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
O FREE T4
Puyallup, WA
See all hospitals reporting CPT 84439 →Price type
Good Samaritan Hospital’s median price of $10 is 43% below the median hospital's median price ($17), higher than 24% of the 2,631 hospitals reporting CPT 84439. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 11 payers, 24 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 | Molina apple health fee schedule · outpatient | $8.93 | $8.93 | $8.93 – $8.93 |
| 2 | Premera hmo fee schedule · outpatient | $9.02 | $9.02 | $9.02 – $9.02 |
| 3 | Premera prime fee schedule · outpatient | $9.02 | $9.02 | $9.02 – $9.02 |
| 4 | Premera signature fee schedule · outpatient | $9.02 | $9.02 | $9.02 – $9.02 |
| 5 | Regence blue high performance fee schedule · outpatient | $9.08 | $9.08 | $9.08 – $9.08 |
| 6 | Regence mcc/ahn fee schedule · outpatient | $9.08 | $9.08 | $9.08 – $9.08 |
| 7 | Aetna medadvantage fee schedule · outpatient | $9.10 | $9.10 | $9.10 – $9.10 |
| 8 | Regence medadvantage fee schedule · outpatient | $9.10 | $9.10 | $9.10 – $9.10 |
| 9 | UnitedHealthcare medadvantage fee schedule · outpatient | $9.19 | $9.19 | $9.19 – $9.19 |
| 10 | Molina medadvantage fee schedule · outpatient | $9.28 | $9.28 | $9.28 – $9.28 |
| 11 | WellCare medadvantage fee schedule · outpatient | $9.28 | $9.28 | $9.28 – $9.28 |
| 12 | Regence realvalue fee schedule · outpatient | $9.34 | $9.34 | $9.34 – $9.34 |
| 13 | UnitedHealthcare apple health fee schedule · outpatient | $9.65 | $9.65 | $9.65 – $9.65 |
| 14 | Kaiser ppo fee schedule · outpatient | $9.92 | $9.92 | $9.92 – $9.92 |
| 15 | Regence commercial fee schedule · outpatient | $10.37 | $10.37 | $10.37 – $10.37 |
| 16 | Cigna all commercial plans fee schedule · outpatient | $10.82 | $10.82 | $10.82 – $10.82 |
| 17 | UnitedHealthcare all commercial plans fee schedule · outpatient | $10.82 | $10.82 | $10.82 – $10.82 |
| 18 | Premera other commercial plans fee schedule · outpatient | $11.27 | $11.27 | $11.27 – $11.27 |
| 19 | Ambetter coordinated care exchange fee schedule · outpatient | $17.68 | $17.68 | $17.68 – $17.68 |
| 20 | First Health all commercial plans percent of total billed charges · outpatientfrom % of charges | $32.12 | $32.12 | $32.12 – $32.12 |
| 21 | MultiPlan all commercial plans percent of total billed charges · outpatientfrom % of charges | $32.12 | $32.12 | $32.12 – $32.12 |
| 22 | First Health all commercial plans percent of total billed charges · inpatientfrom % of charges | $40.15 | $40.15 | $40.15 – $40.15 |
| 23 | MultiPlan all commercial plans percent of total billed charges · inpatientfrom % of charges | $40.15 | $40.15 | $40.15 – $40.15 |
| 24 | Aetna all commercial plans fee schedule · outpatient | $41.85 | $41.85 | $41.85 – $41.85 |
Last updated: Aug 27, 2026
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