SPLINT

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.

Generation details were not recorded for this description.

Original text from hospital filings

HC Kt Orth Merit Sm Fnl Fngr Flxn

Payers reporting HCPCS A4570

Payer pricing summary

Low

Average

$61

Median

$35

High

$821

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Humana fee schedule · outpatient · +13 other terms	90	$39	$65	$57	87%	—	$1 – $273
2	Aetna fee schedule · outpatient · +19 other terms	63	$12	$53	$45	85%	—	$5 – $295
3	UnitedHealthcare fee schedule · outpatient · +21 other terms	58	$8	$27	$40	144%	—	$1 – $349
4	Blue Cross Blue Shield fee schedule · outpatient · +22 other terms	49	$30	$40	$201	496%	—	$0 – $6.1k
5	Medical Mutual facility · percent of total billed charges · bothfrom % of charges · +3 other terms	45	$2	$8	$12	155%	—	$0 – $42
6	Carefirst facility · percent of total billed charges · bothfrom % of charges · +1 other terms	25	$1	$2	$1	54%	—	$1 – $5
7	Premera facility · percent of total billed charges · bothfrom % of charges · +2 other terms	24	$1	$2	$1	56%	—	$1 – $5
8	Cigna fee schedule · both · +19 other terms	23	$27	$20	$8	41%	—	$0 – $41
9	Medica fee schedule · outpatient · +12 other terms	23	$25	$45	$36	80%	—	$1 – $126
10	MultiPlan fee schedule · outpatient · +15 other terms	19	$100	$127	$105	82%	—	$2 – $402
11	Regence fee schedule · outpatient · +5 other terms	17	$13	$23	$7	30%	—	$10 – $38
12	Anthem facility · case rate · outpatient · +13 other terms	15	$15	$17	$4	23%	—	$10 – $26
13	Caresource facility · case rate · outpatient · +8 other terms	15	$16	$17	$4	22%	—	$10 – $27
14	Molina facility · case rate · outpatient · +14 other terms	15	$15	$17	$4	22%	—	$11 – $26
15	Amerihealth Caritas fee schedule · both · +5 other terms	14	$9	$25	$22	86%	—	$9 – $58
16	Phcs fee schedule · outpatient · +6 other terms	14	$100	$115	$77	67%	—	$60 – $380
17	Medicaid fee schedule · outpatient · +3 other terms	13	$103	$151	$278	184%	—	$13 – $2.4k
18	WellCare fee schedule · both · +7 other terms	13	$9	$9	$0	4%	—	$9 – $11
19	Wellmark fee schedule · both · +7 other terms	13	$3	$4	$7	177%	—	$3 – $48
20	Baylor Scott White Health Plan facility · percent of total billed charges · outpatientfrom % of charges	12	$28	$24	$6	26%	—	$9 – $30
21	Bcbs Mn fee schedule · outpatient · +4 other terms	12	$46	$35	$19	55%	—	$15 – $57
22	Bcbs Nc fee schedule · both · +1 other terms	11	$7	$7	$1	10%	—	$6 – $8
23	Optum facility · case rate · outpatient · +11 other terms	11	$14	$16	$3	21%	—	$13 – $24
24	Highmark fee schedule · outpatient · +9 other terms	10	$12	$12	—	—	—	$12 – $12
25	Magellan facility · percent of total billed charges · bothfrom % of charges · +2 other terms	9	$2	$2	$1	54%	—	$1 – $5

Page 1 of 3 · 57 payers

← Hospitals reporting HCPCS A4570 · Snapshot 20261111T120946Z-9134e7f7