Pelvic and abdominal lymphatic imaging, one side at Ascension Seton

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

LYMPH VESSEL X-RAY TRUNK

Luling, TX

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Pricing by billing methodology

Price type

How this price compares nationally

Ascension Seton’s median price of $429 is 85% below the median hospital's median price ($3.0k), higher than 14% of the 1,609 hospitals reporting CPT 75805. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 75805 at Ascension Seton

Negotiated rates from the hospital’s own file: 7 payers, 39 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 3594_blue cross chip/star kids (chi,dcn) inpatient 20240901 fee schedule · both	$286	$286	—	—	—	$286 – $286
2	UnitedHealthcare 3737_chirp uhc star (chi,dcn) inpatient 20240901 fee schedule · both	$286	$286	—	—	—	$286 – $286
3	UnitedHealthcare 3748_chirp uhc star plus (chi,dcn) inpatient 20240901 fee schedule · both	$286	$286	—	—	—	$286 – $286
4	UnitedHealthcare 4322_uhc star kids (chi,dcn) inpatient 20240901 fee schedule · both	$286	$286	—	—	—	$286 – $286
5	Ambetter 3879_superior ambetter (chi,dcn) inpatient 20240901 fee schedule · both	$287	$287	—	—	—	$287 – $287
6	Blue Cross Blue Shield 3693_chirp blue cross star (chi,dcn) inpatient 20240901 fee schedule · both	$287	$287	—	—	—	$287 – $287
7	Blue Cross Blue Shield 4219_chirp blue cross star (chi,dcn) outpatient 20241201 fee schedule · both	$287	$287	—	—	—	$287 – $287
8	UnitedHealthcare 4253_chirp uhc star (chi,dcn) outpatient 20241201 fee schedule · both	$287	$287	—	—	—	$287 – $287
9	UnitedHealthcare 4264_chirp uhc star plus (chi,dcn) outpatient 20241201 fee schedule · both	$287	$287	—	—	—	$287 – $287
10	UnitedHealthcare 4311_uhc star kids (chi,dcn) outpatient 20241201 fee schedule · both	$287	$287	—	—	—	$287 – $287
11	Ambetter 3880_superior ambetter (chi,dcn) outpatient 20240901 fee schedule · outpatient	$313	$313	—	—	—	$313 – $313
12	Blue Cross Blue Shield 4168_blue cross chip (chi,dcn) outpatient 20241201 fee schedule · outpatient	$313	$313	—	—	—	$313 – $313
13	Blue Cross Blue Shield 4168_blue cross chip/star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient	$313	$313	—	—	—	$313 – $313
14	Blue Cross Blue Shield 5003_blue cross star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient	$313	$313	—	—	—	$313 – $313
15	Blue Cross Blue Shield 4221_chirp blue cross star (ebd) outpatient 20241201 fee schedule · both	$429	$429	—	—	—	$429 – $429
16	UnitedHealthcare 4255_chirp uhc star (ebd) outpatient 20241201 fee schedule · both	$429	$429	—	—	—	$429 – $429
17	UnitedHealthcare 4266_chirp uhc star plus (ebd) outpatient 20241201 fee schedule · both	$429	$429	—	—	—	$429 – $429
18	UnitedHealthcare 4313_uhc star kids (ebd) outpatient 20241201 fee schedule · both	$429	$429	—	—	—	$429 – $429
19	Humana 2668_humana hmo 20230701 other · outpatient	$459	$459	—	—	—	$459 – $459
20	Tricare 1229_tricare cah outpatient 20170101 fee schedule · outpatient	$645	$645	—	—	—	$645 – $645
21	Blue Cross Blue Shield 4127_blue cross blue shield bav exchange 20250101 fee schedule · outpatient	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
22	Aetna 4335_aetna sha aisd 20250101 fee schedule · outpatient	$1.3k	$1.3k	—	—	—	$1.3k – $1.3k
23	Cigna 4475_cigna hmo (aus,nw,sw,hay) 20250701 fee schedule · both	$3.4k	$3.4k	—	—	—	$3.4k – $3.4k
24	Cigna 4476_cigna hmo (wil,del) 20250701 fee schedule · outpatient	$3.4k	$3.4k	—	—	—	$3.4k – $3.4k
25	Blue Cross Blue Shield 3596_blue cross chip/star kids (ebd) inpatient 20240901 fee schedule · both	$3.6k	$3.6k	—	—	—	$3.6k – $3.6k

Page 1 of 2 · 39 rates

Last updated: Jan 1, 2026

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