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
Cast Supply Shrt Arm Ad P
Low
$6
Average
$18
Median
$14
High
$128
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
53 payers; the 90th percentile is 3.0× 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.
Filter by billing methodology
Filter by billing class
| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Humana fee schedule · outpatient · +20 other terms | 305 | $11 | $17 | $18 | 105% | — | $5 – $85 |
| 2 | UnitedHealthcare fee schedule · outpatient · +18 other terms | 303 | $11 | $10 | $2 | 19% | — | $1 – $14 |
| 3 | Aetna fee schedule · outpatient · +18 other terms | 279 | $11 | $14 | $8 | 57% | — | $8 – $66 |
| 4 | WellCare fee schedule · outpatient · +9 other terms | 189 | $11 | $12 | $2 | 16% | — | $11 – $22 |
| 5 | Blue Cross Blue Shield fee schedule · outpatient · +16 other terms | 182 | $11 | $15 | $22 | 150% | — | $0 – $420 |
| 6 | Devoted fee schedule · outpatient · +3 other terms | 163 | $11 | $11 | $0 | 2% | — | $11 – $12 |
| 7 | Cigna Healthspring fee schedule · outpatient · +3 other terms | 121 | $11 | $11 | $0 | 3% | — | $11 – $12 |
| 8 | Molina fee schedule · outpatient · +15 other terms | 102 | $14 | $15 | $6 | 41% | — | $5 – $37 |
| 9 | Cigna fee schedule · outpatient · +14 other terms | 79 | $11 | $13 | $4 | 30% | — | $11 – $32 |
| 10 | Anthem fee schedule · outpatient · +12 other terms | 74 | $11 | $11 | $1 | 8% | — | $11 – $18 |
| 11 | Superior Healthplan fee schedule · outpatient | 40 | $12 | $12 | $0 | 1% | — | $11 – $12 |
| 12 | Kaiser fee schedule · outpatient · +6 other terms | 39 | $11 | $11 | $0 | 2% | — | $11 – $11 |
| 13 | Clover fee schedule · outpatient · +1 other terms | 37 | $11 | $11 | $0 | 3% | — | $11 – $12 |
| 14 | Bcbs Tx fee schedule · outpatient | 31 | $10 | $10 | $3 | 29% | — | $8 – $38 |
| 15 | Optum fee schedule · outpatient · +7 other terms | 30 | $11 | $12 | $5 | 40% | — | $11 – $28 |
| 16 | Oscar fee schedule · outpatient · +7 other terms | 24 | $11 | $11 | $0 | 3% | — | $11 – $12 |
| 17 | Caresource facility · case rate · outpatient · +6 other terms | 20 | $11 | $13 | $4 | 34% | — | $7 – $22 |
| 18 | Amerihealth Caritas fee schedule · outpatient · +4 other terms | 18 | $13 | $12 | $2 | 20% | — | $5 – $14 |
| 19 | Medicare fee schedule · outpatient · +5 other terms | 18 | $11 | $11 | $0 | 1% | — | $11 – $11 |
| 20 | Ambetter facility · fee schedule · outpatient · +7 other terms | 17 | $16 | $18 | $2 | 11% | — | $16 – $20 |
| 21 | Medcost professional · percent of total billed charges · outpatientfrom % of charges | 14 | $20 | $21 | $1 | 5% | — | $20 – $22 |
| 22 | Medica professional · fee schedule · outpatient · +11 other terms | 14 | $11 | $12 | $3 | 26% | — | $11 – $29 |
| 23 | Highmark facility · fee schedule · outpatient · +7 other terms | 13 | $20 | $21 | $10 | 50% | — | $10 – $50 |
| 24 | Wellmark fee schedule · both · +4 other terms | 13 | $10 | $10 | $0 | 1% | — | $10 – $11 |
| 25 | Aetna Better Health fee schedule · outpatient · +3 other terms | 12 | $5 | $8 | $3 | 37% | — | $5 – $11 |
← Hospitals reporting HCPCS Q4009 · Snapshot 20261112T181611Z-3fa9fb76