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
RL-A-C PEP 70103
Chandler, AZ
See all hospitals reporting CPT 84681 →Price type
Dignity Community Care’s median price of $21 is 36% below the median hospital's median price ($33), higher than 20% of the 2,639 hospitals reporting CPT 84681. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 25 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 | UnitedHealthcare commercial|dignityhealthemployee fee schedule · outpatient | $12 | $12 | — | — | — | $12 – $12 |
| 2 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $12 | $12 | — | — | — | $12 – $12 |
| 3 | UnitedHealthcare commercial|navigate fee schedule · outpatient | $12 | $12 | — | — | — | $12 – $12 |
| 4 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $12 | $12 | — | — | — | $12 – $12 |
| 5 | Aetna medicare|all plans fee schedule · outpatient | $21 | $21 | — | — | 1–10 | $21 – $21 |
| 6 | Blue Cross Blue Shield medicare|all plans fee schedule · outpatient | $21 | $21 | — | — | — | $21 – $21 |
| 7 | Cigna medicare|all plans fee schedule · outpatient | $21 | $21 | — | — | 1–10 | $21 – $21 |
| 8 | First Health medicare|all plans fee schedule · outpatient | $21 | $21 | — | — | 1–10 | $21 – $21 |
| 9 | Humana medicare|all plans fee schedule · outpatient | $21 | $21 | — | — | 1–10 | $21 – $21 |
| 10 | UnitedHealthcare medicaid|all plans fee schedule · outpatient | $21 | $21 | — | — | — | $21 – $21 |
| 11 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $21 | $21 | — | — | — | $21 – $21 |
| 12 | Cigna commercial|exchange fee schedule · outpatient | $43 | $43 | — | — | — | $43 – $43 |
| 13 | First Health commercial|all plans fee schedule · inpatient | $45 | $45 | — | — | — | $45 – $45 |
| 14 | First Health commercial|all plans fee schedule · outpatient | $45 | $45 | — | — | — | $45 – $45 |
| 15 | Cigna commercial|localplus surefit fee schedule · outpatient | $46 | $46 | — | — | — | $46 – $46 |
| 16 | Blue Cross Blue Shield commercial|maricopafocus fee schedule · outpatient | $53 | $53 | — | — | — | $53 – $53 |
| 17 | Blue Cross Blue Shield commercial|neighborhood fee schedule · outpatient | $53 | $53 | — | — | — | $53 – $53 |
| 18 | Cigna commercial|all other plans fee schedule · outpatient | $61 | $61 | — | — | 1–10 | $61 – $61 |
| 19 | MultiPlan commercial|all plans fee schedule · inpatient | $70 | $70 | — | — | — | $70 – $70 |
| 20 | MultiPlan commercial|all plans fee schedule · outpatient | $70 | $70 | — | — | — | $70 – $70 |
| 21 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $71 | $71 | — | — | 1–10 | $71 – $71 |
| 22 | Aetna commercial|all other plans fee schedule · outpatient | $83 | $83 | — | — | 1–10 | $83 – $83 |
| 23 | Aetna commercial|hmo fee schedule · outpatient | $83 | $83 | — | — | 1–10 | $83 – $83 |
| 24 | Aetna commercial|ppo fee schedule · outpatient | $83 | $83 | — | — | 1–10 | $83 – $83 |
| 25 | Blue Cross Blue Shield commercial|workers comp fee schedule · outpatient | $83 | $83 | — | — | — | $83 – $83 |
Last updated: Feb 28, 2026
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