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
Sewho cap design w/o jnts cf
Low
$545
Average
$2.2k
Median
$2.0k
High
$4.1k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
54 payers; the 90th percentile is 2.2× 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 · +16 other terms | 362 | $1.9k | $2.1k | $1.0k | 49% | — | $104 – $12.3k |
| 2 | UnitedHealthcare fee schedule · outpatient · +15 other terms | 360 | $1.9k | $1.8k | $512 | 28% | — | $104 – $6.1k |
| 3 | Humana fee schedule · outpatient · +15 other terms | 319 | $1.9k | $2.8k | $3.0k | 108% | — | $104 – $14.5k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +16 other terms | 234 | $1.9k | $2.4k | $1.3k | 54% | — | $0 – $9.1k |
| 5 | WellCare fee schedule · outpatient · +8 other terms | 208 | $1.9k | $2.0k | $298 | 15% | — | $1.8k – $3.6k |
| 6 | Devoted fee schedule · outpatient · +5 other terms | 165 | $1.9k | $1.9k | $44 | 2% | — | $1.8k – $2.3k |
| 7 | Molina fee schedule · outpatient · +9 other terms | 138 | $2.7k | $2.6k | $972 | 37% | — | $1.3k – $4.9k |
| 8 | Cigna Healthspring fee schedule · outpatient · +1 other terms | 116 | $1.9k | $1.9k | $67 | 3% | — | $1.9k – $2.3k |
| 9 | Cigna fee schedule · outpatient · +14 other terms | 107 | $1.9k | $1.9k | $776 | 40% | — | $259 – $5.5k |
| 10 | Anthem fee schedule · outpatient · +13 other terms | 85 | $1.9k | $2.0k | $2.2k | 115% | — | $100 – $14.1k |
| 11 | Kaiser fee schedule · outpatient · +7 other terms | 65 | $1.9k | $3.0k | $2.1k | 72% | — | $104 – $13.5k |
| 12 | Superior Healthplan fee schedule · outpatient · +1 other terms | 40 | $2.0k | $2.0k | $10 | 0% | — | $1.9k – $2.0k |
| 13 | Clover fee schedule · outpatient · +2 other terms | 37 | $1.9k | $1.9k | $101 | 5% | — | $1.8k – $2.2k |
| 14 | Oscar fee schedule · outpatient · +6 other terms | 36 | $2.0k | $2.2k | $462 | 21% | — | $1.9k – $3.2k |
| 15 | Ambetter facility · fee schedule · outpatient · +7 other terms | 34 | $3.4k | $3.5k | $851 | 24% | — | $1.8k – $4.7k |
| 16 | Optum fee schedule · outpatient · +4 other terms | 33 | $1.9k | $2.5k | $1000 | 41% | — | $1.8k – $4.7k |
| 17 | Caresource fee schedule · outpatient · +5 other terms | 29 | $1.9k | $2.0k | $545 | 28% | — | $1.0k – $2.9k |
| 18 | Medica facility · fee schedule · outpatient · +6 other terms | 21 | $1.9k | $1.7k | $413 | 24% | — | $626 – $2.5k |
| 19 | Regence facility · fee schedule · outpatient · +5 other terms | 19 | $2.0k | $1.9k | $150 | 8% | — | $1.5k – $2.0k |
| 20 | Amerihealth Caritas fee schedule · outpatient · +2 other terms | 18 | $2.3k | $2.2k | $125 | 6% | — | $1.9k – $2.3k |
| 21 | Bcbs Tx fee schedule · outpatient · +2 other terms | 18 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 22 | Medicare fee schedule · outpatient · +3 other terms | 18 | $1.8k | $1.8k | $14 | 1% | — | $1.8k – $1.9k |
| 23 | Medical Mutual facility · fee schedule · outpatient · +1 other terms | 15 | $1.9k | $2.2k | $535 | 25% | — | $1.0k – $3.0k |
| 24 | Bcbs Mn fee schedule · outpatient · +6 other terms | 13 | $1.7k | $1.7k | $399 | 23% | — | $832 – $2.0k |
| 25 | Wellmark fee schedule · both · +1 other terms | 13 | $1.7k | $1.7k | $60 | 3% | — | $1.4k – $1.7k |
← Hospitals reporting HCPCS L3961 · Snapshot 20261112T181611Z-3fa9fb76