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
ONC OVAR 5 PRTN SER ALG SCOR
Southfield, MI
See all hospitals reporting CPT 0003U →Price type
Henry Ford Health’s median price of $950 is 3% below the median hospital's median price ($979), higher than 10% of the 1,251 hospitals reporting CPT 0003U. 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, 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 | Medicaid 1263_sjpk,sjpr mi medicaid outpatient 20250101 other · outpatient | $551.00 | $551.00 | $551.00 – $551.00 |
| 2 | Molina 1264_sjpk,sjpr medicaid replacement molina health outpatient 20250101 other · outpatient | $551.00 | $551.00 | $551.00 – $551.00 |
| 3 | UnitedHealthcare 1247_sjpk,sjpr medicaid replacement great lakes health plan outpatient 20250101 other · outpatient | $551.00 | $551.00 | $551.00 – $551.00 |
| 4 | Blue Cross Blue Shield 1135_sjpr blue cross blue shield of michigan traditional 20220401 other · outpatient | $925.61 | $925.61 | $925.61 – $925.61 |
| 5 | Blue Cross Blue Shield 1137_sjpr blue cross blue shield ppo 20220401 fee schedule · outpatient | $925.61 | $925.61 | $925.61 – $925.61 |
| 6 | Aetna 1171_sjpk,sjpr medicare advantage aetna inpatient 20241001 other · inpatient | $950.00 | $950.00 | $950.00 – $950.00 |
| 7 | Aetna 1255_sjpk,sjpr medicare advantage aetna outpatient 20250101 other · outpatient | $950.00 | $950.00 | $950.00 – $950.00 |
| 8 | Humana 1177_sjpk,sjpr medicare advantage humana inpatient 20241001 other · inpatient | $959.50 | $959.50 | $959.50 – $959.50 |
| 9 | Humana 1252_sjpk,sjpr medicare advantage humana outpatient 20250101 other · outpatient | $959.50 | $959.50 | $959.50 – $959.50 |
| 10 | Molina 1192_sjpk,sjpr medicare advantage molina inpatient 20241001 other · inpatient | $997.50 | $997.50 | $997.50 – $997.50 |
| 11 | Molina 1249_sjpk,sjpr medicare advantage molina outpatient 20250101 other · outpatient | $997.50 | $997.50 | $997.50 – $997.50 |
| 12 | WellCare 1189_sjpk,sjpr medicare advantage meridian wellcare inpatient 20241001 other · inpatient | $997.50 | $997.50 | $997.50 – $997.50 |
| 13 | WellCare 1250_sjpk,sjpr medicare advantage meridian wellcare outpatient 20250101 other · outpatient | $997.50 | $997.50 | $997.50 – $997.50 |
| 14 | Ambetter 1221_sjpk,sjpr meridian ambetter inpatient 20241001 other · inpatient | $1,188 | $1,188 | $1,188 – $1,188 |
| 15 | Ambetter 1258_sjpk,sjpr meridian ambetter outpatient 20250101 other · outpatient | $1,188 | $1,188 | $1,188 – $1,188 |
| 16 | Molina 1223_sjpk,sjpr molina marketplace inpatient 20241001 other · inpatient | $1,188 | $1,188 | $1,188 – $1,188 |
| 17 | Molina 1259_sjpk,sjpr molina marketplace outpatient 20250101 other · outpatient | $1,188 | $1,188 | $1,188 – $1,188 |
Last updated: Jan 1, 2026
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