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 PREV MED NEW PAT 65+ YRS
Low
$72
Average
$230
Median
$223
High
$473
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
62 payers; the 90th percentile is 2.5× 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 · +25 other terms | 226 | $154 | $243 | $617 | 254% | 1–10 | $1 – $8.3k |
| 2 | UnitedHealthcare fee schedule · outpatient · +35 other terms | 181 | $159 | $181 | $95 | 53% | 1–10 | $1 – $977 |
| 3 | Ucare professional · fee schedule · outpatient · +13 other terms | 18 | $171 | $159 | $29 | 18% | 1–10 | $89 – $184 |
| 4 | Phcs professional · fee schedule · outpatient · +12 other terms | 7 | $229 | $278 | $92 | 33% | 1–10 | $154 – $440 |
| 5 | Oscar professional · fee schedule · both · +15 other terms | 3 | $220 | $195 | $35 | 18% | 1–10 | $145 – $220 |
| 6 | Blue Cross Blue Shield fee schedule · outpatient · +28 other terms | 169 | $370 | $402 | $214 | 53% | — | $0 – $970 |
| 7 | Aetna fee schedule · outpatient · +32 other terms | 140 | $161 | $392 | $897 | 229% | — | $1 – $8.4k |
| 8 | Cigna fee schedule · outpatient · +27 other terms | 94 | $170 | $208 | $112 | 54% | — | $0 – $509 |
| 9 | Anthem fee schedule · outpatient · +24 other terms | 67 | $161 | $162 | $28 | 17% | — | $18 – $210 |
| 10 | Molina fee schedule · outpatient · +25 other terms | 44 | $132 | $147 | $94 | 64% | — | $1 – $430 |
| 11 | Kaiser fee schedule · outpatient · +19 other terms | 37 | $170 | $210 | $101 | 48% | — | $5 – $523 |
| 12 | Caresource fee schedule · outpatient · +19 other terms | 34 | $101 | $147 | $45 | 31% | — | $1 – $189 |
| 13 | Bcbs Tx fee schedule · outpatient · +2 other terms | 23 | $518 | $510 | $163 | 32% | — | $152 – $874 |
| 14 | Devoted fee schedule · outpatient · +17 other terms | 23 | $161 | $172 | $32 | 18% | — | $157 – $319 |
| 15 | Optum professional · fee schedule · outpatient · +15 other terms | 23 | $167 | $134 | $44 | 33% | — | $64 – $176 |
| 16 | Regence fee schedule · outpatient · +13 other terms | 22 | $201 | $205 | $65 | 32% | — | $56 – $529 |
| 17 | Aetna Better Health fee schedule · outpatient · +13 other terms | 21 | $115 | $158 | $82 | 52% | — | $91 – $395 |
| 18 | MultiPlan fee schedule · outpatient · +19 other terms | 21 | $176 | $232 | $152 | 66% | — | $77 – $648 |
| 19 | Medicaid fee schedule · outpatient · +15 other terms | 20 | $293 | $262 | $114 | 44% | — | $1 – $416 |
| 20 | WellCare fee schedule · outpatient · +23 other terms | 19 | $148 | $128 | $33 | 26% | — | $18 – $180 |
| 21 | Wellmark fee schedule · both · +18 other terms | 19 | $208 | $209 | $6 | 3% | — | $176 – $230 |
| 22 | Medica fee schedule · both · +16 other terms | 18 | $265 | $320 | $170 | 53% | — | $91 – $512 |
| 23 | Medicare fee schedule · outpatient · +13 other terms | 18 | $170 | $170 | — | — | — | $170 – $170 |
| 24 | Tricare fee schedule · both · +15 other terms | 18 | $200 | $188 | $32 | 17% | — | $130 – $266 |
| 25 | Ambetter fee schedule · both · +18 other terms | 17 | $171 | $232 | $43 | 19% | — | $39 – $292 |
← Hospitals reporting CPT 99387 · Snapshot 20261111T120946Z-9134e7f7