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
H PYLORI AG IA
Austin, TX
See all hospitals reporting CPT 87339 →Price type
Ascension Seton’s median price of $16 is 2% below the median hospital's median price ($17), higher than 40% of the 1,421 hospitals reporting CPT 87339. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 27 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 | Aetna 4659_medicare advantage aetna inpatient 20251001 other · inpatient | $16 | $16 | — | — | — | $16 – $16 |
| 2 | Devoted 4684_medicare advantage devoted health inpatient 20251001 other · inpatient | $16 | $16 | — | — | — | $16 – $16 |
| 3 | Devoted 4918_medicare advantage devoted health outpatient 20250811 other · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 4 | Humana 4661_medicare advantage humana inpatient (aus,hay,nw,sw) 20251001 other · inpatient | $16 | $16 | — | — | — | $16 – $16 |
| 5 | Humana 4921_medicare advantage humana outpatient (aus,hay,nw,sw.smv) 20250811 other · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 6 | Tricare 4696_tricare inpatient 20251001 other · inpatient | $16 | $16 | — | — | — | $16 – $16 |
| 7 | WellCare 4691_medicare advantage wellcare inpatient 20251001 other · inpatient | $16 | $16 | — | — | — | $16 – $16 |
| 8 | WellCare 4929_medicare advantage wellcare outpatient 20250811 other · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 9 | UnitedHealthcare 4687_medicare advantage united healthcare inpatient (aus,nw,sw,hay) 20251001 other · inpatient | $16 | $16 | — | — | — | $16 – $16 |
| 10 | UnitedHealthcare 4928_medicare advantage united healthcare outpatient (aus,nw,sw,hay,smv) 20250811 other · outpatient | $16 | $16 | — | — | — | $16 – $16 |
| 11 | Humana 2668_humana hmo 20230701 other · outpatient | $26 | $26 | — | — | — | $26 – $26 |
| 12 | Ambetter 4652_superior ambetter inpatient 20251001 other · inpatient | $29 | $29 | — | — | — | $29 – $29 |
| 13 | Ambetter 4960_superior ambetter outpatient 20250811 other · outpatient | $29 | $29 | — | — | — | $29 – $29 |
| 14 | Blue Cross Blue Shield 4127_blue cross blue shield bav exchange 20250101 fee schedule · outpatient | $30 | $30 | — | — | — | $30 – $30 |
| 15 | Aetna 1377_aetna hmo exchange 20200101 fee schedule · outpatient | $32 | $32 | — | — | — | $32 – $32 |
| 16 | Cigna 4475_cigna hmo (aus,nw,sw,hay) 20250701 fee schedule · both | $33 | $33 | — | — | — | $33 – $33 |
| 17 | Cigna 4476_cigna hmo (wil,del) 20250701 fee schedule · outpatient | $33 | $33 | — | — | — | $33 – $33 |
| 18 | Aetna 4489_aetna aco hmo 20250801 fee schedule · both | $35 | $35 | — | — | — | $35 – $35 |
| 19 | Aetna 4490_aetna multi-tier whole health sha 20250801 fee schedule · both | $35 | $35 | — | — | — | $35 – $35 |
| 20 | Blue Cross Blue Shield 4440_blue cross blue shield hpn 20250501 fee schedule · outpatient | $62 | $62 | — | — | — | $62 – $62 |
| 21 | Blue Cross Blue Shield 4497_blue cross blue shield hpn (dell, williamson,hays) 20250501 fee schedule · outpatient | $62 | $62 | — | — | — | $62 – $62 |
| 22 | Blue Cross Blue Shield 4095_blue cross blue shield hmo essentials 20250101 fee schedule · outpatient | $68 | $68 | — | — | — | $68 – $68 |
| 23 | Aetna 4335_aetna sha aisd 20250101 other · outpatient | $70 | $70 | — | — | — | $70 – $70 |
| 24 | Blue Cross Blue Shield 4094_blue cross blue shield ppo 20250101 fee schedule · outpatient | $75 | $75 | — | — | — | $75 – $75 |
| 25 | Aetna 4486_aetna hmo 20250801 other · outpatient | $87 | $87 | — | — | — | $87 – $87 |
Last updated: Jan 1, 2026
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