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
PELV,SEL/SUPRASEL, RS&I
Teaneck, NJ
See all hospitals reporting CPT 75736 →Price type
Holy Name’s median price of $4.1k is 21% below the median hospital's median price ($5.2k), higher than 40% of the 2,049 hospitals reporting CPT 75736. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 21 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 | Aetna whole health facility · fee schedule · outpatient | $315 | $315 | — | — | — | $315 – $315 |
| 2 | UnitedHealthcare uhc facility · other · outpatient | $643 | $643 | — | — | — | $643 – $643 |
| 3 | UnitedHealthcare medicaid facility · percent of total billed charges · outpatientfrom % of charges | $873 | $873 | — | — | — | $873 – $873 |
| 4 | Aetna better health mcd/chip facility · percent of total billed charges · outpatientfrom % of charges | $917 | $917 | — | — | — | $917 – $917 |
| 5 | Aetna qualified health plans facility · percent of total billed charges · outpatientfrom % of charges | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 6 | Ambetter ambetter facility · percent of total billed charges · outpatientfrom % of charges | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 7 | Aetna hmo/pos facility · percent of total billed charges · outpatientfrom % of charges | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 8 | First Health first health facility · percent of total billed charges · outpatientfrom % of charges | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 9 | Aetna worker's comp facility · percent of total billed charges · outpatientfrom % of charges | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 10 | MultiPlan multiplan facility · percent of total billed charges · outpatientfrom % of charges | $3.6k | $3.6k | — | — | — | $3.6k – $3.6k |
| 11 | MultiPlan worker's comp facility · percent of total billed charges · outpatientfrom % of charges | $4.6k | $4.6k | — | — | — | $4.6k – $4.6k |
| 12 | MultiPlan auto accident medical facility · percent of total billed charges · outpatientfrom % of charges | $4.9k | $4.9k | — | — | — | $4.9k – $4.9k |
| 13 | Blue Cross Blue Shield indemnity facility · percent of total billed charges · outpatientfrom % of charges | $5.1k | $5.1k | — | — | — | $5.1k – $5.1k |
| 14 | Blue Cross Blue Shield managed facility · percent of total billed charges · outpatientfrom % of charges | $5.1k | $5.1k | — | — | — | $5.1k – $5.1k |
| 15 | Blue Cross Blue Shield ppo facility · percent of total billed charges · outpatientfrom % of charges | $5.1k | $5.1k | — | — | — | $5.1k – $5.1k |
| 16 | Cigna hmo/pos facility · fee schedule · outpatient | $5.5k | $5.5k | — | — | — | $5.5k – $5.5k |
| 17 | Aetna medicare prime facility · fee schedule · outpatient | $5.7k | $5.7k | — | — | — | $5.7k – $5.7k |
| 18 | Aetna golden medicare facility · fee schedule · outpatient | $6.4k | $6.4k | — | — | — | $6.4k – $6.4k |
| 19 | Clover clover facility · fee schedule · outpatient | $6.4k | $6.4k | — | — | — | $6.4k – $6.4k |
| 20 | UnitedHealthcare medicare facility · fee schedule · outpatient | $6.4k | $6.4k | — | — | — | $6.4k – $6.4k |
| 21 | WellCare medicare facility · fee schedule · outpatient | $6.4k | $6.4k | — | — | — | $6.4k – $6.4k |
Last updated: Nov 10, 2025
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