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
PR QHP R&I MOTION ANALYSIS
Low
$0
Average
$272
Median
$198
High
$1.6k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
52 payers; the 90th percentile is 4.1× 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 | Humana fee schedule · outpatient · +17 other terms | 203 | $103 | $379 | $751 | 198% | — | $76 – $8.3k |
| 2 | Blue Cross Blue Shield fee schedule · outpatient · +18 other terms | 165 | $349 | $378 | $172 | 46% | — | $0 – $817 |
| 3 | UnitedHealthcare fee schedule · outpatient · +20 other terms | 112 | $113 | $456 | $524 | 115% | — | $20 – $2.4k |
| 4 | Aetna fee schedule · outpatient · +20 other terms | 77 | $104 | $579 | $1.4k | 250% | — | $79 – $8.4k |
| 5 | Anthem fee schedule · outpatient · +13 other terms | 63 | $133 | $281 | $267 | 95% | — | $98 – $1.3k |
| 6 | Cigna fee schedule · outpatient · +16 other terms | 38 | $104 | $144 | $55 | 39% | — | $96 – $311 |
| 7 | Molina professional · fee schedule · outpatient · +14 other terms | 32 | $106 | $103 | $11 | 11% | — | $70 – $141 |
| 8 | Bcbs Tx fee schedule · outpatient · +2 other terms | 30 | $469 | $430 | $158 | 37% | — | $138 – $792 |
| 9 | Kaiser fee schedule · outpatient · +9 other terms | 26 | $104 | $121 | $46 | 38% | — | $96 – $235 |
| 10 | WellCare professional · fee schedule · outpatient · +8 other terms | 23 | $100 | $103 | $8 | 8% | — | $75 – $113 |
| 11 | Devoted fee schedule · outpatient · +6 other terms | 21 | $104 | $103 | $1 | 1% | — | $102 – $104 |
| 12 | Regence professional · fee schedule · outpatient · +1 other terms | 21 | $106 | $114 | $29 | 25% | — | $106 – $266 |
| 13 | Caresource facility · case rate · outpatient · +7 other terms | 20 | $354 | $333 | $136 | 41% | — | $98 – $635 |
| 14 | Medicare fee schedule · outpatient · +4 other terms | 18 | $102 | $100 | $2 | 2% | — | $96 – $104 |
| 15 | Wellmark fee schedule · both · +3 other terms | 13 | $193 | $191 | $56 | 29% | — | $99 – $249 |
| 16 | Aetna Better Health fee schedule · outpatient · +5 other terms | 12 | $110 | $105 | $6 | 5% | — | $99 – $110 |
| 17 | Ambetter fee schedule · both · +8 other terms | 12 | $135 | $198 | $33 | 17% | — | $97 – $220 |
| 18 | Bcbs Mn fee schedule · outpatient · +4 other terms | 12 | $518 | $412 | $208 | 51% | — | $107 – $649 |
| 19 | Cigna Healthspring fee schedule · both · +2 other terms | 12 | $99 | $99 | $1 | 1% | — | $99 – $104 |
| 20 | Highmark fee schedule · outpatient · +8 other terms | 12 | $116 | $123 | $36 | 29% | — | $94 – $378 |
| 21 | Medica fee schedule · outpatient · +6 other terms | 12 | $360 | $341 | $117 | 34% | — | $101 – $476 |
| 22 | MultiPlan fee schedule · both · +11 other terms | 12 | $199 | $207 | $35 | 17% | — | $172 – $319 |
| 23 | Optum facility · case rate · outpatient · +6 other terms | 12 | $339 | $338 | $126 | 37% | — | $104 – $564 |
| 24 | Tricare facility · fee schedule · outpatient · +5 other terms | 11 | $103 | $121 | $74 | 61% | — | $90 – $386 |
| 25 | Medical Mutual facility · fee schedule · outpatient · +2 other terms | 10 | $103 | $127 | $27 | 21% | — | $103 – $164 |
← Hospitals reporting CPT 96004 · Snapshot 20261112T181611Z-3fa9fb76