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
XR SM INTSTN/SCT W CON
Los Angeles, CA
See all hospitals reporting CPT 74250 →Price type
Dignity Community Care’s median price of $249 is 5% below the median hospital's median price ($262), higher than 47% of the 2,525 hospitals reporting CPT 74250. 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, 28 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 | Anthem medicaid|all plans fee schedule · outpatient | $118 | $118 | — | — | — | $118 – $118 |
| 2 | Molina medicaid|< 21 fee schedule · outpatient | $190 | $190 | — | — | — | $190 – $190 |
| 3 | Molina medicaid|> 21 fee schedule · outpatient | $190 | $190 | — | — | — | $190 – $190 |
| 4 | Kaiser medicaid|< 21 fee schedule · outpatient | $204 | $204 | — | — | — | $204 – $204 |
| 5 | Kaiser medicaid|> 21 fee schedule · outpatient | $204 | $204 | — | — | — | $204 – $204 |
| 6 | Aetna medicare|all plans fee schedule · outpatient | $226 | $226 | — | — | — | $226 – $226 |
| 7 | Anthem medicare|all plans fee schedule · outpatient | $226 | $226 | — | — | — | $226 – $226 |
| 8 | Blue Cross Blue Shield medicare|all other plans case rate · outpatient | $226 | $226 | — | — | — | $226 – $226 |
| 9 | Molina medicare|all plans fee schedule · outpatient | $226 | $226 | — | — | — | $226 – $226 |
| 10 | UnitedHealthcare medicare|all plans case rate · outpatient | $226 | $226 | — | — | — | $226 – $226 |
| 11 | Anthem commercial|exchange fee schedule · outpatient | $297 | $297 | — | — | — | $297 – $297 |
| 12 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $402 | $402 | — | — | — | $402 – $402 |
| 13 | UnitedHealthcare commercial|ppo fee schedule · outpatient | $402 | $402 | — | — | — | $402 – $402 |
| 14 | Anthem commercial|all other plans fee schedule · outpatient | $450 | $450 | — | — | — | $450 – $450 |
| 15 | Aetna commercial|all other plans fee schedule · outpatient | $502 | $502 | — | — | — | $502 – $502 |
| 16 | Aetna commercial|hmo fee schedule · outpatient | $502 | $502 | — | — | — | $502 – $502 |
| 17 | Aetna commercial|ppo fee schedule · outpatient | $502 | $502 | — | — | — | $502 – $502 |
| 18 | Anthem commercial|mcs fee schedule · outpatient | $554 | $554 | — | — | — | $554 – $554 |
| 19 | Cigna commercial|all other plans fee schedule · outpatient | $647 | $647 | — | — | — | $647 – $647 |
| 20 | Cigna commercial|ppo fee schedule · outpatient | $647 | $647 | — | — | — | $647 – $647 |
| 21 | Blue Cross Blue Shield medicaid|all plans fee schedule · outpatient | $679 | $679 | — | — | — | $679 – $679 |
| 22 | First Health commercial|all plans fee schedule · inpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 23 | First Health commercial|all plans fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 24 | Kaiser commercial|all plans fee schedule · inpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 25 | Kaiser commercial|all plans fee schedule · outpatient | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
Last updated: Feb 28, 2026
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