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
PHENYLALANINE/TYROSINE
Smithville, TX
See all hospitals reporting CPT 84030 →Price type
Ascension Seton’s median price of $16 is 87% above the median hospital's median price ($9), higher than 68% of the 1,950 hospitals reporting CPT 84030. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 51 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 | Ambetter 3880_superior ambetter (chi,dcn) outpatient 20240901 fee schedule · outpatient | $5 | $5 | — | — | — | $5 – $5 |
| 2 | Blue Cross Blue Shield 4168_blue cross chip (chi,dcn) outpatient 20241201 fee schedule · outpatient | $5 | $5 | — | — | — | $5 – $5 |
| 3 | Blue Cross Blue Shield 4168_blue cross chip/star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $5 | $5 | — | — | — | $5 – $5 |
| 4 | Blue Cross Blue Shield 4174_blue cross chip (smv) outpatient 20241201 fee schedule · outpatient | $5 | $5 | — | — | — | $5 – $5 |
| 5 | Blue Cross Blue Shield 5003_blue cross star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $5 | $5 | — | — | — | $5 – $5 |
| 6 | Blue Cross Blue Shield 5015_blue cross star kids (smv) outpatient 20241201 fee schedule · outpatient | $5 | $5 | — | — | — | $5 – $5 |
| 7 | UnitedHealthcare 4253_chirp uhc star (chi,dcn) outpatient 20241201 fee schedule · outpatient | $5 | $5 | — | — | — | $5 – $5 |
| 8 | UnitedHealthcare 4259_chirp uhc star (smv) outpatient 20241201 fee schedule · outpatient | $5 | $5 | — | — | — | $5 – $5 |
| 9 | UnitedHealthcare 4264_chirp uhc star plus (chi,dcn) outpatient 20241201 fee schedule · outpatient | $5 | $5 | — | — | — | $5 – $5 |
| 10 | UnitedHealthcare 4270_chirp uhc star plus (smv) outpatient 20241201 fee schedule · outpatient | $5 | $5 | — | — | — | $5 – $5 |
| 11 | UnitedHealthcare 4311_uhc star kids (chi,dcn) outpatient 20241201 fee schedule · outpatient | $5 | $5 | — | — | — | $5 – $5 |
| 12 | UnitedHealthcare 4317_uhc star kids (smv) outpatient 20241201 fee schedule · outpatient | $5 | $5 | — | — | — | $5 – $5 |
| 13 | Blue Cross Blue Shield 4174_blue cross chip/star kids (smv) outpatient 20241201 fee schedule · both | $6 | $6 | — | — | — | $6 – $6 |
| 14 | Blue Cross Blue Shield 4219_chirp blue cross star (chi,dcn) outpatient 20241201 fee schedule · both | $6 | $6 | — | — | — | $6 – $6 |
| 15 | Blue Cross Blue Shield 4225_chirp blue cross star (smv) outpatient 20241201 fee schedule · both | $6 | $6 | — | — | — | $6 – $6 |
| 16 | Ambetter 3879_superior ambetter (chi,dcn) inpatient 20240901 fee schedule · both | $6 | $6 | — | — | — | $6 – $6 |
| 17 | Humana 2668_humana hmo 20230701 other · outpatient | $9 | $9 | — | — | — | $9 – $9 |
| 18 | Blue Cross Blue Shield 4127_blue cross blue shield bav exchange 20250101 fee schedule · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 19 | Cigna 4475_cigna hmo (aus,nw,sw,hay) 20250701 fee schedule · both | $13 | $13 | — | — | — | $13 – $13 |
| 20 | Cigna 4476_cigna hmo (wil,del) 20250701 fee schedule · outpatient | $13 | $13 | — | — | — | $13 – $13 |
| 21 | Aetna 1377_aetna hmo exchange 20200101 fee schedule · outpatient | $15 | $15 | — | — | — | $15 – $15 |
| 22 | Aetna 4489_aetna aco hmo 20250801 fee schedule · both | $16 | $16 | — | — | — | $16 – $16 |
| 23 | Aetna 4490_aetna multi-tier whole health sha 20250801 fee schedule · both | $16 | $16 | — | — | — | $16 – $16 |
| 24 | Blue Cross Blue Shield 3594_blue cross chip/star kids (chi,dcn) inpatient 20240901 fee schedule · both | $16 | $16 | — | — | — | $16 – $16 |
| 25 | Blue Cross Blue Shield 3600_blue cross chip/star kids (smv) inpatient 20240901 fee schedule · both | $16 | $16 | — | — | — | $16 – $16 |
Last updated: Jan 1, 2026
See Phenylalanine blood test for PKU pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.