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-HCV NS5A 2014139
Carmichael, CA
See all hospitals reporting CPT 87902 →Price type
Dignity Health’s median price of $236 is 27% below the median hospital's median price ($322), higher than 10% of the 2,513 hospitals reporting CPT 87902. 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 | $95 | $95 | $22 | 23% | — | $73 – $116 |
| 2 | Blue Cross Blue Shield commercial|aco trio calpers fee schedule · outpatient | $122 | $122 | $28 | 23% | — | $94 – $150 |
| 3 | Kaiser medicaid|all plans fee schedule · outpatient | $125 | $125 | $28 | 23% | — | $97 – $154 |
| 4 | Blue Cross Blue Shield commercial|exchange fee schedule · outpatient | $128 | $128 | $29 | 23% | — | $99 – $158 |
| 5 | Kaiser commercial|all plans fee schedule · outpatient | $165 | $165 | $37 | 23% | — | $128 – $203 |
| 6 | Blue Cross Blue Shield commercial|ppo tandem fee schedule · outpatient | $168 | $168 | $38 | 23% | — | $130 – $206 |
| 7 | Blue Cross Blue Shield commercial|hmo fee schedule · outpatient | $180 | $180 | $41 | 23% | — | $139 – $221 |
| 8 | Blue Cross Blue Shield commercial|calpers fee schedule · outpatient | $189 | $189 | $43 | 23% | — | $146 – $233 |
| 9 | Blue Cross Blue Shield commercial|ppo fee schedule · outpatient | $202 | $202 | $46 | 23% | — | $156 – $248 |
| 10 | UnitedHealthcare medicaid|< 21 fee schedule · outpatient | $229 | $229 | — | — | — | $229 – $229 |
| 11 | UnitedHealthcare medicaid|> 21 fee schedule · outpatient | $229 | $229 | — | — | — | $229 – $229 |
| 12 | First Health commercial|all plans fee schedule · inpatient | $229 | $229 | $52 | 23% | — | $177 – $281 |
| 13 | First Health commercial|all plans fee schedule · outpatient | $229 | $229 | $52 | 23% | — | $177 – $281 |
| 14 | Anthem medicare|all other plans fee schedule · outpatient | $233 | $233 | $10 | 4% | — | $223 – $243 |
| 15 | Anthem commercial|connection epo fee schedule · outpatient | $244 | $244 | $56 | 23% | — | $189 – $300 |
| 16 | Aetna medicare|all plans fee schedule · outpatient | $247 | $247 | $11 | 4% | — | $236 – $257 |
| 17 | Blue Cross Blue Shield medicare|hmo fee schedule · outpatient | $247 | $247 | $11 | 4% | — | $236 – $257 |
| 18 | Blue Cross Blue Shield medicare|ppo fee schedule · outpatient | $247 | $247 | $11 | 4% | — | $236 – $257 |
| 19 | Humana commercial|all plans fee schedule · outpatient | $247 | $247 | $11 | 4% | — | $236 – $257 |
| 20 | Humana medicare|all plans fee schedule · outpatient | $247 | $247 | $11 | 4% | — | $236 – $257 |
| 21 | Kaiser medicare|all plans fee schedule · outpatient | $247 | $247 | $11 | 4% | — | $236 – $257 |
| 22 | Molina medicare|all plans fee schedule · outpatient | $247 | $247 | $11 | 4% | — | $236 – $257 |
| 23 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $247 | $247 | $11 | 4% | — | $236 – $257 |
| 24 | MultiPlan commercial|all plans fee schedule · inpatient | $254 | $254 | $58 | 23% | — | $196 – $311 |
| 25 | MultiPlan commercial|all plans fee schedule · outpatient | $254 | $254 | $58 | 23% | — | $196 – $311 |
Last updated: Feb 28, 2026
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