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
1417M RL-A-HIVPHENOGT 92399C
Camarillo, CA
See all hospitals reporting CPT 87903 →Price type
Dignity Health’s median price of $89 is 83% below the median hospital's median price ($513), higher than 0% of the 1,751 hospitals reporting CPT 87903. 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, 27 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 commercial|dignityhealth fee schedule · inpatient | $28 | $28 | $4 | 13% | — | $24 – $31 |
| 2 | Anthem commercial|dignityhealth fee schedule · outpatient | $28 | $28 | $4 | 13% | — | $24 – $31 |
| 3 | Blue Cross Blue Shield commercial|epn fee schedule · outpatient | $46 | $46 | $6 | 13% | — | $40 – $52 |
| 4 | Anthem commercial|exchange fee schedule · outpatient | $57 | $57 | $7 | 13% | — | $50 – $65 |
| 5 | Blue Cross Blue Shield commercial|ffs fee schedule · outpatient | $63 | $63 | $8 | 13% | — | $55 – $72 |
| 6 | Kaiser commercial|all plans fee schedule · inpatient | $63 | $63 | $8 | 13% | — | $55 – $72 |
| 7 | Kaiser commercial|all plans fee schedule · outpatient | $63 | $63 | $8 | 13% | — | $55 – $72 |
| 8 | First Health commercial|all plans fee schedule · inpatient | $68 | $68 | $9 | 13% | — | $59 – $77 |
| 9 | First Health commercial|all plans fee schedule · outpatient | $68 | $68 | $9 | 13% | — | $59 – $77 |
| 10 | MultiPlan commercial|all plans fee schedule · inpatient | $82 | $82 | $11 | 13% | — | $71 – $92 |
| 11 | MultiPlan commercial|all plans fee schedule · outpatient | $82 | $82 | $11 | 13% | — | $71 – $92 |
| 12 | Anthem commercial|hmo fee schedule · outpatient | $96 | $96 | $13 | 13% | — | $83 – $108 |
| 13 | Anthem commercial|non-mcs fee schedule · outpatient | $96 | $96 | $13 | 13% | — | $83 – $108 |
| 14 | Aetna medicare|all plans fee schedule · outpatient | $102 | $102 | $13 | 13% | — | $89 – $115 |
| 15 | Anthem commercial|mcs fee schedule · outpatient | $102 | $102 | $13 | 13% | — | $89 – $115 |
| 16 | Anthem medicare|all plans fee schedule · outpatient | $102 | $102 | $13 | 13% | — | $89 – $115 |
| 17 | Blue Cross Blue Shield medicare|all plans fee schedule · outpatient | $102 | $102 | $13 | 13% | — | $89 – $115 |
| 18 | Humana medicare|all plans fee schedule · outpatient | $102 | $102 | $13 | 13% | — | $89 – $115 |
| 19 | Kaiser medicare|all plans fee schedule · outpatient | $102 | $102 | $13 | 13% | — | $89 – $115 |
| 20 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $102 | $102 | $13 | 13% | — | $89 – $115 |
| 21 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $102 | $102 | $13 | 13% | — | $89 – $115 |
| 22 | UnitedHealthcare commercial|navigate fee schedule · outpatient | $102 | $102 | $13 | 13% | — | $89 – $115 |
| 23 | UnitedHealthcare commercial|non-options ppo fee schedule · outpatient | $102 | $102 | $13 | 13% | — | $89 – $115 |
| 24 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $102 | $102 | $13 | 13% | — | $89 – $115 |
| 25 | Cigna commercial|all other plans fee schedule · outpatient | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
Last updated: Feb 28, 2026
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