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
Custom grad com glove med
Low
$133
Average
$423
Median
$331
High
$1.5k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
53 payers; the 90th percentile is 2.2× 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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Filter by billing class
| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Aetna fee schedule · outpatient · +10 other terms | 345 | $315 | $350 | $163 | 47% | — | $178 – $2.1k |
| 2 | UnitedHealthcare fee schedule · outpatient · +11 other terms | 337 | $316 | $314 | $67 | 21% | — | $184 – $1.0k |
| 3 | Humana fee schedule · outpatient · +10 other terms | 313 | $310 | $326 | $109 | 33% | — | $145 – $1.3k |
| 4 | WellCare fee schedule · outpatient · +4 other terms | 215 | $323 | $329 | $51 | 15% | — | $211 – $607 |
| 5 | Blue Cross Blue Shield fee schedule · outpatient · +12 other terms | 197 | $320 | $385 | $151 | 39% | — | $0 – $1.5k |
| 6 | Devoted fee schedule · outpatient · +3 other terms | 163 | $313 | $314 | $5 | 2% | — | $305 – $335 |
| 7 | Molina fee schedule · outpatient · +4 other terms | 134 | $461 | $435 | $162 | 37% | — | $235 – $821 |
| 8 | Cigna Healthspring fee schedule · outpatient · +2 other terms | 113 | $320 | $319 | $9 | 3% | — | $313 – $338 |
| 9 | Cigna fee schedule · outpatient · +6 other terms | 95 | $323 | $360 | $102 | 28% | — | $305 – $906 |
| 10 | Anthem fee schedule · outpatient · +6 other terms | 73 | $307 | $435 | $432 | 99% | — | $305 – $2.3k |
| 11 | Kaiser fee schedule · outpatient · +4 other terms | 61 | $320 | $443 | $328 | 74% | — | $211 – $2.3k |
| 12 | Clover fee schedule · outpatient · +2 other terms | 41 | $309 | $313 | $29 | 9% | — | $205 – $329 |
| 13 | Ambetter facility · fee schedule · outpatient · +5 other terms | 40 | $530 | $567 | $143 | 25% | — | $218 – $778 |
| 14 | Superior Healthplan fee schedule · outpatient | 40 | $329 | $329 | $2 | 1% | — | $305 – $329 |
| 15 | Caresource fee schedule · outpatient · +7 other terms | 36 | $313 | $337 | $70 | 21% | — | $211 – $484 |
| 16 | Oscar fee schedule · outpatient · +4 other terms | 35 | $329 | $359 | $76 | 21% | — | $307 – $533 |
| 17 | Optum fee schedule · outpatient · +2 other terms | 33 | $313 | $411 | $165 | 40% | — | $300 – $783 |
| 18 | Bcbs Tx fee schedule · outpatient | 31 | $326 | $337 | $101 | 30% | — | $252 – $1.2k |
| 19 | Medicare fee schedule · outpatient · +1 other terms | 23 | $307 | $299 | $28 | 9% | — | $205 – $308 |
| 20 | Amerihealth Caritas fee schedule · outpatient · +1 other terms | 18 | $376 | $367 | $18 | 5% | — | $320 – $376 |
| 21 | Regence facility · fee schedule · outpatient · +1 other terms | 18 | $326 | $317 | $19 | 6% | — | $259 – $332 |
| 22 | Medical Mutual facility · fee schedule · outpatient · +1 other terms | 14 | $313 | $360 | $91 | 25% | — | $171 – $495 |
| 23 | Bcbs Mn fee schedule · outpatient · +4 other terms | 13 | $312 | $298 | $14 | 5% | — | $281 – $312 |
| 24 | Wellmark fee schedule · both · +1 other terms | 13 | $275 | $274 | $1 | 0% | — | $267 – $275 |
| 25 | Aetna Better Health fee schedule · outpatient · +3 other terms | 12 | $149 | $214 | $77 | 36% | — | $149 – $305 |
← Hospitals reporting HCPCS A6579 · Snapshot 20261112T124536Z-e251e855