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
HC TC-99M MDP TO 30 MCI
Boulder, CO
See all hospitals reporting HCPCS A9503 →Price type
Boulder Community Health’s median price of $187 is 107% above the median hospital's median price ($90), higher than 78% of the 2,017 hospitals reporting HCPCS A9503. 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, 24 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 | Aetna medicare advantage professional · fee schedule · both | $12 | $12 | — | — | — | $12 – $12 |
| 2 | UnitedHealthcare commercial professional · fee schedule · both | $13 | $13 | — | — | — | $13 – $13 |
| 3 | UnitedHealthcare medicare advantage professional · fee schedule · both | $13 | $13 | — | — | — | $13 – $13 |
| 4 | Cigna commercial facility · fee schedule · outpatient | $13 | $13 | — | — | — | $13 – $13 |
| 5 | Cigna commercial professional · fee schedule · both | $13 | $13 | — | — | — | $13 – $13 |
| 6 | Humana medicare advantage professional · fee schedule · both | $16 | $16 | — | — | — | $16 – $16 |
| 7 | Aetna commercial professional · fee schedule · both | $18 | $18 | $5 | 31% | — | $12 – $23 |
| 8 | Anthem commercial professional · fee schedule · both | $21 | $21 | — | — | — | $21 – $21 |
| 9 | Anthem managed care professional · fee schedule · both | $21 | $21 | — | — | — | $21 – $21 |
| 10 | Healthpartners managed medicaid facility · other · outpatient | $94 | $94 | — | — | 2–20 | $94 – $94 |
| 11 | UnitedHealthcare commercial facility · other · outpatient | $98 | $98 | — | — | 2–20 | $98 – $98 |
| 12 | Anthem commercial facility · percent of total billed charges · outpatientfrom % of charges | $130 | $133 | $70 | 52% | — | $54 – $312 |
| 13 | Anthem managed care facility · percent of total billed charges · outpatientfrom % of charges | $143 | $143 | $58 | 41% | — | $84 – $201 |
| 14 | Devoted medicare advantage facility · percent of total billed charges · inpatientfrom % of charges | $149 | $149 | $61 | 41% | — | $88 – $210 |
| 15 | Devoted medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $149 | $149 | $61 | 41% | — | $88 – $210 |
| 16 | Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges | $132 | $162 | $123 | 76% | 2–20 | $49 – $419 |
| 17 | Anthem commercial facility · percent of total billed charges · inpatientfrom % of charges | $214 | $214 | $88 | 41% | — | $127 – $302 |
| 18 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $241 | $241 | $98 | 41% | — | $142 – $339 |
| 19 | MultiPlan commercial facility · percent of total billed charges · inpatientfrom % of charges | $257 | $257 | $105 | 41% | — | $152 – $362 |
| 20 | Phcs commercial facility · percent of total billed charges · inpatientfrom % of charges | $257 | $257 | $105 | 41% | — | $152 – $362 |
| 21 | MultiPlan commercial facility · percent of total billed charges · outpatientfrom % of charges | $260 | $260 | $106 | 41% | — | $154 – $367 |
| 22 | Phcs commercial facility · percent of total billed charges · outpatientfrom % of charges | $260 | $260 | $106 | 41% | — | $154 – $367 |
| 23 | Cigna commercial facility · percent of total billed charges · inpatientfrom % of charges | $298 | $298 | $122 | 41% | — | $176 – $419 |
| 24 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $324 | $324 | $132 | 41% | — | $192 – $456 |
Last updated: Sep 16, 2026
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