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
HC INSJ/RPLC CARDIAC MODULJ SYS PLS GENERATOR ONLY
Grapevine, TX
See all hospitals reporting CPT 0409T →Price type
Baylor Scott & White Medical Center - Grapevine’s median price of $22.4k is about the same as the median hospital's median price ($22.5k), higher than 48% of the 1,319 hospitals reporting CPT 0409T. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 29 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 | Superior Healthplan medicaid facility · percent of total billed charges · outpatientfrom % of charges | $4,124 | $4,124 | $4,124 – $4,124 |
| 2 | Aetna medicaid facility · percent of total billed charges · outpatientfrom % of charges | $4,207 | $4,207 | $4,207 – $4,207 |
| 3 | UnitedHealthcare medicaid/chip facility · percent of total billed charges · outpatientfrom % of charges | $4,413 | $4,413 | $4,413 – $4,413 |
| 4 | Cigna local plus facility · case rate · outpatient | $7,038 | $7,038 | $7,038 – $7,038 |
| 5 | Cigna hmo/ppo facility · case rate · outpatient | $8,280 | $8,280 | $8,280 – $8,280 |
| 6 | Baylor Scott White Health Plan bsw premier - large group/bsw premier direct to employer (rate 1)/bswh employee facility · percent of total billed charges · outpatientfrom % of charges | $14,023 | $14,023 | $14,023 – $14,023 |
| 7 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $15,122 | $15,122 | $15,122 – $15,122 |
| 8 | Baylor Scott White Health Plan bsw plus - large group/bsw premier direct to employer (rate 2) facility · percent of total billed charges · outpatientfrom % of charges | $16,497 | $16,497 | $16,497 – $16,497 |
| 9 | First Health ppo facility · percent of total billed charges · inpatientfrom % of charges | $19,247 | $19,247 | $19,247 – $19,247 |
| 10 | First Health ppo facility · percent of total billed charges · outpatientfrom % of charges | $19,247 | $19,247 | $19,247 – $19,247 |
| 11 | Humana commercial ppo facility · percent of total billed charges · outpatientfrom % of charges | $19,247 | $19,247 | $19,247 – $19,247 |
| 12 | Baylor Scott White Health Plan medicare advantage facility · fee schedule · outpatient | $21,263 | $21,263 | $21,263 – $21,263 |
| 13 | Aetna medicare advantage facility · fee schedule · outpatient | $22,382 | $22,382 | $22,382 – $22,382 |
| 14 | Humana medicare facility · fee schedule · outpatient | $22,382 | $22,382 | $22,382 – $22,382 |
| 15 | Blue Cross Blue Shield medicare advantage facility · fee schedule · outpatient | $23,501 | $23,501 | $23,501 – $23,501 |
| 16 | Superior Healthplan medicare facility · fee schedule · outpatient | $23,501 | $23,501 | $23,501 – $23,501 |
| 17 | UnitedHealthcare medicare advantage facility · fee schedule · outpatient | $25,068 | $25,068 | $25,068 – $25,068 |
| 18 | Baylor Scott White Health Plan bsw premier - small group facility · fee schedule · outpatient | $26,858 | $26,858 | $26,858 – $26,858 |
| 19 | Baylor Scott White Health Plan bsw premier - individual facility · fee schedule · outpatient | $28,089 | $28,089 | $28,089 – $28,089 |
| 20 | Baylor Scott White Health Plan bsw plus - small group facility · fee schedule · outpatient | $36,930 | $36,930 | $36,930 – $36,930 |
| 21 | Blue Cross Blue Shield blue advantage facility · case rate · outpatient | $38,385 | $38,385 | $38,385 – $38,385 |
| 22 | Ambetter ambetter exchange facility · fee schedule · outpatient | $48,121 | $48,121 | $48,121 – $48,121 |
| 23 | Blue Cross Blue Shield blue premier/high performance network/my bluehealth facility · case rate · outpatient | $54,284 | $54,284 | $54,284 – $54,284 |
| 24 | UnitedHealthcare charter facility · case rate · outpatient | $62,593 | $62,593 | $62,593 – $62,593 |
| 25 | UnitedHealthcare nexus facility · case rate · outpatient | $62,593 | $62,593 | $62,593 – $62,593 |
Last updated: Jun 29, 2026
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