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
TC99M PENT AERS DX 75MCI
CONROE, TX
See all hospitals reporting HCPCS A9567 →Price type
Hca Houston Healthcare Conroe’s median price of $158 is 23% above the median hospital's median price ($128), higher than 56% of the 1,475 hospitals reporting HCPCS A9567. 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, 40 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 chip percent of total billed charges · outpatientfrom % of charges | $30 | $30 | — | — | — | $30 – $30 |
| 2 | Superior Healthplan chpfc percent of total billed charges · outpatientfrom % of charges | $30 | $30 | — | — | — | $30 – $30 |
| 3 | Superior Healthplan star percent of total billed charges · outpatientfrom % of charges | $30 | $30 | — | — | — | $30 – $30 |
| 4 | Superior Healthplan starkids percent of total billed charges · outpatientfrom % of charges | $30 | $30 | — | — | — | $30 – $30 |
| 5 | Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges | $30 | $30 | — | — | — | $30 – $30 |
| 6 | Aetna mcr percent of total billed charges · outpatientfrom % of charges | $33 | $33 | — | — | — | $33 – $33 |
| 7 | UnitedHealthcare allpayerappendix fee schedule · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 8 | UnitedHealthcare narrownetworkindivexchange fee schedule · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 9 | UnitedHealthcare smallgroup fee schedule · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 10 | Cigna csn fee schedule · outpatient | $42 | $42 | — | — | — | $42 – $42 |
| 11 | Cigna openaccessplus fee schedule · outpatient | $45 | $45 | — | — | — | $45 – $45 |
| 12 | Cigna ppo fee schedule · outpatient | $54 | $54 | — | — | — | $54 – $54 |
| 13 | Blue Cross Blue Shield mybluehealth percent of total billed charges · outpatientfrom % of charges | $80 | $80 | — | — | — | $80 – $80 |
| 14 | UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges | $87 | $87 | — | — | — | $87 – $87 |
| 15 | Blue Cross Blue Shield bav percent of total billed charges · outpatientfrom % of charges | $89 | $89 | — | — | — | $89 – $89 |
| 16 | Oscar hix percent of total billed charges · outpatientfrom % of charges | $96 | $96 | — | — | — | $96 – $96 |
| 17 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $111 | $111 | — | — | — | $111 – $111 |
| 18 | Blue Cross Blue Shield eposoa percent of total billed charges · outpatientfrom % of charges | $113 | $113 | — | — | — | $113 – $113 |
| 19 | Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges | $115 | $115 | — | — | — | $115 – $115 |
| 20 | Healthcare Highways narrownetwork percent of total billed charges · outpatientfrom % of charges | $125 | $125 | — | — | — | $125 – $125 |
| 21 | Molina hix percent of total billed charges · outpatientfrom % of charges | $133 | $133 | — | — | — | $133 – $133 |
| 22 | Aetna nbhmo percent of total billed charges · outpatientfrom % of charges | $158 | $158 | — | — | — | $158 – $158 |
| 23 | Aetna nbpos percent of total billed charges · outpatientfrom % of charges | $158 | $158 | — | — | — | $158 – $158 |
| 24 | Aetna nbppo percent of total billed charges · outpatientfrom % of charges | $158 | $158 | — | — | — | $158 – $158 |
| 25 | Aetna commhmo percent of total billed charges · outpatientfrom % of charges | $168 | $168 | — | — | — | $168 – $168 |
Last updated: May 14, 2026
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