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
INS/RPL PRPH SAC/GSTR NPG/R
Kyle, TX
See all hospitals reporting CPT 64590 →Price type
Ascension Seton’s median price of $14.7k is 21% below the median hospital's median price ($18.7k), higher than 40% of the 1,857 hospitals reporting CPT 64590. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 22 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 | Humana 206_humana hmo custom 20140201 other · outpatient | $969 | $969 | — | — | — | $969 – $969 |
| 2 | Oscar 4511_oscar health plan 20251001 other · both | $1k | $1k | — | — | — | $1k – $1k |
| 3 | Blue Cross Blue Shield 4127_blue cross blue shield bav exchange 20250101 fee schedule · outpatient | $13.9k | $13.9k | — | — | — | $13.9k – $13.9k |
| 4 | Blue Cross Blue Shield 4168_blue cross chip (chi,dcn) outpatient 20241201 fee schedule · outpatient | $14.7k | $14.7k | — | — | — | $14.7k – $14.7k |
| 5 | Blue Cross Blue Shield 4168_blue cross chip/star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $14.7k | $14.7k | — | — | — | $14.7k – $14.7k |
| 6 | Blue Cross Blue Shield 4171_blue cross chip (hay) outpatient 20241201 fee schedule · outpatient | $14.7k | $14.7k | — | — | — | $14.7k – $14.7k |
| 7 | Blue Cross Blue Shield 4171_blue cross chip/star kids (hay) outpatient 20241201 fee schedule · outpatient | $14.7k | $14.7k | — | — | — | $14.7k – $14.7k |
| 8 | Blue Cross Blue Shield 4219_chirp blue cross star (chi,dcn) outpatient 20241201 fee schedule · outpatient | $14.7k | $14.7k | — | — | — | $14.7k – $14.7k |
| 9 | Blue Cross Blue Shield 4222_chirp blue cross star (hay) outpatient 20241201 fee schedule · outpatient | $14.7k | $14.7k | — | — | — | $14.7k – $14.7k |
| 10 | Blue Cross Blue Shield 5003_blue cross star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $14.7k | $14.7k | — | — | — | $14.7k – $14.7k |
| 11 | Blue Cross Blue Shield 5009_blue cross star kids (hay) outpatient 20241201 fee schedule · outpatient | $14.7k | $14.7k | — | — | — | $14.7k – $14.7k |
| 12 | UnitedHealthcare 4253_chirp uhc star (chi,dcn) outpatient 20241201 fee schedule · outpatient | $14.7k | $14.7k | — | — | — | $14.7k – $14.7k |
| 13 | UnitedHealthcare 4256_chirp uhc star (hay) outpatient 20241201 fee schedule · outpatient | $14.7k | $14.7k | — | — | — | $14.7k – $14.7k |
| 14 | UnitedHealthcare 4264_chirp uhc star plus (chi,dcn) outpatient 20241201 fee schedule · outpatient | $14.7k | $14.7k | — | — | — | $14.7k – $14.7k |
| 15 | UnitedHealthcare 4267_chirp uhc star plus (hay) outpatient 20241201 fee schedule · outpatient | $14.7k | $14.7k | — | — | — | $14.7k – $14.7k |
| 16 | UnitedHealthcare 4311_uhc star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $14.7k | $14.7k | — | — | — | $14.7k – $14.7k |
| 17 | UnitedHealthcare 4314_uhc star kids (hay) outpatient 20241201 fee schedule · outpatient | $14.7k | $14.7k | — | — | — | $14.7k – $14.7k |
| 18 | Tricare 1229_tricare cah outpatient 20170101 fee schedule · outpatient | $16.8k | $16.8k | — | — | — | $16.8k – $16.8k |
| 19 | Blue Cross Blue Shield 4440_blue cross blue shield hpn 20250501 fee schedule · outpatient | $18.5k | $18.5k | — | — | — | $18.5k – $18.5k |
| 20 | Blue Cross Blue Shield 4497_blue cross blue shield hpn (dell, williamson,hays) 20250501 fee schedule · outpatient | $18.5k | $18.5k | — | — | — | $18.5k – $18.5k |
| 21 | Blue Cross Blue Shield 4095_blue cross blue shield hmo essentials 20250101 fee schedule · outpatient | $19.9k | $19.9k | — | — | — | $19.9k – $19.9k |
| 22 | Blue Cross Blue Shield 4094_blue cross blue shield ppo 20250101 fee schedule · outpatient | $22.6k | $22.6k | — | — | — | $22.6k – $22.6k |
Last updated: Jan 1, 2026
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