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-PFAP 3016457
Northridge, CA
See all hospitals reporting CPT 87633 →Price type
Dignity Community Care’s median price of $417 is 12% below the median hospital's median price ($472), higher than 13% of the 2,323 hospitals reporting CPT 87633. 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, 31 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 | $81 | $81 | $4 | 5% | — | $77 – $86 |
| 2 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $99 | $99 | $5 | 5% | — | $94 – $104 |
| 3 | Kaiser medicaid|< 21 fee schedule · outpatient | $370 | $370 | — | — | — | $370 – $370 |
| 4 | Kaiser medicaid|> 21 fee schedule · outpatient | $370 | $370 | — | — | — | $370 – $370 |
| 5 | Blue Cross Blue Shield medicare|blueshield promise fee schedule · outpatient | $378 | $378 | $20 | 5% | — | $358 – $398 |
| 6 | Aetna medicare|all plans fee schedule · outpatient | $417 | $417 | — | — | — | $417 – $417 |
| 7 | Anthem medicare|all plans fee schedule · outpatient | $417 | $417 | — | — | — | $417 – $417 |
| 8 | Blue Cross Blue Shield medicare|all other plans fee schedule · outpatient | $417 | $417 | — | — | — | $417 – $417 |
| 9 | First Health commercial|all plans fee schedule · outpatient | $417 | $417 | — | — | — | $417 – $417 |
| 10 | Humana commercial|all plans fee schedule · outpatient | $417 | $417 | — | — | — | $417 – $417 |
| 11 | Humana medicare|all plans fee schedule · outpatient | $417 | $417 | — | — | — | $417 – $417 |
| 12 | Kaiser medicare|all plans fee schedule · outpatient | $417 | $417 | — | — | — | $417 – $417 |
| 13 | Molina medicare|all plans fee schedule · outpatient | $417 | $417 | — | — | — | $417 – $417 |
| 14 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $417 | $417 | — | — | — | $417 – $417 |
| 15 | Anthem commercial|vivity fee schedule · outpatient | $459 | $459 | $24 | 5% | — | $435 – $483 |
| 16 | MultiPlan commercial|all plans fee schedule · inpatient | $465 | $465 | $25 | 5% | — | $440 – $490 |
| 17 | MultiPlan commercial|all plans fee schedule · outpatient | $465 | $465 | $25 | 5% | — | $440 – $490 |
| 18 | Anthem medicaid|< 21 fee schedule · outpatient | $493 | $493 | — | — | 2–20 | $493 – $493 |
| 19 | Anthem medicaid|> 21 fee schedule · outpatient | $493 | $493 | — | — | — | $493 – $493 |
| 20 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $500 | $500 | — | — | — | $500 – $500 |
| 21 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $500 | $500 | — | — | — | $500 – $500 |
| 22 | Molina medicaid|< 21 fee schedule · outpatient | $519 | $519 | — | — | 2–20 | $519 – $519 |
| 23 | Molina medicaid|> 21 fee schedule · outpatient | $519 | $519 | — | — | — | $519 – $519 |
| 24 | Anthem commercial|all other plans fee schedule · outpatient | $535 | $535 | $29 | 5% | 2–20 | $506 – $563 |
| 25 | Aetna commercial|all other plans fee schedule · outpatient | $581 | $581 | $31 | 5% | 2–20 | $550 – $612 |
Last updated: Feb 28, 2026
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