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
10004 FNA W/O IMAGE EA ADD LES
Arlington, TX
See all hospitals reporting CPT 10004 →Price type
Texas Health Arlington Memorial Hospital’s median price of $133 is 71% below the median hospital's median price ($461), higher than 29% 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: 9 payers, 32 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 managed medicaid percent of total billed charges · outpatientfrom % of charges | $22.28 | $22.28 | $22.28 – $22.28 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $22.28 | $22.28 | $22.28 – $22.28 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $23.38 | $23.38 | $23.38 – $23.38 |
| 4 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $24.07 | $24.07 | $24.07 – $24.07 |
| 5 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $24.51 | $24.51 | $24.51 – $24.51 |
| 6 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $52.46 | $52.46 | $52.46 – $52.46 |
| 7 | Humana medicare advantage case rate · outpatient | $54.56 | $54.56 | $54.56 – $54.56 |
| 8 | Molina medicare advantage case rate · outpatient | $55.09 | $55.09 | $55.09 – $55.09 |
| 9 | WellCare medicare advantage hmo case rate · outpatient | $55.09 | $55.09 | $55.09 – $55.09 |
| 10 | WellCare medicare advantage mmp case rate · outpatient | $57.71 | $57.71 | $57.71 – $57.71 |
| 11 | UnitedHealthcare medicare advantage ppo case rate · outpatient | $58.23 | $58.23 | $58.23 – $58.23 |
| 12 | UnitedHealthcare medicare advantage hmo case rate · outpatient | $59.28 | $59.28 | $59.28 – $59.28 |
| 13 | Blue Cross Blue Shield exchange percent of total billed charges · outpatientfrom % of charges | $88.84 | $88.84 | $88.84 – $88.84 |
| 14 | Aetna whole health percent of total billed charges · inpatientfrom % of charges | $113.40 | $113.40 | $113.40 – $113.40 |
| 15 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $115.45 | $115.45 | $115.45 – $115.45 |
| 16 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $122.17 | $122.17 | $122.17 – $122.17 |
| 17 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $140.34 | $140.34 | $140.34 – $140.34 |
| 18 | Aetna commercial percent of total billed charges · inpatientfrom % of charges | $151.19 | $151.19 | $151.19 – $151.19 |
| 19 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $153.60 | $153.60 | $153.60 – $153.60 |
| 20 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $153.93 | $153.93 | $153.93 – $153.93 |
| 21 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $154.04 | $154.04 | $154.04 – $154.04 |
| 22 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $154.92 | $154.92 | $154.92 – $154.92 |
| 23 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $154.92 | $154.92 | $154.92 – $154.92 |
| 24 | Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges | $155.81 | $155.81 | $155.81 – $155.81 |
| 25 | Phcs ppo percent of total billed charges · inpatientfrom % of charges | $164.65 | $164.65 | $164.65 – $164.65 |
Last updated: Apr 21, 2026
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