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
810E RL-A-PSA FP 80206
Phoenix, AZ
See all hospitals reporting CPT 84153 →Price type
Dignity Health’s median price of $29 is 6% below the median hospital's median price ($31), higher than 47% of the 2,686 hospitals reporting CPT 84153. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 28 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|navigate fee schedule · outpatient | $8 | $8 | — | — | — | $8 – $8 |
| 2 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $11 | $11 | — | — | 26 | $11 – $11 |
| 3 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $11 | $11 | — | — | — | $11 – $11 |
| 4 | Aetna medicare|all plans fee schedule · outpatient | $18 | $18 | — | — | — | $18 – $18 |
| 5 | Blue Cross Blue Shield medicare|all plans fee schedule · outpatient | $18 | $18 | — | — | — | $18 – $18 |
| 6 | Cigna medicare|all plans fee schedule · outpatient | $18 | $18 | — | — | — | $18 – $18 |
| 7 | First Health medicare|all plans fee schedule · outpatient | $18 | $18 | — | — | — | $18 – $18 |
| 8 | Humana medicare|all plans fee schedule · outpatient | $18 | $18 | — | — | — | $18 – $18 |
| 9 | Optum medicare|optumcare fee schedule · outpatient | $18 | $18 | — | — | 12 | $18 – $18 |
| 10 | UnitedHealthcare medicare|all other plans fee schedule · outpatient | $18 | $18 | — | — | 20 | $18 – $18 |
| 11 | UnitedHealthcare medicare|dual complete fee schedule · outpatient | $18 | $18 | — | — | — | $18 – $18 |
| 12 | UnitedHealthcare medicaid|all plans fee schedule · outpatient | $19 | $19 | — | — | — | $19 – $19 |
| 13 | Optum medicare|optumhealth fee schedule · outpatient | $20 | $20 | — | — | 2–20 | $20 – $20 |
| 14 | UnitedHealthcare commercial|dignityhealthemployee fee schedule · outpatient | $36 | $36 | $17 | 46% | — | $19 – $53 |
| 15 | Cigna commercial|exchange fee schedule · outpatient | $38 | $38 | — | — | 2–20 | $38 – $38 |
| 16 | Cigna commercial|localplus surefit fee schedule · outpatient | $41 | $41 | — | — | 2–20 | $41 – $41 |
| 17 | Cigna commercial|all other plans fee schedule · outpatient | $54 | $54 | — | — | 21 | $54 – $54 |
| 18 | Aetna commercial|all plans fee schedule · outpatient | $58 | $58 | — | — | 12 | $58 – $58 |
| 19 | Blue Cross Blue Shield commercial|maricopafocus fee schedule · outpatient | $63 | $63 | — | — | 2–20 | $63 – $63 |
| 20 | Blue Cross Blue Shield commercial|neighborhood fee schedule · outpatient | $63 | $63 | — | — | 2–20 | $63 – $63 |
| 21 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $85 | $85 | — | — | 43 | $85 – $85 |
| 22 | Optum commercial|optumhealth fee schedule · outpatient | $89 | $89 | $41 | 46% | — | $48 – $131 |
| 23 | Cigna commercial|lifesource fee schedule · outpatient | $105 | $105 | $48 | 46% | — | $56 – $153 |
| 24 | Blue Cross Blue Shield commercial|workers comp fee schedule · outpatient | $113 | $113 | $11 | 10% | — | $102 – $125 |
| 25 | First Health commercial|all plans fee schedule · inpatient | $133 | $133 | $62 | 46% | — | $71 – $195 |
Last updated: Feb 28, 2026
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