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
Microcapillary tube sealant
Low
$0
Average
$253
Median
$77
High
$1.8k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
26 payers; the 90th percentile is 6117.3× 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 · +8 other terms | 29 | $0 | $3 | $2 | 86% | — | $0 – $5 |
| 2 | Blue Cross Blue Shield facility · fee schedule · outpatient · +4 other terms | 22 | $22 | $16 | $17 | 102% | — | $0 – $64 |
| 3 | Anthem facility · case rate · outpatient · +7 other terms | 15 | $15 | $17 | $4 | 23% | — | $10 – $26 |
| 4 | Caresource facility · case rate · outpatient · +2 other terms | 15 | $16 | $17 | $4 | 23% | — | $10 – $27 |
| 5 | Molina facility · case rate · outpatient · +5 other terms | 15 | $15 | $17 | $4 | 23% | — | $11 – $26 |
| 6 | UnitedHealthcare facility · case rate · outpatient · +6 other terms | 15 | $16 | $17 | $4 | 23% | — | $11 – $27 |
| 7 | Optum facility · case rate · outpatient · +1 other terms | 11 | $14 | $16 | $4 | 22% | — | $13 – $24 |
| 8 | Aetna Better Health fee schedule · inpatient · +1 other terms | 7 | $0 | $0 | — | — | — | $0 – $0 |
| 9 | Bcbs Mn fee schedule · outpatient | 5 | $1 | $1 | $0 | 66% | — | $0 – $1 |
| 10 | Humana fee schedule · inpatient · +4 other terms | 5 | $0 | $0 | — | — | — | $0 – $0 |
| 11 | First Health professional · fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 12 | Medical Mutual per diem · both · +1 other terms | 3 | $3.6k | $3.8k | $300 | 8% | — | $3.6k – $4.2k |
| 13 | Cigna professional · fee schedule · outpatient · +3 other terms | 2 | $1 | $1 | $0 | 25% | — | $1 – $2 |
| 14 | Ambetter percent of total billed charges · outpatientfrom % of charges | 1 | $105 | $105 | — | — | — | $105 – $105 |
| 15 | Bcbs Id facility · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 16 | Bcbs La facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 17 | Bcbs Nc facility · fee schedule · outpatient | 1 | $6 | $6 | $2 | 32% | — | $3 – $8 |
| 18 | Bcbs Nv fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 19 | Bcbs Ny percent of total billed charges · bothfrom % of charges | 1 | $633 | $633 | — | — | — | $633 – $633 |
| 20 | Bcbs Vt professional · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 21 | Excellus percent of total billed charges · bothfrom % of charges | 1 | $633 | $633 | — | — | — | $633 – $633 |
| 22 | Kaiser percent of total billed charges · outpatientfrom % of charges | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 23 | Magellan fee schedule · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 24 | MultiPlan percent of total billed charges · outpatientfrom % of charges | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 25 | Premera percent of total billed charges · outpatientfrom % of charges | 1 | $114 | $114 | $4 | 4% | — | $107 – $117 |
← Hospitals reporting HCPCS A4652 · Snapshot 20261112T124536Z-e251e855