Panoramic dental X-ray of the jaw 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 ORTHOPANTOGRAM

Georgetown, TX

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Pricing by billing methodology

Price type

How this price compares nationally

St. David's Georgetown Hospital’s median price of $182 is 89% above the median hospital's median price ($97), higher than 81% of the 1,776 hospitals reporting CPT 70355. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 70355 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	UnitedHealthcare mgmcd fee schedule · outpatient	$18	$18	—	—	—	$18 – $18
2	Blue Cross Blue Shield chip fee schedule · outpatient	$19	$19	—	—	—	$19 – $19
3	Blue Cross Blue Shield mcd fee schedule · outpatient	$19	$19	—	—	—	$19 – $19
4	Molina chip fee schedule · outpatient	$20	$20	—	—	—	$20 – $20
5	Molina mcdstar fee schedule · outpatient	$20	$20	—	—	—	$20 – $20
6	Molina star+plus fee schedule · outpatient	$20	$20	—	—	—	$20 – $20
7	Molina starkids fee schedule · outpatient	$20	$20	—	—	—	$20 – $20
8	Humana mgmcd fee schedule · outpatient	$23	$23	—	—	—	$23 – $23
9	Aetna Better Health mcd fee schedule · outpatient	$23	$23	—	—	—	$23 – $23
10	Superior Healthplan chip percent of total billed charges · outpatientfrom % of charges	$46	$46	—	—	—	$46 – $46
11	Superior Healthplan chpfc percent of total billed charges · outpatientfrom % of charges	$46	$46	—	—	—	$46 – $46
12	Superior Healthplan star percent of total billed charges · outpatientfrom % of charges	$46	$46	—	—	—	$46 – $46
13	Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges	$46	$46	—	—	—	$46 – $46
14	Aetna narrownetwork fee schedule · outpatient	$49	$49	—	—	—	$49 – $49
15	Aetna comm fee schedule · outpatient	$68	$68	—	—	—	$68 – $68
16	Aetna meritain fee schedule · outpatient	$68	$68	—	—	—	$68 – $68
17	Aetna asa fee schedule · outpatient	$79	$79	—	—	—	$79 – $79
18	Aetna oon fee schedule · outpatient	$80	$80	—	—	—	$80 – $80
19	Cigna newbusinessnetwork fee schedule · outpatient	$107	$107	—	—	—	$107 – $107
20	Blue Cross Blue Shield mybluehealth fee schedule · outpatient	$115	$115	—	—	—	$115 – $115
21	Cigna hmo fee schedule · outpatient	$115	$115	—	—	—	$115 – $115
22	Cigna openaccess fee schedule · outpatient	$115	$115	—	—	—	$115 – $115
23	Cigna openaccessplus fee schedule · outpatient	$115	$115	—	—	—	$115 – $115
24	UnitedHealthcare narrownetworkhix fee schedule · outpatient	$124	$124	—	—	—	$124 – $124
25	Cigna ppo fee schedule · outpatient	$136	$136	—	—	—	$136 – $136

Page 1 of 2 · 45 rates

Last updated: Sep 1, 2026

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