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
INTERROG EVL PM/LDLS PM IP
Smithville, TX
See all hospitals reporting CPT 93288 →Price type
Ascension Seton’s median price of $118 is 99% above the median hospital's median price ($59), higher than 75% of the 1,812 hospitals reporting CPT 93288. 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, 19 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 | $32 | $32 | — | — | — | $32 – $32 |
| 2 | Blue Cross Blue Shield 4127_blue cross blue shield bav exchange 20250101 fee schedule · outpatient | $62 | $62 | — | — | — | $62 – $62 |
| 3 | Aetna 4335_aetna sha aisd 20250101 percent of total billed charges · outpatientfrom % of charges | $98 | $91 | $10 | 11% | — | $78 – $98 |
| 4 | Aetna 4489_aetna aco hmo 20250801 percent of total billed charges · outpatientfrom % of charges | $98 | $91 | $10 | 11% | — | $78 – $98 |
| 5 | Aetna 4490_aetna multi-tier whole health sha 20250801 percent of total billed charges · outpatientfrom % of charges | $109 | $101 | $11 | 11% | — | $86 – $109 |
| 6 | Aetna 4495_aetna aco hmo (smv) 20250801 percent of total billed charges · outpatientfrom % of charges | $109 | $109 | — | — | — | $109 – $109 |
| 7 | Aetna 4486_aetna hmo 20250801 percent of total billed charges · outpatientfrom % of charges | $124 | $115 | $12 | 11% | — | $98 – $124 |
| 8 | Aetna 4496_aetna multi-tier whole health (smv) 20250801 percent of total billed charges · outpatientfrom % of charges | $118 | $118 | — | — | — | $118 – $118 |
| 9 | Aetna 4488_aetna ppo 20250801 percent of total billed charges · outpatientfrom % of charges | $120 | $120 | — | — | — | $120 – $120 |
| 10 | Blue Cross Blue Shield 4440_blue cross blue shield hpn 20250501 fee schedule · outpatient | $123 | $123 | — | — | — | $123 – $123 |
| 11 | Blue Cross Blue Shield 4497_blue cross blue shield hpn (dell, williamson,hays) 20250501 fee schedule · outpatient | $123 | $123 | — | — | — | $123 – $123 |
| 12 | Aetna 4492_aetna hmo (smv) 20250801 percent of total billed charges · outpatientfrom % of charges | $133 | $133 | — | — | — | $133 – $133 |
| 13 | Aetna 4493_aetna ppo (smv) 20250801 percent of total billed charges · outpatientfrom % of charges | $133 | $133 | — | — | — | $133 – $133 |
| 14 | Blue Cross Blue Shield 4095_blue cross blue shield hmo essentials 20250101 fee schedule · outpatient | $136 | $136 | — | — | — | $136 – $136 |
| 15 | Aetna 4483_aetna aco ppo/hmo (chi,dcn) 20250801 percent of total billed charges · outpatientfrom % of charges | $150 | $150 | — | — | — | $150 – $150 |
| 16 | Blue Cross Blue Shield 4094_blue cross blue shield ppo 20250101 fee schedule · outpatient | $150 | $150 | — | — | — | $150 – $150 |
| 17 | Aetna 4484_aetna multi-tier whole health sha (chi,dcn) 20250801 percent of total billed charges · outpatientfrom % of charges | $165 | $165 | — | — | — | $165 – $165 |
| 18 | Aetna 4481_aetna hmo (chi,dcn) 20250801 percent of total billed charges · outpatientfrom % of charges | $182 | $182 | — | — | — | $182 – $182 |
| 19 | Aetna 4482_aetna ppo (chi,dcn) 20250801 percent of total billed charges · outpatientfrom % of charges | $182 | $182 | — | — | — | $182 – $182 |
Last updated: Jan 1, 2026
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