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.
Generation details were not recorded for this description.
Original text from hospital filings
Small disposable underpad
Low
$0
Average
$8
Median
$1
High
$72
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
21 payers; the 90th percentile is 89.9× 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 · +4 other terms | 22 | $3 | $2 | $2 | 106% | — | $0 – $8 |
| 2 | Aetna fee schedule · outpatient · +5 other terms | 20 | $2 | $3 | $3 | 113% | — | $1 – $16 |
| 3 | Anthem facility · case rate · outpatient · +4 other terms | 15 | $15 | $17 | $4 | 23% | — | $10 – $26 |
| 4 | Caresource facility · case rate · outpatient · +1 other terms | 15 | $16 | $17 | $4 | 23% | — | $10 – $27 |
| 5 | Molina facility · case rate · outpatient · +2 other terms | 15 | $15 | $17 | $4 | 23% | — | $11 – $26 |
| 6 | UnitedHealthcare fee schedule · outpatient · +3 other terms | 15 | $0 | $0 | $0 | 64% | — | $0 – $1 |
| 7 | Wellmark fee schedule · both | 13 | $72 | $72 | — | — | — | $72 – $72 |
| 8 | Bcbs Mn fee schedule · outpatient · +3 other terms | 12 | $1 | $1 | $0 | 56% | — | $0 – $1 |
| 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 | $0 | $0 | — | — | — | $0 – $0 |
| 11 | Medica fee schedule · both · +1 other terms | 9 | $0 | $0 | — | — | — | $0 – $0 |
| 12 | Ucare fee schedule · both · +1 other terms | 9 | $0 | $0 | $0 | 5% | — | $0 – $0 |
| 13 | Aetna Better Health fee schedule · inpatient · +1 other terms | 7 | $2 | $2 | — | — | — | $2 – $2 |
| 14 | Cigna facility · fee schedule · outpatient · +1 other terms | 5 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | Humana fee schedule · inpatient · +2 other terms | 5 | $2 | $2 | — | — | — | $2 – $2 |
| 16 | First Health professional · fee schedule · both | 3 | $2 | $2 | — | — | — | $2 – $2 |
| 17 | Amerihealth Caritas professional · fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 18 | Bcbs Id facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 19 | Bcbs La facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 20 | Bcbs Nc facility · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 21 | Bcbs Vt professional · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
← Hospitals reporting HCPCS T4542 · Snapshot 20261112T181611Z-3fa9fb76