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
$4
Average
$25
Median
$20
High
$57
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
23 payers; the 90th percentile is 4.5× 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 | Blue Cross Blue Shield fee schedule · outpatient · +6 other terms | 29 | $58 | $60 | $29 | 48% | — | $18 – $155 |
| 2 | MultiPlan fee schedule · inpatient · +6 other terms | 10 | $45 | $43 | $2 | 6% | — | $40 – $45 |
| 3 | Phcs fee schedule · inpatient · +3 other terms | 10 | $38 | $39 | $1 | 3% | — | $38 – $40 |
| 4 | UnitedHealthcare fee schedule · outpatient · +9 other terms | 10 | $24 | $26 | $12 | 47% | — | $7 – $40 |
| 5 | Medica fee schedule · outpatient · +1 other terms | 9 | $27 | $31 | $7 | 22% | — | $14 – $39 |
| 6 | First Health facility · percent of total billed charges · outpatientfrom % of charges · +2 other terms | 7 | $7 | $7 | $1 | 14% | — | $5 – $9 |
| 7 | Humana fee schedule · outpatient · +5 other terms | 5 | $18 | $17 | $4 | 26% | — | $12 – $25 |
| 8 | Caresource professional · percent of total billed charges · bothfrom % of charges | 4 | $24 | $24 | — | — | — | $24 – $24 |
| 9 | Highmark facility · fee schedule · outpatient | 3 | $13 | $13 | $1 | 4% | — | $13 – $14 |
| 10 | Aetna fee schedule · outpatient · +9 other terms | 2 | $63 | $63 | — | — | — | $63 – $63 |
| 11 | Ambetter professional · percent of total billed charges · bothfrom % of charges · +1 other terms | 2 | $41 | $41 | — | — | — | $41 – $41 |
| 12 | Cigna fee schedule · both · +9 other terms | 2 | $8 | $7 | $1 | 10% | — | $6 – $8 |
| 13 | Kaiser fee schedule · both · +1 other terms | 2 | $18 | $18 | — | — | — | $18 – $18 |
| 14 | Sanford Health Plan facility · fee schedule · outpatient · +2 other terms | 2 | $6 | $6 | — | — | — | $6 – $6 |
| 15 | Wellmark fee schedule · inpatient | 2 | $24 | $24 | $1 | 3% | — | $23 – $25 |
| 16 | Anthem fee schedule · outpatient · +4 other terms | 1 | $161 | $161 | — | — | — | $161 – $161 |
| 17 | Bcbs Id professional · fee schedule · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 18 | Healthpartners facility · fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 19 | Medcost professional · percent of total billed charges · outpatientfrom % of charges | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 20 | Medicaid facility · other · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 21 | Molina facility · fee schedule · outpatient · +1 other terms | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 22 | Tricare percent of total billed charges · bothfrom % of charges | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 23 | WellCare other · both | 1 | $46 | $46 | — | — | — | $46 – $46 |
← Hospitals reporting HCPCS J0150 · Snapshot 20261112T181611Z-3fa9fb76