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
30901 EPISTAXIS-ANT PACK
Arlington, TX
See all hospitals reporting CPT 30901 →Price type
AMH Cath Labs LLC’s median price of $268 is 31% above the median hospital's median price ($205), higher than 63% of the 2,468 hospitals reporting CPT 30901. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 35 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges | $42 | $42 | — | — | — | $42 – $42 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $42 | $42 | — | — | — | $42 – $42 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $44 | $44 | — | — | — | $44 – $44 |
| 4 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $46 | $46 | — | — | — | $46 – $46 |
| 5 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $46 | $46 | — | — | — | $46 – $46 |
| 6 | Blue Cross Blue Shield exchange case rate · outpatient | $125 | $125 | — | — | — | $125 – $125 |
| 7 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $134 | $134 | — | — | — | $134 – $134 |
| 8 | Humana medicare advantage case rate · outpatient | $139 | $139 | — | — | — | $139 – $139 |
| 9 | Humana medicare advantage ppo case rate · outpatient | $139 | $139 | — | — | — | $139 – $139 |
| 10 | Molina medicare advantage case rate · outpatient | $141 | $141 | — | — | — | $141 – $141 |
| 11 | WellCare medicare advantage hmo case rate · outpatient | $141 | $141 | — | — | — | $141 – $141 |
| 12 | WellCare medicare advantage mmp case rate · outpatient | $147 | $147 | — | — | — | $147 – $147 |
| 13 | UnitedHealthcare medicare advantage ppo case rate · outpatient | $149 | $149 | — | — | — | $149 – $149 |
| 14 | Blue Cross Blue Shield exchange percent of total billed charges · outpatientfrom % of charges | $150 | $150 | — | — | — | $150 – $150 |
| 15 | UnitedHealthcare medicare advantage hmo case rate · outpatient | $151 | $151 | — | — | — | $151 – $151 |
| 16 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $201 | $201 | — | — | — | $201 – $201 |
| 17 | Blue Cross Blue Shield hmo case rate · outpatient | $256 | $256 | — | — | — | $256 – $256 |
| 18 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $262 | $262 | — | — | — | $262 – $262 |
| 19 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $268 | $268 | — | — | — | $268 – $268 |
| 20 | Blue Cross Blue Shield ppo case rate · outpatient | $285 | $285 | — | — | — | $285 – $285 |
| 21 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $301 | $301 | — | — | — | $301 – $301 |
| 22 | Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges | $301 | $301 | — | — | — | $301 – $301 |
| 23 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $329 | $329 | — | — | — | $329 – $329 |
| 24 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $330 | $330 | — | — | — | $330 – $330 |
| 25 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $332 | $332 | — | — | — | $332 – $332 |
Last updated: Apr 21, 2026
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