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-IFE SPEP 3002568A
Glendale, CA
See all hospitals reporting CPT 84155 →Price type
Dignity Community Care’s median price of $5 is 26% below the median hospital's median price ($7), higher than 34% of the 2,637 hospitals reporting CPT 84155. 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 | Humana commercial|all plans fee schedule · outpatient | $4 | $4 | — | — | — | $4 – $4 |
| 2 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $4 | $4 | — | — | — | $4 – $4 |
| 3 | Anthem medicare|alhambra senior fee schedule · outpatient | $4 | $4 | — | — | — | $4 – $4 |
| 4 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $4 | $4 | — | — | — | $4 – $4 |
| 5 | UnitedHealthcare commercial|navigate fee schedule · outpatient | $4 | $4 | — | — | — | $4 – $4 |
| 6 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $4 | $4 | — | — | — | $4 – $4 |
| 7 | UnitedHealthcare commercial|ppo fee schedule · outpatient | $4 | $4 | — | — | — | $4 – $4 |
| 8 | Anthem commercial|alhambra fee schedule · outpatient | $5 | $5 | — | — | — | $5 – $5 |
| 9 | Anthem commercial|hcla fee schedule · outpatient | $5 | $5 | — | — | — | $5 – $5 |
| 10 | Anthem medicaid|all plans fee schedule · outpatient | $6 | $5 | $0 | 3% | — | $5 – $6 |
| 11 | Molina medicaid|all plans fee schedule · outpatient | $6 | $6 | $0 | 6% | — | $5 – $6 |
| 12 | Kaiser medicaid|< 21 fee schedule · outpatient | $6 | $6 | — | — | — | $6 – $6 |
| 13 | Kaiser medicaid|> 21 fee schedule · outpatient | $6 | $6 | — | — | — | $6 – $6 |
| 14 | Cigna commercial|all other plans fee schedule · outpatient | $8 | $8 | — | — | — | $8 – $8 |
| 15 | Cigna commercial|ppo fee schedule · outpatient | $8 | $8 | — | — | — | $8 – $8 |
| 16 | Aetna commercial|all other plans fee schedule · outpatient | $13 | $13 | $5 | 39% | — | $5 – $19 |
| 17 | Aetna commercial|hmo fee schedule · outpatient | $13 | $13 | $5 | 39% | — | $5 – $19 |
| 18 | Aetna commercial|ppo fee schedule · outpatient | $13 | $13 | $5 | 39% | — | $5 – $19 |
| 19 | Blue Cross Blue Shield commercial|exchange fee schedule · outpatient | $3 | $14 | $17 | 123% | — | $1 – $43 |
| 20 | Anthem commercial|non-mcs fee schedule · outpatient | $11 | $17 | $12 | 74% | 6–60 | $4 – $34 |
| 21 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $4 | $19 | $23 | 123% | — | $1 – $58 |
| 22 | Anthem commercial|mcs fee schedule · outpatient | $13 | $22 | $17 | 77% | — | $5 – $45 |
| 23 | Kaiser commercial|all plans fee schedule · inpatient | $7 | $39 | $48 | 123% | — | $3 – $120 |
| 24 | Kaiser commercial|all plans fee schedule · outpatient | $7 | $39 | $48 | 123% | — | $3 – $120 |
| 25 | Blue Cross Blue Shield commercial|magellan fee schedule · inpatient | $8 | $42 | $51 | 123% | — | $3 – $128 |
Last updated: Feb 28, 2026
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