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
PF I&R FB TISSUE SUBQ COMPLICATED
Ogallala, NE
See all hospitals reporting CPT 10121 →Price type
Banner Ogallala Community Hospital’s median price of $366 is 80% below the median hospital's median price ($1.8k), higher than 9% 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: 6 payers, 13 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 | Bcbs Wy medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $169.40 | $169.40 | $169.40 – $169.40 |
| 2 | Medica medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $169.40 | $169.40 | $169.40 – $169.40 |
| 3 | UnitedHealthcare uhc medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $177.10 | $177.10 | $177.10 – $177.10 |
| 4 | Molina medicaid/chip facility · percent of total billed charges · outpatientfrom % of charges | $188.65 | $188.65 | $188.65 – $188.65 |
| 5 | UnitedHealthcare commercial/individual exchange facility · percent of total billed charges · inpatientfrom % of charges | $365.75 | $365.75 | $365.75 – $365.75 |
| 6 | UnitedHealthcare commercial/individual exchange facility · percent of total billed charges · outpatientfrom % of charges | $365.75 | $365.75 | $365.75 – $365.75 |
| 7 | Medica commercial facility · percent of total billed charges · outpatientfrom % of charges | $366.90 | $366.90 | $366.90 – $366.90 |
| 8 | Bcbs Wy network blue facility · percent of total billed charges · inpatientfrom % of charges | $369.60 | $369.60 | $369.60 – $369.60 |
| 9 | Bcbs Wy network blue facility · percent of total billed charges · outpatientfrom % of charges | $369.60 | $369.60 | $369.60 – $369.60 |
| 10 | First Health medical rental facility · percent of total billed charges · inpatientfrom % of charges | $369.60 | $369.60 | $369.60 – $369.60 |
| 11 | First Health medical rental facility · percent of total billed charges · outpatientfrom % of charges | $369.60 | $369.60 | $369.60 – $369.60 |
| 12 | MultiPlan commercial facility · percent of total billed charges · inpatientfrom % of charges | $373.45 | $373.45 | $373.45 – $373.45 |
| 13 | MultiPlan commercial facility · percent of total billed charges · outpatientfrom % of charges | $373.45 | $373.45 | $373.45 – $373.45 |
Last updated: Feb 12, 2026
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