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
AQUAPORIN-4 ANTIBODY NMO FLOW CYTOMETRY EACH SO 86053.900
Wheaton, MN
See all hospitals reporting CPT 86053 →Price type
Sanford Wheaton’s median price of $207 is 420% above the median hospital's median price ($40), higher than 88% of the 1,969 hospitals reporting CPT 86053. 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, 26 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 | Bcbs Mn pmap percent of total billed charges · outpatientfrom % of charges | $58 | $58 | — | — | — | $58 – $58 |
| 2 | Sanford Health Plan medicare replacement percent of total billed charges · outpatientfrom % of charges | $120 | $120 | — | — | — | $120 – $120 |
| 3 | Ucare medicare replacement percent of total billed charges · outpatientfrom % of charges | $129 | $129 | — | — | — | $129 – $129 |
| 4 | Aetna medicare replacement percent of total billed charges · outpatientfrom % of charges | $130 | $130 | — | — | — | $130 – $130 |
| 5 | Bcbs Mn medicare replacement percent of total billed charges · outpatientfrom % of charges | $130 | $130 | — | — | — | $130 – $130 |
| 6 | UnitedHealthcare medicare replacement percent of total billed charges · outpatientfrom % of charges | $130 | $130 | — | — | — | $130 – $130 |
| 7 | Bcbs Nd commercial percent of total billed charges · outpatientfrom % of charges | $164 | $164 | — | — | — | $164 – $164 |
| 8 | Sanford Health Plan group health/true percent of total billed charges · inpatientfrom % of charges | $188 | $188 | — | — | — | $188 – $188 |
| 9 | Sanford Health Plan group health/true percent of total billed charges · outpatientfrom % of charges | $188 | $188 | — | — | — | $188 – $188 |
| 10 | UnitedHealthcare commercial + top 20 percent of total billed charges · inpatientfrom % of charges | $199 | $199 | — | — | — | $199 – $199 |
| 11 | UnitedHealthcare commercial + top 20 percent of total billed charges · outpatientfrom % of charges | $199 | $199 | — | — | — | $199 – $199 |
| 12 | Aetna commercial percent of total billed charges · inpatientfrom % of charges | $207 | $207 | — | — | — | $207 – $207 |
| 13 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $207 | $207 | — | — | — | $207 – $207 |
| 14 | Ucare commercial percent of total billed charges · inpatientfrom % of charges | $209 | $209 | — | — | — | $209 – $209 |
| 15 | Ucare commercial percent of total billed charges · outpatientfrom % of charges | $209 | $209 | — | — | — | $209 – $209 |
| 16 | Medica choice percent of total billed charges · outpatientfrom % of charges | $209 | $209 | — | — | — | $209 – $209 |
| 17 | Medica choice percent of total billed charges · inpatientfrom % of charges | $210 | $210 | — | — | — | $210 – $210 |
| 18 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $214 | $214 | — | — | — | $214 – $214 |
| 19 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $214 | $214 | — | — | — | $214 – $214 |
| 20 | Bcbs Mn commercial/federal percent of total billed charges · outpatientfrom % of charges | $220 | $220 | — | — | — | $220 – $220 |
| 21 | Sanford Health Plan commercial/nd pers/sd exchange commercial percent of total billed charges · inpatientfrom % of charges | $221 | $221 | — | — | — | $221 – $221 |
| 22 | Sanford Health Plan commercial/nd pers/sd exchange commercial percent of total billed charges · outpatientfrom % of charges | $221 | $221 | — | — | — | $221 – $221 |
| 23 | Sanford Health Plan sd exchange true percent of total billed charges · inpatientfrom % of charges | $221 | $221 | — | — | — | $221 – $221 |
| 24 | Sanford Health Plan sd exchange true percent of total billed charges · outpatientfrom % of charges | $221 | $221 | — | — | — | $221 – $221 |
| 25 | Medica elect percent of total billed charges · outpatientfrom % of charges | $224 | $224 | — | — | — | $224 – $224 |
Last updated: Mar 4, 2026
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