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
C EWHO DYNAMIC/ELBOW RT
Pasadena, TX
See all hospitals reporting HCPCS L3764 →Price type
Pmc Hospital, Llc’s median price of $319 is 65% below the median hospital's median price ($920), higher than 2% of the 1,044 hospitals reporting HCPCS L3764. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 36 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 | Blue Cross Blue Shield commercial|exchange fee schedule · outpatient | $210 | $210 | $6 | 3% | — | $205 – $216 |
| 2 | Blue Cross Blue Shield commercial|blue premier fee schedule · outpatient | $220 | $220 | $6 | 3% | — | $214 – $226 |
| 3 | Blue Cross Blue Shield commercial|exchange fee schedule · inpatient | $220 | $220 | $6 | 3% | — | $214 – $226 |
| 4 | UnitedHealthcare commercial|exchange fee schedule · outpatient | $240 | $240 | $7 | 3% | — | $234 – $247 |
| 5 | Blue Cross Blue Shield commercial|blue premier fee schedule · inpatient | $250 | $250 | $7 | 3% | — | $244 – $257 |
| 6 | Blue Cross Blue Shield commercial|myblue health exchange fee schedule · outpatient | $260 | $260 | $7 | 3% | — | $253 – $268 |
| 7 | UnitedHealthcare commercial|exchange fee schedule · inpatient | $260 | $260 | $7 | 3% | — | $253 – $268 |
| 8 | Blue Cross Blue Shield commercial|hmo fee schedule · outpatient | $270 | $270 | $7 | 3% | — | $263 – $278 |
| 9 | Blue Cross Blue Shield commercial|myblue health exchange fee schedule · inpatient | $280 | $280 | $8 | 3% | — | $273 – $288 |
| 10 | UnitedHealthcare commercial|charter fee schedule · outpatient | $280 | $280 | $8 | 3% | — | $273 – $288 |
| 11 | Blue Cross Blue Shield commercial|hmo fee schedule · inpatient | $291 | $291 | $8 | 3% | — | $283 – $298 |
| 12 | Blue Cross Blue Shield commercial|ppo fee schedule · outpatient | $301 | $301 | $8 | 3% | — | $292 – $309 |
| 13 | Cigna commercial|hmo fee schedule · inpatient | $301 | $301 | $8 | 3% | — | $292 – $309 |
| 14 | Cigna commercial|hmo fee schedule · outpatient | $301 | $301 | $8 | 3% | — | $292 – $309 |
| 15 | Cigna commercial|ppo fee schedule · inpatient | $301 | $301 | $8 | 3% | — | $292 – $309 |
| 16 | Cigna commercial|ppo fee schedule · outpatient | $301 | $301 | $8 | 3% | — | $292 – $309 |
| 17 | Cigna commercial|surefit fee schedule · inpatient | $301 | $301 | $8 | 3% | — | $292 – $309 |
| 18 | Cigna commercial|surefit fee schedule · outpatient | $301 | $301 | $8 | 3% | — | $292 – $309 |
| 19 | Blue Cross Blue Shield commercial|ppo fee schedule · inpatient | $311 | $311 | $8 | 3% | — | $302 – $319 |
| 20 | UnitedHealthcare commercial|charter fee schedule · inpatient | $311 | $311 | $8 | 3% | — | $302 – $319 |
| 21 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $311 | $311 | $8 | 3% | — | $302 – $319 |
| 22 | UnitedHealthcare commercial|ppo fee schedule · outpatient | $311 | $311 | $8 | 3% | — | $302 – $319 |
| 23 | UnitedHealthcare commercial|hmo fee schedule · inpatient | $351 | $351 | $10 | 3% | — | $341 – $360 |
| 24 | UnitedHealthcare commercial|ppo fee schedule · inpatient | $351 | $351 | $10 | 3% | — | $341 – $360 |
| 25 | Humana commercial|hmo fee schedule · inpatient | $421 | $421 | $11 | 3% | — | $409 – $432 |
Last updated: Feb 28, 2026
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