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
Test to assess the ability to complete specific functional tasks applicable to environment
Low
$76
Average
$259
Median
$245
High
$784
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
70 payers; the 90th percentile is 3.4× 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 | UnitedHealthcare fee schedule · outpatient · +37 other terms | 564 | $106 | $167 | $136 | 81% | 51–60 | $1 – $1.2k |
| 2 | Cigna fee schedule · outpatient · +32 other terms | 194 | $111 | $161 | $142 | 88% | 19 | $58 – $1.8k |
| 3 | Kaiser fee schedule · outpatient · +24 other terms | 90 | $108 | $192 | $130 | 68% | 2–20 | $60 – $813 |
| 4 | Humana fee schedule · outpatient · +32 other terms | 436 | $102 | $200 | $434 | 217% | 1–10 | $1 – $8.3k |
| 5 | Caresource fee schedule · outpatient · +21 other terms | 69 | $116 | $164 | $46 | 28% | 1–10 | $1 – $406 |
| 6 | Bcbs Mt fee schedule · outpatient · +2 other terms | 1 | $100 | $100 | — | — | 1–10 | $100 – $100 |
| 7 | Aetna fee schedule · outpatient · +36 other terms | 533 | $104 | $206 | $524 | 254% | — | $1 – $8.4k |
| 8 | Blue Cross Blue Shield fee schedule · outpatient · +36 other terms | 442 | $168 | $270 | $175 | 65% | — | $0 – $1.1k |
| 9 | WellCare fee schedule · outpatient · +25 other terms | 258 | $103 | $105 | $13 | 12% | — | $43 – $201 |
| 10 | Molina fee schedule · outpatient · +30 other terms | 193 | $151 | $159 | $97 | 61% | — | $1 – $867 |
| 11 | Devoted fee schedule · outpatient · +18 other terms | 163 | $102 | $102 | $2 | 2% | — | $97 – $110 |
| 12 | Anthem fee schedule · outpatient · +32 other terms | 144 | $106 | $141 | $105 | 74% | — | $29 – $839 |
| 13 | Cigna Healthspring fee schedule · outpatient · +8 other terms | 132 | $106 | $105 | $3 | 3% | — | $93 – $119 |
| 14 | Ambetter facility · fee schedule · outpatient · +20 other terms | 89 | $173 | $172 | $40 | 23% | — | $100 – $312 |
| 15 | Tricare facility · fee schedule · outpatient · +19 other terms | 77 | $98 | $124 | $114 | 92% | — | $87 – $716 |
| 16 | Oscar fee schedule · outpatient · +20 other terms | 72 | $118 | $140 | $66 | 47% | — | $1 – $285 |
| 17 | Optum fee schedule · outpatient · +25 other terms | 60 | $102 | $164 | $105 | 64% | — | $93 – $453 |
| 18 | Medicare fee schedule · both · +14 other terms | 57 | $99 | $111 | $8 | 7% | — | $90 – $144 |
| 19 | MultiPlan fee schedule · outpatient · +21 other terms | 57 | $383 | $371 | $236 | 64% | — | $37 – $1.2k |
| 20 | Superior Healthplan fee schedule · outpatient · +4 other terms | 45 | $109 | $108 | $6 | 6% | — | $97 – $164 |
| 21 | Amerihealth Caritas fee schedule · outpatient · +13 other terms | 37 | $122 | $115 | $51 | 45% | — | $47 – $333 |
| 22 | Medica facility · fee schedule · outpatient · +24 other terms | 35 | $100 | $114 | $27 | 24% | — | $63 – $191 |
| 23 | Highmark fee schedule · outpatient · +17 other terms | 34 | $118 | $150 | $100 | 66% | — | $45 – $594 |
| 24 | Bcbs Tx fee schedule · outpatient · +5 other terms | 30 | $448 | $410 | $151 | 37% | — | $132 – $756 |
| 25 | Clover fee schedule · outpatient · +11 other terms | 30 | $104 | $105 | $5 | 4% | — | $97 – $118 |
← Hospitals reporting CPT 96125 · Snapshot 20261111T120946Z-9134e7f7