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
Disposable liner/shield/pad
Low
$0
Average
$10
Median
$5
High
$32
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
27 payers; the 90th percentile is 84.1× 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 | 22 | $3 | $2 | $2 | 94% | — | $1 – $8 |
| 2 | Aetna fee schedule · outpatient · +7 other terms | 20 | $2 | $3 | $3 | 116% | — | $0 – $16 |
| 3 | UnitedHealthcare fee schedule · outpatient · +6 other terms | 16 | $1 | $1 | $0 | 21% | — | $0 – $1 |
| 4 | Anthem facility · case rate · outpatient · +4 other terms | 15 | $15 | $17 | $4 | 23% | — | $10 – $26 |
| 5 | Caresource facility · case rate · outpatient · +2 other terms | 15 | $16 | $17 | $4 | 23% | — | $10 – $27 |
| 6 | Molina facility · case rate · outpatient · +2 other terms | 15 | $15 | $17 | $4 | 23% | — | $11 – $26 |
| 7 | Wellmark fee schedule · both | 13 | $0 | $0 | — | — | — | $0 – $0 |
| 8 | Bcbs Mn fee schedule · outpatient · +3 other terms | 12 | $2 | $1 | $1 | 57% | — | $1 – $2 |
| 9 | Optum facility · case rate · outpatient · +1 other terms | 11 | $14 | $16 | $4 | 22% | — | $13 – $24 |
| 10 | Highmark fee schedule · outpatient · +2 other terms | 10 | $1 | $1 | — | — | — | $1 – $1 |
| 11 | Medica fee schedule · both · +1 other terms | 9 | $1 | $1 | — | — | — | $1 – $1 |
| 12 | Ucare fee schedule · both · +1 other terms | 9 | $1 | $1 | $0 | 3% | — | $1 – $1 |
| 13 | Aetna Better Health fee schedule · inpatient · +2 other terms | 7 | $2 | $2 | — | — | — | $2 – $2 |
| 14 | Cigna facility · fee schedule · outpatient · +5 other terms | 6 | $0 | $1 | $1 | 100% | — | $0 – $2 |
| 15 | Humana fee schedule · inpatient · +2 other terms | 5 | $2 | $2 | — | — | — | $2 – $2 |
| 16 | MultiPlan percent of total billed charges · bothfrom % of charges | 4 | $28 | $28 | — | — | — | $28 – $28 |
| 17 | Bcbs Ks fee schedule · outpatient · +1 other terms | 3 | $24 | $25 | $1 | 6% | — | $24 – $27 |
| 18 | First Health professional · fee schedule · both · +1 other terms | 3 | $2 | $2 | — | — | — | $2 – $2 |
| 19 | Amerihealth Caritas professional · fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 20 | Bcbs Id facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 21 | Bcbs La facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 22 | Bcbs Nc facility · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 23 | Bcbs Tx percent of total billed charges · outpatientfrom % of charges | 1 | $24 | $24 | $3 | 13% | — | $21 – $27 |
| 24 | Bcbs Vt professional · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 25 | Healthpartners facility · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
← Hospitals reporting HCPCS T4535 · Snapshot 20261112T181611Z-3fa9fb76