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
Cltx Fx Grt Toe Phlx/Phlg W/O Manj
Eureka, IL
See all hospitals reporting CPT 28490 →Price type
Carle Eureka Hospital’s median price of $278 is 11% below the median hospital's median price ($313), higher than 41% of the 1,959 hospitals reporting CPT 28490. 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, 22 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 | Cigna ppo case rate · outpatient | $82 | $82 | — | — | — | $82 – $82 |
| 2 | Humana medicare-medicaid (d-snp) fee schedule · inpatient | $114 | $114 | — | — | — | $114 – $114 |
| 3 | Humana medicare-medicaid (d-snp) fee schedule · outpatient | $114 | $114 | — | — | — | $114 – $114 |
| 4 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · inpatient | $118 | $118 | — | — | — | $118 – $118 |
| 5 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 6 | Molina managed medicaid percent of total billed charges · inpatientfrom % of charges | $130 | $130 | $14 | 11% | — | $116 – $143 |
| 7 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $130 | $130 | $14 | 11% | — | $116 – $143 |
| 8 | Molina medicare-medicaid (d-snp) percent of total billed charges · inpatientfrom % of charges | $130 | $130 | $14 | 11% | — | $116 – $143 |
| 9 | Aetna commercial fee schedule · outpatient | $241 | $241 | — | — | — | $241 – $241 |
| 10 | WellCare medicare advantage hmo case rate · outpatient | $264 | $264 | — | — | — | $264 – $264 |
| 11 | Aetna medicare advantage percent of total billed charges · outpatientfrom % of charges | $292 | $292 | $31 | 11% | — | $261 – $323 |
| 12 | Humana medicare advantage percent of total billed charges · outpatientfrom % of charges | $292 | $292 | $31 | 11% | — | $261 – $323 |
| 13 | UnitedHealthcare medicare advantage percent of total billed charges · outpatientfrom % of charges | $292 | $292 | $31 | 11% | — | $261 – $323 |
| 14 | UnitedHealthcare va ccn/optum percent of total billed charges · outpatientfrom % of charges | $292 | $292 | $31 | 11% | — | $261 – $323 |
| 15 | Molina medicare-medicaid (d-snp) percent of total billed charges · outpatientfrom % of charges | $311 | $311 | $33 | 11% | — | $278 – $344 |
| 16 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $398 | $398 | $42 | 11% | — | $356 – $440 |
| 17 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $400 | $400 | $43 | 11% | — | $357 – $442 |
| 18 | Aetna ppo percent of total billed charges · inpatientfrom % of charges | $428 | $428 | $46 | 11% | — | $383 – $474 |
| 19 | Aetna ppo percent of total billed charges · outpatientfrom % of charges | $428 | $428 | $46 | 11% | — | $383 – $474 |
| 20 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $434 | $434 | $46 | 11% | — | $388 – $480 |
| 21 | MultiPlan ppo percent of total billed charges · outpatientfrom % of charges | $486 | $486 | $52 | 11% | — | $434 – $538 |
| 22 | Blue Cross Blue Shield blue choice/options/ppo percent of total billed charges · outpatientfrom % of charges | $544 | $544 | $58 | 11% | — | $486 – $602 |
Last updated: Apr 15, 2026
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