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
HDR RDNCL NTRSTL/ICAV BRCHTX
Smithville, TX
See all hospitals reporting CPT 77771 →Price type
Ascension Seton’s median price of $1.7k is 74% above the median hospital's median price ($996), higher than 73% of the 1,558 hospitals reporting CPT 77771. 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 | $673 | $673 | — | — | — | $673 – $673 |
| 2 | Humana 2668_humana hmo 20230701 other · outpatient | $723 | $723 | — | — | — | $723 – $723 |
| 3 | Blue Cross Blue Shield 4127_blue cross blue shield bav exchange 20250101 fee schedule · outpatient | $744 | $744 | — | — | — | $744 – $744 |
| 4 | Blue Cross Blue Shield 4440_blue cross blue shield hpn 20250501 fee schedule · outpatient | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 5 | Blue Cross Blue Shield 4497_blue cross blue shield hpn (dell, williamson,hays) 20250501 fee schedule · outpatient | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 6 | Blue Cross Blue Shield 4095_blue cross blue shield hmo essentials 20250101 fee schedule · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 7 | Blue Cross Blue Shield 4094_blue cross blue shield ppo 20250101 fee schedule · outpatient | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 8 | Cigna 4475_cigna hmo (aus,nw,sw,hay) 20250701 fee schedule · both | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 9 | Cigna 4476_cigna hmo (wil,del) 20250701 fee schedule · outpatient | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 10 | Aetna 1377_aetna hmo exchange 20200101 fee schedule · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 11 | Aetna 4489_aetna aco hmo 20250801 fee schedule · both | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 12 | Aetna 4490_aetna multi-tier whole health sha 20250801 fee schedule · both | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 13 | Aetna 4335_aetna sha aisd 20250101 other · outpatient | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
| 14 | Aetna 4486_aetna hmo 20250801 other · outpatient | $3.9k | $3.9k | — | — | — | $3.9k – $3.9k |
Last updated: Jan 1, 2026
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