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
REMOVE CONTRACEPTIVE CAPSULE
San Antonio, TX
See all hospitals reporting CPT 11976 →Price type
Santa Rosa Hospital - Alamo Heights’s median price of $661 is 16% below the median hospital's median price ($787), higher than 29% of the 1,815 hospitals reporting CPT 11976. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 31 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 | Aetna chip km fee schedule · outpatient | $61.74 | $61.74 | $61.74 – $61.74 |
| 2 | Aetna star km fee schedule · outpatient | $61.74 | $61.74 | $61.74 – $61.74 |
| 3 | Bcbs Tx star chip km fee schedule · outpatient | $61.74 | $61.74 | $61.74 – $61.74 |
| 4 | Molina chip km fee schedule · outpatient | $61.74 | $61.74 | $61.74 – $61.74 |
| 5 | Molina star plus km fee schedule · outpatient | $61.74 | $61.74 | $61.74 – $61.74 |
| 6 | UnitedHealthcare chip km fee schedule · outpatient | $61.74 | $61.74 | $61.74 – $61.74 |
| 7 | UnitedHealthcare star km fee schedule · outpatient | $61.74 | $61.74 | $61.74 – $61.74 |
| 8 | UnitedHealthcare star plus km fee schedule · outpatient | $61.74 | $61.74 | $61.74 – $61.74 |
| 9 | Bcbs Tx blue advantangehmo fee schedule · outpatient | $81.46 | $81.46 | $81.46 – $81.46 |
| 10 | Bcbs Tx heb fee schedule · outpatient | $90.52 | $90.52 | $90.52 – $90.52 |
| 11 | Bcbs Tx hmo fee schedule · outpatient | $98.06 | $98.06 | $98.06 – $98.06 |
| 12 | Bcbs Tx ppo fee schedule · outpatient | $100.32 | $100.32 | $100.32 – $100.32 |
| 13 | Bcbs Tx traditional fee schedule · outpatient | $116.92 | $116.92 | $116.92 – $116.92 |
| 14 | Humana choicecare other · outpatient | $199.00 | $199.00 | $199.00 – $199.00 |
| 15 | Aetna mm fee schedule · outpatient | $660.66 | $660.66 | $660.66 – $660.66 |
| 16 | Bcbs Tx mm fee schedule · outpatient | $660.66 | $660.66 | $660.66 – $660.66 |
| 17 | Humana gold choice mm fee schedule · outpatient | $660.66 | $660.66 | $660.66 – $660.66 |
| 18 | Humana gold plus mm fee schedule · outpatient | $660.66 | $660.66 | $660.66 – $660.66 |
| 19 | Molina medicare adv mm fee schedule · outpatient | $660.66 | $660.66 | $660.66 – $660.66 |
| 20 | UnitedHealthcare mm fee schedule · outpatient | $660.66 | $660.66 | $660.66 – $660.66 |
| 21 | WellCare mm fee schedule · outpatient | $660.66 | $660.66 | $660.66 – $660.66 |
| 22 | Devoted mm fee schedule · outpatient | $713.51 | $713.51 | $713.51 – $713.51 |
| 23 | Aetna new business case rate · outpatient | $1,612 | $1,612 | $1,612 – $1,612 |
| 24 | Aetna epo case rate · outpatient | $1,791 | $1,791 | $1,791 – $1,791 |
| 25 | Aetna hmo case rate · outpatient | $1,791 | $1,791 | $1,791 – $1,791 |
Last updated: Jan 13, 2026
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