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
VISCOELASTIC CLOT INT/RP
CONROE, TX
See all hospitals reporting CPT 85396 →Price type
Hca Houston Healthcare Conroe’s median price of $191 is 463% above the median hospital's median price ($34), higher than 90% of the 1,395 hospitals reporting CPT 85396. 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, 41 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 allpayerappendix fee schedule · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 2 | UnitedHealthcare narrownetworkindivexchange fee schedule · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 3 | UnitedHealthcare smallgroup fee schedule · outpatient | $20 | $20 | — | — | — | $20 – $20 |
| 4 | Blue Cross Blue Shield mybluehealth fee schedule · outpatient | $42 | $42 | — | — | — | $42 – $42 |
| 5 | Blue Cross Blue Shield bav fee schedule · outpatient | $47 | $47 | — | — | — | $47 – $47 |
| 6 | Superior Healthplan chip percent of total billed charges · outpatientfrom % of charges | $52 | $52 | $3 | 5% | — | $48 – $56 |
| 7 | Superior Healthplan chpfc percent of total billed charges · outpatientfrom % of charges | $52 | $52 | $3 | 5% | — | $48 – $56 |
| 8 | Superior Healthplan star percent of total billed charges · outpatientfrom % of charges | $52 | $52 | $3 | 5% | — | $48 – $56 |
| 9 | Superior Healthplan starkids percent of total billed charges · outpatientfrom % of charges | $52 | $52 | $3 | 5% | — | $48 – $56 |
| 10 | Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges | $52 | $52 | $3 | 5% | — | $48 – $56 |
| 11 | Cigna csn fee schedule · outpatient | $54 | $54 | — | — | — | $54 – $54 |
| 12 | Aetna mcr percent of total billed charges · outpatientfrom % of charges | $58 | $58 | $3 | 5% | — | $53 – $62 |
| 13 | Blue Cross Blue Shield hmo fee schedule · outpatient | $58 | $58 | — | — | — | $58 – $58 |
| 14 | Cigna openaccessplus fee schedule · outpatient | $59 | $59 | — | — | — | $59 – $59 |
| 15 | Blue Cross Blue Shield eposoa fee schedule · outpatient | $62 | $62 | — | — | — | $62 – $62 |
| 16 | Blue Cross Blue Shield ppo fee schedule · outpatient | $67 | $67 | — | — | — | $67 – $67 |
| 17 | Cigna ppo fee schedule · outpatient | $70 | $70 | — | — | — | $70 – $70 |
| 18 | Aetna qhpexchange fee schedule · outpatient | $74 | $74 | — | — | — | $74 – $74 |
| 19 | Aetna nbhmo fee schedule · outpatient | $99 | $99 | — | — | — | $99 – $99 |
| 20 | Aetna nbpos fee schedule · outpatient | $99 | $99 | — | — | — | $99 – $99 |
| 21 | Aetna nbppo fee schedule · outpatient | $99 | $99 | — | — | — | $99 – $99 |
| 22 | Aetna commhmo fee schedule · outpatient | $105 | $105 | — | — | — | $105 – $105 |
| 23 | Aetna commpos fee schedule · outpatient | $105 | $105 | — | — | — | $105 – $105 |
| 24 | Aetna commppo fee schedule · outpatient | $105 | $105 | — | — | — | $105 – $105 |
| 25 | Aetna oonhmo fee schedule · outpatient | $123 | $123 | — | — | — | $123 – $123 |
Last updated: May 14, 2026
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