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
Rep cast part frame man
Low
$100
Average
$702
Median
$222
High
$8.2k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
28 payers; the 90th percentile is 11.2× 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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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Molina facility · case rate · outpatient · +5 other terms | 29 | $1.5k | $4.4k | $19.6k | 450% | — | $115 – $111.7k |
| 2 | Aetna fee schedule · outpatient · +8 other terms | 22 | $107 | $210 | $190 | 91% | — | $63 – $865 |
| 3 | Blue Cross Blue Shield facility · fee schedule · outpatient · +7 other terms | 20 | $354 | $382 | $95 | 25% | — | $314 – $827 |
| 4 | UnitedHealthcare fee schedule · outpatient · +10 other terms | 19 | $153 | $155 | $56 | 36% | — | $35 – $288 |
| 5 | Anthem facility · case rate · outpatient · +5 other terms | 15 | $1.5k | $8.6k | $26.7k | 309% | — | $1.5k – $108.4k |
| 6 | Caresource facility · case rate · outpatient · +1 other terms | 15 | $1.5k | $8.6k | $26.7k | 309% | — | $1.4k – $108.4k |
| 7 | Optum facility · case rate · outpatient · +2 other terms | 13 | $1.4k | $1.2k | $451 | 39% | — | $109 – $1.4k |
| 8 | Highmark fee schedule · outpatient · +1 other terms | 11 | $104 | $109 | $38 | 35% | — | $104 – $480 |
| 9 | Cigna professional · fee schedule · outpatient · +4 other terms | 10 | $97 | $93 | $5 | 6% | — | $85 – $97 |
| 10 | Humana facility · case rate · outpatient · +4 other terms | 8 | $115 | $119 | $6 | 5% | — | $115 – $126 |
| 11 | Aetna Better Health facility · case rate · outpatient | 7 | $138 | $139 | $5 | 4% | — | $132 – $157 |
| 12 | Amerihealth Caritas facility · case rate · outpatient · +2 other terms | 7 | $126 | $128 | $4 | 3% | — | $126 – $138 |
| 13 | Medicaid fee schedule · outpatient · +1 other terms | 7 | $279 | $279 | — | — | — | $279 – $279 |
| 14 | Kaiser fee schedule · outpatient · +1 other terms | 4 | $324 | $309 | $99 | 32% | — | $152 – $523 |
| 15 | MultiPlan percent of total billed charges · outpatientfrom % of charges · +3 other terms | 4 | $223 | $223 | $20 | 9% | — | $195 – $251 |
| 16 | Oscar professional · percent of total billed charges · outpatientfrom % of charges | 4 | $108 | $108 | — | — | — | $108 – $108 |
| 17 | Medica fee schedule · outpatient · +2 other terms | 3 | $177 | $177 | — | — | — | $177 – $177 |
| 18 | Wellmark facility · case rate · outpatient | 3 | $512 | $450 | $142 | 32% | — | $209 – $566 |
| 19 | First Health percent of total billed charges · outpatientfrom % of charges · +2 other terms | 2 | $226 | $226 | $3 | 1% | — | $223 – $229 |
| 20 | Bcbs Id professional · fee schedule · outpatient | 1 | $195 | $195 | — | — | — | $195 – $195 |
| 21 | Bcbs Mn fee schedule · outpatient | 1 | $354 | $354 | — | — | — | $354 – $354 |
| 22 | Bcbs Nv fee schedule · outpatient | 1 | $100 | $100 | — | — | — | $100 – $100 |
| 23 | Bcbs Ny percent of total billed charges · bothfrom % of charges | 1 | $191 | $191 | — | — | — | $191 – $191 |
| 24 | Bcbs Vt professional · fee schedule · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 25 | Excellus percent of total billed charges · bothfrom % of charges · +1 other terms | 1 | $191 | $191 | — | — | — | $191 – $191 |
← Hospitals reporting HCPCS D5621 · Snapshot 20261112T181611Z-3fa9fb76