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HCPCS E2204-NU

Frame depth 22 to 25 in

Payer pricing summary

i

Low

$686

Average

$986

Median

$904

High

$1.7k

Payer rate distribution

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Filter by billing methodology

All methodologies Case rate 0 Fee schedule 10 Per diem 0 Percent of billed charges 0 Other 0

Filter by billing class

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#
1	Anthem facility · fee schedule · outpatient · +1 other terms	7	$914	$974	$385	39%	—	$688 – $2.2k
2	Blue Cross Blue Shield facility · fee schedule · outpatient	5	$939	$939	—	—	—	$939 – $939
3	Humana facility · fee schedule · outpatient	5	$864	$869	$11	1%	—	$864 – $892
4	Aetna facility · fee schedule · outpatient	4	$1.6k	$1.4k	$485	35%	—	$527 – $1.6k
5	UnitedHealthcare facility · fee schedule · outpatient	4	$692	$692	—	—	—	$692 – $692
6	WellCare facility · fee schedule · outpatient	4	$939	$939	—	—	—	$939 – $939
7	Cigna facility · fee schedule · outpatient	3	$1.8k	$1.7k	$337	20%	—	$1.3k – $2.3k
8	Regence facility · fee schedule · outpatient	2	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
9	Caresource facility · fee schedule · outpatient	1	$792	$792	—	—	—	$792 – $792
10	Molina facility · fee schedule · outpatient	1	$784	$784	—	—	—	$784 – $784

← Hospitals reporting HCPCS E2204-NU · Snapshot 20261115T194459Z-975ba28a