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
Ftrst compl assembly repl ea
Low
$1
Average
$67
Median
$62
High
$230
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
50 payers; the 90th percentile is 4.0× 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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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Humana fee schedule · outpatient · +7 other terms | 267 | $68 | $58 | $25 | 43% | — | $5 – $275 |
| 2 | Aetna fee schedule · outpatient · +7 other terms | 259 | $69 | $73 | $73 | 100% | — | $3 – $1.1k |
| 3 | UnitedHealthcare fee schedule · outpatient · +10 other terms | 256 | $69 | $50 | $26 | 52% | — | $3 – $166 |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +7 other terms | 190 | $70 | $76 | $31 | 41% | — | $0 – $214 |
| 5 | WellCare fee schedule · outpatient · +2 other terms | 185 | $71 | $73 | $12 | 16% | — | $66 – $133 |
| 6 | Devoted fee schedule · outpatient · +1 other terms | 165 | $69 | $65 | $14 | 22% | — | $7 – $78 |
| 7 | Cigna Healthspring fee schedule · outpatient | 111 | $71 | $70 | $2 | 3% | — | $69 – $75 |
| 8 | Molina fee schedule · outpatient · +3 other terms | 96 | $85 | $75 | $43 | 57% | — | $5 – $181 |
| 9 | Cigna fee schedule · outpatient · +3 other terms | 77 | $67 | $59 | $38 | 64% | — | $7 – $198 |
| 10 | Superior Healthplan fee schedule · outpatient | 40 | $72 | $72 | $0 | 0% | — | $72 – $73 |
| 11 | Anthem fee schedule · outpatient · +5 other terms | 38 | $69 | $48 | $25 | 53% | — | $7 – $71 |
| 12 | Clover fee schedule · outpatient | 34 | $71 | $70 | $3 | 4% | — | $67 – $73 |
| 13 | Bcbs Tx fee schedule · outpatient | 31 | $66 | $68 | $20 | 29% | — | $51 – $250 |
| 14 | Optum fee schedule · outpatient · +2 other terms | 28 | $69 | $52 | $34 | 66% | — | $7 – $172 |
| 15 | Kaiser fee schedule · outpatient · +3 other terms | 27 | $69 | $46 | $26 | 56% | — | $7 – $72 |
| 16 | Oscar fee schedule · outpatient | 24 | $67 | $69 | $2 | 3% | — | $67 – $72 |
| 17 | Medicare fee schedule · outpatient | 18 | $41 | $41 | $23 | 56% | — | $6 – $72 |
| 18 | Amerihealth Caritas fee schedule · outpatient · +1 other terms | 17 | $82 | $82 | $2 | 2% | — | $78 – $83 |
| 19 | Caresource fee schedule · outpatient · +3 other terms | 15 | $69 | $69 | — | — | — | $69 – $69 |
| 20 | Wellmark fee schedule · both · +1 other terms | 13 | $29 | $29 | $23 | 82% | — | $5 – $52 |
| 21 | Bcbs Mn fee schedule · outpatient · +3 other terms | 12 | $60 | $61 | $16 | 26% | — | $30 – $72 |
| 22 | Bcbs Nj fee schedule · outpatient | 12 | $67 | $144 | $98 | 68% | — | $67 – $296 |
| 23 | MultiPlan facility · fee schedule · outpatient · +3 other terms | 11 | $20 | $33 | $41 | 124% | — | $20 – $164 |
| 24 | Highmark fee schedule · outpatient · +3 other terms | 10 | $42 | $43 | $36 | 82% | — | $3 – $174 |
| 25 | Medica fee schedule · outpatient · +6 other terms | 10 | $132 | $126 | $43 | 34% | — | $11 – $170 |
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