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
LAB DET IA RESP MLTPLX 3-5 TGT
Page, AZ
See all hospitals reporting CPT 87631 →Price type
Page Hospital’s median price of $244 is 48% above the median hospital's median price ($165), higher than 72% of the 2,188 hospitals reporting CPT 87631. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 24 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 | Humana medicare advantage facility · fee schedule · outpatient | $143 | $143 | — | — | — | $143 – $143 |
| 2 | Humana medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $145 | $145 | — | — | — | $145 – $145 |
| 3 | Aetna banner employee plans facility · percent of total billed charges · outpatientfrom % of charges | $214 | $214 | — | — | — | $214 – $214 |
| 4 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $227 | $227 | — | — | — | $227 – $227 |
| 5 | Bcbs Az medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $227 | $227 | — | — | — | $227 – $227 |
| 6 | Cigna hmo medicare advantage plan/ppo medicare advantage plan facility · percent of total billed charges · outpatientfrom % of charges | $227 | $227 | — | — | — | $227 – $227 |
| 7 | Kaiser medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $227 | $227 | — | — | — | $227 – $227 |
| 8 | UnitedHealthcare uhc medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $227 | $227 | — | — | — | $227 – $227 |
| 9 | UnitedHealthcare uhc individual exchange facility · percent of total billed charges · outpatientfrom % of charges | $235 | $235 | — | — | — | $235 – $235 |
| 10 | Devoted medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $250 | $250 | — | — | — | $250 – $250 |
| 11 | Bcbs Az bxbsaz neighborhood facility · percent of total billed charges · outpatientfrom % of charges | $253 | $253 | — | — | — | $253 – $253 |
| 12 | Bcbs Az bxbsaz alliance/bxbsaz blue hpn facility · percent of total billed charges · outpatientfrom % of charges | $270 | $270 | — | — | — | $270 – $270 |
| 13 | Bcbs Az bxbsaz alliance chs facility · percent of total billed charges · outpatientfrom % of charges | $284 | $284 | — | — | — | $284 – $284 |
| 14 | Aetna aetna qualified health plan facility · percent of total billed charges · outpatientfrom % of charges | $309 | $309 | — | — | — | $309 – $309 |
| 15 | Aetna joint venture facility · percent of total billed charges · outpatientfrom % of charges | $311 | $311 | — | — | — | $311 – $311 |
| 16 | Bcbs Az bcbsaz medicare facility · percent of total billed charges · outpatientfrom % of charges | $338 | $338 | — | — | — | $338 – $338 |
| 17 | Bcbs Az bcbsaz workers comp facility · percent of total billed charges · outpatientfrom % of charges | $338 | $338 | — | — | — | $338 – $338 |
| 18 | Bcbs Az commercial facility · percent of total billed charges · outpatientfrom % of charges | $338 | $338 | — | — | — | $338 – $338 |
| 19 | Oscar commercial facility · percent of total billed charges · outpatientfrom % of charges | $374 | $374 | — | — | — | $374 – $374 |
| 20 | Aetna medical rental facility · percent of total billed charges · inpatientfrom % of charges | $381 | $381 | — | — | — | $381 – $381 |
| 21 | Aetna medical rental facility · percent of total billed charges · outpatientfrom % of charges | $381 | $381 | — | — | — | $381 – $381 |
| 22 | Aetna broad network facility · percent of total billed charges · outpatientfrom % of charges | $389 | $389 | — | — | — | $389 – $389 |
| 23 | Cigna commerical/hmo benefit plan/local flex plan/network benefit plan/open access plan facility · percent of total billed charges · inpatientfrom % of charges | $394 | $394 | — | — | — | $394 – $394 |
| 24 | Cigna commerical/hmo benefit plan/local flex plan/network benefit plan/open access plan facility · percent of total billed charges · outpatientfrom % of charges | $394 | $394 | — | — | — | $394 – $394 |
Last updated: Mar 2, 2026
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