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
Custom gradient sleev/glov
Low
$0
Average
$343
Median
$131
High
$2.1k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
20 payers; the 90th percentile is 210.4× 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 facility · fee schedule · outpatient · +4 other terms | 22 | $262 | $239 | $146 | 61% | — | $87 – $679 |
| 2 | Aetna fee schedule · outpatient · +5 other terms | 20 | $4 | $14 | $19 | 141% | — | $4 – $73 |
| 3 | Cigna facility · fee schedule · outpatient · +3 other terms | 18 | $256 | $430 | $393 | 91% | — | $112 – $2.1k |
| 4 | Anthem facility · case rate · outpatient · +5 other terms | 15 | $10 | $11 | $3 | 23% | — | $7 – $17 |
| 5 | Caresource facility · case rate · outpatient · +1 other terms | 15 | $10 | $11 | $3 | 23% | — | $7 – $17 |
| 6 | Molina facility · case rate · outpatient · +1 other terms | 15 | $10 | $11 | $3 | 23% | — | $7 – $17 |
| 7 | UnitedHealthcare facility · case rate · outpatient · +3 other terms | 15 | $10 | $11 | $3 | 23% | — | $7 – $17 |
| 8 | Optum facility · case rate · outpatient · +1 other terms | 11 | $10 | $10 | $2 | 22% | — | $9 – $15 |
| 9 | Highmark fee schedule · outpatient · +2 other terms | 10 | $578 | $578 | — | — | — | $578 – $578 |
| 10 | Aetna Better Health fee schedule · inpatient · +1 other terms | 7 | $4 | $4 | — | — | — | $4 – $4 |
| 11 | Humana fee schedule · inpatient · +2 other terms | 5 | $4 | $4 | — | — | — | $4 – $4 |
| 12 | Bcbs Ks fee schedule · outpatient · +1 other terms | 3 | $220 | $228 | $14 | 6% | — | $218 – $247 |
| 13 | First Health professional · fee schedule · both | 3 | $4 | $4 | — | — | — | $4 – $4 |
| 14 | Bcbs Il professional · fee schedule · both | 1 | $767 | $767 | — | — | — | $767 – $767 |
| 15 | Bcbs La facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 16 | Bcbs Nc facility · fee schedule · outpatient | 1 | $375 | $375 | — | — | — | $375 – $375 |
| 17 | Bcbs Nv fee schedule · outpatient | 1 | $140 | $140 | — | — | — | $140 – $140 |
| 18 | Bcbs Vt professional · fee schedule · outpatient | 1 | $24 | $24 | — | — | — | $24 – $24 |
| 19 | Healthpartners facility · fee schedule · outpatient | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 20 | Wellmark case rate · outpatient · +1 other terms | 1 | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
← Hospitals reporting HCPCS S8420 · Snapshot 20261112T181611Z-3fa9fb76