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
Evaluation by ocularist
Low
$0
Average
$107
Median
$66
High
$335
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
12 payers; the 90th percentile is 6.4× 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 | Anthem facility · case rate · outpatient · +4 other terms | 15 | $58 | $63 | $15 | 23% | — | $39 – $98 |
| 2 | Caresource facility · case rate · outpatient · +1 other terms | 15 | $59 | $63 | $14 | 23% | — | $39 – $100 |
| 3 | Molina facility · case rate · outpatient · +1 other terms | 15 | $58 | $63 | $15 | 23% | — | $40 – $98 |
| 4 | UnitedHealthcare facility · case rate · outpatient · +3 other terms | 15 | $59 | $64 | $15 | 23% | — | $40 – $100 |
| 5 | Aetna fee schedule · both · +3 other terms | 13 | $106 | $106 | $0 | 0% | — | $106 – $108 |
| 6 | Wellmark fee schedule · both | 13 | $34 | $34 | — | — | — | $34 – $34 |
| 7 | Blue Cross Blue Shield facility · fee schedule · outpatient · +2 other terms | 12 | $598 | $694 | $324 | 47% | — | $420 – $1.6k |
| 8 | Optum facility · case rate · outpatient · +1 other terms | 11 | $54 | $60 | $13 | 22% | — | $49 – $89 |
| 9 | Humana facility · other · outpatient | 2 | $85 | $85 | $13 | 15% | — | $73 – $98 |
| 10 | Bcbs La facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 11 | Bcbs Nc facility · fee schedule · outpatient | 1 | $204 | $204 | — | — | — | $204 – $204 |
| 12 | Bcbs Nv fee schedule · outpatient | 1 | $88 | $88 | $14 | 15% | — | $75 – $102 |
← Hospitals reporting HCPCS S9150 · Snapshot 20261112T181611Z-3fa9fb76