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-BS-AB ID PNLRARE LS120
Carmichael, CA
See all hospitals reporting CPT 86870 →Price type
Dignity Health’s median price of $120 is 62% below the median hospital's median price ($312), higher than 16% of the 2,626 hospitals reporting CPT 86870. 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, 39 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 | UnitedHealthcare medicaid|< 21 fee schedule · outpatient | $24 | $24 | — | — | — | $24 – $24 |
| 2 | UnitedHealthcare medicaid|> 21 fee schedule · outpatient | $24 | $24 | — | — | — | $24 – $24 |
| 3 | Molina medicaid|all plans fee schedule · outpatient | $31 | $31 | — | — | — | $31 – $31 |
| 4 | Anthem medicaid|all plans fee schedule · outpatient | $52 | $52 | — | — | 6–60 | $52 – $52 |
| 5 | Aetna commercial|all other plans fee schedule · outpatient | $83 | $83 | — | — | — | $83 – $83 |
| 6 | Aetna commercial|hmo fee schedule · outpatient | $83 | $83 | — | — | — | $83 – $83 |
| 7 | Aetna commercial|ppo fee schedule · outpatient | $83 | $83 | — | — | — | $83 – $83 |
| 8 | Cigna commercial|localplus fee schedule · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 9 | Blue Cross Blue Shield commercial|aco trio fee schedule · outpatient | $67 | $102 | $96 | 94% | — | $33 – $311 |
| 10 | Cigna commercial|all other plans fee schedule · outpatient | $129 | $129 | — | — | — | $129 – $129 |
| 11 | Blue Cross Blue Shield commercial|aco trio calpers fee schedule · outpatient | $86 | $132 | $124 | 94% | — | $42 – $401 |
| 12 | Kaiser medicaid|all plans fee schedule · outpatient | $88 | $135 | $127 | 94% | — | $43 – $411 |
| 13 | Blue Cross Blue Shield commercial|exchange fee schedule · outpatient | $91 | $138 | $130 | 94% | — | $44 – $421 |
| 14 | Kaiser commercial|all plans fee schedule · outpatient | $116 | $178 | $167 | 94% | — | $57 – $542 |
| 15 | Blue Cross Blue Shield commercial|ppo tandem fee schedule · outpatient | $119 | $181 | $170 | 94% | — | $58 – $552 |
| 16 | Blue Cross Blue Shield commercial|hmo fee schedule · outpatient | $127 | $194 | $183 | 94% | — | $62 – $592 |
| 17 | Anthem commercial|connection epo fee schedule · outpatient | $172 | $196 | $106 | 54% | — | $84 – $396 |
| 18 | Blue Cross Blue Shield commercial|calpers fee schedule · outpatient | $134 | $204 | $192 | 94% | — | $65 – $622 |
| 19 | Blue Cross Blue Shield commercial|ppo fee schedule · outpatient | $142 | $217 | $204 | 94% | — | $69 – $662 |
| 20 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $216 | $220 | $92 | 42% | 6–60 | $105 – $350 |
| 21 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $216 | $220 | $92 | 42% | — | $105 – $350 |
| 22 | UnitedHealthcare commercial|non-options ppo fee schedule · outpatient | $216 | $220 | $92 | 42% | — | $105 – $350 |
| 23 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $216 | $220 | $92 | 42% | — | $105 – $350 |
| 24 | Anthem medicare|all other plans fee schedule · outpatient | $203 | $227 | $119 | 52% | 6–60 | $99 – $446 |
| 25 | Aetna medicare|all plans fee schedule · outpatient | $216 | $241 | $126 | 52% | — | $105 – $473 |
Last updated: Feb 28, 2026
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