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
Fountain Valley, CA
See all hospitals reporting CPT 0409T →Price type
MemorialCare Orange Coast Medical Center’s median price of $31.5k is 40% above the median hospital's median price ($22.5k), higher than 81% 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: 5 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 hmo fee schedule · outpatient | $3,548 | $3,548 | $3,548 – $3,548 |
| 2 | Blue Cross Blue Shield epn/covered ca other commercial plan fee schedule · outpatient | $3,966 | $3,966 | $3,966 – $3,966 |
| 3 | Blue Cross Blue Shield trio other commercial plan fee schedule · outpatient | $4,192 | $4,192 | $4,192 – $4,192 |
| 4 | Cigna select hmo fee schedule · outpatient | $4,204 | $4,204 | $4,204 – $4,204 |
| 5 | Blue Cross Blue Shield tandem ppo other commercial plan fee schedule · outpatient | $4,420 | $4,420 | $4,420 – $4,420 |
| 6 | Cigna value hmo fee schedule · outpatient | $4,778 | $4,778 | $4,778 – $4,778 |
| 7 | Blue Cross Blue Shield hmo/pos fee schedule · outpatient | $4,796 | $4,796 | $4,796 – $4,796 |
| 8 | Blue Cross Blue Shield ppo/epo fee schedule · outpatient | $5,324 | $5,324 | $5,324 – $5,324 |
| 9 | Aetna gatekeeper hmo fee schedule · outpatient | $5,696 | $5,696 | $5,696 – $5,696 |
| 10 | Aetna non-gatekeeper ppo fee schedule · outpatient | $6,095 | $6,095 | $6,095 – $6,095 |
| 11 | Cigna all commercial plans fee schedule · outpatient | $6,370 | $6,370 | $6,370 – $6,370 |
| 12 | Blue Cross Blue Shield senior medicare managed care plan fee schedule · outpatient | $28,323 | $28,323 | $28,037 – $28,609 |
| 13 | Molina senior medicare managed care plan fee schedule · outpatient | $29,467 | $29,467 | $29,467 – $29,467 |
| 14 | Blue Cross Blue Shield anthem vivity city other commercial plan fee schedule · outpatient | $29,973 | $29,973 | $29,973 – $29,973 |
| 15 | Blue Cross Blue Shield anthem vivity non-city other commercial plan fee schedule · outpatient | $33,758 | $33,758 | $33,758 – $33,758 |
| 16 | Blue Cross Blue Shield anthem hmo exchange fee schedule · outpatient | $42,316 | $42,316 | $42,316 – $42,316 |
| 17 | UnitedHealthcare preferred hmo fee schedule · outpatient | $57,616 | $57,616 | $57,616 – $57,616 |
| 18 | Blue Cross Blue Shield anthem non-mcs other commercial plan fee schedule · outpatient | $65,102 | $65,102 | $65,102 – $65,102 |
| 19 | Blue Cross Blue Shield anthem mcs other commercial plan fee schedule · outpatient | $78,122 | $78,122 | $78,122 – $78,122 |
| 20 | UnitedHealthcare non-preferred hmo fee schedule · outpatient | $89,331 | $89,331 | $89,331 – $89,331 |
| 21 | UnitedHealthcare all payer other commercial plan fee schedule · outpatient | $89,843 | $89,843 | $89,843 – $89,843 |
Last updated: Apr 1, 2026
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