Cisternography with contrast dye and radiologist review at St. David's Georgetown Hospital

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

XR CISTERNOGRM PS CON

Georgetown, TX

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How this price compares nationally

St. David's Georgetown Hospital’s median price of $272 is 66% below the median hospital's median price ($790), higher than 21% of the 1,482 hospitals reporting CPT 70015. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 70015 at St. David's Georgetown Hospital

Negotiated rates from the hospital’s own file: 11 payers, 45 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	Superior Healthplan chip percent of total billed charges · outpatientfrom % of charges	$35	$35	—	—	—	$35 – $35
2	Superior Healthplan chpfc percent of total billed charges · outpatientfrom % of charges	$35	$35	—	—	—	$35 – $35
3	Superior Healthplan star percent of total billed charges · outpatientfrom % of charges	$35	$35	—	—	—	$35 – $35
4	Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges	$35	$35	—	—	—	$35 – $35
5	Superior Healthplan ambetterepo percent of total billed charges · outpatientfrom % of charges	$119	$119	—	—	—	$119 – $119
6	Superior Healthplan ambetterhmo percent of total billed charges · outpatientfrom % of charges	$119	$119	—	—	—	$119 – $119
7	Superior Healthplan valuehmo percent of total billed charges · outpatientfrom % of charges	$119	$119	—	—	—	$119 – $119
8	UnitedHealthcare mgmcd fee schedule · outpatient	$172	$172	—	—	—	$172 – $172
9	UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges	$174	$174	—	—	—	$174 – $174
10	Blue Cross Blue Shield chip fee schedule · outpatient	$175	$175	—	—	—	$175 – $175
11	Blue Cross Blue Shield mcd fee schedule · outpatient	$175	$175	—	—	—	$175 – $175
12	Molina chip fee schedule · outpatient	$183	$183	—	—	—	$183 – $183
13	Molina mcdstar fee schedule · outpatient	$183	$183	—	—	—	$183 – $183
14	Molina star+plus fee schedule · outpatient	$183	$183	—	—	—	$183 – $183
15	Molina starkids fee schedule · outpatient	$183	$183	—	—	—	$183 – $183
16	Humana hmo percent of total billed charges · outpatientfrom % of charges	$194	$194	—	—	—	$194 – $194
17	Humana ppo percent of total billed charges · outpatientfrom % of charges	$194	$194	—	—	—	$194 – $194
18	Healthcare Highways epo percent of total billed charges · outpatientfrom % of charges	$203	$203	—	—	—	$203 – $203
19	Humana mgmcd fee schedule · outpatient	$208	$208	—	—	—	$208 – $208
20	Healthcare Highways ppo percent of total billed charges · outpatientfrom % of charges	$209	$209	—	—	—	$209 – $209
21	Aetna Better Health mcd fee schedule · outpatient	$210	$210	—	—	—	$210 – $210
22	Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges	$223	$223	—	—	—	$223 – $223
23	UnitedHealthcare globalbenefitplan percent of total billed charges · outpatientfrom % of charges	$314	$314	—	—	—	$314 – $314
24	First Health ppo percent of total billed charges · outpatientfrom % of charges	$470	$453	$38	8%	—	$399 – $488
25	MultiPlan phcsprimarynetwork percent of total billed charges · outpatientfrom % of charges	$524	$524	—	—	—	$524 – $524

Page 1 of 2 · 45 rates

Last updated: Sep 1, 2026

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