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
EXC S/N/H/F/G MAL+MRG >4 CM
San Angelo, TX
See all hospitals reporting CPT 11626 →Price type
Shannon River Crest Hospital’s median price of $4.4k is 48% above the median hospital's median price ($3.0k), higher than 80% of the 1,992 hospitals reporting CPT 11626. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 4 payers, 6 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 | Molina managed medicaid facility · fee schedule · outpatient | $856 | $856 | — | — | — | $856 – $856 |
| 2 | Humana medicare advantage facility · case rate · outpatient | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 3 | Ambetter ppo facility · case rate · outpatient | $5.8k | $5.8k | — | — | — | $5.8k – $5.8k |
| 4 | Bcbs Tx hmo facility · fee schedule · outpatient | $6.3k | $6.3k | — | — | — | $6.3k – $6.3k |
| 5 | Bcbs Tx bav facility · fee schedule · outpatient | $6.6k | $6.6k | — | — | — | $6.6k – $6.6k |
| 6 | Bcbs Tx ppo facility · fee schedule · outpatient | $6.6k | $6.6k | — | — | — | $6.6k – $6.6k |
Last updated: Dec 8, 2025
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