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-C DIFF TOX B TCDB PC
Folsom, CA
See all hospitals reporting CPT 87493 →Price type
Dignity Health’s median price of $33 is 47% below the median hospital's median price ($61), higher than 2% of the 2,621 hospitals reporting CPT 87493. 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, 36 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 | $29 | $29 | — | — | — | $29 – $29 |
| 2 | UnitedHealthcare medicaid|> 21 fee schedule · outpatient | $29 | $29 | — | — | — | $29 – $29 |
| 3 | Anthem medicare|all other plans fee schedule · outpatient | $33 | $33 | $2 | 7% | — | $31 – $35 |
| 4 | Aetna medicare|all plans fee schedule · outpatient | $35 | $35 | $2 | 7% | — | $33 – $37 |
| 5 | Blue Cross Blue Shield medicare|hmo fee schedule · outpatient | $35 | $35 | $2 | 7% | — | $33 – $37 |
| 6 | Blue Cross Blue Shield medicare|ppo fee schedule · outpatient | $35 | $35 | $2 | 7% | — | $33 – $37 |
| 7 | Humana commercial|all plans fee schedule · outpatient | $35 | $35 | $2 | 7% | — | $33 – $37 |
| 8 | Kaiser medicare|all plans fee schedule · outpatient | $35 | $35 | $2 | 7% | 2–20 | $33 – $37 |
| 9 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $35 | $35 | $2 | 7% | — | $33 – $37 |
| 10 | Anthem medicare|imperial fee schedule · outpatient | $36 | $36 | $2 | 7% | — | $34 – $38 |
| 11 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $39 | $39 | $6 | 16% | 2–20 | $33 – $45 |
| 12 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $39 | $39 | $6 | 16% | 2–20 | $33 – $45 |
| 13 | UnitedHealthcare commercial|non-options ppo fee schedule · outpatient | $39 | $39 | $6 | 16% | — | $33 – $45 |
| 14 | Molina medicaid|all plans fee schedule · outpatient | $43 | $43 | $11 | 25% | — | $33 – $54 |
| 15 | Anthem medicaid|all plans fee schedule · outpatient | $44 | $44 | $11 | 25% | — | $33 – $54 |
| 16 | Cigna commercial|localplus fee schedule · outpatient | $83 | $83 | — | — | — | $83 – $83 |
| 17 | Kaiser medicaid|all plans fee schedule · outpatient | $90 | $90 | $76 | 85% | — | $13 – $166 |
| 18 | Cigna commercial|all other plans fee schedule · outpatient | $110 | $110 | — | — | — | $110 – $110 |
| 19 | Blue Cross Blue Shield commercial|aco trio fee schedule · outpatient | $120 | $120 | $102 | 85% | — | $18 – $222 |
| 20 | Aetna commercial|all other plans fee schedule · outpatient | $137 | $137 | $104 | 76% | 2–20 | $33 – $241 |
| 21 | Aetna commercial|hmo fee schedule · outpatient | $137 | $137 | $104 | 76% | 2–20 | $33 – $241 |
| 22 | Aetna commercial|ppo fee schedule · outpatient | $137 | $137 | $104 | 76% | 2–20 | $33 – $241 |
| 23 | Blue Cross Blue Shield commercial|aco trio calpers fee schedule · outpatient | $155 | $155 | $132 | 85% | — | $23 – $287 |
| 24 | Blue Cross Blue Shield commercial|exchange fee schedule · outpatient | $157 | $157 | $134 | 85% | — | $23 – $291 |
| 25 | First Health commercial|all plans fee schedule · inpatient | $164 | $164 | $139 | 85% | — | $24 – $303 |
Last updated: Feb 28, 2026
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