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 scrn tbco id as non user
Low
$0
Average
$21
Median
$1
High
$267
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
20 payers; the 90th percentile is 2170.8× 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 | Aetna fee schedule · outpatient · +5 other terms | 17 | $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 · +1 other terms | 15 | $10 | $11 | $2 | 23% | — | $7 – $17 |
| 4 | Molina facility · case rate · outpatient · +1 other terms | 15 | $10 | $11 | $2 | 23% | — | $7 – $16 |
| 5 | UnitedHealthcare facility · case rate · outpatient · +4 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 | Aetna Better Health fee schedule · inpatient · +2 other terms | 7 | $0 | $0 | — | — | — | $0 – $0 |
| 9 | Humana fee schedule · inpatient · +2 other terms | 5 | $0 | $0 | — | — | — | $0 – $0 |
| 10 | Blue Cross Blue Shield fee schedule · outpatient · +2 other terms | 4 | $3 | $4 | $3 | 73% | — | $0 – $7 |
| 11 | First Health professional · fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 12 | Bcbs Id professional · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 13 | Bcbs La facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 14 | Bcbs Vt professional · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | Cigna professional · fee schedule · outpatient · +1 other terms | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 16 | Highmark percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 17 | Kaiser professional · per diem · both | 1 | $267 | $267 | $66 | 25% | — | $181 – $434 |
| 18 | MultiPlan percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 19 | Tricare percent of total billed charges · bothfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 20 | WellCare professional · fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
← Hospitals reporting HCPCS G9903 · Snapshot 20261113T090226Z-3ce6c0b8