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
$1
Average
$992
Median
$834
High
$4.2k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
20 payers; the 90th percentile is 20.4× 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 · +3 other terms | 16 | $168 | $210 | $93 | 44% | — | $126 – $430 |
| 2 | Anthem facility · fee schedule · outpatient · +3 other terms | 7 | $3.9k | $2.1k | $2.0k | 96% | — | $209 – $5.0k |
| 3 | Highmark facility · fee schedule · outpatient · +1 other terms | 4 | $84 | $222 | $340 | 153% | — | $81 – $1.1k |
| 4 | Humana facility · case rate · outpatient · +2 other terms | 3 | $1.1k | $1.2k | $53 | 5% | — | $1.1k – $1.2k |
| 5 | Molina facility · fee schedule · outpatient · +1 other terms | 3 | $788 | $593 | $276 | 46% | — | $203 – $788 |
| 6 | Sanford Health Plan fee schedule · outpatient · +1 other terms | 3 | $83 | $83 | — | — | — | $83 – $83 |
| 7 | Aetna professional · fee schedule · both · +5 other terms | 2 | $81 | $81 | — | — | — | $81 – $81 |
| 8 | Cigna fee schedule · both · +3 other terms | 2 | $101 | $97 | $9 | 9% | — | $87 – $107 |
| 9 | UnitedHealthcare facility · fee schedule · outpatient · +4 other terms | 2 | $1.4k | $1.4k | $660 | 46% | — | $788 – $2.1k |
| 10 | Aetna Better Health facility · case rate · outpatient | 1 | $1.3k | $1.3k | $7 | 1% | — | $1.3k – $1.3k |
| 11 | Ambetter facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.0k | $1.0k | $635 | 61% | — | $162 – $1.6k |
| 12 | Amerihealth Caritas facility · case rate · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 13 | Bcbs Id professional · fee schedule · outpatient | 1 | $77 | $77 | — | — | — | $77 – $77 |
| 14 | Devoted facility · fee schedule · outpatient | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 15 | Healthpartners facility · fee schedule · outpatient | 1 | $253 | $253 | — | — | — | $253 – $253 |
| 16 | Kaiser facility · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 17 | MultiPlan professional · fee schedule · outpatient · +2 other terms | 1 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 18 | Oscar facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 1 | $1.3k | $1.3k | $777 | 61% | — | $199 – $2.0k |
| 19 | Tricare facility · fee schedule · outpatient | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 20 | Wellmark facility · case rate · outpatient | 1 | $4.2k | $4.2k | $196 | 5% | — | $4.0k – $4.4k |
← Hospitals reporting HCPCS Q5102 · Snapshot 20261113T090226Z-3ce6c0b8