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
PWC gp3 xhd mult pow opt s/b
Cedar Rapids, IA
See all hospitals reporting HCPCS K0864 →Price type
St Luke's Methodist Hospital’s median price of $5.5k is 137% above the median hospital's median price ($2.3k), higher than 70% of the 570 hospitals reporting HCPCS K0864. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 4 payers, 8 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 hmo fee schedule · both | $4.1k | $4.1k | $3.1k | 74% | — | $1.1k – $7.2k |
| 2 | UnitedHealthcare ppo fee schedule · both | $4.1k | $4.1k | $3.1k | 74% | — | $1.1k – $7.2k |
| 3 | Cigna commercial fee schedule · both | $5.5k | $5.5k | — | — | — | $5.5k – $5.5k |
| 4 | Wellmark commercial fee schedule · both | $10.7k | $10.7k | $8.8k | 82% | — | $1.9k – $19.5k |
| 5 | Wellmark hmo fee schedule · both | $10.7k | $10.7k | $8.8k | 82% | — | $1.9k – $19.5k |
| 6 | Wellmark ppo fee schedule · both | $10.7k | $10.7k | $8.8k | 82% | — | $1.9k – $19.5k |
| 7 | Aetna hmo fee schedule · both | $13.3k | $13.3k | $10.9k | 82% | — | $2.4k – $24.2k |
| 8 | Aetna ppo fee schedule · both | $13.3k | $13.3k | $10.9k | 82% | — | $2.4k – $24.2k |
Last updated: Jan 28, 2026
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