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
S9122
Low
$0
Average
$33
Median
$29
High
$87
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
26 payers; the 90th percentile is 3.3× 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.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Humana fee schedule · outpatient · +2 other terms | 86 | $48 | $46 | $8 | 18% | — | $15 – $54 |
| 2 | Blue Cross Blue Shield facility · fee schedule · outpatient · +4 other terms | 28 | $101 | $107 | $104 | 97% | — | $10 – $459 |
| 3 | Aetna fee schedule · outpatient · +8 other terms | 20 | $15 | $34 | $34 | 97% | — | $15 – $150 |
| 4 | UnitedHealthcare fee schedule · outpatient · +5 other terms | 16 | $44 | $49 | $12 | 25% | — | $27 – $72 |
| 5 | Caresource fee schedule · outpatient | 15 | $50 | $50 | — | — | — | $50 – $50 |
| 6 | Wellmark fee schedule · both · +1 other terms | 13 | $32 | $32 | $1 | 5% | — | $23 – $32 |
| 7 | Bcbs Nj fee schedule · outpatient · +2 other terms | 12 | $18 | $22 | $8 | 37% | — | $15 – $41 |
| 8 | Cigna professional · fee schedule · outpatient · +3 other terms | 10 | $4 | $6 | $4 | 62% | — | $4 – $14 |
| 9 | Anthem professional · fee schedule · outpatient · +2 other terms | 8 | $19 | $19 | — | — | — | $19 – $19 |
| 10 | Bcbs Mn fee schedule · both · +2 other terms | 8 | $11 | $11 | $0 | 1% | — | $10 – $11 |
| 11 | Bcbs Pa facility · percent of total billed charges · outpatientfrom % of charges | 8 | $46 | $49 | $27 | 56% | — | $18 – $125 |
| 12 | Aetna Better Health fee schedule · inpatient · +1 other terms | 7 | $15 | $15 | — | — | — | $15 – $15 |
| 13 | Oscar facility · percent of total billed charges · outpatientfrom % of charges | 7 | $32 | $32 | — | — | — | $32 – $32 |
| 14 | Tricare facility · fee schedule · outpatient | 5 | $44 | $46 | $2 | 5% | — | $43 – $48 |
| 15 | First Health professional · fee schedule · both | 3 | $17 | $17 | — | — | — | $17 – $17 |
| 16 | Molina facility · fee schedule · outpatient | 3 | $19 | $21 | $3 | 14% | — | $19 – $25 |
| 17 | Highmark facility · fee schedule · outpatient · +1 other terms | 2 | $25 | $26 | $3 | 11% | — | $22 – $28 |
| 18 | Kaiser fee schedule · both | 2 | $19 | $19 | — | — | — | $19 – $19 |
| 19 | Optum facility · fee schedule · outpatient | 2 | $45 | $45 | $3 | 7% | — | $42 – $48 |
| 20 | Bcbs Id professional · fee schedule · outpatient | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 21 | Bcbs Il professional · fee schedule · both | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 22 | Bcbs La facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 23 | Bcbs Nc facility · fee schedule · outpatient | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 24 | Bcbs Nv fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 25 | Bcbs Vt professional · fee schedule · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
← Hospitals reporting HCPCS S9122 · Snapshot 20261111T120946Z-9134e7f7