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
TX RADIAT SMPL >=1MEV(11-19)
Arlington, TX
See all hospitals reporting CPT 77402 →Price type
AMH Cath Labs LLC’s median price of $494 is 115% above the median hospital's median price ($230), higher than 74% of the 1,748 hospitals reporting CPT 77402. 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, 31 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 | $89 | $89 | — | — | — | $89 – $89 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $89 | $89 | — | — | — | $89 – $89 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $93 | $93 | — | — | — | $93 – $93 |
| 4 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $96 | $96 | — | — | — | $96 – $96 |
| 5 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $98 | $98 | — | — | — | $98 – $98 |
| 6 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $103 | $103 | — | — | — | $103 – $103 |
| 7 | Humana medicare advantage case rate · outpatient | $107 | $107 | — | — | — | $107 – $107 |
| 8 | Humana medicare advantage ppo case rate · outpatient | $107 | $107 | — | — | — | $107 – $107 |
| 9 | Molina medicare advantage case rate · outpatient | $108 | $108 | — | — | — | $108 – $108 |
| 10 | WellCare medicare advantage hmo case rate · outpatient | $108 | $108 | — | — | — | $108 – $108 |
| 11 | WellCare medicare advantage mmp case rate · outpatient | $113 | $113 | — | — | — | $113 – $113 |
| 12 | UnitedHealthcare medicare advantage ppo case rate · outpatient | $114 | $114 | — | — | — | $114 – $114 |
| 13 | UnitedHealthcare medicare advantage hmo case rate · outpatient | $116 | $116 | — | — | — | $116 – $116 |
| 14 | Blue Cross Blue Shield exchange fee schedule · outpatient | $148 | $148 | — | — | — | $148 – $148 |
| 15 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $411 | $411 | — | — | — | $411 – $411 |
| 16 | Blue Cross Blue Shield hmo fee schedule · outpatient | $466 | $466 | — | — | — | $466 – $466 |
| 17 | Blue Cross Blue Shield ppo fee schedule · outpatient | $518 | $518 | — | — | — | $518 – $518 |
| 18 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $547 | $547 | — | — | — | $547 – $547 |
| 19 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $553 | $553 | — | — | — | $553 – $553 |
| 20 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $695 | $695 | — | — | — | $695 – $695 |
| 21 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $697 | $697 | — | — | — | $697 – $697 |
| 22 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $701 | $701 | — | — | — | $701 – $701 |
| 23 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $701 | $701 | — | — | — | $701 – $701 |
| 24 | Phcs ppo percent of total billed charges · inpatientfrom % of charges | $745 | $745 | — | — | — | $745 – $745 |
| 25 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $870 | $870 | — | — | — | $870 – $870 |
Last updated: Apr 21, 2026
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