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
Replacement bulb th lightbox
Low
$0
Average
$57
Median
$26
High
$205
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
18 payers; the 90th percentile is 112.1× 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 | Aetna fee schedule · outpatient · +5 other terms | 29 | $225 | $348 | $232 | 67% | — | $22 – $1.0k |
| 2 | Blue Cross Blue Shield facility · fee schedule · outpatient · +4 other terms | 20 | $21 | $30 | $31 | 104% | — | $0 – $105 |
| 3 | Anthem facility · case rate · outpatient · +4 other terms | 15 | $15 | $17 | $4 | 23% | — | $10 – $26 |
| 4 | Caresource facility · case rate · outpatient · +1 other terms | 15 | $16 | $17 | $4 | 23% | — | $10 – $27 |
| 5 | Molina facility · case rate · outpatient · +1 other terms | 15 | $15 | $17 | $4 | 23% | — | $11 – $26 |
| 6 | UnitedHealthcare facility · case rate · outpatient · +3 other terms | 15 | $16 | $17 | $4 | 23% | — | $11 – $27 |
| 7 | Bcbs Mn fee schedule · outpatient · +3 other terms | 12 | $6 | $4 | $3 | 75% | — | $0 – $8 |
| 8 | Optum facility · case rate · outpatient · +1 other terms | 11 | $14 | $16 | $4 | 22% | — | $13 – $24 |
| 9 | Cigna professional · fee schedule · outpatient · +2 other terms | 10 | $25 | $25 | — | — | — | $25 – $25 |
| 10 | Highmark fee schedule · outpatient · +2 other terms | 10 | $35 | $35 | — | — | — | $35 – $35 |
| 11 | Aetna Better Health fee schedule · inpatient · +1 other terms | 7 | $162 | $162 | — | — | — | $162 – $162 |
| 12 | Humana fee schedule · inpatient · +2 other terms | 5 | $157 | $157 | — | — | — | $157 – $157 |
| 13 | First Health professional · fee schedule · both | 3 | $121 | $121 | $73 | 61% | — | $17 – $173 |
| 14 | Bcbs La facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | Bcbs Nc facility · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 16 | Bcbs Nv fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 17 | Bcbs Vt professional · fee schedule · outpatient | 1 | $86 | $86 | $71 | 82% | — | $16 – $157 |
| 18 | Healthpartners facility · fee schedule · outpatient | 1 | $117 | $117 | — | — | — | $117 – $117 |
← Hospitals reporting HCPCS A4634 · Snapshot 20261112T181611Z-3fa9fb76