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
Non-prscrp lens
Low
$0
Average
$56
Median
$38
High
$358
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
16 payers; the 90th percentile is 3.8× 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 | Aetna fee schedule · outpatient · +5 other terms | 20 | $50 | $115 | $112 | 97% | — | $50 – $500 |
| 2 | Anthem facility · case rate · outpatient · +4 other terms | 15 | $33 | $36 | $8 | 23% | — | $23 – $56 |
| 3 | Caresource facility · case rate · outpatient · +1 other terms | 15 | $34 | $36 | $8 | 23% | — | $23 – $57 |
| 4 | Molina facility · case rate · outpatient · +1 other terms | 15 | $33 | $36 | $8 | 23% | — | $23 – $56 |
| 5 | UnitedHealthcare facility · case rate · outpatient · +1 other terms | 15 | $34 | $37 | $9 | 23% | — | $23 – $57 |
| 6 | Wellmark fee schedule · both | 13 | $34 | $34 | — | — | — | $34 – $34 |
| 7 | Optum facility · case rate · outpatient | 11 | $31 | $34 | $8 | 22% | — | $28 – $51 |
| 8 | Aetna Better Health fee schedule · inpatient · +1 other terms | 7 | $52 | $52 | — | — | — | $52 – $52 |
| 9 | Humana fee schedule · inpatient · +2 other terms | 5 | $50 | $50 | — | — | — | $50 – $50 |
| 10 | First Health professional · fee schedule · both | 3 | $55 | $55 | — | — | — | $55 – $55 |
| 11 | Highmark professional · fee schedule · both | 3 | $47 | $47 | — | — | — | $47 – $47 |
| 12 | Blue Cross Blue Shield fee schedule · outpatient · +2 other terms | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 13 | Bcbs La facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 14 | Bcbs Nv fee schedule · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 15 | Bcbs Vt professional · fee schedule · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 16 | Cigna fee schedule · both | 1 | $43 | $43 | — | — | — | $43 – $43 |
← Hospitals reporting HCPCS S0510 · Snapshot 20261113T090226Z-3ce6c0b8