Every billing code / CPT 53430 / Seattle Children's Hospital
CPT 53430 at Seattle Children's Hospital
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Seattle Children's Hospital, Seattle
This name is the CMS category the code belongs to (CMS's Restructured BETOS Classification System), shared with similar codes. The official CPT description belongs to the American Medical Association and isn't shown.
What Seattle Children's Hospital publishes for this code: as an outpatient
Seattle Children's Hospital’s prices for CPT 53430, as an outpatient| Who pays | Hospital’s fee (lowest – highest) | Doctor’s fee the hospital lists |
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| Commercial insuranceInsurer rates | $1,500 – $3,264at least 58 plans | — |
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| Medicaid managed careInsurer rates | $576 – $619at least 9 plans | — |
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| Medicaid (state program)Insurer rates | $559 – $563at least 1 plan | — |
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| Other government programInsurer rates | $1,179 – $1,186at least 1 plan | — |
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| UnknownInsurer rates | $559 – $2,527at least 21 plans | — |
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| Cash pricePaying yourself, without insurance | $4,080 – $73,802 | — |
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| List priceBefore any discount; few people pay it | $4,060 – $4,080 | — |
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Lowest and highest amounts Seattle Children's Hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. This is one line of a bill; most care brings several.
What Seattle Children's Hospital publishes for this code: during a hospital stay
Seattle Children's Hospital’s prices for CPT 53430, during a hospital stay| Who pays | Hospital’s fee (lowest – highest) | Doctor’s fee the hospital lists |
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| Commercial insuranceInsurer rates | $1,500 – $4,222at least 58 plans | — |
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| Medicaid managed careInsurer rates | $576 – $800at least 9 plans | — |
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| Medicaid (state program)Insurer rates | $559 – $727at least 1 plan | — |
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| Other government programInsurer rates | $1,179 – $1,532at least 1 plan | — |
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| UnknownInsurer rates | $559 – $3,278at least 21 plans | — |
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| Cash pricePaying yourself, without insurance | $5,278 | — |
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| List priceBefore any discount; few people pay it | $4,060 – $5,278 | — |
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Lowest and highest amounts Seattle Children's Hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. This is one line of a bill; most care brings several.
Bills to expect
The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in Seattle (King County) for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.
Bills to expect for CPT 53430 at Seattle Children's Hospital| Bill | What it’s for | Original Medicare allows | Private plan estimate |
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| Hospital's feeThe hospital | The operating or procedure room, nursing, supplies and recovery | — | The price above |
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| Surgeon or doctor doing itThe doctor's practice | The procedure, and routine follow-up visits for 90 days | $937 | $1,106 – $1,678 |
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| AnesthesiaAn anesthesia group (only sometimes) | Anesthesia or deep sedation, if you need itOnly if an anesthesia team is part of your care. Its amount depends on how long it takes. | — | — |
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Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.
Compare CPT 53430 at every Washington hospital, with Medicare’s reference amounts.