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
PWC gp 3 xhd cap chair
Low
$32
Average
$5.3k
Median
$3.1k
High
$57.0k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
46 payers; the 90th percentile is 5.6× 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 · +5 other terms | 247 | $1.7k | $2.6k | $2.8k | 107% | — | $1.1k – $12.9k |
| 2 | Aetna fee schedule · outpatient · +5 other terms | 236 | $1.7k | $3.6k | $9.7k | 272% | — | $412 – $110.6k |
| 3 | UnitedHealthcare fee schedule · outpatient · +8 other terms | 232 | $1.7k | $2.6k | $2.5k | 93% | — | $697 – $11.7k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +5 other terms | 178 | $1.7k | $3.8k | $7.6k | 201% | — | $0 – $58.6k |
| 5 | WellCare fee schedule · outpatient · +1 other terms | 169 | $1.7k | $1.8k | $293 | 16% | — | $1.6k – $3.3k |
| 6 | Devoted fee schedule · outpatient · +1 other terms | 151 | $1.7k | $1.7k | $30 | 2% | — | $1.6k – $1.8k |
| 7 | Cigna Healthspring fee schedule · outpatient | 104 | $1.7k | $1.7k | $46 | 3% | — | $1.7k – $1.8k |
| 8 | Molina fee schedule · outpatient · +3 other terms | 89 | $2.5k | $2.3k | $902 | 39% | — | $1.4k – $4.4k |
| 9 | Cigna fee schedule · outpatient · +3 other terms | 69 | $1.7k | $2.9k | $6.4k | 222% | — | $1.6k – $49.2k |
| 10 | Superior Healthplan fee schedule · outpatient | 39 | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 11 | Anthem fee schedule · outpatient · +5 other terms | 34 | $1.7k | $1.7k | $179 | 11% | — | $1.6k – $2.7k |
| 12 | Clover fee schedule · outpatient | 32 | $1.7k | $1.7k | $56 | 3% | — | $1.6k – $1.8k |
| 13 | Bcbs Tx fee schedule · outpatient | 31 | $1.5k | $1.6k | $465 | 29% | — | $1.2k – $5.7k |
| 14 | Kaiser fee schedule · outpatient · +2 other terms | 24 | $1.7k | $1.7k | $47 | 3% | — | $1.6k – $1.7k |
| 15 | Optum fee schedule · outpatient · +1 other terms | 24 | $1.7k | $2.0k | $827 | 42% | — | $1.6k – $4.2k |
| 16 | Oscar fee schedule · outpatient | 24 | $1.6k | $1.7k | $58 | 3% | — | $1.6k – $1.8k |
| 17 | Amerihealth Caritas fee schedule · outpatient | 16 | $2.0k | $2.0k | $39 | 2% | — | $1.9k – $2.0k |
| 18 | Caresource fee schedule · outpatient · +3 other terms | 15 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 19 | Medicare fee schedule · outpatient | 15 | $1.6k | $1.6k | $7 | 0% | — | $1.6k – $1.6k |
| 20 | Wellmark fee schedule · both · +1 other terms | 13 | $8.1k | $8.1k | $6.7k | 82% | — | $1.2k – $15.7k |
| 21 | Bcbs Mn fee schedule · outpatient · +3 other terms | 12 | $15.4k | $15.6k | $4.0k | 26% | — | $7.8k – $18.8k |
| 22 | Bcbs Nj fee schedule · outpatient | 12 | $1.6k | $3.5k | $2.4k | 68% | — | $1.6k – $7.3k |
| 23 | Highmark fee schedule · outpatient · +3 other terms | 10 | $4.2k | $4.2k | $4.9k | 117% | — | $772 – $13.6k |
| 24 | Medica fee schedule · outpatient · +4 other terms | 10 | $3.3k | $3.3k | $820 | 25% | — | $2.0k – $4.2k |
| 25 | Medical Mutual fee schedule · outpatient | 9 | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
← Hospitals reporting HCPCS K0855 · Snapshot 20261113T090226Z-3ce6c0b8