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
$17
Average
$162
Median
$59
High
$1.0k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
18 payers; the 90th percentile is 20.1× 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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Filter by billing class
| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Humana fee schedule · outpatient · +2 other terms | 32 | $135 | $163 | $24 | 15% | — | $135 – $184 |
| 2 | Highmark fee schedule · outpatient · +2 other terms | 10 | $23 | $23 | $0 | 2% | — | $22 – $24 |
| 3 | Anthem facility · fee schedule · outpatient | 7 | $984 | $532 | $512 | 96% | — | $50 – $1.3k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +1 other terms | 5 | $79 | $79 | $0 | 1% | — | $78 – $79 |
| 5 | Molina facility · case rate · outpatient · +1 other terms | 4 | $473 | $494 | $122 | 25% | — | $345 – $685 |
| 6 | Sanford Health Plan fee schedule · outpatient · +1 other terms | 3 | $21 | $21 | — | — | — | $21 – $21 |
| 7 | Wellmark facility · case rate · outpatient | 3 | $1.2k | $1.0k | $321 | 32% | — | $473 – $1.3k |
| 8 | Aetna facility · case rate · outpatient · +3 other terms | 2 | $579 | $579 | $106 | 18% | — | $473 – $685 |
| 9 | Amerihealth Caritas professional · fee schedule · outpatient · +2 other terms | 2 | $20 | $20 | $1 | 7% | — | $19 – $22 |
| 10 | Cigna facility · fee schedule · outpatient · +3 other terms | 2 | $42 | $34 | $15 | 45% | — | $22 – $59 |
| 11 | Aetna Better Health other · outpatient · +1 other terms | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 12 | Bcbs Id professional · fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 13 | Bcbs La other · outpatient · +1 other terms | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 14 | First Health percent of total billed charges · outpatientfrom % of charges | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 15 | Healthpartners facility · fee schedule · outpatient | 1 | $59 | $59 | — | — | — | $59 – $59 |
| 16 | MultiPlan other · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 17 | Optum other · outpatient | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 18 | UnitedHealthcare other · outpatient · +2 other terms | 1 | $13 | $13 | $5 | 43% | — | $5 – $17 |
← Hospitals reporting HCPCS Q9993 · Snapshot 20261113T090226Z-3ce6c0b8