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
Fee Schedule
Low
$1
Average
$16
Median
$11
High
$57
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
34 payers; the 90th percentile is 18.0× 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 | Humana fee schedule · outpatient · +5 other terms | 41 | $39 | $37 | $17 | 46% | — | $5 – $53 |
| 2 | First Health facility · percent of total billed charges · bothfrom % of charges · +1 other terms | 35 | $2 | $2 | $1 | 67% | — | $0 – $6 |
| 3 | Medical Mutual facility · percent of total billed charges · bothfrom % of charges | 29 | $2 | $2 | $1 | 60% | — | $0 – $5 |
| 4 | Phcs facility · percent of total billed charges · bothfrom % of charges · +1 other terms | 27 | $3 | $3 | $1 | 36% | — | $1 – $5 |
| 5 | Anthem facility · case rate · outpatient · +8 other terms | 15 | $15 | $17 | $4 | 23% | — | $10 – $26 |
| 6 | Blue Cross Blue Shield fee schedule · outpatient · +3 other terms | 15 | $19 | $18 | $11 | 61% | — | $6 – $33 |
| 7 | Caresource facility · case rate · outpatient · +2 other terms | 15 | $16 | $17 | $4 | 23% | — | $10 – $27 |
| 8 | Molina facility · case rate · outpatient · +3 other terms | 15 | $15 | $17 | $4 | 23% | — | $11 – $26 |
| 9 | UnitedHealthcare facility · case rate · outpatient · +6 other terms | 15 | $16 | $17 | $4 | 23% | — | $11 – $27 |
| 10 | Medcost facility · percent of total billed charges · bothfrom % of charges | 14 | $2 | $3 | $1 | 44% | — | $2 – $6 |
| 11 | Medica facility · percent of total billed charges · bothfrom % of charges | 13 | $1 | $1 | $1 | 77% | — | $1 – $4 |
| 12 | Optum facility · case rate · outpatient · +1 other terms | 11 | $14 | $16 | $4 | 22% | — | $13 – $24 |
| 13 | WellCare facility · fee schedule · outpatient · +2 other terms | 10 | $5 | $5 | — | — | — | $5 – $5 |
| 14 | Magellan facility · percent of total billed charges · bothfrom % of charges · +2 other terms | 9 | $4 | $3 | $1 | 46% | — | $2 – $6 |
| 15 | Bcbs Mn fee schedule · outpatient · +1 other terms | 7 | $6 | $6 | $2 | 33% | — | $3 – $7 |
| 16 | Aetna fee schedule · outpatient · +6 other terms | 3 | $27 | $23 | $4 | 19% | — | $17 – $27 |
| 17 | Highmark facility · fee schedule · outpatient · +2 other terms | 3 | $5 | $5 | $0 | 4% | — | $5 – $5 |
| 18 | Amerihealth Caritas professional · fee schedule · outpatient · +2 other terms | 2 | $5 | $5 | — | — | — | $5 – $5 |
| 19 | Cigna fee schedule · both · +6 other terms | 2 | $5 | $5 | $2 | 33% | — | $3 – $7 |
| 20 | Kaiser fee schedule · both · +3 other terms | 2 | $7 | $7 | — | — | — | $7 – $7 |
| 21 | Medicaid facility · percent of total billed charges · bothfrom % of charges · +1 other terms | 2 | $2 | $2 | $0 | 19% | — | $2 – $2 |
| 22 | Oscar facility · percent of total billed charges · bothfrom % of charges | 2 | $2 | $2 | $1 | 44% | — | $1 – $2 |
| 23 | Tricare facility · percent of total billed charges · bothfrom % of charges | 2 | $3 | $3 | $0 | 15% | — | $2 – $3 |
| 24 | Ucare facility · percent of total billed charges · bothfrom % of charges | 2 | $2 | $2 | $0 | 19% | — | $2 – $2 |
| 25 | Ambetter professional · fee schedule · outpatient · +1 other terms | 1 | $5 | $5 | — | — | — | $5 – $5 |
← Hospitals reporting HCPCS A4397 · Snapshot 20261111T120946Z-9134e7f7