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-CAFFEINE S 2011603
Glendale, CA
See all hospitals reporting CPT 80155 →Price type
Dignity Community Care’s median price of $32 is 21% below the median hospital's median price ($41), higher than 7% of the 1,909 hospitals reporting CPT 80155. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 30 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 commercial|exchange fee schedule · outpatient | $7 | $7 | — | — | — | $7 – $7 |
| 2 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 3 | Anthem medicaid|all plans fee schedule · outpatient | $19 | $19 | — | — | — | $19 – $19 |
| 4 | Kaiser commercial|all plans fee schedule · inpatient | $20 | $20 | — | — | — | $20 – $20 |
| 5 | Kaiser commercial|all plans fee schedule · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 6 | Blue Cross Blue Shield commercial|magellan fee schedule · inpatient | $21 | $21 | — | — | — | $21 – $21 |
| 7 | Blue Cross Blue Shield commercial|magellan fee schedule · outpatient | $21 | $21 | — | — | — | $21 – $21 |
| 8 | Molina medicaid|all plans fee schedule · outpatient | $22 | $22 | — | — | — | $22 – $22 |
| 9 | First Health commercial|all plans fee schedule · inpatient | $23 | $23 | — | — | — | $23 – $23 |
| 10 | First Health commercial|all plans fee schedule · outpatient | $23 | $23 | — | — | — | $23 – $23 |
| 11 | Kaiser medicaid|< 21 fee schedule · outpatient | $23 | $23 | — | — | — | $23 – $23 |
| 12 | Kaiser medicaid|> 21 fee schedule · outpatient | $23 | $23 | — | — | — | $23 – $23 |
| 13 | MultiPlan commercial|all plans fee schedule · inpatient | $28 | $28 | — | — | — | $28 – $28 |
| 14 | MultiPlan commercial|all plans fee schedule · outpatient | $28 | $28 | — | — | — | $28 – $28 |
| 15 | Anthem commercial|non-mcs fee schedule · outpatient | $29 | $29 | — | — | — | $29 – $29 |
| 16 | Aetna commercial|all other plans fee schedule · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 17 | Aetna commercial|hmo fee schedule · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 18 | Aetna commercial|ppo fee schedule · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 19 | Anthem commercial|mcs fee schedule · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 20 | Humana commercial|all plans fee schedule · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 21 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 22 | UnitedHealthcare commercial|navigate fee schedule · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 23 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 24 | UnitedHealthcare commercial|ppo fee schedule · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 25 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $35 | $35 | — | — | — | $35 – $35 |
Last updated: Feb 28, 2026
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