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-FECLACTO 61164
Gilbert, AZ
See all hospitals reporting CPT 83630 →Price type
Dignity Health’s median price of $24 is 20% below the median hospital's median price ($30), higher than 39% of the 2,265 hospitals reporting CPT 83630. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 26 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 commercial|dignityhealthemployee fee schedule · outpatient | $11 | $11 | — | — | — | $11 – $11 |
| 2 | Aetna medicare|all plans fee schedule · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 3 | Blue Cross Blue Shield medicare|all plans fee schedule · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 4 | Cigna medicare|all plans fee schedule · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 5 | First Health medicare|all plans fee schedule · outpatient | $20 | $20 | — | — | 1–10 | $20 – $20 |
| 6 | Humana medicare|all plans fee schedule · outpatient | $20 | $20 | — | — | 1–10 | $20 – $20 |
| 7 | UnitedHealthcare medicaid|all plans fee schedule · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 8 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 9 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $24 | $24 | — | — | — | $24 – $24 |
| 10 | UnitedHealthcare commercial|navigate fee schedule · outpatient | $24 | $24 | — | — | — | $24 – $24 |
| 11 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $24 | $24 | — | — | — | $24 – $24 |
| 12 | Cigna commercial|exchange fee schedule · outpatient | $41 | $41 | — | — | — | $41 – $41 |
| 13 | First Health commercial|all plans fee schedule · inpatient | $43 | $43 | — | — | — | $43 – $43 |
| 14 | First Health commercial|all plans fee schedule · outpatient | $43 | $43 | — | — | — | $43 – $43 |
| 15 | Cigna commercial|localplus surefit fee schedule · outpatient | $44 | $44 | — | — | — | $44 – $44 |
| 16 | Blue Cross Blue Shield commercial|maricopafocus fee schedule · outpatient | $50 | $50 | — | — | — | $50 – $50 |
| 17 | Blue Cross Blue Shield commercial|neighborhood fee schedule · outpatient | $50 | $50 | — | — | — | $50 – $50 |
| 18 | Cigna commercial|all other plans fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 19 | Cigna commercial|ppo fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 20 | MultiPlan commercial|all plans fee schedule · inpatient | $61 | $61 | — | — | — | $61 – $61 |
| 21 | MultiPlan commercial|all plans fee schedule · outpatient | $61 | $61 | — | — | — | $61 – $61 |
| 22 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $67 | $67 | — | — | — | $67 – $67 |
| 23 | Aetna commercial|all other plans fee schedule · outpatient | $79 | $79 | — | — | — | $79 – $79 |
| 24 | Aetna commercial|hmo fee schedule · outpatient | $79 | $79 | — | — | — | $79 – $79 |
| 25 | Aetna commercial|ppo fee schedule · outpatient | $79 | $79 | — | — | — | $79 – $79 |
Last updated: Feb 28, 2026
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