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
2263E RL-A-BIO T MASS 81057
Phoenix, AZ
See all hospitals reporting CPT 84403 →Price type
Dignity Health’s median price of $28 is 27% below the median hospital's median price ($39), higher than 32% of the 2,692 hospitals reporting CPT 84403. 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 | $11 | $11 | — | — | — | $11 – $11 |
| 2 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $15 | $15 | — | — | 17 | $15 – $15 |
| 3 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 4 | Aetna medicare|all plans fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 5 | Blue Cross Blue Shield medicare|all plans fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 6 | Cigna medicare|all plans fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 7 | First Health medicare|all plans fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 8 | Humana medicare|all plans fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 9 | Optum medicare|optumcare fee schedule · outpatient | $26 | $26 | — | — | 5–50 | $26 – $26 |
| 10 | UnitedHealthcare medicare|all other plans fee schedule · outpatient | $26 | $26 | — | — | 5–50 | $26 – $26 |
| 11 | UnitedHealthcare medicare|dual complete fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 12 | UnitedHealthcare medicaid|all plans fee schedule · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 13 | Optum medicare|optumhealth fee schedule · outpatient | $28 | $28 | — | — | — | $28 – $28 |
| 14 | UnitedHealthcare commercial|dignityhealthemployee fee schedule · outpatient | $27 | $31 | $18 | 58% | — | $14 – $66 |
| 15 | Cigna commercial|exchange fee schedule · outpatient | $54 | $54 | — | — | 5–50 | $54 – $54 |
| 16 | Cigna commercial|localplus surefit fee schedule · outpatient | $57 | $57 | — | — | — | $57 – $57 |
| 17 | Cigna commercial|all other plans fee schedule · outpatient | $76 | $76 | — | — | 5–50 | $76 – $76 |
| 18 | Optum commercial|optumhealth fee schedule · outpatient | $67 | $77 | $45 | 58% | — | $36 – $163 |
| 19 | Aetna commercial|all plans fee schedule · outpatient | $81 | $80 | $2 | 3% | 5–50 | $76 – $81 |
| 20 | Blue Cross Blue Shield commercial|maricopafocus fee schedule · outpatient | $89 | $86 | $5 | 6% | — | $76 – $89 |
| 21 | Blue Cross Blue Shield commercial|neighborhood fee schedule · outpatient | $89 | $86 | $5 | 6% | — | $76 – $89 |
| 22 | Cigna commercial|lifesource fee schedule · outpatient | $78 | $90 | $52 | 58% | — | $42 – $190 |
| 23 | Blue Cross Blue Shield commercial|all other plans fee schedule · outpatient | $119 | $107 | $17 | 15% | 13 | $76 – $119 |
| 24 | First Health commercial|all plans fee schedule · inpatient | $99 | $114 | $67 | 58% | — | $53 – $242 |
| 25 | First Health commercial|all plans fee schedule · outpatient | $99 | $114 | $67 | 58% | — | $53 – $242 |
Last updated: Feb 28, 2026
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