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
HC St Re-Eval (Medicaid)
Low
$0
Average
$174
Median
$158
High
$401
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
37 payers; the 90th percentile is 3.6× 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 | Blue Cross Blue Shield facility · fee schedule · outpatient · +16 other terms | 45 | $165 | $185 | $177 | 95% | — | $37 – $917 |
| 2 | Aetna fee schedule · outpatient · +16 other terms | 37 | $75 | $194 | $196 | 101% | — | $13 – $697 |
| 3 | Molina facility · case rate · outpatient · +9 other terms | 29 | $109 | $151 | $88 | 58% | — | $45 – $399 |
| 4 | UnitedHealthcare fee schedule · outpatient · +17 other terms | 29 | $362 | $373 | $308 | 83% | — | $19 – $780 |
| 5 | Humana fee schedule · outpatient · +10 other terms | 17 | $59 | $213 | $190 | 89% | — | $55 – $622 |
| 6 | Anthem facility · case rate · outpatient · +8 other terms | 15 | $64 | $70 | $16 | 23% | — | $44 – $109 |
| 7 | Caresource facility · case rate · outpatient · +2 other terms | 15 | $65 | $70 | $16 | 23% | — | $44 – $111 |
| 8 | Cigna per diem · both · +13 other terms | 13 | $510 | $456 | $134 | 29% | — | $75 – $510 |
| 9 | Medcost percent of total billed charges · bothfrom % of charges · +2 other terms | 13 | $211 | $211 | $12 | 6% | — | $199 – $223 |
| 10 | Optum facility · case rate · outpatient · +1 other terms | 13 | $62 | $84 | $43 | 51% | — | $54 – $179 |
| 11 | Wellmark fee schedule · both · +1 other terms | 13 | $37 | $37 | — | — | — | $37 – $37 |
| 12 | Ambetter percent of total billed charges · bothfrom % of charges · +2 other terms | 12 | $161 | $161 | — | — | — | $161 – $161 |
| 13 | Bcbs Mn fee schedule · outpatient · +3 other terms | 12 | $270 | $258 | $114 | 44% | — | $69 – $552 |
| 14 | Highmark fee schedule · outpatient · +5 other terms | 11 | $40 | $45 | $31 | 70% | — | $18 – $345 |
| 15 | Aetna Better Health fee schedule · inpatient · +4 other terms | 7 | $61 | $61 | — | — | — | $61 – $61 |
| 16 | Amerihealth Caritas facility · case rate · outpatient · +2 other terms | 7 | $208 | $210 | $7 | 3% | — | $208 – $226 |
| 17 | Medicaid facility · case rate · outpatient · +2 other terms | 4 | $101 | $101 | $88 | 87% | — | $13 – $189 |
| 18 | MultiPlan fee schedule · inpatient · +7 other terms | 4 | $622 | $467 | $184 | 39% | — | $148 – $622 |
| 19 | Bcbs Ks fee schedule · outpatient · +1 other terms | 3 | $138 | $143 | $8 | 6% | — | $137 – $155 |
| 20 | First Health professional · fee schedule · both · +6 other terms | 3 | $65 | $65 | — | — | — | $65 – $65 |
| 21 | Phcs fee schedule · inpatient · +4 other terms | 3 | $711 | $711 | — | — | — | $711 – $711 |
| 22 | Healthcare Highways facility · percent of total billed charges · bothfrom % of charges | 2 | $167 | $167 | — | — | — | $167 – $167 |
| 23 | Medica facility · percent of total billed charges · bothfrom % of charges · +2 other terms | 2 | $299 | $299 | — | — | — | $299 – $299 |
| 24 | WellCare fee schedule · outpatient · +2 other terms | 2 | $132 | $132 | $1 | 0% | — | $132 – $133 |
| 25 | Bcbs La facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
← Hospitals reporting HCPCS S9152 · Snapshot 20261111T120946Z-9134e7f7