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Payers and negotiated rates for HCPCS G0504 | medprice.ai

Fee Schedule

Payers reporting HCPCS G0504

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Payer pricing summary

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Low

$41

Average

$116

Median

$94

High

$326

Payer rate distribution

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#
1	Anthem facility · fee schedule · outpatient · +1 other terms	10	$113	$372	$803	216%	—	$0 – $2.8k
2	Medicare facility · percent of total billed charges · outpatientfrom % of charges	5	$65	$69	$5	7%	—	$65 – $77
3	Aetna facility · fee schedule · outpatient · +2 other terms	3	$42	$42	—	—	—	$42 – $42
4	Blue Cross Blue Shield facility · fee schedule · outpatient	3	$68	$90	$31	34%	—	$68 – $134
5	Humana facility · case rate · outpatient · +1 other terms	3	$48	$49	$2	5%	—	$48 – $52
6	Cigna fee schedule · both · +2 other terms	2	$57	$55	$5	10%	—	$48 – $61
7	Molina facility · fee schedule · outpatient · +1 other terms	2	$33	$33	—	—	—	$33 – $33
8	Aetna Better Health facility · case rate · outpatient	1	$58	$58	$3	5%	—	$55 – $60
9	Amerihealth Caritas facility · case rate · outpatient	1	$57	$57	—	—	—	$57 – $57
10	Healthpartners facility · fee schedule · outpatient · +1 other terms	1	$213	$213	—	—	—	$213 – $213
11	UnitedHealthcare facility · case rate · outpatient · +2 other terms	1	$52	$52	—	—	—	$52 – $52
12	Wellmark facility · case rate · outpatient	1	$197	$197	$9	5%	—	$188 – $206

← Hospitals reporting HCPCS G0504 · Snapshot 20261113T090226Z-3ce6c0b8