RC 403
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 77067 SCRN BILATERAL MG INCL CAD
Orange, TX
See all hospitals reporting RC 403 →Price type
CHRISTUS Hospital - Orange’s median price of $189 is 42% above the median hospital's median price ($133), higher than 71% of the 1,823 hospitals reporting RC 403. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 11 payers, 28 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 | UnitedHealthcare hix fee schedule · outpatient | $39 | $39 | — | — | — | $39 – $39 |
| 2 | UnitedHealthcare chip km percent of total billed charges · outpatientfrom % of charges | $69 | $70 | $28 | 41% | — | $15 – $100 |
| 3 | UnitedHealthcare star kid km percent of total billed charges · outpatientfrom % of charges | $69 | $70 | $28 | 41% | — | $15 – $100 |
| 4 | UnitedHealthcare star km percent of total billed charges · outpatientfrom % of charges | $69 | $70 | $28 | 41% | — | $15 – $100 |
| 5 | UnitedHealthcare star plus km percent of total billed charges · outpatientfrom % of charges | $69 | $70 | $28 | 41% | — | $15 – $100 |
| 6 | UnitedHealthcare all payer fee schedule · outpatient | $111 | $111 | — | — | — | $111 – $111 |
| 7 | Aetna mm percent of total billed charges · outpatientfrom % of charges | $164 | $167 | $68 | 41% | — | $36 – $240 |
| 8 | Cigna new business fee schedule · outpatient | $197 | $197 | — | — | — | $197 – $197 |
| 9 | Molina chip km percent of total billed charges · outpatientfrom % of charges | $206 | $209 | $85 | 41% | — | $45 – $300 |
| 10 | Molina star km percent of total billed charges · outpatientfrom % of charges | $206 | $209 | $85 | 41% | — | $45 – $300 |
| 11 | Molina star plus km percent of total billed charges · outpatientfrom % of charges | $206 | $209 | $85 | 41% | — | $45 – $300 |
| 12 | Bcbs Tx blue advantage hmo fee schedule · outpatient | $286 | $215 | $101 | 47% | — | $73 – $286 |
| 13 | Humana choicecare fee schedule · outpatient | $299 | $241 | $83 | 34% | — | $124 – $299 |
| 14 | Cigna ppo fee schedule · outpatient | $254 | $254 | — | — | — | $254 – $254 |
| 15 | Healthcare Highways ppo other · outpatient | $263 | $263 | — | — | — | $263 – $263 |
| 16 | Bcbs Tx heb fee schedule · outpatient | $402 | $302 | $141 | 47% | — | $102 – $402 |
| 17 | Bcbs Tx hmo fee schedule · outpatient | $402 | $302 | $141 | 47% | — | $102 – $402 |
| 18 | Bcbs Tx ppo fee schedule · outpatient | $447 | $336 | $157 | 47% | — | $113 – $447 |
| 19 | Devoted mm percent of total billed charges · outpatientfrom % of charges | $343 | $349 | $142 | 41% | — | $75 – $500 |
| 20 | Bcbs Tx traditional fee schedule · outpatient | $474 | $356 | $167 | 47% | — | $120 – $474 |
| 21 | Aetna new business percent of total billed charges · outpatientfrom % of charges | $425 | $433 | $176 | 41% | — | $92 – $619 |
| 22 | First Health ppo percent of total billed charges · outpatientfrom % of charges | $445 | $454 | $185 | 41% | — | $97 – $649 |
| 23 | MultiPlan ppo percent of total billed charges · outpatientfrom % of charges | $445 | $454 | $185 | 41% | — | $97 – $649 |
| 24 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $445 | $454 | $185 | 41% | — | $97 – $649 |
| 25 | Aetna epo percent of total billed charges · outpatientfrom % of charges | $473 | $482 | $196 | 41% | — | $103 – $689 |
Last updated: Jan 13, 2026
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