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 W/O IMG GDN EA ADDL
Manitowoc, WI
See all hospitals reporting CPT 10004 →Price type
Holy Family Memorial Inc’s median price of $48 is 90% below the median hospital's median price ($461), higher than 11% 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: 4 payers, 9 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 | Anthem medicare advantage fee schedule · outpatient | $48.01 | $48.01 | $48.01 – $48.01 |
| 2 | Humana medicare advantage fee schedule · outpatient | $48.01 | $48.01 | $48.01 – $48.01 |
| 3 | Molina medicare advantage fee schedule · outpatient | $48.01 | $48.01 | $48.01 – $48.01 |
| 4 | UnitedHealthcare medicare advantage fee schedule · outpatient | $48.01 | $48.01 | $48.01 – $48.01 |
| 5 | Molina marketplace plans fee schedule · outpatient | $51.85 | $51.85 | $51.85 – $51.85 |
| 6 | UnitedHealthcare manitowoc schools case rate · outpatient | $967.20 | $967.20 | $967.20 – $967.20 |
| 7 | UnitedHealthcare nexus case rate · outpatient | $994.00 | $994.00 | $994.00 – $994.00 |
| 8 | UnitedHealthcare apa case rate · outpatient | $1,209 | $1,209 | $1,209 – $1,209 |
| 9 | UnitedHealthcare ppo case rate · outpatient | $1,449 | $1,449 | $1,449 – $1,449 |
Last updated: Dec 31, 2025
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