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
Pre-op service LVRS 10-15dos
Low
$115
Average
$654
Median
$414
High
$4.2k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
57 payers; the 90th percentile is 5.8× 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 | Aetna fee schedule · outpatient · +13 other terms | 363 | $267 | $333 | $226 | 68% | — | $1 – $2.1k |
| 2 | UnitedHealthcare fee schedule · outpatient · +15 other terms | 277 | $289 | $373 | $462 | 124% | — | $1 – $9.2k |
| 3 | Blue Cross Blue Shield fee schedule · outpatient · +5 other terms | 257 | $386 | $535 | $492 | 92% | — | $1 – $4.8k |
| 4 | Humana fee schedule · outpatient · +12 other terms | 226 | $283 | $268 | $66 | 25% | — | $1 – $696 |
| 5 | Cigna fee schedule · outpatient · +12 other terms | 140 | $249 | $343 | $213 | 62% | — | $195 – $1.1k |
| 6 | WellCare fee schedule · outpatient · +3 other terms | 122 | $292 | $317 | $129 | 41% | — | $199 – $730 |
| 7 | Molina fee schedule · outpatient · +8 other terms | 106 | $320 | $329 | $109 | 33% | — | $1 – $848 |
| 8 | Ambetter facility · fee schedule · outpatient · +3 other terms | 72 | $459 | $504 | $174 | 35% | — | $234 – $797 |
| 9 | Anthem fee schedule · outpatient · +12 other terms | 71 | $313 | $554 | $440 | 79% | — | $214 – $1.9k |
| 10 | Devoted fee schedule · outpatient · +2 other terms | 68 | $239 | $259 | $53 | 20% | — | $201 – $345 |
| 11 | Kaiser fee schedule · outpatient · +6 other terms | 59 | $313 | $466 | $347 | 74% | — | $216 – $2.2k |
| 12 | Oscar fee schedule · outpatient · +5 other terms | 38 | $442 | $417 | $91 | 22% | — | $255 – $617 |
| 13 | Optum fee schedule · outpatient · +3 other terms | 34 | $216 | $298 | $152 | 51% | — | $196 – $797 |
| 14 | Bcbs Tx fee schedule · outpatient · +1 other terms | 31 | $508 | $478 | $185 | 39% | — | $162 – $930 |
| 15 | Caresource fee schedule · outpatient · +6 other terms | 27 | $209 | $203 | $82 | 40% | — | $1 – $369 |
| 16 | Clover facility · fee schedule · outpatient · +2 other terms | 27 | $230 | $242 | $40 | 16% | — | $202 – $367 |
| 17 | Regence facility · fee schedule · outpatient · +3 other terms | 21 | $231 | $392 | $299 | 76% | — | $219 – $1.1k |
| 18 | Medicare fee schedule · outpatient · +3 other terms | 19 | $216 | $219 | $12 | 5% | — | $216 – $273 |
| 19 | Baylor Scott White Health Plan facility · fee schedule · outpatient · +1 other terms | 15 | $274 | $273 | $55 | 20% | — | $206 – $358 |
| 20 | First Health fee schedule · outpatient · +4 other terms | 15 | $225 | $259 | $73 | 28% | — | $225 – $440 |
| 21 | Highmark fee schedule · outpatient · +2 other terms | 15 | $414 | $409 | $145 | 35% | — | $140 – $760 |
| 22 | Medical Mutual facility · fee schedule · outpatient · +2 other terms | 15 | $206 | $261 | $162 | 62% | — | $111 – $812 |
| 23 | MultiPlan fee schedule · outpatient · +5 other terms | 15 | $503 | $496 | $38 | 8% | — | $292 – $503 |
| 24 | Ucare case rate · outpatient · +6 other terms | 15 | $327 | $322 | $6 | 2% | — | $312 – $327 |
| 25 | Bcbs Mn fee schedule · outpatient · +2 other terms | 13 | $322 | $412 | $235 | 57% | — | $139 – $1.1k |
← Hospitals reporting HCPCS G0303 · Snapshot 20261112T181611Z-3fa9fb76