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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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Fee Schedule

Payers reporting HCPCS S0073

Payer pricing summary

Low

Average

$113

Median

$70

High

$700

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Blue Cross Blue Shield fee schedule · outpatient · +15 other terms	50	$20	$68	$58	86%	—	$11 – $203
2	Humana fee schedule · outpatient · +9 other terms	44	$97	$95	$41	44%	—	$13 – $172
3	MultiPlan percent of total billed charges · outpatientfrom % of charges · +6 other terms	21	$35	$76	$89	116%	—	$13 – $386
4	Molina facility · case rate · outpatient · +3 other terms	16	$48	$63	$35	56%	—	$33 – $184
5	UnitedHealthcare fee schedule · outpatient · +13 other terms	16	$13	$32	$60	188%	—	$1 – $213
6	Anthem facility · case rate · outpatient · +5 other terms	15	$47	$52	$12	23%	—	$32 – $80
7	Caresource facility · case rate · outpatient · +1 other terms	15	$48	$52	$12	23%	—	$32 – $82
8	Optum facility · case rate · outpatient · +3 other terms	11	$45	$49	$11	22%	—	$40 – $73
9	Cigna facility · fee schedule · outpatient · +13 other terms	10	$24	$31	$13	41%	—	$15 – $58
10	Healthcare Highways percent of total billed charges · outpatientfrom % of charges	8	$252	$280	$199	71%	—	$8 – $630
11	Bcbs Mn fee schedule · outpatient · +1 other terms	7	$17	$17	$6	33%	—	$9 – $21
12	Medicaid fee schedule · outpatient · +1 other terms	6	$1	$1	—	—	—	$1 – $1
13	Sanford Health Plan fee schedule · outpatient · +2 other terms	6	$120	$59	$89	150%	—	$15 – $244
14	Aetna case rate · outpatient · +13 other terms	5	$15	$15	$6	39%	—	$9 – $21
15	Ambetter case rate · outpatient · +2 other terms	5	$10	$10	—	—	—	$10 – $10
16	Clover case rate · outpatient	5	$10	$10	—	—	—	$10 – $10
17	Highmark facility · fee schedule · outpatient · +1 other terms	5	$17	$52	$29	56%	—	$15 – $111
18	WellCare case rate · outpatient · +2 other terms	5	$10	$10	—	—	—	$10 – $10
19	Bcbs Tx facility · fee schedule · outpatient	3	$15	$15	$0	2%	—	$14 – $15
20	First Health facility · percent of total billed charges · inpatientfrom % of charges · +2 other terms	3	$119	$172	$144	83%	—	$7 – $559
21	Medica fee schedule · outpatient · +1 other terms	3	$151	$156	$60	39%	—	$87 – $246
22	Ucare fee schedule · inpatient · +1 other terms	3	$226	$226	—	—	—	$226 – $226
23	Amerihealth Caritas professional · fee schedule · outpatient	2	$10	$10	—	—	—	$10 – $10
24	Kaiser fee schedule · both · +2 other terms	2	$22	$22	—	—	—	$22 – $22
25	Phcs facility · percent of total billed charges · inpatientfrom % of charges · +3 other terms	2	$7	$7	—	—	—	$7 – $7

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