3D rendering of CT, MRI, or ultrasound imaging 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

3D CT/MRI/US/OTH NOT IND

Austin, TX

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Pricing by billing methodology

Price type

How this price compares nationally

St.davids Surgical Hospital’s median price of $468 is 113% above the median hospital's median price ($220), higher than 67% of the 2,158 hospitals reporting CPT 76376. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 76376 at St.davids Surgical Hospital

Negotiated rates from the hospital’s own file: 7 payers, 26 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	Blue Cross Blue Shield mybluehealth fee schedule · outpatient	$19	$19	—	—	—	$19 – $19
2	Blue Cross Blue Shield blueadvantage fee schedule · outpatient	$24	$24	—	—	—	$24 – $24
3	Blue Cross Blue Shield blueessentials fee schedule · outpatient	$35	$35	—	—	—	$35 – $35
4	Blue Cross Blue Shield blueessentialsaccess fee schedule · outpatient	$35	$35	—	—	—	$35 – $35
5	Blue Cross Blue Shield eposoa fee schedule · outpatient	$38	$38	—	—	—	$38 – $38
6	Blue Cross Blue Shield ppo fee schedule · outpatient	$41	$41	—	—	—	$41 – $41
7	Superior Healthplan chip percent of total billed charges · outpatientfrom % of charges	$79	$79	—	—	—	$79 – $79
8	Superior Healthplan chpfc percent of total billed charges · outpatientfrom % of charges	$79	$79	—	—	—	$79 – $79
9	Superior Healthplan star percent of total billed charges · outpatientfrom % of charges	$79	$79	—	—	—	$79 – $79
10	Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges	$79	$79	—	—	—	$79 – $79
11	Superior Healthplan ambetterepo percent of total billed charges · outpatientfrom % of charges	$270	$270	—	—	—	$270 – $270
12	Superior Healthplan ambetterhmo percent of total billed charges · outpatientfrom % of charges	$270	$270	—	—	—	$270 – $270
13	Superior Healthplan valuehmo percent of total billed charges · outpatientfrom % of charges	$270	$270	—	—	—	$270 – $270
14	UnitedHealthcare optionsppo percent of total billed charges · outpatientfrom % of charges	$395	$395	—	—	—	$395 – $395
15	Humana hmo percent of total billed charges · outpatientfrom % of charges	$441	$441	—	—	—	$441 – $441
16	Humana ppo percent of total billed charges · outpatientfrom % of charges	$441	$441	—	—	—	$441 – $441
17	Blue Cross Blue Shield traditional percent of total billed charges · outpatientfrom % of charges	$468	$468	—	—	—	$468 – $468
18	UnitedHealthcare globalbenefitplan percent of total billed charges · outpatientfrom % of charges	$714	$714	—	—	—	$714 – $714
19	First Health ppo percent of total billed charges · outpatientfrom % of charges	$1.1k	$1.0k	$86	8%	—	$897 – $1.1k
20	MultiPlan phcsprimarynetwork percent of total billed charges · outpatientfrom % of charges	$1.2k	$1.2k	—	—	—	$1.2k – $1.2k
21	MultiPlan complementarynetwork percent of total billed charges · outpatientfrom % of charges	$1.3k	$1.3k	—	—	—	$1.3k – $1.3k
22	Aetna narrownetwork per diem · outpatient	$1.7k	$1.7k	—	—	—	$1.7k – $1.7k
23	Aetna comm per diem · outpatient	$2.3k	$2.3k	—	—	—	$2.3k – $2.3k
24	Aetna meritain per diem · outpatient	$2.3k	$2.3k	—	—	—	$2.3k – $2.3k
25	Aetna asa per diem · outpatient	$2.7k	$2.7k	—	—	—	$2.7k – $2.7k

Page 1 of 2 · 26 rates

Last updated: Sep 1, 2026

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