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
Replace prox & dist upright
Low
$112
Average
$415
Median
$390
High
$898
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
53 payers; the 90th percentile is 2.1× 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 | Aetna fee schedule · outpatient · +12 other terms | 361 | $359 | $430 | $300 | 70% | — | $173 – $4.8k |
| 2 | UnitedHealthcare fee schedule · outpatient · +14 other terms | 358 | $355 | $357 | $104 | 29% | — | $102 – $1.3k |
| 3 | Humana fee schedule · outpatient · +10 other terms | 319 | $348 | $569 | $664 | 117% | — | $166 – $3.1k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +10 other terms | 219 | $399 | $494 | $256 | 52% | — | $0 – $2.0k |
| 5 | WellCare fee schedule · outpatient · +5 other terms | 208 | $394 | $404 | $54 | 13% | — | $312 – $631 |
| 6 | Devoted fee schedule · outpatient · +3 other terms | 165 | $348 | $385 | $34 | 9% | — | $311 – $440 |
| 7 | Molina fee schedule · outpatient · +5 other terms | 140 | $505 | $540 | $214 | 40% | — | $102 – $1.1k |
| 8 | Cigna Healthspring fee schedule · outpatient · +1 other terms | 116 | $373 | $390 | $28 | 7% | — | $323 – $444 |
| 9 | Cigna fee schedule · outpatient · +8 other terms | 102 | $375 | $405 | $106 | 26% | — | $311 – $948 |
| 10 | Anthem fee schedule · outpatient · +6 other terms | 80 | $323 | $452 | $426 | 94% | — | $180 – $2.4k |
| 11 | Kaiser fee schedule · outpatient · +6 other terms | 64 | $330 | $608 | $465 | 76% | — | $311 – $2.8k |
| 12 | Superior Healthplan fee schedule · outpatient | 40 | $427 | $427 | $2 | 0% | — | $399 – $427 |
| 13 | Clover fee schedule · outpatient · +2 other terms | 37 | $348 | $357 | $43 | 12% | — | $317 – $431 |
| 14 | Oscar fee schedule · outpatient · +4 other terms | 36 | $399 | $449 | $119 | 27% | — | $356 – $733 |
| 15 | Ambetter facility · fee schedule · outpatient · +6 other terms | 35 | $612 | $672 | $137 | 20% | — | $342 – $871 |
| 16 | Optum fee schedule · outpatient · +2 other terms | 33 | $348 | $484 | $246 | 51% | — | $311 – $1.0k |
| 17 | Caresource fee schedule · outpatient · +5 other terms | 28 | $348 | $361 | $93 | 26% | — | $180 – $500 |
| 18 | Regence facility · fee schedule · outpatient · +4 other terms | 19 | $336 | $341 | $12 | 3% | — | $319 – $366 |
| 19 | Amerihealth Caritas fee schedule · outpatient · +1 other terms | 18 | $418 | $405 | $28 | 7% | — | $330 – $418 |
| 20 | Bcbs Tx fee schedule · outpatient | 18 | $399 | $399 | — | — | — | $399 – $399 |
| 21 | Medicare fee schedule · outpatient · +1 other terms | 18 | $311 | $312 | $2 | 1% | — | $311 – $317 |
| 22 | Medical Mutual facility · fee schedule · outpatient · +2 other terms | 15 | $323 | $375 | $93 | 25% | — | $176 – $511 |
| 23 | Bcbs Mn fee schedule · outpatient · +4 other terms | 13 | $294 | $294 | $69 | 23% | — | $143 – $344 |
| 24 | Wellmark fee schedule · both · +1 other terms | 13 | $343 | $340 | $17 | 5% | — | $235 – $343 |
| 25 | Aetna Better Health fee schedule · outpatient · +2 other terms | 12 | $171 | $242 | $84 | 35% | — | $171 – $342 |
← Hospitals reporting HCPCS L4070 · Snapshot 20261112T181611Z-3fa9fb76