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
Fee Schedule
Low
$0
Average
$51
Median
$22
High
$187
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
27 payers; the 90th percentile is 14993.1× 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 | Molina facility · case rate · outpatient · +4 other terms | 27 | $171 | $151 | $62 | 41% | — | $78 – $308 |
| 2 | UnitedHealthcare facility · case rate · outpatient · +8 other terms | 18 | $183 | $184 | $61 | 33% | — | $78 – $314 |
| 3 | Anthem facility · case rate · outpatient · +7 other terms | 15 | $182 | $199 | $47 | 23% | — | $124 – $308 |
| 4 | Caresource facility · case rate · outpatient · +1 other terms | 15 | $185 | $199 | $46 | 23% | — | $124 – $314 |
| 5 | Optum facility · case rate · outpatient | 13 | $164 | $171 | $57 | 33% | — | $74 – $279 |
| 6 | Humana fee schedule · outpatient · +6 other terms | 11 | $0 | $40 | $72 | 180% | — | $0 – $171 |
| 7 | Aetna Better Health facility · case rate · outpatient | 7 | $93 | $93 | $2 | 2% | — | $89 – $93 |
| 8 | Amerihealth Caritas facility · case rate · outpatient · +2 other terms | 7 | $86 | $87 | $3 | 3% | — | $86 – $93 |
| 9 | Cigna fee schedule · outpatient · +7 other terms | 7 | $0 | $0 | — | — | — | $0 – $0 |
| 10 | MultiPlan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 7 | $1 | $6 | $9 | 154% | — | $0 – $20 |
| 11 | Aetna facility · case rate · outpatient · +7 other terms | 5 | $93 | $107 | $31 | 29% | — | $78 – $171 |
| 12 | First Health facility · percent of total billed charges · outpatientfrom % of charges · +2 other terms | 5 | $0 | $8 | $12 | 139% | — | $0 – $25 |
| 13 | Blue Cross Blue Shield facility · case rate · outpatient · +4 other terms | 4 | $359 | $350 | $113 | 32% | — | $230 – $518 |
| 14 | Sanford Health Plan fee schedule · outpatient · +3 other terms | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | Wellmark facility · case rate · outpatient · +1 other terms | 3 | $290 | $254 | $80 | 32% | — | $118 – $320 |
| 16 | Highmark facility · percent of total billed charges · outpatientfrom % of charges | 2 | — | — | — | — | — | — – $0 |
| 17 | Medicaid facility · case rate · outpatient | 2 | $78 | $78 | — | — | — | $78 – $78 |
| 18 | Phcs facility · percent of total billed charges · inpatientfrom % of charges · +2 other terms | 2 | $25 | $25 | — | — | — | $25 – $25 |
| 19 | Tricare facility · fee schedule · outpatient · +2 other terms | 2 | $29 | $29 | — | — | — | $29 – $29 |
| 20 | Bcbs Id professional · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 21 | Beechstreet facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 22 | Clover facility · percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 23 | Healthpartners facility · fee schedule · outpatient · +3 other terms | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 24 | Kaiser facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 25 | Medical Mutual facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 1 | $0 | $0 | — | — | — | $0 – $0 |
← Hospitals reporting HCPCS Q0239 · Snapshot 20261112T181611Z-3fa9fb76