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
$5
Average
$13
Median
$12
High
$44
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
35 hospitals; the 90th percentile is 3.8× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Filter by billing methodology
Filter by billing class
35 hospital rates
iThe hospitals that file a Blue Cross Blue Shield rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Hoag Memorial Hospital Presbyterian Irvine, CA facility · fee schedule · outpatient | 3 | $9 | $9 | — | — | — | $9 – $9 |
| 2 | Keck Hospital of USC Los Angeles, CA facility · fee schedule · outpatient | 5 | $7 | $18 | $13 | 71% | — | $7 – $34 |
| 3 | Long Beach Memorial Medical Center Long Beach, CA fee schedule · outpatient | 5 | $5 | $5 | — | — | — | $5 – $5 |
| 4 | MemorialCare Miller Children's & Women's Hospital Long Beach Long Beach, CA fee schedule · outpatient | 5 | $5 | $5 | — | — | — | $5 – $5 |
| 5 | MemorialCare Orange Coast Medical Center Fountain Valley, CA fee schedule · outpatient | 5 | $5 | $5 | — | — | — | $5 – $5 |
| 6 | MemorialCare Saddleback Medical Center Laguna Hills, CA fee schedule · outpatient | 5 | $5 | $5 | — | — | — | $5 – $5 |
| 7 | Mission Hospital Regional Med Center Laguna Beach, CA fee schedule · outpatient | 2 | $19 | $19 | — | — | — | $19 – $19 |
| 8 | Newport Hospital Newport, RI facility · fee schedule · outpatient | 3 | $5 | $5 | $0 | 2% | — | $5 – $5 |
| 9 | NorCal HealthConnect LLC Petaluma, CA fee schedule · outpatient | 3 | $17 | $16 | $1 | 8% | — | $14 – $17 |
| 10 | NorCal HealthConnect LLC Healdsburg, CA fee schedule · outpatient | 3 | $5 | $15 | $15 | 96% | — | $5 – $36 |
| 11 | Providence Health System - Southern California Santa Monica, CA fee schedule · outpatient | 5 | $5 | $10 | $10 | 104% | — | $5 – $31 |
| 12 | Providence Health System - Southern California Burbank, CA fee schedule · outpatient | 5 | $5 | $12 | $14 | 113% | — | $5 – $40 |
| 13 | Providence Health System - Southern California Mission Hills, CA fee schedule · outpatient | 5 | $5 | $13 | $16 | 121% | — | $5 – $45 |
| 14 | Providence Health System - Southern California Torrance, CA fee schedule · outpatient | 6 | $5 | $12 | $15 | 126% | — | $5 – $46 |
| 15 | Providence Health System - Southern California San Pedro, CA fee schedule · outpatient | 6 | $5 | $12 | $16 | 129% | — | $5 – $48 |
| 16 | Rady Children's Hospital - San Diego Murrieta, CA facility · fee schedule · outpatient | 2 | $44 | $44 | $2 | 4% | — | $42 – $46 |
| 17 | Resnick Neuropsychiatric Hospital at UCLA Los Angeles, CA fee schedule · outpatient | 2 | $5 | $5 | — | — | — | $5 – $5 |
| 18 | Rhode Island Hospital Providence, RI facility · fee schedule · outpatient | 4 | $5 | $5 | $1 | 17% | — | $3 – $5 |
| 19 | Ronald Reagan UCLA Medical Center Los Angeles, CA fee schedule · outpatient | 2 | $5 | $5 | — | — | — | $5 – $5 |
| 20 | Santa Monica UCLA Medical Center and Orthopaedic Hospital Santa Monica, CA fee schedule · outpatient | 2 | $5 | $5 | — | — | — | $5 – $5 |
| 21 | St Joseph Hospital of Orange Orange, CA fee schedule · outpatient | 2 | $18 | $18 | — | — | — | $18 – $18 |
| 22 | St Joseph Health Northern California LLC Fortuna, CA fee schedule · outpatient | 2 | $18 | $18 | — | — | — | $18 – $18 |
| 23 | St Joseph Health Northern California LLC Santa Rosa, CA fee schedule · outpatient | 3 | $18 | $17 | $1 | 8% | — | $15 – $18 |
| 24 | St Joseph Health Northern California LLC Eureka, CA fee schedule · outpatient | 2 | $18 | $18 | — | — | — | $18 – $18 |
| 25 | St Joseph Health Northern California LLC Napa, CA fee schedule · outpatient | 3 | $18 | $17 | $1 | 8% | — | $15 – $18 |
← Payers reporting HCPCS S5011 · Snapshot 20261113T090226Z-3ce6c0b8