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
HLA CLASS I AND II QUAL 3002850 R1
Arlington, TX
See all hospitals reporting CPT 86828 →Price type
AMH Cath Labs LLC’s median price of $153 is 114% above the median hospital's median price ($71), higher than 82% of the 1,742 hospitals reporting CPT 86828. 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, 31 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 fee schedule · outpatient | $54 | $54 | — | — | — | $54 – $54 |
| 2 | UnitedHealthcare managed medicaid fee schedule · outpatient | $54 | $54 | — | — | — | $54 – $54 |
| 3 | WellCare managed medicaid fee schedule · outpatient | $57 | $57 | — | — | — | $57 – $57 |
| 4 | Molina managed medicaid fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 5 | Aetna managed medicaid fee schedule · outpatient | $59 | $59 | — | — | — | $59 – $59 |
| 6 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $64 | $64 | — | — | — | $64 – $64 |
| 7 | UnitedHealthcare all payer fee schedule · outpatient | $64 | $64 | — | — | — | $64 – $64 |
| 8 | UnitedHealthcare ppo fee schedule · outpatient | $64 | $64 | — | — | — | $64 – $64 |
| 9 | Humana medicare advantage case rate · outpatient | $67 | $67 | — | — | — | $67 – $67 |
| 10 | Humana medicare advantage ppo case rate · outpatient | $67 | $67 | — | — | — | $67 – $67 |
| 11 | Molina medicare advantage case rate · outpatient | $67 | $67 | — | — | — | $67 – $67 |
| 12 | WellCare medicare advantage hmo case rate · outpatient | $67 | $67 | — | — | — | $67 – $67 |
| 13 | WellCare medicare advantage mmp case rate · outpatient | $71 | $71 | — | — | — | $71 – $71 |
| 14 | UnitedHealthcare medicare advantage ppo case rate · outpatient | $71 | $71 | — | — | — | $71 – $71 |
| 15 | UnitedHealthcare medicare advantage hmo case rate · outpatient | $73 | $73 | — | — | — | $73 – $73 |
| 16 | Blue Cross Blue Shield exchange fee schedule · outpatient | $89 | $89 | — | — | — | $89 – $89 |
| 17 | Aetna whole health fee schedule · outpatient | $123 | $123 | — | — | — | $123 – $123 |
| 18 | Blue Cross Blue Shield hmo fee schedule · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 19 | Blue Cross Blue Shield ppo fee schedule · outpatient | $141 | $141 | — | — | — | $141 – $141 |
| 20 | Aetna commercial fee schedule · outpatient | $164 | $164 | — | — | — | $164 – $164 |
| 21 | Blue Cross Blue Shield traditional fee schedule · outpatient | $376 | $376 | — | — | — | $376 – $376 |
| 22 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $601 | $601 | — | — | — | $601 – $601 |
| 23 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $755 | $755 | — | — | — | $755 – $755 |
| 24 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $757 | $757 | — | — | — | $757 – $757 |
| 25 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $762 | $762 | — | — | — | $762 – $762 |
Last updated: Apr 21, 2026
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