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
O shoe convert to sof counte
Low
$17
Average
$78
Median
$69
High
$180
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
53 payers; the 90th percentile is 2.0× 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 | Aetna fee schedule · outpatient · +9 other terms | 358 | $66 | $76 | $35 | 46% | — | $33 – $428 |
| 2 | UnitedHealthcare fee schedule · outpatient · +11 other terms | 355 | $66 | $67 | $15 | 23% | — | $29 – $213 |
| 3 | Humana fee schedule · outpatient · +9 other terms | 316 | $66 | $99 | $106 | 107% | — | $34 – $508 |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +7 other terms | 216 | $67 | $86 | $45 | 52% | — | $0 – $318 |
| 5 | WellCare fee schedule · outpatient · +4 other terms | 208 | $68 | $70 | $10 | 15% | — | $63 – $125 |
| 6 | Devoted fee schedule · outpatient · +3 other terms | 165 | $66 | $66 | $2 | 2% | — | $64 – $80 |
| 7 | Molina fee schedule · outpatient · +4 other terms | 137 | $94 | $91 | $34 | 37% | — | $49 – $173 |
| 8 | Cigna Healthspring fee schedule · outpatient · +1 other terms | 116 | $67 | $67 | $2 | 3% | — | $66 – $80 |
| 9 | Cigna fee schedule · outpatient · +6 other terms | 102 | $68 | $75 | $21 | 27% | — | $64 – $192 |
| 10 | Anthem fee schedule · outpatient · +6 other terms | 80 | $65 | $90 | $87 | 96% | — | $63 – $492 |
| 11 | Kaiser fee schedule · outpatient · +4 other terms | 64 | $68 | $105 | $74 | 70% | — | $64 – $470 |
| 12 | Superior Healthplan fee schedule · outpatient | 40 | $69 | $69 | $0 | 0% | — | $65 – $69 |
| 13 | Clover fee schedule · outpatient · +2 other terms | 37 | $66 | $66 | $4 | 5% | — | $63 – $78 |
| 14 | Oscar fee schedule · outpatient · +3 other terms | 36 | $69 | $76 | $16 | 21% | — | $65 – $111 |
| 15 | Ambetter facility · fee schedule · outpatient · +5 other terms | 34 | $118 | $123 | $32 | 26% | — | $48 – $165 |
| 16 | Optum fee schedule · outpatient · +2 other terms | 33 | $66 | $86 | $35 | 41% | — | $63 – $165 |
| 17 | Caresource fee schedule · outpatient · +4 other terms | 26 | $66 | $75 | $15 | 20% | — | $66 – $101 |
| 18 | Medica facility · fee schedule · outpatient · +5 other terms | 22 | $67 | $62 | $16 | 26% | — | $22 – $109 |
| 19 | Regence facility · fee schedule · outpatient · +3 other terms | 19 | $69 | $66 | $5 | 8% | — | $53 – $70 |
| 20 | Amerihealth Caritas fee schedule · outpatient · +1 other terms | 18 | $79 | $77 | $4 | 6% | — | $65 – $79 |
| 21 | Bcbs Tx fee schedule · outpatient | 18 | $65 | $65 | — | — | — | $65 – $65 |
| 22 | Medicare fee schedule · outpatient · +1 other terms | 18 | $64 | $64 | $0 | 1% | — | $64 – $65 |
| 23 | Medical Mutual facility · fee schedule · outpatient · +1 other terms | 15 | $66 | $76 | $19 | 25% | — | $36 – $104 |
| 24 | Bcbs Mn fee schedule · outpatient · +6 other terms | 13 | $60 | $60 | $14 | 23% | — | $29 – $70 |
| 25 | Wellmark fee schedule · both · +1 other terms | 13 | $61 | $61 | $2 | 3% | — | $48 – $61 |
← Hospitals reporting HCPCS L3590 · Snapshot 20261112T181611Z-3fa9fb76