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
FNA BX WO IMG EA ADD LES
Sacramento, CA
See all hospitals reporting CPT 10004 →Price type
Dignity Health’s median price of $580 is 26% above the median hospital's median price ($461), higher than 56% of the 1,449 hospitals reporting CPT 10004. 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, 17 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 medicaid|< 21 fee schedule · outpatient | $45.05 | $45.05 | $45.05 – $45.05 |
| 2 | UnitedHealthcare medicaid|> 21 fee schedule · outpatient | $45.05 | $45.05 | $45.05 – $45.05 |
| 3 | Molina medicaid|all plans fee schedule · outpatient | $84.69 | $84.69 | $84.69 – $84.69 |
| 4 | Anthem medicaid|all plans fee schedule · outpatient | $85.60 | $85.60 | $85.60 – $85.60 |
| 5 | Kaiser medicaid|all plans fee schedule · outpatient | $323.49 | $323.49 | $323.49 – $323.49 |
| 6 | First Health commercial|all plans fee schedule · inpatient | $591.75 | $591.75 | $591.75 – $591.75 |
| 7 | First Health commercial|all plans fee schedule · outpatient | $591.75 | $591.75 | $591.75 – $591.75 |
| 8 | Kaiser commercial|all plans fee schedule · outpatient | $623.31 | $623.31 | $623.31 – $623.31 |
| 9 | MultiPlan commercial|all plans fee schedule · inpatient | $631.20 | $631.20 | $631.20 – $631.20 |
| 10 | MultiPlan commercial|all plans fee schedule · outpatient | $631.20 | $631.20 | $631.20 – $631.20 |
| 11 | UnitedHealthcare commercial|non-options ppo fee schedule · outpatient | $789.00 | $789.00 | $789.00 – $789.00 |
| 12 | Anthem commercial|connection epo case rate · outpatient | $3,631 | $3,631 | $3,631 – $3,631 |
| 13 | Anthem commercial|all other plans case rate · outpatient | $4,539 | $4,539 | $4,539 – $4,539 |
| 14 | Aetna commercial|all other plans case rate · outpatient | $5,002 | $5,002 | $5,002 – $5,002 |
| 15 | Aetna commercial|hmo case rate · outpatient | $5,002 | $5,002 | $5,002 – $5,002 |
| 16 | Aetna commercial|ppo case rate · outpatient | $5,002 | $5,002 | $5,002 – $5,002 |
| 17 | Anthem commercial|mcs case rate · outpatient | $6,582 | $6,582 | $6,582 – $6,582 |
Last updated: Feb 28, 2026
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