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
$0
Average
$376
Median
$161
High
$2.0k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
29 payers; the 90th percentile is 997.9× 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 | 30 | $2 | $2 | $1 | 45% | — | $1 – $4 |
| 2 | Molina facility · case rate · outpatient · +5 other terms | 27 | $171 | $151 | $62 | 41% | — | $78 – $308 |
| 3 | UnitedHealthcare facility · case rate · outpatient · +7 other terms | 18 | $183 | $184 | $61 | 33% | — | $78 – $314 |
| 4 | Anthem facility · case rate · outpatient · +5 other terms | 15 | $182 | $199 | $47 | 23% | — | $124 – $308 |
| 5 | Caresource facility · case rate · outpatient | 15 | $185 | $199 | $46 | 23% | — | $124 – $314 |
| 6 | Optum facility · case rate · outpatient · +1 other terms | 13 | $164 | $171 | $57 | 33% | — | $74 – $279 |
| 7 | Humana facility · case rate · outpatient · +5 other terms | 8 | $78 | $81 | $4 | 5% | — | $78 – $86 |
| 8 | Aetna Better Health facility · case rate · outpatient | 7 | $93 | $93 | $2 | 2% | — | $89 – $93 |
| 9 | Amerihealth Caritas facility · case rate · outpatient · +2 other terms | 7 | $86 | $87 | $3 | 3% | — | $86 – $93 |
| 10 | Bcbs Mn fee schedule · outpatient · +1 other terms | 7 | $1 | $1 | $0 | 33% | — | $0 – $1 |
| 11 | Aetna facility · case rate · outpatient · +8 other terms | 5 | $93 | $107 | $31 | 29% | — | $78 – $171 |
| 12 | First Health facility · percent of total billed charges · outpatientfrom % of charges · +1 other terms | 4 | $1.4k | $1.2k | $869 | 72% | — | $5 – $2.0k |
| 13 | Phcs facility · percent of total billed charges · outpatientfrom % of charges · +1 other terms | 4 | $1.1k | $1.2k | $430 | 35% | — | $760 – $1.8k |
| 14 | Bcbs Tx facility · fee schedule · outpatient | 3 | $2 | $2 | $0 | 3% | — | $1 – $2 |
| 15 | Highmark facility · fee schedule · outpatient | 3 | $1 | $1 | $0 | 4% | — | $1 – $1 |
| 16 | MultiPlan facility · percent of total billed charges · inpatientfrom % of charges · +2 other terms | 3 | $393 | $264 | $183 | 69% | — | $6 – $393 |
| 17 | Sanford Health Plan fee schedule · outpatient · +1 other terms | 3 | $1 | $1 | — | — | — | $1 – $1 |
| 18 | Wellmark facility · case rate · outpatient | 3 | $290 | $254 | $80 | 32% | — | $118 – $320 |
| 19 | Cigna facility · fee schedule · outpatient · +5 other terms | 2 | $3 | $2 | $1 | 60% | — | $1 – $4 |
| 20 | Medcost facility · percent of total billed charges · outpatientfrom % of charges | 2 | $1.5k | $1.5k | $306 | 20% | — | $1.2k – $1.8k |
| 21 | Medicaid facility · case rate · outpatient | 2 | $78 | $78 | — | — | — | $78 – $78 |
| 22 | Medical Mutual facility · percent of total billed charges · outpatientfrom % of charges | 2 | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 23 | Tricare facility · fee schedule · outpatient | 2 | $894 | $894 | — | — | — | $894 – $894 |
| 24 | Bcbs Ca facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 25 | Bcbs Id professional · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
← Hospitals reporting HCPCS J0693 · Snapshot 20261113T090226Z-3ce6c0b8