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
Fna Bx W/O Img Gdn Ea Addl
Sayre, PA
See all hospitals reporting CPT 10004 →Price type
Robert Packer Hospital’s median price of $114 is 75% below the median hospital's median price ($461), higher than 27% 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: 5 payers, 14 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 blue medicare hmo/ppo facility · percent of total billed charges · outpatientfrom % of charges | $21.55 | $21.55 | $21.55 – $21.55 |
| 2 | Blue Cross Blue Shield medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $21.55 | $21.55 | $21.55 – $21.55 |
| 3 | Blue Cross Blue Shield managed medicaid facility · fee schedule · outpatient | $49.37 | $49.37 | $49.37 – $49.37 |
| 4 | UnitedHealthcare empire facility · percent of total billed charges · outpatientfrom % of charges | $104.32 | $104.32 | $104.32 – $104.32 |
| 5 | UnitedHealthcare student facility · percent of total billed charges · outpatientfrom % of charges | $104.32 | $104.32 | $104.32 – $104.32 |
| 6 | Blue Cross Blue Shield excellus facility · fee schedule · outpatient | $123.94 | $123.94 | $123.94 – $123.94 |
| 7 | Blue Cross Blue Shield highmark ppo facility · fee schedule · both | $123.94 | $123.94 | $123.94 – $123.94 |
| 8 | Blue Cross Blue Shield highmark ppo facility · fee schedule · outpatient | $123.94 | $123.94 | $123.94 – $123.94 |
| 9 | Cigna behavioral facility · other · outpatient | $142.90 | $142.90 | $142.90 – $142.90 |
| 10 | Tricare medicare advantage facility · other · outpatient | $142.90 | $142.90 | $142.90 – $142.90 |
| 11 | UnitedHealthcare managed medicaid facility · other · outpatient | $142.90 | $142.90 | $142.90 – $142.90 |
| 12 | UnitedHealthcare medicare advantage facility · other · outpatient | $142.90 | $142.90 | $142.90 – $142.90 |
| 13 | WellCare fidelis medicare advantage facility · other · outpatient | $142.90 | $142.90 | $142.90 – $142.90 |
| 14 | WellCare managed medicaid facility · other · outpatient | $142.90 | $142.90 | $142.90 – $142.90 |
Last updated: Mar 31, 2026
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