This name is the CMS category the code belongs to (CMS's Restructured BETOS Classification System), shared with similar codes. The official CPT description belongs to the American Medical Association and isn't shown.
What Washington hospitals publish for this code
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
Prices for CPT 90875 by hospital
Hospital
Medicare Advantage rates (lowest – highest)
Cash price
List price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27
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Island HospitalAnacortes
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Kadlec Regional Medical CenterRichlandFile dated 2026-04-01
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Mary Bridge Children's HospitalTacomaFile dated 2026-08-27
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MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27
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MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27
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MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27
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Olympic Medical CenterPort AngelesFile dated 2026-06-24
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Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01
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Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27
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University of Washington Medical CtrSeattleFile dated 2026-04-01
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$69.34
$99.05
Virginia Mason Medical CenterSeattle
$20.71 – $1,30513 plans
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Yakima Valley MemorialYakimaFile dated 2026-08-27
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Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.