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
FT WORTH, TX
See all hospitals reporting CPT 42815 →Price type
Medical City Fort Worth’s median price of $8.0k is 33% above the median hospital's median price ($6.0k), higher than 76% 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: 11 payers, 38 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 chip fee schedule · outpatient | $1,954 | $1,954 | $1,954 – $1,954 |
| 2 | UnitedHealthcare star fee schedule · outpatient | $1,954 | $1,954 | $1,954 – $1,954 |
| 3 | UnitedHealthcare starkids fee schedule · outpatient | $1,954 | $1,954 | $1,954 – $1,954 |
| 4 | UnitedHealthcare starperinate fee schedule · outpatient | $1,954 | $1,954 | $1,954 – $1,954 |
| 5 | UnitedHealthcare starplus fee schedule · outpatient | $1,954 | $1,954 | $1,954 – $1,954 |
| 6 | Cigna Healthspring mgmcd fee schedule · outpatient | $2,052 | $2,052 | $2,052 – $2,052 |
| 7 | Molina chip fee schedule · outpatient | $2,169 | $2,169 | $2,150 – $2,189 |
| 8 | Molina mcdstar fee schedule · outpatient | $2,169 | $2,169 | $2,150 – $2,189 |
| 9 | Molina star+plus fee schedule · outpatient | $2,169 | $2,169 | $2,150 – $2,189 |
| 10 | Molina starkids fee schedule · outpatient | $2,169 | $2,169 | $2,150 – $2,189 |
| 11 | Aetna Better Health chip fee schedule · outpatient | $2,345 | $2,345 | $2,345 – $2,345 |
| 12 | Aetna Better Health mcd fee schedule · outpatient | $2,345 | $2,345 | $2,345 – $2,345 |
| 13 | Humana mgmcd fee schedule · outpatient | $2,443 | $2,443 | $2,443 – $2,443 |
| 14 | Aetna qhphix case rate · outpatient | $2,513 | $2,513 | $2,513 – $2,513 |
| 15 | Aetna newbusiness case rate · outpatient | $3,445 | $3,445 | $3,445 – $3,445 |
| 16 | Aetna comm case rate · outpatient | $3,682 | $3,682 | $3,682 – $3,682 |
| 17 | Aetna meritain case rate · outpatient | $3,682 | $3,682 | $3,682 – $3,682 |
| 18 | Aetna oon case rate · outpatient | $4,332 | $4,332 | $4,332 – $4,332 |
| 19 | MultiPlan primarynetwork case rate · outpatient | $7,092 | $7,092 | $7,092 – $7,092 |
| 20 | Blue Cross Blue Shield bluepremier fee schedule · outpatient | $7,179 | $7,179 | $7,179 – $7,179 |
| 21 | UnitedHealthcare narrownetworkindivexchange case rate · outpatient | $7,284 | $7,284 | $7,284 – $7,284 |
| 22 | Healthcare Highways narrownetwork case rate · outpatient | $7,300 | $7,300 | $7,300 – $7,300 |
| 23 | Oscar hix case rate · outpatient | $8,024 | $8,024 | $8,024 – $8,024 |
| 24 | UnitedHealthcare smallgroup case rate · outpatient | $8,830 | $8,830 | $8,830 – $8,830 |
| 25 | Humana comm case rate · outpatient | $11,743 | $11,743 | $11,743 – $11,743 |
Last updated: Mar 1, 2026
See Surgical removal of branchial cleft cyst or fistula pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.