Capsule endoscopy imaging of the small intestine at Ascension Providence

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

GI TRC IMG INTRAL ESOPH-ILE

Waco, TX

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How this price compares nationally

Ascension Providence’s median price of $783 is 36% below the median hospital's median price ($1.2k), higher than 12% of the 1,943 hospitals reporting CPT 91110. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 91110 at Ascension Providence

Negotiated rates from the hospital’s own file: 8 payers, 28 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 974_bcbs star inpatient 20240901 fee schedule · both	$762	$762	—	—	—	$762 – $762
2	Molina 891_molina chip inpatient 20240901 fee schedule · both	$762	$762	—	—	—	$762 – $762
3	Superior Healthplan 817_superior star inpatient 20240901 fee schedule · both	$762	$762	—	—	—	$762 – $762
4	Superior Healthplan 856_superior star plus inpatient 20240901 fee schedule · both	$762	$762	—	—	—	$762 – $762
5	UnitedHealthcare 852_uhc star plus inpatient 20240901 fee schedule · both	$762	$762	—	—	—	$762 – $762
6	UnitedHealthcare 894_uhc star kids inpatient 20240901 fee schedule · both	$762	$762	—	—	—	$762 – $762
7	UnitedHealthcare 929_uhc star inpatient 20250701 fee schedule · both	$762	$762	—	—	—	$762 – $762
8	Blue Cross Blue Shield 975_bcbs star outpatient 20241201 fee schedule · outpatient	$783	$783	—	—	—	$783 – $783
9	Molina 908_molina chip outpatient 20241201 fee schedule · outpatient	$783	$783	—	—	—	$783 – $783
10	Superior Healthplan 904_superior star outpatient 20241201 fee schedule · outpatient	$783	$783	—	—	—	$783 – $783
11	Superior Healthplan 907_superior star plus outpatient 20241201 fee schedule · outpatient	$783	$783	—	—	—	$783 – $783
12	UnitedHealthcare 906_uhc star plus outpatient 20241201 fee schedule · outpatient	$783	$783	—	—	—	$783 – $783
13	UnitedHealthcare 909_uhc star kids outpatient 20241201 fee schedule · outpatient	$783	$783	—	—	—	$783 – $783
14	UnitedHealthcare 928_uhc star outpatient 20250701 fee schedule · outpatient	$783	$783	—	—	—	$783 – $783
15	Tricare 877_tricare outpatient 20250101 other · outpatient	$919	$919	—	—	—	$919 – $919
16	Tricare 986_tricare inpatient 20251001 other · inpatient	$919	$919	—	—	—	$919 – $919
17	WellCare 918_wellcare allwell medicare advantage outpatient 20250101 other · outpatient	$919	$919	—	—	—	$919 – $919
18	WellCare 994_wellcare allwell medicare advantage inpatient 20251001 other · inpatient	$919	$919	—	—	—	$919 – $919
19	Aetna 880_medicare advantage aetna outpatient 20250101 other · outpatient	$937	$937	—	—	—	$937 – $937
20	Aetna 989_medicare advantage aetna inpatient 20251001 other · inpatient	$937	$937	—	—	—	$937 – $937
21	UnitedHealthcare 883_medicare advantage united healthcare outpatient 20250101 other · outpatient	$937	$937	—	—	—	$937 – $937
22	UnitedHealthcare 991_medicare advantage united healthcare inpatient 20251001 other · inpatient	$937	$937	—	—	—	$937 – $937
23	Blue Cross Blue Shield 872_blue cross blue shield myblueheath 20250101 other · outpatient	$1.3k	$1.3k	—	—	—	$1.3k – $1.3k
24	Ambetter 876_superior ambetter outpatient 20250101 other · outpatient	$1.4k	$1.4k	—	—	—	$1.4k – $1.4k
25	Ambetter 985_superior ambetter inpatient 20251001 other · inpatient	$1.4k	$1.4k	—	—	—	$1.4k – $1.4k

Page 1 of 2 · 28 rates

Last updated: Jan 1, 2026

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