Esophageal balloon distension test

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

HC Esoph Balloon Distension Tst

Payers reporting CPT 91040

Payer pricing summary

Low

$103

Average

$919

Median

$753

High

$3.0k

Payer rate distribution

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#
1	Cigna fee schedule · outpatient · +27 other terms	153	$499	$667	$657	98%	1–10	$52 – $6.1k
2	UnitedHealthcare fee schedule · outpatient · +32 other terms	415	$533	$1.1k	$1.4k	129%	—	$0 – $15.6k
3	Aetna fee schedule · outpatient · +32 other terms	401	$492	$1.2k	$2.3k	199%	—	$1 – $19.0k
4	Blue Cross Blue Shield fee schedule · outpatient · +28 other terms	323	$898	$1.3k	$1.0k	80%	—	$1 – $7.9k
5	Humana fee schedule · outpatient · +27 other terms	292	$515	$1.0k	$1.1k	111%	—	$1 – $8.3k
6	Molina fee schedule · outpatient · +27 other terms	146	$531	$621	$999	161%	—	$1 – $11.3k
7	WellCare fee schedule · outpatient · +15 other terms	139	$502	$628	$632	101%	—	$51 – $4.3k
8	Oscar case rate · outpatient · +17 other terms	129	$2.5k	$2.6k	$797	31%	—	$830 – $7.5k
9	Anthem fee schedule · outpatient · +22 other terms	94	$516	$658	$924	140%	—	$8 – $5.6k
10	Ambetter facility · fee schedule · outpatient · +14 other terms	85	$698	$896	$683	76%	—	$404 – $7.1k
11	Kaiser fee schedule · outpatient · +20 other terms	69	$622	$934	$854	91%	—	$105 – $4.3k
12	Devoted fee schedule · outpatient · +11 other terms	68	$446	$450	$94	21%	—	$101 – $599
13	Optum fee schedule · outpatient · +19 other terms	53	$482	$522	$202	39%	—	$339 – $1.4k
14	Caresource fee schedule · outpatient · +16 other terms	40	$405	$643	$1.1k	165%	—	$1 – $4.3k
15	Clover facility · fee schedule · outpatient · +9 other terms	34	$399	$410	$60	15%	—	$345 – $625
16	Bcbs Tx fee schedule · outpatient · +3 other terms	31	$1.5k	$1.4k	$654	45%	—	$498 – $2.9k
17	Tricare fee schedule · outpatient · +14 other terms	29	$383	$7.9k	$17.8k	225%	—	$339 – $50k
18	Medicare fee schedule · outpatient · +17 other terms	28	$446	$911	$1.2k	132%	—	$368 – $4.2k
19	MultiPlan fee schedule · outpatient · +21 other terms	27	$859	$923	$137	15%	—	$498 – $1.2k
20	Baylor Scott White Health Plan facility · fee schedule · outpatient · +1 other terms	25	$474	$473	$94	20%	—	$356 – $620
21	Bcbs La fee schedule · outpatient · +1 other terms	25	$355	$448	$300	67%	—	$206 – $1.4k
22	Medica fee schedule · outpatient · +19 other terms	24	$560	$503	$250	50%	—	$49 – $885
23	Regence facility · fee schedule · outpatient · +11 other terms	23	$393	$602	$464	77%	—	$378 – $1.9k
24	Superior Healthplan facility · fee schedule · outpatient · +5 other terms	21	$394	$387	$9	2%	—	$375 – $394
25	Highmark facility · fee schedule · outpatient · +11 other terms	20	$757	$678	$368	54%	—	$36 – $1.7k

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