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
$68
Average
$224
Median
$131
High
$744
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
12 payers; the 90th percentile is 7.6× 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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Filter by billing class
| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Humana fee schedule · outpatient · +1 other terms | 32 | $557 | $673 | $99 | 15% | — | $557 – $758 |
| 2 | Wellmark fee schedule · both · +1 other terms | 13 | $119 | $119 | — | — | — | $119 – $119 |
| 3 | Anthem facility · fee schedule · outpatient | 9 | $272 | $744 | $1.5k | 207% | — | $56 – $5.1k |
| 4 | Molina facility · case rate · outpatient · +1 other terms | 4 | $126 | $132 | $31 | 24% | — | $96 – $182 |
| 5 | Aetna facility · fee schedule · outpatient · +4 other terms | 3 | $77 | $77 | — | — | — | $77 – $77 |
| 6 | Cigna fee schedule · both · +1 other terms | 2 | $84 | $88 | $12 | 14% | — | $73 – $104 |
| 7 | Aetna Better Health facility · case rate · outpatient | 1 | $93 | $93 | $1 | 2% | — | $92 – $94 |
| 8 | Amerihealth Caritas facility · case rate · outpatient | 1 | $96 | $96 | — | — | — | $96 – $96 |
| 9 | Blue Cross Blue Shield facility · fee schedule · outpatient | 1 | $219 | $219 | — | — | — | $219 – $219 |
| 10 | Healthpartners facility · fee schedule · outpatient | 1 | $252 | $252 | — | — | — | $252 – $252 |
| 11 | MultiPlan percent of total billed charges · outpatientfrom % of charges | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 12 | UnitedHealthcare facility · case rate · outpatient · +1 other terms | 1 | $88 | $88 | — | — | — | $88 – $88 |
← Hospitals reporting HCPCS G9686 · Snapshot 20261113T090226Z-3ce6c0b8