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
PERQ P-ART REVSC EACH ADDL
Cedar Rapids, IA
See all hospitals reporting CPT 33904 →Price type
St Luke's Methodist Hospital’s median price of $562 is 74% below the median hospital's median price ($2.2k), higher than 28% of the 1,212 hospitals reporting CPT 33904. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 11 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 | Aetna medicare advantage fee schedule · both | $254 | $254 | — | — | — | $254 – $254 |
| 2 | Molina medicare advantage fee schedule · both | $259 | $259 | — | — | — | $259 – $259 |
| 3 | Wellmark medicare advantage fee schedule · both | $259 | $259 | — | — | — | $259 – $259 |
| 4 | Humana medicare advantage fee schedule · both | $266 | $266 | — | — | — | $266 – $266 |
| 5 | UnitedHealthcare medicare advantage fee schedule · both | $266 | $266 | — | — | — | $266 – $266 |
| 6 | Wellmark commercial fee schedule · both | $581 | $581 | — | — | — | $581 – $581 |
| 7 | Wellmark hmo fee schedule · both | $581 | $581 | — | — | — | $581 – $581 |
| 8 | Cigna commercial fee schedule · both | $675 | $675 | — | — | — | $675 – $675 |
| 9 | Wellmark ppo fee schedule · both | $683 | $683 | — | — | — | $683 – $683 |
| 10 | UnitedHealthcare hmo fee schedule · both | $914 | $914 | — | — | — | $914 – $914 |
| 11 | UnitedHealthcare ppo fee schedule · both | $914 | $914 | — | — | — | $914 – $914 |
Last updated: Jan 28, 2026
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