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
3d photo image capture only
Low
$17
Average
$357
Median
$77
High
$2.8k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
15 payers; the 90th percentile is 25.4× 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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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Molina facility · case rate · outpatient · +3 other terms | 27 | $568 | $357 | $334 | 94% | — | $24 – $1.0k |
| 2 | UnitedHealthcare facility · case rate · outpatient · +3 other terms | 18 | $593 | $534 | $295 | 55% | — | $24 – $1.0k |
| 3 | Anthem facility · case rate · outpatient · +3 other terms | 15 | $604 | $660 | $155 | 23% | — | $411 – $1.0k |
| 4 | Caresource facility · case rate · outpatient | 15 | $615 | $661 | $151 | 23% | — | $411 – $1.0k |
| 5 | Optum facility · case rate · outpatient | 13 | $546 | $533 | $253 | 47% | — | $23 – $927 |
| 6 | Humana facility · case rate · outpatient · +2 other terms | 8 | $24 | $25 | $1 | 5% | — | $24 – $26 |
| 7 | Aetna Better Health facility · case rate · outpatient | 7 | $29 | $29 | $0 | 1% | — | $28 – $29 |
| 8 | Amerihealth Caritas facility · case rate · outpatient · +1 other terms | 7 | $26 | $27 | $1 | 3% | — | $26 – $29 |
| 9 | Aetna facility · case rate · outpatient · +3 other terms | 5 | $29 | $33 | $10 | 31% | — | $24 – $54 |
| 10 | Blue Cross Blue Shield facility · case rate · outpatient · +2 other terms | 4 | $62 | $62 | $19 | 31% | — | $40 – $89 |
| 11 | Wellmark facility · case rate · outpatient | 3 | $91 | $80 | $25 | 32% | — | $37 – $101 |
| 12 | Cigna professional · fee schedule · outpatient | 2 | $17 | $17 | $0 | 0% | — | $17 – $18 |
| 13 | Medicaid facility · case rate · outpatient | 2 | $24 | $24 | — | — | — | $24 – $24 |
| 14 | Bcbs Vt professional · fee schedule · outpatient | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 15 | WellCare facility · case rate · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
← Hospitals reporting HCPCS D0704 · Snapshot 20261112T181611Z-3fa9fb76