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
Fee Schedule
Low
$13
Average
$51
Median
$48
High
$111
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
18 payers; the 90th percentile is 5.2× 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 | Anthem facility · fee schedule · outpatient · +5 other terms | 19 | $12 | $12 | $3 | 23% | — | $8 – $26 |
| 2 | Blue Cross Blue Shield fee schedule · outpatient · +3 other terms | 17 | $109 | $111 | $46 | 42% | — | $20 – $182 |
| 3 | Cigna fee schedule · outpatient · +7 other terms | 9 | $1 | $14 | $13 | 93% | — | $1 – $34 |
| 4 | First Health professional · percent of total billed charges · bothfrom % of charges · +2 other terms | 6 | $56 | $59 | $6 | 10% | — | $56 – $72 |
| 5 | Aetna fee schedule · outpatient · +8 other terms | 3 | $65 | $50 | $21 | 43% | — | $20 – $65 |
| 6 | Ambetter professional · percent of total billed charges · bothfrom % of charges · +1 other terms | 2 | $48 | $48 | — | — | — | $48 – $48 |
| 7 | Excellus facility · fee schedule · outpatient | 2 | $13 | $13 | — | — | — | $13 – $13 |
| 8 | Oscar percent of total billed charges · outpatientfrom % of charges | 2 | $44 | $44 | $35 | 78% | — | $10 – $79 |
| 9 | Phcs professional · percent of total billed charges · bothfrom % of charges | 2 | $56 | $56 | — | — | — | $56 – $56 |
| 10 | UnitedHealthcare fee schedule · outpatient · +4 other terms | 2 | $345 | $237 | $307 | 130% | — | $20 – $671 |
| 11 | Amerihealth Caritas facility · percent of total billed charges · outpatientfrom % of charges | 1 | $35 | $35 | $13 | 38% | — | $21 – $48 |
| 12 | Caresource fee schedule · outpatient · +1 other terms | 1 | $24 | $24 | $4 | 18% | — | $20 – $28 |
| 13 | Healthpartners facility · fee schedule · outpatient | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 14 | Highmark other · both · +1 other terms | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 15 | Humana fee schedule · outpatient · +6 other terms | 1 | $671 | $671 | — | — | — | $671 – $671 |
| 16 | Molina percent of total billed charges · outpatientfrom % of charges | 1 | $15 | $15 | $3 | 17% | — | $12 – $18 |
| 17 | MultiPlan fee schedule · outpatient · +5 other terms | 1 | $38 | $38 | — | — | — | $38 – $38 |
| 18 | Tricare fee schedule · outpatient | 1 | $20 | $20 | — | — | — | $20 – $20 |
← Hospitals reporting HCPCS G0434 · Snapshot 20261112T181611Z-3fa9fb76