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
STENT LACRIMAL MINI-MONOKA SIL
Arlington, TX
See all hospitals reporting HCPCS A4263 →Price type
AMH Cath Labs LLC’s median price of $237 is 147% above the median hospital's median price ($96), higher than 77% of the 529 hospitals reporting HCPCS A4263. 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, 23 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 | $36 | $34 | $2 | 6% | — | $32 – $36 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $36 | $34 | $2 | 6% | — | $32 – $36 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $38 | $36 | $2 | 6% | — | $33 – $38 |
| 4 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $39 | $37 | $2 | 6% | — | $34 – $39 |
| 5 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $39 | $38 | $2 | 6% | — | $35 – $39 |
| 6 | Blue Cross Blue Shield exchange percent of total billed charges · outpatientfrom % of charges | $125 | $120 | $7 | 6% | — | $110 – $125 |
| 7 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $165 | $159 | $9 | 6% | — | $146 – $165 |
| 8 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $201 | $193 | $11 | 6% | — | $178 – $201 |
| 9 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $220 | $212 | $12 | 6% | — | $195 – $220 |
| 10 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $222 | $214 | $12 | 6% | — | $196 – $222 |
| 11 | Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges | $223 | $215 | $12 | 6% | — | $198 – $223 |
| 12 | Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges | $223 | $215 | $12 | 6% | — | $198 – $223 |
| 13 | UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges | $253 | $243 | $14 | 6% | — | $224 – $253 |
| 14 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $268 | $258 | $15 | 6% | — | $237 – $268 |
| 15 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $279 | $268 | $15 | 6% | — | $247 – $279 |
| 16 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $280 | $269 | $15 | 6% | — | $248 – $280 |
| 17 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $282 | $271 | $15 | 6% | — | $249 – $282 |
| 18 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $282 | $271 | $15 | 6% | — | $249 – $282 |
| 19 | Phcs ppo percent of total billed charges · inpatientfrom % of charges | $299 | $288 | $16 | 6% | — | $265 – $299 |
| 20 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $350 | $336 | $19 | 6% | — | $309 – $350 |
| 21 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $350 | $336 | $19 | 6% | — | $309 – $350 |
| 22 | Cigna indemnity percent of total billed charges · inpatientfrom % of charges | $378 | $364 | $21 | 6% | — | $334 – $378 |
| 23 | Cigna indemnity percent of total billed charges · outpatientfrom % of charges | $378 | $364 | $21 | 6% | — | $334 – $378 |
Last updated: Apr 21, 2026
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