 | $259 | $95 | 36% | — | $140 – $361 |
| 9 | Caresource fee schedule · outpatient | 1 | $95 | $95 | — | — | — | $95 – $95 |
| 10 | Excellus facility · fee schedule · outpatient | 1 | $91 | $91 | — | — | — | $91 – $91 |
← Hospitals reporting CPT 95904 · Snapshot 20261113T090226Z-3ce6c0b8