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
$14
Average
$40
Median
$40
High
$92
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
10 payers; the 90th percentile is 5.1× 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 · +2 other terms | 10 | $29 | $29 | — | — | — | $29 – $29 |
| 2 | Anthem facility · fee schedule · outpatient · +4 other terms | 9 | $7 | $11 | $4 | 37% | — | $7 – $23 |
| 3 | Cigna fee schedule · outpatient · +3 other terms | 6 | $1 | $1 | — | — | — | $1 – $1 |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +1 other terms | 5 | $105 | $99 | $10 | 10% | — | $82 – $109 |
| 5 | Wellmark facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 3 | $45 | $46 | $11 | 24% | — | $33 – $60 |
| 6 | Excellus facility · fee schedule · outpatient | 2 | $14 | $14 | $0 | 0% | — | $14 – $14 |
| 7 | UnitedHealthcare facility · fee schedule · outpatient · +2 other terms | 2 | $23 | $21 | $2 | 12% | — | $20 – $27 |
| 8 | First Health percent of total billed charges · outpatientfrom % of charges | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 9 | Healthpartners facility · fee schedule · outpatient | 1 | $69 | $69 | — | — | — | $69 – $69 |
| 10 | Oscar facility · percent of total billed charges · outpatientfrom % of charges | 1 | $39 | $39 | — | — | — | $39 – $39 |
← Hospitals reporting HCPCS G6053 · Snapshot 20261112T181611Z-3fa9fb76