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
$74
Median
$45
High
$297
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
19 payers; the 90th percentile is 13.6× 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 | Highmark fee schedule · outpatient · +2 other terms | 10 | $13 | $13 | — | — | — | $13 – $13 |
| 2 | Anthem facility · fee schedule · outpatient · +1 other terms | 7 | $266 | $142 | $141 | 99% | — | $0 – $342 |
| 3 | Blue Cross Blue Shield facility · fee schedule · outpatient | 5 | $14 | $14 | $2 | 15% | — | $9 – $19 |
| 4 | Humana facility · case rate · outpatient | 3 | $78 | $80 | $4 | 5% | — | $78 – $86 |
| 5 | Molina facility · fee schedule · outpatient · +1 other terms | 3 | $54 | $47 | $10 | 21% | — | $33 – $54 |
| 6 | Sanford Health Plan fee schedule · outpatient · +1 other terms | 3 | $14 | $14 | — | — | — | $14 – $14 |
| 7 | Aetna professional · fee schedule · both · +5 other terms | 2 | $14 | $14 | — | — | — | $14 – $14 |
| 8 | Cigna fee schedule · both · +4 other terms | 2 | $17 | $17 | $2 | 10% | — | $14 – $18 |
| 9 | MultiPlan facility · percent of total billed charges · outpatientfrom % of charges · +1 other terms | 2 | $171 | $122 | $139 | 114% | — | $22 – $319 |
| 10 | UnitedHealthcare facility · fee schedule · outpatient · +1 other terms | 2 | $27 | $18 | $26 | 141% | — | $0 – $54 |
| 11 | Aetna Better Health facility · case rate · outpatient | 1 | $89 | $89 | $0 | 1% | — | $89 – $90 |
| 12 | Ambetter facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 13 | Amerihealth Caritas facility · case rate · outpatient | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 14 | Bcbs Id professional · fee schedule · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 15 | Devoted facility · fee schedule · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 16 | Healthpartners facility · fee schedule · outpatient | 1 | $42 | $42 | — | — | — | $42 – $42 |
| 17 | Kaiser facility · fee schedule · outpatient | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 18 | Phcs facility · percent of total billed charges · outpatientfrom % of charges | 1 | $297 | $297 | — | — | — | $297 – $297 |
| 19 | Wellmark facility · case rate · outpatient | 1 | $290 | $290 | $14 | 5% | — | $276 – $303 |
← Hospitals reporting HCPCS Q9989 · Snapshot 20261113T090226Z-3ce6c0b8