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
N.MENINGITIDIS B,LIPID FHBP RC 120 MCG/0.5 ML INTRAMUSC SYRG [127525]
Arlington, TX
See all hospitals reporting CPT 90621 →Price type
AMH Cath Labs LLC’s median price of $377 is 39% above the median hospital's median price ($272), higher than 66% of the 1,393 hospitals reporting CPT 90621. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 25 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 | $61 | $61 | — | — | — | $61 – $61 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $61 | $61 | — | — | — | $61 – $61 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $64 | $64 | — | — | — | $64 – $64 |
| 4 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $66 | $66 | — | — | — | $66 – $66 |
| 5 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $67 | $67 | — | — | — | $67 – $67 |
| 6 | Aetna whole health percent of total billed charges · inpatientfrom % of charges | $236 | $236 | — | — | — | $236 – $236 |
| 7 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $280 | $280 | — | — | — | $280 – $280 |
| 8 | Aetna commercial percent of total billed charges · inpatientfrom % of charges | $315 | $315 | — | — | — | $315 – $315 |
| 9 | Blue Cross Blue Shield hmo fee schedule · outpatient | $334 | $334 | — | — | — | $334 – $334 |
| 10 | Blue Cross Blue Shield exchange fee schedule · outpatient | $343 | $343 | — | — | — | $343 – $343 |
| 11 | UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges | $353 | $353 | — | — | — | $353 – $353 |
| 12 | Blue Cross Blue Shield ppo fee schedule · outpatient | $372 | $372 | — | — | — | $372 – $372 |
| 13 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $374 | $374 | — | — | — | $374 – $374 |
| 14 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $374 | $374 | — | — | — | $374 – $374 |
| 15 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $377 | $377 | — | — | — | $377 – $377 |
| 16 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $474 | $474 | — | — | — | $474 – $474 |
| 17 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $476 | $476 | — | — | — | $476 – $476 |
| 18 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $478 | $478 | — | — | — | $478 – $478 |
| 19 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $478 | $478 | — | — | — | $478 – $478 |
| 20 | Phcs ppo percent of total billed charges · inpatientfrom % of charges | $508 | $508 | — | — | — | $508 – $508 |
| 21 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $594 | $594 | — | — | — | $594 – $594 |
| 22 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $594 | $594 | — | — | — | $594 – $594 |
| 23 | Cigna indemnity percent of total billed charges · inpatientfrom % of charges | $642 | $642 | — | — | — | $642 – $642 |
| 24 | Cigna indemnity percent of total billed charges · outpatientfrom % of charges | $642 | $642 | — | — | — | $642 – $642 |
| 25 | Blue Cross Blue Shield traditional fee schedule · outpatient | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
Last updated: Apr 21, 2026
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