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
ABO ISOAGGABDTT TTR(STAT)-SWID
Smithville, TX
See all hospitals reporting CPT 86976 →Price type
Ascension Seton’s median price of $73 is 99% above the median hospital's median price ($37), higher than 81% of the 1,693 hospitals reporting CPT 86976. 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, 12 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 | $29 | $29 | — | — | — | $29 – $29 |
| 2 | Blue Cross Blue Shield 4127_blue cross blue shield bav exchange 20250101 fee schedule · outpatient | $44 | $44 | — | — | — | $44 – $44 |
| 3 | Humana 2668_humana hmo 20230701 other · outpatient | $63 | $63 | — | — | — | $63 – $63 |
| 4 | Aetna 1377_aetna hmo exchange 20200101 fee schedule · outpatient | $67 | $67 | — | — | — | $67 – $67 |
| 5 | Aetna 4489_aetna aco hmo 20250801 fee schedule · both | $73 | $73 | — | — | — | $73 – $73 |
| 6 | Aetna 4490_aetna multi-tier whole health sha 20250801 fee schedule · both | $73 | $73 | — | — | — | $73 – $73 |
| 7 | Cigna 4475_cigna hmo (aus,nw,sw,hay) 20250701 fee schedule · both | $77 | $77 | — | — | — | $77 – $77 |
| 8 | Cigna 4476_cigna hmo (wil,del) 20250701 fee schedule · outpatient | $77 | $77 | — | — | — | $77 – $77 |
| 9 | Blue Cross Blue Shield 4440_blue cross blue shield hpn 20250501 fee schedule · outpatient | $89 | $89 | — | — | — | $89 – $89 |
| 10 | Blue Cross Blue Shield 4497_blue cross blue shield hpn (dell, williamson,hays) 20250501 fee schedule · outpatient | $89 | $89 | — | — | — | $89 – $89 |
| 11 | Blue Cross Blue Shield 4095_blue cross blue shield hmo essentials 20250101 fee schedule · outpatient | $98 | $98 | — | — | — | $98 – $98 |
| 12 | Blue Cross Blue Shield 4094_blue cross blue shield ppo 20250101 fee schedule · outpatient | $108 | $108 | — | — | — | $108 – $108 |
Last updated: Jan 1, 2026
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