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
IMPL RETINAL PRUETT 12MM MIDI
Low
$978
Average
$3.6k
Median
$3.6k
High
$9.6k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
54 payers; the 90th percentile is 3.7× 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 · +10 other terms | 363 | $4.1k | $4.5k | $2.2k | 49% | — | $509 – $25.2k |
| 2 | UnitedHealthcare fee schedule · outpatient · +13 other terms | 360 | $4.1k | $3.7k | $1.3k | 35% | — | $722 – $13.5k |
| 3 | Humana fee schedule · outpatient · +9 other terms | 321 | $4.1k | $5.8k | $6.2k | 108% | — | $1.5k – $30.7k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +8 other terms | 229 | $4.1k | $5.3k | $2.8k | 53% | — | $0 – $19.4k |
| 5 | WellCare fee schedule · outpatient · +6 other terms | 208 | $4.1k | $4.3k | $841 | 20% | — | $3.9k – $8.8k |
| 6 | Devoted fee schedule · outpatient · +3 other terms | 165 | $4.0k | $3.9k | $440 | 11% | — | $1.5k – $5.0k |
| 7 | Molina fee schedule · outpatient · +5 other terms | 138 | $5.9k | $5.3k | $2.1k | 40% | — | $1.3k – $10.5k |
| 8 | Cigna Healthspring fee schedule · outpatient · +1 other terms | 116 | $4.2k | $4.1k | $186 | 5% | — | $3.9k – $5.1k |
| 9 | Cigna fee schedule · outpatient · +11 other terms | 102 | $4.2k | $4.3k | $1.6k | 38% | — | $1.5k – $12.1k |
| 10 | Anthem fee schedule · outpatient · +7 other terms | 81 | $3.9k | $4.9k | $4.8k | 98% | — | $1.5k – $31.0k |
| 11 | Kaiser fee schedule · outpatient · +5 other terms | 64 | $4.0k | $5.8k | $4.6k | 79% | — | $1.5k – $29.9k |
| 12 | Superior Healthplan fee schedule · outpatient | 40 | $4.2k | $4.2k | $20 | 0% | — | $3.9k – $4.2k |
| 13 | Clover fee schedule · outpatient · +2 other terms | 37 | $4.4k | $4.3k | $159 | 4% | — | $4.1k – $4.9k |
| 14 | Oscar fee schedule · outpatient · +4 other terms | 36 | $4.3k | $4.7k | $1.1k | 24% | — | $3.9k – $7.2k |
| 15 | Ambetter facility · fee schedule · outpatient · +7 other terms | 34 | $7.4k | $7.8k | $1.7k | 22% | — | $4.0k – $10.1k |
| 16 | Optum fee schedule · outpatient · +5 other terms | 33 | $4.1k | $4.3k | $2.2k | 52% | — | $1.5k – $10.0k |
| 17 | Caresource fee schedule · outpatient · +5 other terms | 28 | $4.1k | $4.3k | $1.3k | 31% | — | $1.7k – $6.4k |
| 18 | Carefirst facility · percent of total billed charges · bothfrom % of charges | 23 | $933 | $1.0k | $1.1k | 109% | — | $1 – $5.0k |
| 19 | Regence facility · fee schedule · outpatient · +4 other terms | 19 | $4.1k | $3.7k | $686 | 18% | — | $1.5k – $4.1k |
| 20 | Amerihealth Caritas fee schedule · outpatient · +3 other terms | 18 | $4.9k | $4.8k | $205 | 4% | — | $4.2k – $4.9k |
| 21 | Bcbs Tx fee schedule · outpatient | 18 | $3.9k | $3.9k | — | — | — | $3.9k – $3.9k |
| 22 | Medicare fee schedule · outpatient · +2 other terms | 18 | $2.9k | $3.0k | $1.0k | 34% | — | $1.5k – $3.8k |
| 23 | Medical Mutual facility · fee schedule · outpatient · +2 other terms | 15 | $4.1k | $4.8k | $1.2k | 25% | — | $2.3k – $6.5k |
| 24 | Bcbs Mn fee schedule · outpatient · +4 other terms | 13 | $3.8k | $3.8k | $877 | 23% | — | $1.8k – $4.4k |
| 25 | Wellmark fee schedule · both · +2 other terms | 13 | $3.7k | $3.6k | $104 | 3% | — | $3.0k – $3.7k |
← Hospitals reporting HCPCS L8042 · Snapshot 20261111T120946Z-9134e7f7