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-HIV1 NGS 3003853B
Carmichael, CA
See all hospitals reporting CPT 87901 →Price type
Dignity Health’s median price of $140 is 56% below the median hospital's median price ($322), higher than 3% of the 2,239 hospitals reporting CPT 87901. 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 | Blue Cross Blue Shield commercial|aco trio fee schedule · outpatient | $43 | $55 | $23 | 41% | — | $36 – $87 |
| 2 | Blue Cross Blue Shield commercial|aco trio calpers fee schedule · outpatient | $56 | $71 | $29 | 41% | — | $46 – $112 |
| 3 | Kaiser medicaid|all plans fee schedule · outpatient | $57 | $73 | $30 | 41% | — | $47 – $115 |
| 4 | Blue Cross Blue Shield commercial|exchange fee schedule · outpatient | $59 | $75 | $31 | 41% | — | $48 – $118 |
| 5 | Kaiser commercial|all plans fee schedule · outpatient | $76 | $96 | $39 | 41% | — | $62 – $151 |
| 6 | Blue Cross Blue Shield commercial|ppo tandem fee schedule · outpatient | $77 | $98 | $40 | 41% | — | $63 – $154 |
| 7 | Blue Cross Blue Shield commercial|hmo fee schedule · outpatient | $83 | $105 | $43 | 41% | — | $68 – $165 |
| 8 | Blue Cross Blue Shield commercial|calpers fee schedule · outpatient | $87 | $111 | $45 | 41% | — | $72 – $174 |
| 9 | Blue Cross Blue Shield commercial|ppo fee schedule · outpatient | $92 | $118 | $48 | 41% | — | $76 – $185 |
| 10 | First Health commercial|all plans fee schedule · inpatient | $105 | $134 | $54 | 41% | — | $87 – $210 |
| 11 | First Health commercial|all plans fee schedule · outpatient | $105 | $134 | $54 | 41% | — | $87 – $210 |
| 12 | Anthem commercial|connection epo fee schedule · outpatient | $112 | $143 | $58 | 41% | — | $92 – $224 |
| 13 | MultiPlan commercial|all plans fee schedule · inpatient | $116 | $148 | $60 | 41% | — | $96 – $233 |
| 14 | MultiPlan commercial|all plans fee schedule · outpatient | $116 | $148 | $60 | 41% | — | $96 – $233 |
| 15 | Anthem medicare|all other plans fee schedule · outpatient | $132 | $161 | $58 | 36% | — | $109 – $243 |
| 16 | UnitedHealthcare medicaid|< 21 fee schedule · outpatient | $140 | $161 | $49 | 30% | — | $115 – $229 |
| 17 | UnitedHealthcare medicaid|> 21 fee schedule · outpatient | $140 | $161 | $49 | 30% | — | $115 – $229 |
| 18 | Aetna medicare|all plans fee schedule · outpatient | $140 | $171 | $62 | 36% | — | $115 – $257 |
| 19 | Blue Cross Blue Shield medicare|hmo fee schedule · outpatient | $140 | $171 | $62 | 36% | — | $115 – $257 |
| 20 | Blue Cross Blue Shield medicare|ppo fee schedule · outpatient | $140 | $171 | $62 | 36% | — | $115 – $257 |
| 21 | Humana commercial|all plans fee schedule · outpatient | $140 | $171 | $62 | 36% | — | $115 – $257 |
| 22 | Humana medicare|all plans fee schedule · outpatient | $140 | $171 | $62 | 36% | — | $115 – $257 |
| 23 | Kaiser medicare|all plans fee schedule · outpatient | $140 | $171 | $62 | 36% | — | $115 – $257 |
| 24 | Molina medicare|all plans fee schedule · outpatient | $140 | $171 | $62 | 36% | — | $115 – $257 |
| 25 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $140 | $171 | $62 | 36% | — | $115 – $257 |
Last updated: Feb 28, 2026
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