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
Pt in hos
Low
$0
Average
$2
Median
$0
High
$13
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
20 payers; the 90th percentile is 786.3× 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 · +5 other terms | 16 | $0 | $0 | $0 | 50% | — | $0 – $0 |
| 2 | Anthem facility · case rate · outpatient · +2 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 · +2 other terms | 15 | $10 | $11 | $2 | 23% | — | $7 – $16 |
| 5 | UnitedHealthcare facility · case rate · outpatient · +2 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 | 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 · +3 other terms | 7 | $0 | $0 | — | — | — | $0 – $0 |
| 13 | Blue Cross Blue Shield fee schedule · outpatient · +3 other terms | 4 | $3 | $4 | $3 | 73% | — | $0 – $7 |
| 14 | Cigna professional · fee schedule · both · +1 other terms | 4 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | Ambetter professional · fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 16 | MultiPlan professional · fee schedule · both | 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 Vt professional · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
← Hospitals reporting HCPCS G9690 · Snapshot 20261113T090226Z-3ce6c0b8