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-Q-MTHYLMLNC ACD SRM QT
Merced, CA
See all hospitals reporting CPT 83921 →Price type
Dignity Health’s median price of $15 is 54% below the median hospital's median price ($33), higher than 2% of the 2,621 hospitals reporting CPT 83921. 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, 34 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 | Kaiser medicaid|< 21 fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 2 | Kaiser medicaid|> 21 fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 3 | Molina medicaid|< 21 fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 4 | Molina medicaid|> 21 fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 5 | Anthem medicaid|< 21 fee schedule · outpatient | $17 | $16 | $1 | 5% | — | $15 – $17 |
| 6 | Anthem medicaid|> 21 fee schedule · outpatient | $17 | $16 | $1 | 5% | — | $15 – $17 |
| 7 | Aetna medicare|all plans fee schedule · outpatient | $21 | $19 | $3 | 15% | — | $15 – $21 |
| 8 | Anthem medicare|all plans fee schedule · outpatient | $21 | $19 | $3 | 15% | — | $15 – $21 |
| 9 | Blue Cross Blue Shield medicare|all plans fee schedule · outpatient | $21 | $19 | $3 | 15% | — | $15 – $21 |
| 10 | Humana medicare|all plans fee schedule · outpatient | $21 | $19 | $3 | 15% | — | $15 – $21 |
| 11 | Kaiser medicare|all plans fee schedule · outpatient | $21 | $19 | $3 | 15% | — | $15 – $21 |
| 12 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $21 | $19 | $3 | 15% | — | $15 – $21 |
| 13 | Blue Cross Blue Shield commercial|exchange fee schedule · outpatient | $9 | $21 | $20 | 97% | — | $4 – $49 |
| 14 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $25 | $22 | $5 | 22% | 3–30 | $15 – $25 |
| 15 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $25 | $22 | $5 | 22% | — | $15 – $25 |
| 16 | UnitedHealthcare commercial|non-options ppo fee schedule · outpatient | $25 | $22 | $5 | 22% | — | $15 – $25 |
| 17 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $25 | $22 | $5 | 22% | — | $15 – $25 |
| 18 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $12 | $28 | $27 | 97% | — | $6 – $66 |
| 19 | Cigna commercial|all other plans fee schedule · inpatient | $20 | $47 | $45 | 97% | — | $10 – $111 |
| 20 | Cigna commercial|all other plans fee schedule · outpatient | $20 | $47 | $45 | 97% | — | $10 – $111 |
| 21 | Cigna commercial|ppo fee schedule · inpatient | $20 | $47 | $45 | 97% | — | $10 – $111 |
| 22 | Cigna commercial|ppo fee schedule · outpatient | $20 | $47 | $45 | 97% | — | $10 – $111 |
| 23 | Aetna commercial|all other plans fee schedule · outpatient | $31 | $49 | $37 | 76% | — | $15 – $101 |
| 24 | Aetna commercial|hmo fee schedule · outpatient | $31 | $49 | $37 | 76% | — | $15 – $101 |
| 25 | Aetna commercial|ppo fee schedule · outpatient | $31 | $49 | $37 | 76% | — | $15 – $101 |
Last updated: Feb 28, 2026
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