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 grad sleeve heavy
Low
$0
Average
$171
Median
$110
High
$835
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
21 payers; the 90th percentile is 109.0× 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 · +5 other terms | 32 | $156 | $201 | $95 | 47% | — | $102 – $538 |
| 2 | Aetna fee schedule · outpatient · +5 other terms | 20 | $4 | $40 | $83 | 209% | — | $4 – $308 |
| 3 | Anthem facility · case rate · outpatient · +4 other terms | 15 | $10 | $11 | $3 | 23% | — | $7 – $17 |
| 4 | Caresource facility · case rate · outpatient · +1 other terms | 15 | $10 | $11 | $3 | 23% | — | $7 – $17 |
| 5 | Molina facility · case rate · outpatient · +1 other terms | 15 | $10 | $11 | $3 | 23% | — | $7 – $17 |
| 6 | UnitedHealthcare facility · case rate · outpatient · +3 other terms | 15 | $10 | $11 | $3 | 23% | — | $7 – $17 |
| 7 | Cigna facility · fee schedule · outpatient · +3 other terms | 13 | $88 | $181 | $163 | 90% | — | $88 – $835 |
| 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 | $440 | $440 | — | — | — | $440 – $440 |
| 10 | Bcbs Mn fee schedule · both · +2 other terms | 8 | $158 | $158 | $1 | 1% | — | $156 – $159 |
| 11 | Aetna Better Health fee schedule · inpatient · +1 other terms | 7 | $4 | $4 | — | — | — | $4 – $4 |
| 12 | Humana fee schedule · inpatient · +2 other terms | 5 | $4 | $4 | — | — | — | $4 – $4 |
| 13 | Bcbs Ks fee schedule · outpatient · +1 other terms | 3 | $372 | $387 | $23 | 6% | — | $369 – $419 |
| 14 | First Health professional · fee schedule · both | 3 | $4 | $4 | — | — | — | $4 – $4 |
| 15 | Bcbs Il professional · fee schedule · both | 1 | $230 | $230 | — | — | — | $230 – $230 |
| 16 | Bcbs La facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 17 | Bcbs Nc facility · fee schedule · outpatient | 1 | $236 | $236 | — | — | — | $236 – $236 |
| 18 | Bcbs Nv fee schedule · outpatient | 1 | $105 | $105 | — | — | — | $105 – $105 |
| 19 | Bcbs Vt professional · fee schedule · outpatient | 1 | $117 | $117 | — | — | — | $117 – $117 |
| 20 | Healthpartners facility · fee schedule · outpatient | 1 | $835 | $835 | — | — | — | $835 – $835 |
| 21 | Wellmark case rate · outpatient · +1 other terms | 1 | $683 | $683 | — | — | — | $683 – $683 |
← Hospitals reporting HCPCS S8423 · Snapshot 20261112T181611Z-3fa9fb76