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
HB Fna Bx W/O Img Gdn Ea Addl
Sandwich, IL
See all hospitals reporting CPT 10004 →Price type
Northwestern Medicine Valley West Hospital’s median price of $499 is 8% above the median hospital's median price ($461), higher than 53% 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: 7 payers, 17 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 | Blue Cross Blue Shield vwh blue cross medicare advt percent of total billed charges · outpatientfrom % of charges | $145.54 | $145.54 | $145.54 – $145.54 |
| 2 | Humana vwh medicare percent of total billed charges · outpatientfrom % of charges | $145.54 | $145.54 | $145.54 – $145.54 |
| 3 | Aetna vwh aetna nm employees percent of total billed charges · outpatientfrom % of charges | $194.56 | $194.56 | $194.56 – $194.56 |
| 4 | Aetna vwh aetna il preferred percent of total billed charges · outpatientfrom % of charges | $266.57 | $266.57 | $266.57 – $266.57 |
| 5 | Cigna vwh cigna alternative percent of total billed charges · outpatientfrom % of charges | $347.00 | $347.00 | $347.00 – $347.00 |
| 6 | Cigna vwh cigna broad percent of total billed charges · outpatientfrom % of charges | $369.98 | $369.98 | $369.98 – $369.98 |
| 7 | UnitedHealthcare vwh uhc core percent of total billed charges · outpatientfrom % of charges | $384.53 | $384.53 | $384.53 – $384.53 |
| 8 | Blue Cross Blue Shield vwh bcbs par/indemnity adp percent of total billed charges · outpatientfrom % of charges | $428.19 | $428.19 | $428.19 – $428.19 |
| 9 | Blue Cross Blue Shield vwh bcbs hmo percent of total billed charges · outpatientfrom % of charges | $499.05 | $499.05 | $499.05 – $499.05 |
| 10 | Aetna vwh aetna percent of total billed charges · outpatientfrom % of charges | $500.96 | $500.96 | $500.96 – $500.96 |
| 11 | UnitedHealthcare vwh uhc hmo/ppo percent of total billed charges · outpatientfrom % of charges | $512.45 | $512.45 | $512.45 – $512.45 |
| 12 | Aetna vwh aetna asa percent of total billed charges · outpatientfrom % of charges | $530.84 | $530.84 | $530.84 – $530.84 |
| 13 | MultiPlan vwh phcs percent of total billed charges · outpatientfrom % of charges | $612.80 | $612.80 | $612.80 – $612.80 |
| 14 | MultiPlan vwh multiplan percent of total billed charges · outpatientfrom % of charges | $670.25 | $670.25 | $670.25 – $670.25 |
| 15 | First Health vwh non-contracted payors percent of total billed charges · outpatientfrom % of charges | $766.00 | $766.00 | $766.00 – $766.00 |
| 16 | MultiPlan vwh non-contracted payors percent of total billed charges · outpatientfrom % of charges | $766.00 | $766.00 | $766.00 – $766.00 |
| 17 | UnitedHealthcare vwh uhc non-contracted oon - ed only percent of total billed charges · outpatientfrom % of charges | $766.00 | $766.00 | $766.00 – $766.00 |
Last updated: Apr 1, 2026
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