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
SCRN MAM DIR DIGITAL-UNILAT
Smithville, TX
See all hospitals reporting CPT 77067 →Price type
Ascension Seton’s median price of $327 is 87% above the median hospital's median price ($174), higher than 84% of the 2,456 hospitals reporting CPT 77067. 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, 14 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 | Tricare 1229_tricare cah outpatient 20170101 fee schedule · outpatient | $44.79 | $44.79 | $44.79 – $44.79 |
| 2 | Blue Cross Blue Shield 4127_blue cross blue shield bav exchange 20250101 fee schedule · outpatient | $99.47 | $99.47 | $99.47 – $99.47 |
| 3 | Humana 2668_humana hmo 20230701 other · outpatient | $168.58 | $168.58 | $168.58 – $168.58 |
| 4 | Cigna 4475_cigna hmo (aus,nw,sw,hay) 20250701 fee schedule · both | $326.69 | $326.69 | $326.69 – $326.69 |
| 5 | Cigna 4476_cigna hmo (wil,del) 20250701 fee schedule · outpatient | $326.69 | $326.69 | $326.69 – $326.69 |
| 6 | Blue Cross Blue Shield 4440_blue cross blue shield hpn 20250501 fee schedule · outpatient | $330.24 | $330.24 | $330.24 – $330.24 |
| 7 | Blue Cross Blue Shield 4497_blue cross blue shield hpn (dell, williamson,hays) 20250501 fee schedule · outpatient | $330.24 | $330.24 | $330.24 – $330.24 |
| 8 | Blue Cross Blue Shield 4095_blue cross blue shield hmo essentials 20250101 fee schedule · outpatient | $365.05 | $365.05 | $365.05 – $365.05 |
| 9 | Blue Cross Blue Shield 4094_blue cross blue shield ppo 20250101 fee schedule · outpatient | $402.85 | $402.85 | $402.85 – $402.85 |
| 10 | Aetna 1377_aetna hmo exchange 20200101 fee schedule · outpatient | $563.36 | $563.36 | $563.36 – $563.36 |
| 11 | Aetna 4489_aetna aco hmo 20250801 fee schedule · both | $615.93 | $615.93 | $615.93 – $615.93 |
| 12 | Aetna 4490_aetna multi-tier whole health sha 20250801 fee schedule · both | $615.93 | $615.93 | $615.93 – $615.93 |
| 13 | Aetna 4335_aetna sha aisd 20250101 other · outpatient | $735.70 | $735.70 | $735.70 – $735.70 |
| 14 | Aetna 4486_aetna hmo 20250801 other · outpatient | $919.62 | $919.62 | $919.62 – $919.62 |
Last updated: Jan 1, 2026
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