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
HC ALYS BRN NPGT PRGRMG ADDL 15
Low
$35
Average
$177
Median
$127
High
$905
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
60 payers; the 90th percentile is 7.9× 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.
Filter by billing methodology
Filter by billing class
| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Premera professional · fee schedule · both · +6 other terms | 4 | $71 | $69 | $21 | 30% | 14–23 | $33 – $85 |
| 2 | Blue Cross Blue Shield fee schedule · outpatient · +30 other terms | 190 | $142 | $155 | $93 | 60% | — | $0 – $603 |
| 3 | UnitedHealthcare fee schedule · outpatient · +32 other terms | 142 | $45 | $258 | $1.4k | 526% | — | $1 – $13.9k |
| 4 | Aetna fee schedule · outpatient · +29 other terms | 91 | $42 | $439 | $1.4k | 321% | — | $1 – $8.4k |
| 5 | Humana fee schedule · outpatient · +24 other terms | 83 | $41 | $68 | $44 | 65% | — | $1 – $161 |
| 6 | Anthem fee schedule · outpatient · +19 other terms | 65 | $44 | $110 | $109 | 99% | — | $29 – $517 |
| 7 | Cigna fee schedule · both · +25 other terms | 43 | $99 | $104 | $49 | 47% | — | $32 – $246 |
| 8 | Molina professional · fee schedule · outpatient · +24 other terms | 41 | $42 | $40 | $5 | 13% | — | $25 – $57 |
| 9 | WellCare fee schedule · both · +14 other terms | 30 | $39 | $44 | $9 | 20% | — | $32 – $69 |
| 10 | Kaiser fee schedule · outpatient · +19 other terms | 28 | $42 | $54 | $22 | 41% | — | $38 – $95 |
| 11 | Baylor Scott White Health Plan facility · percent of total billed charges · outpatientfrom % of charges | 26 | $108 | $97 | $21 | 22% | — | $34 – $117 |
| 12 | Bcbs Tx fee schedule · outpatient · +1 other terms | 26 | $181 | $168 | $62 | 37% | — | $58 – $305 |
| 13 | Regence professional · fee schedule · outpatient · +9 other terms | 26 | $42 | $71 | $35 | 49% | — | $42 – $135 |
| 14 | Devoted fee schedule · outpatient · +9 other terms | 21 | $42 | $42 | $1 | 1% | — | $41 – $42 |
| 15 | Caresource facility · case rate · outpatient · +13 other terms | 20 | $86 | $85 | $24 | 28% | — | $40 – $145 |
| 16 | Medicare fee schedule · outpatient · +11 other terms | 18 | $41 | $40 | $1 | 2% | — | $38 – $42 |
| 17 | Aetna Better Health facility · fee schedule · outpatient · +18 other terms | 15 | $47 | $46 | $15 | 32% | — | $32 – $68 |
| 18 | Highmark fee schedule · outpatient · +11 other terms | 15 | $46 | $50 | $21 | 41% | — | $27 – $237 |
| 19 | Optum facility · case rate · outpatient · +17 other terms | 14 | $80 | $80 | $22 | 28% | — | $42 – $129 |
| 20 | Ambetter facility · fee schedule · outpatient · +14 other terms | 13 | $79 | $73 | $11 | 15% | — | $42 – $79 |
| 21 | Wellmark fee schedule · both · +12 other terms | 13 | $78 | $77 | $23 | 29% | — | $40 – $101 |
| 22 | Amerihealth Caritas fee schedule · both · +11 other terms | 12 | $38 | $38 | — | — | — | $38 – $38 |
| 23 | Bcbs Mn fee schedule · outpatient · +4 other terms | 12 | $76 | $48 | $42 | 86% | — | $0 – $95 |
| 24 | Bcbs Nj fee schedule · outpatient · +4 other terms | 12 | $43 | $54 | $20 | 37% | — | $37 – $101 |
| 25 | Beechstreet percent of total billed charges · inpatientfrom % of charges · +1 other terms | 12 | $901 | $905 | $27 | 3% | — | $871 – $961 |
← Hospitals reporting CPT 95984 · Snapshot 20261112T124536Z-e251e855