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
RP LOCLZJ TUM WHBDY 2+D IMG
Park, TX
See all hospitals reporting CPT 78804 →Price type
Ascension Cedar Park’s median price of $602 is 57% below the median hospital's median price ($1.4k), higher than 15% of the 2,093 hospitals reporting CPT 78804. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 36 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 4127_blue cross blue shield bav exchange 20250101 fee schedule · outpatient | $537 | $537 | — | — | — | $537 – $537 |
| 2 | Blue Cross Blue Shield 3594_blue cross chip/star kids (chi,dcn) inpatient 20240901 fee schedule · both | $547 | $547 | — | — | — | $547 – $547 |
| 3 | UnitedHealthcare 3737_chirp uhc star (chi,dcn) inpatient 20240901 fee schedule · both | $547 | $547 | — | — | — | $547 – $547 |
| 4 | UnitedHealthcare 3748_chirp uhc star plus (chi,dcn) inpatient 20240901 fee schedule · both | $547 | $547 | — | — | — | $547 – $547 |
| 5 | UnitedHealthcare 4322_uhc star kids (chi,dcn) inpatient 20240901 fee schedule · both | $547 | $547 | — | — | — | $547 – $547 |
| 6 | Ambetter 3879_superior ambetter (chi,dcn) inpatient 20240901 fee schedule · both | $553 | $553 | — | — | — | $553 – $553 |
| 7 | Blue Cross Blue Shield 3693_chirp blue cross star (chi,dcn) inpatient 20240901 fee schedule · both | $553 | $553 | — | — | — | $553 – $553 |
| 8 | Blue Cross Blue Shield 4219_chirp blue cross star (chi,dcn) outpatient 20241201 fee schedule · both | $553 | $553 | — | — | — | $553 – $553 |
| 9 | UnitedHealthcare 4253_chirp uhc star (chi,dcn) outpatient 20241201 fee schedule · both | $553 | $553 | — | — | — | $553 – $553 |
| 10 | UnitedHealthcare 4264_chirp uhc star plus (chi,dcn) outpatient 20241201 fee schedule · both | $553 | $553 | — | — | — | $553 – $553 |
| 11 | UnitedHealthcare 4311_uhc star kids (chi,dcn) outpatient 20241201 fee schedule · both | $553 | $553 | — | — | — | $553 – $553 |
| 12 | Ambetter 3880_superior ambetter (chi,dcn) outpatient 20240901 fee schedule · outpatient | $602 | $602 | — | — | — | $602 – $602 |
| 13 | Blue Cross Blue Shield 4168_blue cross chip (chi,dcn) outpatient 20241201 fee schedule · outpatient | $602 | $602 | — | — | — | $602 – $602 |
| 14 | Blue Cross Blue Shield 4168_blue cross chip/star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $602 | $602 | — | — | — | $602 – $602 |
| 15 | Blue Cross Blue Shield 5003_blue cross star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $602 | $602 | — | — | — | $602 – $602 |
| 16 | Tricare 1229_tricare cah outpatient 20170101 fee schedule · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 17 | Humana 2668_humana hmo 20230701 other · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 18 | Blue Cross Blue Shield 4440_blue cross blue shield hpn 20250501 fee schedule · outpatient | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 19 | Blue Cross Blue Shield 4497_blue cross blue shield hpn (dell, williamson,hays) 20250501 fee schedule · outpatient | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 20 | Blue Cross Blue Shield 4095_blue cross blue shield hmo essentials 20250101 fee schedule · outpatient | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 21 | Blue Cross Blue Shield 4094_blue cross blue shield ppo 20250101 fee schedule · outpatient | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 22 | Aetna 4489_aetna aco hmo 20250801 fee schedule · both | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 23 | Aetna 4490_aetna multi-tier whole health sha 20250801 fee schedule · both | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 24 | Superior Healthplan 3509_chirp superior star (chi,dcn) inpatient 20240901 fee schedule · both | $4.0k | $4.0k | — | — | — | $4.0k – $4.0k |
| 25 | Superior Healthplan 4188_superior star foster outpatient 20241201 fee schedule · outpatient | $4.0k | $4.0k | — | — | — | $4.0k – $4.0k |
Last updated: Jan 1, 2026
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