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
ESPHG DSTL 2/3 W/LAPS MOBLJ
Smithville, TX
See all hospitals reporting CPT 43287 →Price type
Ascension Seton’s median price of $3.6k is 31% below the median hospital's median price ($5.2k), higher than 33% of the 1,223 hospitals reporting CPT 43287. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 3 payers, 7 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 | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 4 | Blue Cross Blue Shield 4440_blue cross blue shield hpn 20250501 fee schedule · outpatient | $3.6k | $3.6k | — | — | — | $3.6k – $3.6k |
| 5 | Blue Cross Blue Shield 4497_blue cross blue shield hpn (dell, williamson,hays) 20250501 fee schedule · outpatient | $3.6k | $3.6k | — | — | — | $3.6k – $3.6k |
| 6 | Blue Cross Blue Shield 4095_blue cross blue shield hmo essentials 20250101 fee schedule · outpatient | $3.9k | $3.9k | — | — | — | $3.9k – $3.9k |
| 7 | Blue Cross Blue Shield 4094_blue cross blue shield ppo 20250101 fee schedule · outpatient | $4.4k | $4.4k | — | — | — | $4.4k – $4.4k |
Last updated: Jan 1, 2026
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