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
Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)
Low
$77
Average
$279
Median
$139
High
$2.3k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
31 payers; the 90th percentile is 3.6× 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 · +7 other terms | 229 | $2.5k | $2.6k | $1.0k | 38% | — | $51 – $5.8k |
| 2 | Blue Cross Blue Shield fee schedule · outpatient · +3 other terms | 56 | $24 | $27 | $13 | 47% | — | $1 – $134 |
| 3 | Aetna facility · fee schedule · outpatient · +6 other terms | 26 | $119 | $166 | $159 | 96% | — | $116 – $980 |
| 4 | Humana fee schedule · outpatient · +5 other terms | 22 | $133 | $132 | $6 | 5% | — | $116 – $146 |
| 5 | Cigna fee schedule · outpatient · +3 other terms | 21 | $133 | $1.4k | $663 | 47% | — | $133 – $1.8k |
| 6 | Medicare fee schedule · outpatient | 18 | $133 | $133 | — | — | — | $133 – $133 |
| 7 | Molina facility · fee schedule · outpatient · +4 other terms | 17 | $116 | $108 | $38 | 35% | — | $61 – $238 |
| 8 | WellCare facility · fee schedule · outpatient · +4 other terms | 15 | $116 | $119 | $6 | 5% | — | $116 – $139 |
| 9 | Kaiser fee schedule · outpatient · +3 other terms | 13 | $133 | $133 | — | — | — | $133 – $133 |
| 10 | Anthem fee schedule · outpatient · +4 other terms | 12 | $133 | $155 | $70 | 45% | — | $133 – $396 |
| 11 | Caresource fee schedule · outpatient · +2 other terms | 12 | $51 | $51 | — | — | — | $51 – $51 |
| 12 | Devoted fee schedule · outpatient · +3 other terms | 10 | $133 | $133 | $2 | 1% | — | $133 – $139 |
| 13 | Medical Mutual facility · fee schedule · outpatient | 10 | $116 | $143 | $30 | 21% | — | $116 – $184 |
| 14 | Optum fee schedule · outpatient | 10 | $133 | $133 | — | — | — | $133 – $133 |
| 15 | Ambetter facility · fee schedule · outpatient · +2 other terms | 8 | $209 | $209 | — | — | — | $209 – $209 |
| 16 | Excellus facility · fee schedule · outpatient · +1 other terms | 3 | $252 | $256 | $189 | 74% | — | $103 – $565 |
| 17 | First Health professional · fee schedule · both | 3 | $77 | $77 | — | — | — | $77 – $77 |
| 18 | Highmark professional · fee schedule · both · +3 other terms | 3 | $111 | $112 | $3 | 2% | — | $111 – $116 |
| 19 | Bcbs Al facility · case rate · outpatient | 2 | $125 | $125 | — | — | — | $125 – $125 |
| 20 | Bcbs Ks fee schedule · outpatient | 2 | $133 | $133 | — | — | — | $133 – $133 |
| 21 | Bcbs Mi facility · case rate · outpatient · +1 other terms | 2 | $61 | $61 | — | — | — | $61 – $61 |
| 22 | Cigna Healthspring facility · case rate · outpatient | 2 | $130 | $130 | $3 | 2% | — | $127 – $132 |
| 23 | Clover fee schedule · outpatient | 2 | $139 | $139 | — | — | — | $139 – $139 |
| 24 | Tricare facility · fee schedule · outpatient | 2 | $115 | $115 | $6 | 5% | — | $109 – $121 |
| 25 | Bcbs Il professional · fee schedule · both | 1 | $105 | $105 | $12 | 11% | — | $93 – $116 |
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