Pelvic and abdominal lymphatic imaging, one side 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

SP LYMPHANG PEL/AB UN RT

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 $1.3k is 55% below the median hospital's median price ($3.0k), higher than 28% of the 1,609 hospitals reporting CPT 75805. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 75805 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	$172	$172	—	—	—	$172 – $172
2	Superior Healthplan chpfc percent of total billed charges · outpatientfrom % of charges	$172	$172	—	—	—	$172 – $172
3	Superior Healthplan star percent of total billed charges · outpatientfrom % of charges	$172	$172	—	—	—	$172 – $172
4	Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges	$172	$172	—	—	—	$172 – $172
5	UnitedHealthcare mgmcd fee schedule · outpatient	$320	$320	—	—	—	$320 – $320
6	Blue Cross Blue Shield chip fee schedule · outpatient	$329	$329	—	—	—	$329 – $329
7	Blue Cross Blue Shield mcd fee schedule · outpatient	$329	$329	—	—	—	$329 – $329
8	Molina chip fee schedule · outpatient	$345	$345	—	—	—	$345 – $345
9	Molina mcdstar fee schedule · outpatient	$345	$345	—	—	—	$345 – $345
10	Molina star+plus fee schedule · outpatient	$345	$345	—	—	—	$345 – $345
11	Molina starkids fee schedule · outpatient	$345	$345	—	—	—	$345 – $345
12	Humana mgmcd fee schedule · outpatient	$392	$392	—	—	—	$392 – $392
13	Aetna Better Health mcd fee schedule · outpatient	$395	$395	—	—	—	$395 – $395
14	Superior Healthplan ambetterepo percent of total billed charges · outpatientfrom % of charges	$584	$584	—	—	—	$584 – $584
15	Superior Healthplan ambetterhmo percent of total billed charges · outpatientfrom % of charges	$584	$584	—	—	—	$584 – $584
16	Superior Healthplan valuehmo percent of total billed charges · outpatientfrom % of charges	$584	$584	—	—	—	$584 – $584
17	UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges	$855	$855	—	—	—	$855 – $855
18	Humana hmo percent of total billed charges · outpatientfrom % of charges	$954	$954	—	—	—	$954 – $954
19	Humana ppo percent of total billed charges · outpatientfrom % of charges	$954	$954	—	—	—	$954 – $954
20	Healthcare Highways epo percent of total billed charges · outpatientfrom % of charges	$1000	$1000	—	—	—	$1000 – $1000
21	Healthcare Highways ppo percent of total billed charges · outpatientfrom % of charges	$1.0k	$1.0k	—	—	—	$1.0k – $1.0k
22	Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
23	UnitedHealthcare globalbenefitplan percent of total billed charges · outpatientfrom % of charges	$1.5k	$1.5k	—	—	—	$1.5k – $1.5k
24	Blue Cross Blue Shield mybluehealth fee schedule · outpatient	$1.6k	$1.6k	—	—	—	$1.6k – $1.6k
25	Blue Cross Blue Shield blueadvantage fee schedule · outpatient	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k

Page 1 of 2 · 45 rates

Last updated: Sep 1, 2026

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