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
QUAN CT TISS CHARAC W/O CT
Waco, TX
See all hospitals reporting CPT 0721T →Price type
Ascension Providence’s median price of $650 is 10% below the median hospital's median price ($726), higher than 26% of the 965 hospitals reporting CPT 0721T. 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 | Tricare 877_tricare outpatient 20250101 other · outpatient | $638 | $638 | — | — | — | $638 – $638 |
| 2 | Tricare 986_tricare inpatient 20251001 other · inpatient | $638 | $638 | — | — | — | $638 – $638 |
| 3 | WellCare 918_wellcare allwell medicare advantage outpatient 20250101 other · outpatient | $638 | $638 | — | — | — | $638 – $638 |
| 4 | WellCare 994_wellcare allwell medicare advantage inpatient 20251001 other · inpatient | $638 | $638 | — | — | — | $638 – $638 |
| 5 | Aetna 880_medicare advantage aetna outpatient 20250101 other · outpatient | $650 | $650 | — | — | — | $650 – $650 |
| 6 | Aetna 989_medicare advantage aetna inpatient 20251001 other · inpatient | $650 | $650 | — | — | — | $650 – $650 |
| 7 | UnitedHealthcare 883_medicare advantage united healthcare outpatient 20250101 other · outpatient | $650 | $650 | — | — | — | $650 – $650 |
| 8 | UnitedHealthcare 991_medicare advantage united healthcare inpatient 20251001 other · inpatient | $650 | $650 | — | — | — | $650 – $650 |
| 9 | Ambetter 876_superior ambetter outpatient 20250101 other · outpatient | $956 | $956 | — | — | — | $956 – $956 |
| 10 | Ambetter 985_superior ambetter inpatient 20251001 other · inpatient | $956 | $956 | — | — | — | $956 – $956 |
| 11 | Blue Cross Blue Shield 872_blue cross blue shield myblueheath 20250101 fee schedule · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 12 | Blue Cross Blue Shield 871_blue cross blue shield advantage hmo 20250101 other · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 13 | Blue Cross Blue Shield 870_blue cross blue shield hmo essentials 20250101 fee schedule · outpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 14 | Blue Cross Blue Shield 869_blue cross blue shield ppo 20250101 fee schedule · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
Last updated: Jan 1, 2026
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