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
FINE NDL ASP W/O US E AD
SAN ANTONIO, TX
See all hospitals reporting CPT 10004 →Price type
Stone Oak Rehab’s median price of $1.9k is 304% above the median hospital's median price ($461), higher than 72% 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: 7 payers, 29 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 | First Health chip per diem · outpatient | $365.00 | $365.00 | $365.00 – $365.00 |
| 2 | First Health chipperinate per diem · outpatient | $365.00 | $365.00 | $365.00 – $365.00 |
| 3 | First Health mcdstar per diem · outpatient | $365.00 | $365.00 | $365.00 – $365.00 |
| 4 | Aetna qhphix case rate · outpatient | $1,153 | $1,153 | $1,153 – $1,153 |
| 5 | UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges | $1,410 | $1,410 | $1,410 – $1,410 |
| 6 | First Health hmo percent of total billed charges · outpatientfrom % of charges | $1,516 | $1,516 | $1,516 – $1,516 |
| 7 | Aetna narrownetwork case rate · outpatient | $1,609 | $1,609 | $1,609 – $1,609 |
| 8 | Blue Cross Blue Shield mybluehealth percent of total billed charges · outpatientfrom % of charges | $1,623 | $1,623 | $1,623 – $1,623 |
| 9 | Cigna newbusinessnetwork percent of total billed charges · outpatientfrom % of charges | $1,640 | $1,640 | $1,640 – $1,640 |
| 10 | Blue Cross Blue Shield trad percent of total billed charges · outpatientfrom % of charges | $1,657 | $1,657 | $1,657 – $1,657 |
| 11 | Healthcare Highways narrownetwork percent of total billed charges · outpatientfrom % of charges | $1,730 | $1,730 | $1,730 – $1,730 |
| 12 | Cigna hmo percent of total billed charges · outpatientfrom % of charges | $1,797 | $1,797 | $1,797 – $1,797 |
| 13 | Cigna openaccessplus percent of total billed charges · outpatientfrom % of charges | $1,797 | $1,797 | $1,797 – $1,797 |
| 14 | Aetna newbusinessrates case rate · outpatient | $1,827 | $1,827 | $1,827 – $1,827 |
| 15 | Aetna commercialbasenetwork case rate · outpatient | $1,861 | $1,861 | $1,861 – $1,861 |
| 16 | UnitedHealthcare smallgroup case rate · outpatient | $1,908 | $1,908 | $1,908 – $1,908 |
| 17 | UnitedHealthcare charter case rate · outpatient | $1,913 | $1,913 | $1,913 – $1,913 |
| 18 | UnitedHealthcare nexusaco case rate · outpatient | $1,913 | $1,913 | $1,913 – $1,913 |
| 19 | Blue Cross Blue Shield blueadvantage percent of total billed charges · outpatientfrom % of charges | $1,966 | $1,966 | $1,966 – $1,966 |
| 20 | UnitedHealthcare allpayerappendix case rate · outpatient | $2,014 | $2,014 | $2,014 – $2,014 |
| 21 | Blue Cross Blue Shield blueessentials percent of total billed charges · outpatientfrom % of charges | $2,056 | $2,056 | $2,056 – $2,056 |
| 22 | Blue Cross Blue Shield blueessentialsaccess percent of total billed charges · outpatientfrom % of charges | $2,056 | $2,056 | $2,056 – $2,056 |
| 23 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $2,174 | $2,174 | $2,174 – $2,174 |
| 24 | Aetna oon case rate · outpatient | $2,190 | $2,190 | $2,190 – $2,190 |
| 25 | Blue Cross Blue Shield healthselectopenaccess(eposoa) percent of total billed charges · outpatientfrom % of charges | $2,247 | $2,247 | $2,247 – $2,247 |
Last updated: May 1, 2026
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