CT upper extremity scan with contrast dye at St.davids Surgical 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

CT UP EXTREM W/CONT BI

Austin, TX

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Pricing by billing methodology

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How this price compares nationally

St.davids Surgical Hospital’s median price of $563 is 7% below the median hospital's median price ($608), higher than 46% of the 2,587 hospitals reporting CPT 73201. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 73201 at St.davids Surgical Hospital

Negotiated rates from the hospital’s own file: 8 payers, 31 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	$56	$75	$26	35%	—	$56 – $112
2	Superior Healthplan chpfc percent of total billed charges · outpatientfrom % of charges	$56	$75	$26	35%	—	$56 – $112
3	Superior Healthplan star percent of total billed charges · outpatientfrom % of charges	$56	$75	$26	35%	—	$56 – $112
4	Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges	$56	$75	$26	35%	—	$56 – $112
5	Superior Healthplan ambetterepo percent of total billed charges · outpatientfrom % of charges	$191	$254	$90	35%	—	$191 – $382
6	Superior Healthplan ambetterhmo percent of total billed charges · outpatientfrom % of charges	$191	$254	$90	35%	—	$191 – $382
7	Superior Healthplan valuehmo percent of total billed charges · outpatientfrom % of charges	$191	$254	$90	35%	—	$191 – $382
8	Humana mgmcd fee schedule · outpatient	$258	$258	—	—	—	$258 – $258
9	Aetna Better Health mcd fee schedule · outpatient	$260	$260	—	—	—	$260 – $260
10	UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges	$280	$373	$132	35%	—	$280 – $559
11	Humana hmo percent of total billed charges · outpatientfrom % of charges	$312	$416	$147	35%	—	$312 – $624
12	Humana ppo percent of total billed charges · outpatientfrom % of charges	$312	$416	$147	35%	—	$312 – $624
13	Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges	$331	$442	$156	35%	—	$331 – $662
14	UnitedHealthcare narrownetworkhix fee schedule · outpatient	$563	$563	—	—	—	$563 – $563
15	UnitedHealthcare globalbenefitplan percent of total billed charges · outpatientfrom % of charges	$505	$674	$238	35%	—	$505 – $1.0k
16	UnitedHealthcare allpayerappendix fee schedule · outpatient	$828	$828	—	—	—	$828 – $828
17	UnitedHealthcare smallgroup fee schedule · outpatient	$828	$828	—	—	—	$828 – $828
18	Blue Cross Blue Shield mybluehealth fee schedule · outpatient	$871	$871	—	—	—	$871 – $871
19	First Health ppo percent of total billed charges · outpatientfrom % of charges	$775	$958	$349	36%	—	$635 – $1.5k
20	Blue Cross Blue Shield blueadvantage fee schedule · outpatient	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
21	MultiPlan phcsprimarynetwork percent of total billed charges · outpatientfrom % of charges	$842	$1.1k	$397	35%	—	$842 – $1.7k
22	MultiPlan complementarynetwork percent of total billed charges · outpatientfrom % of charges	$955	$1.3k	$450	35%	—	$955 – $1.9k
23	Blue Cross Blue Shield blueessentials fee schedule · outpatient	$1.5k	$1.5k	—	—	—	$1.5k – $1.5k
24	Blue Cross Blue Shield blueessentialsaccess fee schedule · outpatient	$1.5k	$1.5k	—	—	—	$1.5k – $1.5k
25	Blue Cross Blue Shield eposoa fee schedule · outpatient	$1.6k	$1.6k	—	—	—	$1.6k – $1.6k

Page 1 of 2 · 31 rates

Last updated: Sep 1, 2026

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