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
S/O PROS NDL SAT BX 10-20
Gilbert, AZ
See all hospitals reporting HCPCS G0416 →Price type
Dignity Health’s median price of $411 is 2% above the median hospital's median price ($403), higher than 52% of the 1,835 hospitals reporting HCPCS G0416. 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, 25 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 | $215 | $215 | — | — | — | $215 – $215 |
| 2 | Aetna medicare|all plans fee schedule · outpatient | $383 | $383 | — | — | — | $383 – $383 |
| 3 | Blue Cross Blue Shield medicare|all plans fee schedule · outpatient | $383 | $383 | — | — | — | $383 – $383 |
| 4 | Cigna medicare|all plans fee schedule · outpatient | $383 | $383 | — | — | — | $383 – $383 |
| 5 | First Health medicare|all plans fee schedule · outpatient | $383 | $383 | — | — | — | $383 – $383 |
| 6 | Humana medicare|all plans fee schedule · outpatient | $383 | $383 | — | — | — | $383 – $383 |
| 7 | Cigna commercial|exchange fee schedule · outpatient | $392 | $392 | — | — | — | $392 – $392 |
| 8 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $393 | $393 | — | — | — | $393 – $393 |
| 9 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $411 | $411 | — | — | 1–10 | $411 – $411 |
| 10 | UnitedHealthcare commercial|navigate fee schedule · outpatient | $411 | $411 | — | — | — | $411 – $411 |
| 11 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $411 | $411 | — | — | — | $411 – $411 |
| 12 | Cigna commercial|localplus surefit fee schedule · outpatient | $419 | $419 | — | — | 1–10 | $419 – $419 |
| 13 | Cigna commercial|all other plans fee schedule · outpatient | $551 | $551 | — | — | — | $551 – $551 |
| 14 | Cigna commercial|ppo fee schedule · outpatient | $551 | $551 | — | — | — | $551 – $551 |
| 15 | First Health commercial|all plans fee schedule · inpatient | $828 | $828 | — | — | — | $828 – $828 |
| 16 | First Health commercial|all plans fee schedule · outpatient | $828 | $828 | — | — | — | $828 – $828 |
| 17 | MultiPlan commercial|all plans fee schedule · inpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 18 | MultiPlan commercial|all plans fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 19 | Aetna commercial|all other plans fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 20 | Aetna commercial|hmo fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 21 | Aetna commercial|ppo fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 22 | Blue Cross Blue Shield commercial|maricopafocus fee schedule · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 23 | Blue Cross Blue Shield commercial|neighborhood fee schedule · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 24 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 25 | Blue Cross Blue Shield commercial|workers comp fee schedule · outpatient | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
Last updated: Feb 28, 2026
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