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
$23
Median
$21
High
$108
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
41 payers; the 90th percentile is 26.7× 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 | Blue Cross Blue Shield fee schedule · outpatient · +11 other terms | 45 | $4 | $6 | $7 | 119% | — | $1 – $33 |
| 2 | Humana fee schedule · outpatient · +12 other terms | 44 | $19 | $18 | $8 | 46% | — | $3 – $26 |
| 3 | Superior Healthplan percent of total billed charges · outpatientfrom % of charges | 17 | $5 | $9 | $8 | 93% | — | $1 – $36 |
| 4 | UnitedHealthcare facility · case rate · outpatient · +16 other terms | 17 | $50 | $67 | $59 | 89% | — | $33 – $300 |
| 5 | Anthem facility · case rate · outpatient · +6 other terms | 15 | $47 | $52 | $12 | 23% | — | $32 – $80 |
| 6 | Caresource facility · case rate · outpatient · +2 other terms | 15 | $48 | $52 | $12 | 23% | — | $32 – $82 |
| 7 | Molina facility · case rate · outpatient · +4 other terms | 15 | $47 | $52 | $12 | 23% | — | $33 – $80 |
| 8 | Cigna facility · fee schedule · outpatient · +13 other terms | 11 | $2 | $8 | $9 | 109% | — | $1 – $36 |
| 9 | MultiPlan percent of total billed charges · outpatientfrom % of charges · +6 other terms | 11 | $38 | $64 | $78 | 122% | — | $10 – $314 |
| 10 | Optum facility · case rate · outpatient · +4 other terms | 11 | $45 | $49 | $11 | 22% | — | $40 – $73 |
| 11 | Bcbs Mn fee schedule · outpatient · +1 other terms | 7 | $1 | $1 | $0 | 33% | — | $0 – $1 |
| 12 | Sanford Health Plan fee schedule · outpatient · +4 other terms | 6 | $10 | $7 | $9 | 130% | — | $1 – $24 |
| 13 | Aetna fee schedule · outpatient · +13 other terms | 4 | $4 | $3 | $1 | 34% | — | $1 – $4 |
| 14 | Healthcare Highways percent of total billed charges · outpatientfrom % of charges · +1 other terms | 4 | $27 | $53 | $39 | 74% | — | $13 – $125 |
| 15 | Tricare facility · fee schedule · outpatient · +5 other terms | 4 | $8 | $17 | $10 | 58% | — | $6 – $32 |
| 16 | Bcbs Tx facility · fee schedule · outpatient · +1 other terms | 3 | $2 | $2 | $0 | 3% | — | $2 – $2 |
| 17 | Highmark facility · fee schedule · outpatient · +1 other terms | 3 | $2 | $2 | $0 | 4% | — | $2 – $2 |
| 18 | Medica fee schedule · outpatient · +2 other terms | 3 | $12 | $13 | $6 | 45% | — | $6 – $25 |
| 19 | Regence facility · percent of total billed charges · bothfrom % of charges · +1 other terms | 3 | $13 | $13 | — | — | — | $13 – $13 |
| 20 | Ucare fee schedule · inpatient · +1 other terms | 3 | $19 | $19 | $4 | 21% | — | $15 – $22 |
| 21 | Aetna Better Health other · outpatient · +2 other terms | 2 | $11 | $11 | $0 | 3% | — | $11 – $11 |
| 22 | Amerihealth Caritas other · outpatient · +1 other terms | 2 | $11 | $11 | $0 | 3% | — | $11 – $11 |
| 23 | Bcbs La other · outpatient · +1 other terms | 2 | $44 | $44 | — | — | — | $44 – $44 |
| 24 | Bcbs Ok per diem · inpatient | 2 | $29 | $29 | — | — | — | $29 – $29 |
| 25 | Kaiser fee schedule · both · +4 other terms | 2 | $4 | $4 | — | — | — | $4 – $4 |
← Hospitals reporting HCPCS S0077 · Snapshot 20261112T181611Z-3fa9fb76