Thyrotropin Receptor Antibody at Somervell County Hospital District dba Glen Rose Medical Center

Glen Rose, TX

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Pricing by billing methodology

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Payers reporting CPT 52003 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	$68	$68	—	—	—	$68 – $68
2	Blue Cross Blue Shield pos percent of total billed charges · outpatientfrom % of charges	$73	$73	—	—	—	$73 – $73
3	Aetna non hmo percent of total billed charges · outpatientfrom % of charges	$78	$78	—	—	—	$78 – $78
4	Aetna ppo percent of total billed charges · outpatientfrom % of charges	$78	$78	—	—	—	$78 – $78
5	Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges	$82	$82	—	—	—	$82 – $82
6	Anthem amerihealth hmo percent of total billed charges · outpatientfrom % of charges	$90	$90	—	—	—	$90 – $90
7	Humana commercial hmo percent of total billed charges · outpatientfrom % of charges	$101	$101	—	—	—	$101 – $101
8	Humana ppo percent of total billed charges · outpatientfrom % of charges	$106	$106	—	—	—	$106 – $106
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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