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
INSJ/RPLC CAR MODULJ PLS GN
Tacoma, WA
See all hospitals reporting CPT 0409T →Price type
Mary Bridge Children's Hospital’s median price of $35.4k is 57% above the median hospital's median price ($22.5k), higher than 85% of the 1,319 hospitals reporting CPT 0409T. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 12 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 medadvantage fee schedule · outpatient | $26,204 | $26,204 | $26,204 – $26,204 |
| 2 | Regence medadvantage fee schedule · outpatient | $26,204 | $26,204 | $26,204 – $26,204 |
| 3 | UnitedHealthcare medadvantage hmo fee schedule · outpatient | $26,458 | $26,458 | $26,458 – $26,458 |
| 4 | Molina medadvantage fee schedule · outpatient | $26,712 | $26,712 | $26,712 – $26,712 |
| 5 | WellCare medadvantage fee schedule · outpatient | $26,712 | $26,712 | $26,712 – $26,712 |
| 6 | Premera hmo fee schedule · outpatient | $42,747 | $42,747 | $42,747 – $42,747 |
| 7 | Premera signature fee schedule · outpatient | $86,124 | $86,124 | $86,124 – $86,124 |
| 8 | Premera prime fee schedule · outpatient | $88,062 | $88,062 | $88,062 – $88,062 |
| 9 | Premera other commercial plans fee schedule · outpatient | $108,230 | $108,230 | $108,230 – $108,230 |
| 10 | Regence realvalue fee schedule · outpatient | $123,177 | $123,177 | $123,177 – $123,177 |
| 11 | Aetna all commercial plans fee schedule · outpatient | $153,553 | $153,553 | $153,553 – $153,553 |
| 12 | Kaiser hmo/ppo fee schedule · outpatient | $179,466 | $179,466 | $179,466 – $179,466 |
Last updated: Aug 27, 2026
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