Orbital venogram imaging with radiologist review

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

XR VENOGRAM ORBITAL

Payers reporting CPT 75880

Payer pricing summary

Low

$64

Average

$784

Median

$662

High

$2.1k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +29 other terms	571	$827	$777	$752	97%	—	$1 – $18.2k
2	Aetna fee schedule · outpatient · +26 other terms	519	$607	$618	$600	97%	—	$1 – $8.4k
3	Cigna fee schedule · outpatient · +23 other terms	392	$627	$831	$800	96%	—	$49 – $9.0k
4	Blue Cross Blue Shield fee schedule · outpatient · +26 other terms	380	$734	$993	$927	93%	—	$1 – $5.0k
5	Humana fee schedule · outpatient · +24 other terms	312	$600	$482	$355	74%	—	$31 – $2.1k
6	Molina fee schedule · outpatient · +22 other terms	194	$643	$434	$411	95%	—	$28 – $2.4k
7	Anthem fee schedule · outpatient · +19 other terms	129	$288	$275	$504	183%	—	$32 – $6.1k
8	WellCare fee schedule · outpatient · +15 other terms	122	$628	$674	$286	42%	—	$35 – $1.4k
9	Ambetter fee schedule · outpatient · +12 other terms	80	$968	$729	$560	77%	—	$88 – $2.1k
10	Aetna Better Health fee schedule · outpatient · +16 other terms	69	$117	$143	$94	66%	—	$95 – $580
11	Kaiser fee schedule · outpatient · +17 other terms	67	$911	$1.1k	$817	77%	—	$64 – $4.5k
12	Devoted fee schedule · outpatient · +11 other terms	64	$634	$573	$185	32%	—	$74 – $701
13	Oscar fee schedule · outpatient · +14 other terms	51	$1.2k	$826	$588	71%	—	$1 – $1.8k
14	Caresource fee schedule · outpatient · +11 other terms	37	$605	$494	$284	58%	—	$70 – $1.1k
15	Optum fee schedule · outpatient · +15 other terms	36	$569	$685	$559	82%	—	$74 – $2.3k
16	Cigna Healthspring fee schedule · outpatient · +6 other terms	31	$215	$404	$245	61%	—	$113 – $649
17	First Health fee schedule · outpatient · +15 other terms	31	$655	$444	$1.1k	239%	—	$108 – $6.5k
18	MultiPlan fee schedule · outpatient · +17 other terms	30	$1.0k	$866	$1.3k	147%	—	$118 – $7.4k
19	Bcbs Tx fee schedule · outpatient · +3 other terms	28	$1.9k	$2.1k	$1.0k	47%	—	$581 – $4.6k
20	Tricare fee schedule · outpatient · +15 other terms	28	$627	$1.5k	$990	67%	—	$569 – $2.6k
21	Clover fee schedule · outpatient · +8 other terms	26	$676	$660	$43	7%	—	$566 – $728
22	Regence professional · fee schedule · outpatient · +9 other terms	26	$52	$66	$38	57%	—	$33 – $270
23	Medicare fee schedule · outpatient · +13 other terms	22	$74	$192	$234	122%	—	$64 – $700
24	Highmark fee schedule · outpatient · +9 other terms	19	$298	$279	$349	125%	—	$31 – $1.8k
25	Medica fee schedule · both · +10 other terms	16	$163	$174	$139	79%	—	$24 – $701

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