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
EXCISION BRANCHIAL CLEFT CYST, VESTIGE, OR FISTULA, EXTENDING BENEATH SUBCUTANEOUS TISSUES AND/OR INTO PHARYNX
Plano, TX
See all hospitals reporting CPT 42815 →Price type
Baylor Scott & White Medical Center - Plano’s median price of $7.4k is 22% above the median hospital's median price ($6.0k), higher than 70% of the 1,666 hospitals reporting CPT 42815. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 22 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 · fee schedule · outpatient | $1,954 | $1,954 | $1,954 – $1,954 |
| 2 | UnitedHealthcare medicaid/chip facility · fee schedule · outpatient | $2,091 | $2,091 | $2,091 – $2,091 |
| 3 | Baylor Scott White Health Plan medicare advantage facility · fee schedule · outpatient | $5,649 | $5,649 | $5,649 – $5,649 |
| 4 | Aetna medicare advantage facility · fee schedule · outpatient | $5,947 | $5,947 | $5,947 – $5,947 |
| 5 | Humana medicare facility · fee schedule · outpatient | $5,947 | $5,947 | $5,947 – $5,947 |
| 6 | Blue Cross Blue Shield medicare advantage facility · fee schedule · outpatient | $6,244 | $6,244 | $6,244 – $6,244 |
| 7 | Superior Healthplan medicare facility · fee schedule · outpatient | $6,244 | $6,244 | $6,244 – $6,244 |
| 8 | UnitedHealthcare medicare advantage facility · fee schedule · outpatient | $6,660 | $6,660 | $6,660 – $6,660 |
| 9 | Baylor Scott White Health Plan bsw premier - small group facility · fee schedule · outpatient | $7,136 | $7,136 | $7,136 – $7,136 |
| 10 | Cigna local plus facility · case rate · outpatient | $7,373 | $7,373 | $7,373 – $7,373 |
| 11 | Baylor Scott White Health Plan bsw premier - individual facility · fee schedule · outpatient | $7,463 | $7,463 | $7,463 – $7,463 |
| 12 | UnitedHealthcare charter facility · case rate · outpatient | $7,711 | $7,711 | $7,711 – $7,711 |
| 13 | UnitedHealthcare nexus facility · case rate · outpatient | $7,711 | $7,711 | $7,711 – $7,711 |
| 14 | Blue Cross Blue Shield blue advantage facility · case rate · outpatient | $8,197 | $8,197 | $8,197 – $8,197 |
| 15 | UnitedHealthcare commercial broad facility · case rate · outpatient | $8,568 | $8,568 | $8,568 – $8,568 |
| 16 | Cigna hmo/ppo facility · case rate · outpatient | $8,674 | $8,674 | $8,674 – $8,674 |
| 17 | Baylor Scott White Health Plan bsw plus - small group facility · fee schedule · outpatient | $9,812 | $9,812 | $9,812 – $9,812 |
| 18 | Blue Cross Blue Shield blue premier/high performance network/my bluehealth facility · case rate · outpatient | $11,593 | $11,593 | $11,593 – $11,593 |
| 19 | Ambetter ambetter exchange facility · fee schedule · outpatient | $12,786 | $12,786 | $12,786 – $12,786 |
| 20 | Blue Cross Blue Shield city of dallas facility · case rate · outpatient | $15,570 | $15,570 | $15,570 – $15,570 |
| 21 | Blue Cross Blue Shield blue essentials (hmo) facility · case rate · outpatient | $16,443 | $16,443 | $16,443 – $16,443 |
| 22 | Blue Cross Blue Shield bluechoice (ppo) facility · case rate · outpatient | $17,316 | $17,316 | $17,316 – $17,316 |
Last updated: Jun 29, 2026
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