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
HCHG RAD XRAY BONE SURVEY INFANT/CHILD
Ulm, MN
See all hospitals reporting CPT 77076 →Price type
Allina Health Systems’s median price of $393 is 122% above the median hospital's median price ($177), higher than 83% of the 2,390 hospitals reporting CPT 77076. 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, 25 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 | Bcbs Mn bc pmap (n) facility · other · outpatient | $91 | $91 | — | — | — | $91 – $91 |
| 2 | Aetna allina aetna medicare (n) facility · fee schedule · outpatient | $102 | $102 | — | — | — | $102 – $102 |
| 3 | Medicare medicare (n) facility · fee schedule · outpatient | $108 | $108 | — | — | — | $108 – $108 |
| 4 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $123 | $123 | — | — | — | $123 – $123 |
| 5 | Medica medica pmap (n) facility · percent of total billed charges · outpatientfrom % of charges | $195 | $195 | — | — | — | $195 – $195 |
| 6 | Medicaid medicaid ma (n) facility · other · outpatient | $269 | $269 | — | — | — | $269 – $269 |
| 7 | Medica medica medicare (r) facility · fee schedule · outpatient | $273 | $273 | — | — | — | $273 – $273 |
| 8 | Medica medica dual solutions (r) facility · percent of total billed charges · outpatientfrom % of charges | $276 | $276 | — | — | — | $276 – $276 |
| 9 | Bcbs Mn bc state health plan (n) facility · other · outpatient | $277 | $277 | — | — | — | $277 – $277 |
| 10 | Blue Cross Blue Shield bc medicare (n) facility · fee schedule · outpatient | $285 | $285 | — | — | — | $285 – $285 |
| 11 | Bcbs Mn bc premier(n) facility · other · outpatient | $356 | $356 | — | — | — | $356 – $356 |
| 12 | Aetna aetna elevate (n r) facility · percent of total billed charges · inpatientfrom % of charges | $376 | $376 | — | — | — | $376 – $376 |
| 13 | Aetna aetna elevate (n r) facility · percent of total billed charges · outpatientfrom % of charges | $380 | $380 | — | — | — | $380 – $380 |
| 14 | Aetna aetna performance (n r) facility · percent of total billed charges · inpatientfrom % of charges | $406 | $406 | — | — | — | $406 – $406 |
| 15 | Aetna aetna performance (n r) facility · percent of total billed charges · outpatientfrom % of charges | $410 | $410 | — | — | — | $410 – $410 |
| 16 | Blue Cross Blue Shield bc aehp (n) facility · other · outpatient | $418 | $418 | — | — | — | $418 – $418 |
| 17 | Medica medica ubh (n) facility · percent of total billed charges · inpatientfrom % of charges | $429 | $429 | — | — | — | $429 – $429 |
| 18 | Bcbs Mn bc high value/performance network (n) facility · other · outpatient | $449 | $449 | — | — | — | $449 – $449 |
| 19 | Medica medica ubh pmap (n) facility · percent of total billed charges · outpatientfrom % of charges | $491 | $491 | — | — | — | $491 – $491 |
| 20 | Cigna hpi cigna (n) facility · other · outpatient | $502 | $502 | — | — | — | $502 – $502 |
| 21 | First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges | $515 | $515 | — | — | — | $515 – $515 |
| 22 | First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges | $515 | $515 | — | — | — | $515 – $515 |
| 23 | Medica medica ubh (n) facility · percent of total billed charges · outpatientfrom % of charges | $515 | $515 | — | — | — | $515 – $515 |
| 24 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · inpatientfrom % of charges | $519 | $519 | — | — | — | $519 – $519 |
| 25 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · outpatientfrom % of charges | $524 | $524 | — | — | — | $524 – $524 |
Last updated: Jun 16, 2026
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