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
US NRV&ACC STRUX 1XTR COMPRE
Waco, TX
See all hospitals reporting CPT 76883 →Price type
Ascension Providence’s median price of $104 is 12% below the median hospital's median price ($119), higher than 30% of the 1,527 hospitals reporting CPT 76883. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 21 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 975_bcbs star outpatient 20241201 fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 2 | Molina 908_molina chip outpatient 20241201 fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 3 | Superior Healthplan 904_superior star outpatient 20241201 fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 4 | Superior Healthplan 907_superior star plus outpatient 20241201 fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 5 | UnitedHealthcare 906_uhc star plus outpatient 20241201 fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 6 | UnitedHealthcare 909_uhc star kids outpatient 20241201 fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 7 | UnitedHealthcare 928_uhc star outpatient 20250701 fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 8 | Tricare 877_tricare outpatient 20250101 other · outpatient | $104 | $104 | — | — | — | $104 – $104 |
| 9 | Tricare 986_tricare inpatient 20251001 other · inpatient | $104 | $104 | — | — | — | $104 – $104 |
| 10 | WellCare 918_wellcare allwell medicare advantage outpatient 20250101 other · outpatient | $104 | $104 | — | — | — | $104 – $104 |
| 11 | WellCare 994_wellcare allwell medicare advantage inpatient 20251001 other · inpatient | $104 | $104 | — | — | — | $104 – $104 |
| 12 | Aetna 880_medicare advantage aetna outpatient 20250101 other · outpatient | $106 | $106 | — | — | — | $106 – $106 |
| 13 | Aetna 989_medicare advantage aetna inpatient 20251001 other · inpatient | $106 | $106 | — | — | — | $106 – $106 |
| 14 | UnitedHealthcare 883_medicare advantage united healthcare outpatient 20250101 other · outpatient | $106 | $106 | — | — | — | $106 – $106 |
| 15 | UnitedHealthcare 991_medicare advantage united healthcare inpatient 20251001 other · inpatient | $106 | $106 | — | — | — | $106 – $106 |
| 16 | Ambetter 876_superior ambetter outpatient 20250101 other · outpatient | $156 | $156 | — | — | — | $156 – $156 |
| 17 | Ambetter 985_superior ambetter inpatient 20251001 other · inpatient | $156 | $156 | — | — | — | $156 – $156 |
| 18 | Blue Cross Blue Shield 872_blue cross blue shield myblueheath 20250101 fee schedule · outpatient | $180 | $180 | — | — | — | $180 – $180 |
| 19 | Blue Cross Blue Shield 871_blue cross blue shield advantage hmo 20250101 other · outpatient | $224 | $224 | — | — | — | $224 – $224 |
| 20 | Blue Cross Blue Shield 870_blue cross blue shield hmo essentials 20250101 fee schedule · outpatient | $237 | $237 | — | — | — | $237 – $237 |
| 21 | Blue Cross Blue Shield 869_blue cross blue shield ppo 20250101 fee schedule · outpatient | $262 | $262 | — | — | — | $262 – $262 |
Last updated: Jan 1, 2026
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