Vit B1 (So) at Somervell County Hospital District dba Glen Rose Medical Center

Glen Rose, TX

Pricing by billing methodology

Price type

Payers reporting CPT 42501 at Somervell County Hospital District dba Glen Rose Medical Center

Negotiated rates from the hospital’s own file: 5 payers, 11 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 hmo percent of total billed charges · outpatientfrom % of charges	$84	$84	—	—	—	$84 – $84
2	Blue Cross Blue Shield pos percent of total billed charges · outpatientfrom % of charges	$90	$90	—	—	—	$90 – $90
3	Aetna non hmo percent of total billed charges · outpatientfrom % of charges	$97	$97	—	—	—	$97 – $97
4	Aetna ppo percent of total billed charges · outpatientfrom % of charges	$97	$97	—	—	—	$97 – $97
5	Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges	$101	$101	—	—	—	$101 – $101
6	Anthem amerihealth hmo percent of total billed charges · outpatientfrom % of charges	$110	$110	—	—	—	$110 – $110
7	Humana commercial hmo percent of total billed charges · outpatientfrom % of charges	$124	$124	—	—	—	$124 – $124
8	Humana ppo percent of total billed charges · outpatientfrom % of charges	$131	$131	—	—	—	$131 – $131
9	Cigna flexcare fee schedule · outpatient	$4.5k	$4.5k	—	—	—	$4.5k – $4.5k
10	Cigna hmo fee schedule · outpatient	$4.5k	$4.5k	—	—	—	$4.5k – $4.5k
11	Cigna ppo fee schedule · outpatient	$4.5k	$4.5k	—	—	—	$4.5k – $4.5k

Last updated: Aug 21, 2026

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