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
OB PE KDR ENG&RBP4 IA ALG
Waco, TX
See all hospitals reporting CPT 0390U →Price type
Ascension Providence’s median price of $66 is about the same as the median hospital's median price ($66), higher than 39% of the 1,234 hospitals reporting CPT 0390U. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 14 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 872_blue cross blue shield myblueheath 20250101 fee schedule · outpatient | $59 | $59 | — | — | — | $59 – $59 |
| 2 | Tricare 877_tricare outpatient 20250101 other · outpatient | $64 | $64 | — | — | — | $64 – $64 |
| 3 | Tricare 986_tricare inpatient 20251001 other · inpatient | $64 | $64 | — | — | — | $64 – $64 |
| 4 | WellCare 918_wellcare allwell medicare advantage outpatient 20250101 other · outpatient | $64 | $64 | — | — | — | $64 – $64 |
| 5 | WellCare 994_wellcare allwell medicare advantage inpatient 20251001 other · inpatient | $64 | $64 | — | — | — | $64 – $64 |
| 6 | Aetna 880_medicare advantage aetna outpatient 20250101 other · outpatient | $66 | $66 | — | — | — | $66 – $66 |
| 7 | Aetna 989_medicare advantage aetna inpatient 20251001 other · inpatient | $66 | $66 | — | — | — | $66 – $66 |
| 8 | UnitedHealthcare 883_medicare advantage united healthcare outpatient 20250101 other · outpatient | $66 | $66 | — | — | — | $66 – $66 |
| 9 | UnitedHealthcare 991_medicare advantage united healthcare inpatient 20251001 other · inpatient | $66 | $66 | — | — | — | $66 – $66 |
| 10 | Blue Cross Blue Shield 871_blue cross blue shield advantage hmo 20250101 other · outpatient | $74 | $74 | — | — | — | $74 – $74 |
| 11 | Ambetter 876_superior ambetter outpatient 20250101 other · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 12 | Ambetter 985_superior ambetter inpatient 20251001 other · inpatient | $97 | $97 | — | — | — | $97 – $97 |
| 13 | Blue Cross Blue Shield 870_blue cross blue shield hmo essentials 20250101 fee schedule · outpatient | $128 | $128 | — | — | — | $128 – $128 |
| 14 | Blue Cross Blue Shield 869_blue cross blue shield ppo 20250101 fee schedule · outpatient | $140 | $140 | — | — | — | $140 – $140 |
Last updated: Jan 1, 2026
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