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
HC FNA BX W/O IMG GDN EA ADDL
Philadelphia, PA
See all hospitals reporting CPT 10004 →Price type
Pennsylvania Hospital of the University of Pennsylvania Health System’s median price of $366 is 21% below the median hospital's median price ($461), higher than 44% 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: 11 payers, 31 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 | UnitedHealthcare unitedhealthcare community (fka americhoice ma) facility · fee schedule · outpatient | $69.97 | $69.97 | $69.97 – $69.97 |
| 2 | Highmark highmark facility · other · outpatient | $114.50 | $114.50 | $114.50 – $114.50 |
| 3 | Bcbs Nj horizon blue cross of nj- hmo pos and direct access facility · other · outpatient | $123.66 | $123.66 | $123.66 – $123.66 |
| 4 | Cigna cigna facility · percent of total billed charges · outpatientfrom % of charges | $155.12 | $155.12 | $155.12 – $155.12 |
| 5 | UnitedHealthcare unitedhealthcare compass exchange facility · other · outpatient | $226.00 | $226.00 | $226.00 – $226.00 |
| 6 | First Health first health global facility · percent of total billed charges · inpatientfrom % of charges | $229.00 | $229.00 | $229.00 – $229.00 |
| 7 | First Health first health global facility · percent of total billed charges · outpatientfrom % of charges | $229.00 | $229.00 | $229.00 – $229.00 |
| 8 | Bcbs Nj horizon blue cross of nj-ppo facility · percent of total billed charges · outpatientfrom % of charges | $233.58 | $233.58 | $233.58 – $233.58 |
| 9 | Bcbs Nj horizon blue cross of nj-indemnity facility · percent of total billed charges · outpatientfrom % of charges | $279.38 | $279.38 | $279.38 – $279.38 |
| 10 | Humana humana choice care facility · percent of total billed charges · inpatientfrom % of charges | $366.40 | $366.40 | $366.40 – $366.40 |
| 11 | Humana humana choice care facility · percent of total billed charges · outpatientfrom % of charges | $366.40 | $366.40 | $366.40 – $366.40 |
| 12 | Aetna aetna commercial facility · other · outpatient | $458.00 | $458.00 | $458.00 – $458.00 |
| 13 | Aetna aetna commercial hmo with capitation facility · other · outpatient | $458.00 | $458.00 | $458.00 – $458.00 |
| 14 | Aetna aetna hmo facility · percent of total billed charges · inpatientfrom % of charges | $458.00 | $458.00 | $458.00 – $458.00 |
| 15 | Aetna aetna ppo facility · percent of total billed charges · inpatientfrom % of charges | $458.00 | $458.00 | $458.00 – $458.00 |
| 16 | Bcbs Nj horizon blue cross of nj-indemnity facility · percent of total billed charges · inpatientfrom % of charges | $458.00 | $458.00 | $458.00 – $458.00 |
| 17 | Bcbs Nj horizon blue cross of nj-medicare hmo facility · other · outpatient | $458.00 | $458.00 | $458.00 – $458.00 |
| 18 | Bcbs Nj horizon blue cross of nj-ppo facility · percent of total billed charges · inpatientfrom % of charges | $458.00 | $458.00 | $458.00 – $458.00 |
| 19 | Blue Cross Blue Shield keystone health plan east-ibc hmo facility · other · outpatient | $458.00 | $458.00 | $458.00 – $458.00 |
| 20 | Clover clover health plan facility · other · outpatient | $458.00 | $458.00 | $458.00 – $458.00 |
| 21 | Highmark highmark medicare advantage facility · other · outpatient | $458.00 | $458.00 | $458.00 – $458.00 |
| 22 | Humana humana medicare facility · other · outpatient | $458.00 | $458.00 | $458.00 – $458.00 |
| 23 | Oscar oscar health plan facility · other · outpatient | $458.00 | $458.00 | $458.00 – $458.00 |
| 24 | Tricare tricare facility · fee schedule · outpatient | $458.00 | $458.00 | $458.00 – $458.00 |
| 25 | UnitedHealthcare unitedhealthcare non options facility · case rate · inpatient | $458.00 | $458.00 | $458.00 – $458.00 |
Last updated: Mar 20, 2026
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