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
Scr for dep not cpt doc rsn
Low
$0
Average
$5
Median
$0
High
$47
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
27 payers; the 90th percentile is 1740.0× 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.
Filter by billing methodology
Filter by billing class
| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Aetna fee schedule · outpatient · +9 other terms | 20 | $0 | $1 | $3 | 462% | — | $0 – $13 |
| 2 | Anthem facility · case rate · outpatient · +3 other terms | 15 | $10 | $11 | $2 | 23% | — | $7 – $16 |
| 3 | Caresource facility · case rate · outpatient · +2 other terms | 15 | $10 | $11 | $2 | 23% | — | $7 – $17 |
| 4 | Molina facility · case rate · outpatient · +3 other terms | 15 | $10 | $11 | $2 | 23% | — | $7 – $16 |
| 5 | UnitedHealthcare facility · case rate · outpatient · +6 other terms | 15 | $10 | $11 | $3 | 24% | — | $7 – $17 |
| 6 | Wellmark fee schedule · both | 13 | $1 | $1 | — | — | — | $1 – $1 |
| 7 | Optum facility · case rate · outpatient | 11 | $9 | $10 | $2 | 22% | — | $8 – $15 |
| 8 | First Health professional · fee schedule · both · +1 other terms | 8 | $0 | $0 | — | — | — | $0 – $0 |
| 9 | WellCare professional · fee schedule · both | 8 | $0 | $0 | — | — | — | $0 – $0 |
| 10 | Aetna Better Health fee schedule · inpatient · +2 other terms | 7 | $0 | $0 | — | — | — | $0 – $0 |
| 11 | Bcbs Il professional · fee schedule · both | 7 | $0 | $0 | — | — | — | $0 – $0 |
| 12 | Humana professional · fee schedule · both · +6 other terms | 7 | $0 | $0 | — | — | — | $0 – $0 |
| 13 | Blue Cross Blue Shield fee schedule · outpatient · +4 other terms | 4 | $3 | $4 | $3 | 73% | — | $0 – $7 |
| 14 | Cigna professional · fee schedule · both · +6 other terms | 4 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | Ambetter professional · fee schedule · both · +1 other terms | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 16 | MultiPlan professional · fee schedule · both · +3 other terms | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 17 | Phcs professional · fee schedule · both | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 18 | Bcbs Id professional · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 19 | Bcbs La facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 20 | Bcbs Nv fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 21 | Bcbs Tx percent of total billed charges · outpatientfrom % of charges | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 22 | Bcbs Vt professional · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 23 | Devoted facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 24 | Highmark percent of total billed charges · bothfrom % of charges · +1 other terms | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 25 | Medcost facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 1 | $0 | $0 | — | — | — | $0 – $0 |
← Hospitals reporting HCPCS G8433 · Snapshot 20261113T090226Z-3ce6c0b8