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
$22
Average
$45
Median
$34
High
$94
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
12 payers; the 90th percentile is 3.0× 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 facility · fee schedule · outpatient · +3 other terms | 12 | $36 | $35 | $6 | 17% | — | $20 – $48 |
| 2 | Anthem facility · fee schedule · outpatient · +4 other terms | 9 | $10 | $14 | $5 | 36% | — | $10 – $30 |
| 3 | Cigna fee schedule · outpatient · +3 other terms | 6 | $1 | $1 | — | — | — | $1 – $1 |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +3 other terms | 5 | $131 | $122 | $12 | 10% | — | $102 – $135 |
| 5 | Excellus facility · fee schedule · outpatient | 3 | $17 | $37 | $20 | 54% | — | $17 – $57 |
| 6 | UnitedHealthcare facility · fee schedule · outpatient · +1 other terms | 3 | $33 | $31 | $11 | 37% | — | $25 – $57 |
| 7 | MultiPlan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 2 | $53 | $53 | — | — | — | $53 – $53 |
| 8 | First Health facility · other · outpatient · +3 other terms | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 9 | Healthpartners facility · fee schedule · outpatient | 1 | $85 | $85 | — | — | — | $85 – $85 |
| 10 | Medicare facility · fee schedule · outpatient | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 11 | Molina facility · fee schedule · outpatient | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 12 | WellCare facility · fee schedule · outpatient | 1 | $29 | $29 | — | — | — | $29 – $29 |
← Hospitals reporting HCPCS G6039 · Snapshot 20261112T181611Z-3fa9fb76