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
Restorigin, 1 cc
Low
$27
Average
$1.8k
Median
$1.9k
High
$5.6k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
19 payers; the 90th percentile is 60.1× 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.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield fee schedule · outpatient · +5 other terms | 108 | $29 | $438 | $1.1k | 261% | — | $0 – $14.4k |
| 2 | Bcbs Tx fee schedule · outpatient · +1 other terms | 30 | $31 | $28 | $9 | 33% | — | $12 – $49 |
| 3 | UnitedHealthcare fee schedule · outpatient · +2 other terms | 22 | $51 | $597 | $856 | 143% | — | $48 – $2.5k |
| 4 | Caresource fee schedule · outpatient · +1 other terms | 14 | $51 | $50 | $1 | 2% | — | $48 – $51 |
| 5 | Wellmark fee schedule · both · +1 other terms | 13 | $2.5k | $2.5k | $64 | 3% | — | $2.1k – $2.5k |
| 6 | Anthem facility · fee schedule · outpatient · +3 other terms | 12 | $48 | $44 | $13 | 30% | — | $0 – $49 |
| 7 | Bcbs Nj fee schedule · outpatient | 10 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 8 | Molina fee schedule · outpatient · +2 other terms | 9 | $2.0k | $1.9k | $751 | 39% | — | $51 – $3.4k |
| 9 | Bcbs Mn fee schedule · outpatient | 5 | $1 | $652 | $976 | 150% | — | $1 – $2.1k |
| 10 | Excellus facility · fee schedule · outpatient | 5 | $3.7k | $4.1k | $2.2k | 52% | — | $2.6k – $9.9k |
| 11 | Humana fee schedule · outpatient | 5 | $2.0k | $1.6k | $798 | 49% | — | $48 – $2.0k |
| 12 | Aetna facility · fee schedule · outpatient · +2 other terms | 4 | $6.9k | $6.3k | $1.5k | 23% | — | $2.7k – $7.0k |
| 13 | Highmark fee schedule · outpatient | 2 | $2.3k | $2.2k | $634 | 29% | — | $1.5k – $3.4k |
| 14 | Optum facility · fee schedule · outpatient | 2 | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 15 | Sanford Health Plan facility · fee schedule · outpatient | 2 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 16 | Bcbs Id professional · fee schedule · outpatient | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 17 | Bcbs Il professional · fee schedule · both | 1 | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 18 | Bcbs La fee schedule · outpatient · +1 other terms | 1 | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 19 | Bcbs Nc facility · fee schedule · outpatient | 1 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
← Hospitals reporting HCPCS Q4192 · Snapshot 20261111T120946Z-9134e7f7