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
CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ
Vero Beach, FL
See all hospitals reporting CPT 28510 →Price type
Indian River Memorial Hospital Inc’s median price of $304 is about the same as the median hospital's median price ($305), higher than 49% of the 1,935 hospitals reporting CPT 28510. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 12 payers, 60 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 | Optum managed medicaid professional · fee schedule · outpatient | $57.86 | $57.86 | $57.86 – $57.86 |
| 2 | Medicaid managed medicaid professional · fee schedule · outpatient | $97.02 | $97.02 | $97.02 – $97.02 |
| 3 | Molina managed medicaid professional · fee schedule · outpatient | $97.02 | $97.02 | $97.02 – $97.02 |
| 4 | WellCare managed medicaid professional · fee schedule · outpatient | $97.02 | $97.02 | $97.02 – $97.02 |
| 5 | Blue Cross Blue Shield health options professional · fee schedule · outpatient | $108.21 | $108.21 | $108.21 – $108.21 |
| 6 | Blue Cross Blue Shield network blue professional · fee schedule · outpatient | $110.87 | $110.87 | $110.87 – $110.87 |
| 7 | Blue Cross Blue Shield perferred patient care professional · fee schedule · outpatient | $113.53 | $113.53 | $113.53 – $113.53 |
| 8 | Blue Cross Blue Shield traditional (pps) professional · fee schedule · outpatient | $113.53 | $113.53 | $113.53 – $113.53 |
| 9 | UnitedHealthcare medicare advantage professional · fee schedule · outpatient | $126.49 | $126.49 | $126.49 – $126.49 |
| 10 | Blue Cross Blue Shield medicare advantage hmo professional · fee schedule · outpatient | $130.68 | $130.68 | $130.68 – $130.68 |
| 11 | Blue Cross Blue Shield medicare advantage ppo professional · fee schedule · outpatient | $130.68 | $130.68 | $130.68 – $130.68 |
| 12 | Magellan medicare advantage professional · fee schedule · outpatient | $130.68 | $130.68 | $130.68 – $130.68 |
| 13 | WellCare medicare advantage professional · fee schedule · outpatient | $130.68 | $130.68 | $130.68 – $130.68 |
| 14 | Aetna medicare advantage behavioral health professional · fee schedule · outpatient | $156.82 | $156.82 | $156.82 – $156.82 |
| 15 | Aetna medicare advantage pcp professional · fee schedule · outpatient | $162.04 | $162.04 | $162.04 – $162.04 |
| 16 | Aetna medicare advantage specialist professional · fee schedule · outpatient | $164.66 | $164.66 | $164.66 – $164.66 |
| 17 | Cigna individual family plan mid-level professional · fee schedule · outpatient | $176.66 | $176.66 | $176.66 – $176.66 |
| 18 | Cigna surefit mid-level professional · fee schedule · outpatient | $180.05 | $180.05 | $180.05 – $180.05 |
| 19 | Aetna pos first health professional · fee schedule · outpatient | $182.91 | $182.91 | $182.91 – $182.91 |
| 20 | Aetna ppo first health professional · fee schedule · outpatient | $187.08 | $187.08 | $187.08 – $187.08 |
| 21 | Cigna all products mid-level professional · fee schedule · outpatient | $194.43 | $194.43 | $194.43 – $194.43 |
| 22 | Cigna individual family plan physician professional · fee schedule · outpatient | $207.85 | $207.85 | $207.85 – $207.85 |
| 23 | Cigna surefit physician professional · fee schedule · outpatient | $211.82 | $211.82 | $211.82 – $211.82 |
| 24 | Cigna all products physician professional · fee schedule · outpatient | $228.76 | $228.76 | $228.76 – $228.76 |
| 25 | Blue Cross Blue Shield medicare advantage hmo facility · fee schedule · outpatient | $240.79 | $240.79 | $240.79 – $240.79 |
Last updated: Jun 15, 2026
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