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
INC&RMVL FB SUBQ TISS COMP
Waco, TX
See all hospitals reporting CPT 10121 →Price type
Ascension Providence’s median price of $486 is 73% below the median hospital's median price ($1.8k), higher than 12% of the 2,260 hospitals reporting CPT 10121. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 4 payers, 11 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 975_bcbs star outpatient 20241201 fee schedule · outpatient | $486.45 | $486.45 | $486.45 – $486.45 |
| 2 | Molina 908_molina chip outpatient 20241201 fee schedule · outpatient | $486.45 | $486.45 | $486.45 – $486.45 |
| 3 | Superior Healthplan 904_superior star outpatient 20241201 fee schedule · outpatient | $486.45 | $486.45 | $486.45 – $486.45 |
| 4 | Superior Healthplan 907_superior star plus outpatient 20241201 fee schedule · outpatient | $486.45 | $486.45 | $486.45 – $486.45 |
| 5 | UnitedHealthcare 906_uhc star plus outpatient 20241201 fee schedule · outpatient | $486.45 | $486.45 | $486.45 – $486.45 |
| 6 | UnitedHealthcare 909_uhc star kids outpatient 20241201 fee schedule · outpatient | $486.45 | $486.45 | $486.45 – $486.45 |
| 7 | UnitedHealthcare 928_uhc star outpatient 20250701 fee schedule · outpatient | $486.45 | $486.45 | $486.45 – $486.45 |
| 8 | Blue Cross Blue Shield 872_blue cross blue shield myblueheath 20250101 fee schedule · outpatient | $1,098 | $1,098 | $1,098 – $1,098 |
| 9 | Blue Cross Blue Shield 871_blue cross blue shield advantage hmo 20250101 fee schedule · outpatient | $1,373 | $1,373 | $1,373 – $1,373 |
| 10 | Blue Cross Blue Shield 870_blue cross blue shield hmo essentials 20250101 fee schedule · outpatient | $2,333 | $2,333 | $2,333 – $2,333 |
| 11 | Blue Cross Blue Shield 869_blue cross blue shield ppo 20250101 fee schedule · outpatient | $2,594 | $2,594 | $2,594 – $2,594 |
Last updated: Jan 1, 2026
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