|
Blepharoplasty, upper eyelid; with excessive skin weighting down lid
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 15823
|
| Hospital Charge Code |
36015823
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$709.01 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$709.01
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,072.68
|
| Rate for Payer: Amerigroup Medicare |
$2,072.68
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,709.98
|
| Rate for Payer: BCBS of TX Blue Essentials |
$3,245.48
|
| Rate for Payer: BCBS of TX Medicare |
$2,072.68
|
| Rate for Payer: BCBS of TX PPO |
$4,089.30
|
| Rate for Payer: Cigna Commercial |
$4,381.27
|
| Rate for Payer: Cigna Medicare |
$2,072.68
|
| Rate for Payer: Employer Direct Commercial |
$2,072.68
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,072.68
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,072.68
|
| Rate for Payer: Molina Medicare |
$2,072.68
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$3,834.46
|
| Rate for Payer: Scott and White Medicare |
$2,072.68
|
| Rate for Payer: Superior Health Plan EPO |
$2,072.68
|
| Rate for Payer: Superior Health Plan Medicare |
$2,072.68
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,072.68
|
| Rate for Payer: Universal American Medicare |
$2,072.68
|
| Rate for Payer: Wellcare Medicare |
$2,072.68
|
| Rate for Payer: Wellmed Medicare |
$2,072.68
|
|
|
Blepharoplasty, upper eyelid; with excessive skin weighting down lid
|
Facility
|
OP
|
$8,518.00
|
|
|
Service Code
|
HCPCS 15823
|
| Hospital Charge Code |
9900140
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$709.01 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$709.01
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,072.68
|
| Rate for Payer: Amerigroup Medicare |
$2,072.68
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,709.98
|
| Rate for Payer: BCBS of TX Blue Essentials |
$3,245.48
|
| Rate for Payer: BCBS of TX Medicare |
$2,072.68
|
| Rate for Payer: BCBS of TX PPO |
$4,089.30
|
| Rate for Payer: Cash Price |
$5,792.24
|
| Rate for Payer: Cash Price |
$5,792.24
|
| Rate for Payer: Cash Price |
$5,792.24
|
| Rate for Payer: Cigna Commercial |
$4,381.27
|
| Rate for Payer: Cigna Medicaid |
$6,132.96
|
| Rate for Payer: Cigna Medicare |
$2,072.68
|
| Rate for Payer: Employer Direct Commercial |
$2,072.68
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,072.68
|
| Rate for Payer: Molina CHIP/Medicaid |
$6,132.96
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,072.68
|
| Rate for Payer: Molina Medicare |
$2,072.68
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Parkland Medicaid |
$6,132.96
|
| Rate for Payer: Scott and White EPO/PPO |
$3,834.46
|
| Rate for Payer: Scott and White Medicare |
$2,072.68
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$6,132.96
|
| Rate for Payer: Superior Health Plan EPO |
$2,072.68
|
| Rate for Payer: Superior Health Plan Medicare |
$2,072.68
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,072.68
|
| Rate for Payer: Universal American Medicare |
$2,072.68
|
| Rate for Payer: Wellcare Medicare |
$2,072.68
|
| Rate for Payer: Wellmed Medicare |
$2,072.68
|
|
|
Blepharoplasty, upper eyelid; with excessive skin weighting down lid
|
Facility
|
IP
|
$8,518.00
|
|
|
Service Code
|
HCPCS 15823
|
| Hospital Charge Code |
9900140
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$5,792.24
|
|
|
BLOCK, BITE PLASTIC UNIVERSAL ADULT
|
Facility
|
OP
|
$18.53
|
|
| Hospital Charge Code |
993661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.67 |
| Max. Negotiated Rate |
$13.34 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$5.56
|
| Rate for Payer: BCBS of TX Blue Essentials |
$6.67
|
| Rate for Payer: BCBS of TX PPO |
$7.41
|
| Rate for Payer: Cash Price |
$12.60
|
| Rate for Payer: Cigna Medicaid |
$13.34
|
| Rate for Payer: Molina CHIP/Medicaid |
$13.34
|
| Rate for Payer: Multiplan Auto |
$12.04
|
| Rate for Payer: Multiplan Commercial |
$12.04
|
| Rate for Payer: Multiplan Workers Comp |
$12.04
|
| Rate for Payer: Parkland Medicaid |
$13.34
|
| Rate for Payer: Scott and White EPO/PPO |
$9.27
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$13.34
|
| Rate for Payer: Superior Health Plan EPO |
$2.52
|
|
|
BLOCK, BITE PLASTIC UNIVERSAL ADULT
|
Facility
|
IP
|
$18.53
|
|
| Hospital Charge Code |
993661
|
|
Hospital Revenue Code
|
270
|
| Rate for Payer: Cash Price |
$12.60
|
|
|
BLOCKER ENDOBRONCHIAL RUSCH EZ-BLOCK
|
Facility
|
IP
|
$894.38
|
|
| Hospital Charge Code |
145525
|
|
Hospital Revenue Code
|
272
|
| Rate for Payer: Cash Price |
$608.18
|
|
|
BLOCKER ENDOBRONCHIAL RUSCH EZ-BLOCK
|
Facility
|
OP
|
$894.38
|
|
| Hospital Charge Code |
145525
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.49 |
| Max. Negotiated Rate |
$643.95 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$80.49
|
| Rate for Payer: BCBS of TX Blue Advantage |
$268.31
|
| Rate for Payer: BCBS of TX Blue Essentials |
$321.98
|
| Rate for Payer: BCBS of TX PPO |
$357.75
|
| Rate for Payer: Cash Price |
$608.18
|
| Rate for Payer: Cigna Medicaid |
$643.95
|
| Rate for Payer: Molina CHIP/Medicaid |
$643.95
|
| Rate for Payer: Multiplan Auto |
$581.35
|
| Rate for Payer: Multiplan Commercial |
$581.35
|
| Rate for Payer: Multiplan Workers Comp |
$581.35
|
| Rate for Payer: Parkland Medicaid |
$643.95
|
| Rate for Payer: Scott and White EPO/PPO |
$447.19
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$643.95
|
| Rate for Payer: Superior Health Plan EPO |
$121.64
|
|
|
Blood Administration Charges: -> Blood Administration Complete
|
Facility
|
OP
|
$2,059.00
|
|
|
Service Code
|
HCPCS 36430
|
| Hospital Charge Code |
2408664
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$58.47 |
| Max. Negotiated Rate |
$1,482.48 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$185.31
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$443.18
|
| Rate for Payer: Amerigroup Medicare |
$443.18
|
| Rate for Payer: BCBS of TX Blue Advantage |
$58.47
|
| Rate for Payer: BCBS of TX Blue Essentials |
$70.02
|
| Rate for Payer: BCBS of TX Medicare |
$443.18
|
| Rate for Payer: BCBS of TX PPO |
$88.23
|
| Rate for Payer: Cash Price |
$1,400.12
|
| Rate for Payer: Cash Price |
$1,400.12
|
| Rate for Payer: Cash Price |
$1,400.12
|
| Rate for Payer: Cigna Commercial |
$936.81
|
| Rate for Payer: Cigna Medicaid |
$1,482.48
|
| Rate for Payer: Cigna Medicare |
$443.18
|
| Rate for Payer: Employer Direct Commercial |
$443.18
|
| Rate for Payer: Humana Medicare/TRICARE |
$443.18
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,482.48
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$443.18
|
| Rate for Payer: Molina Medicare |
$443.18
|
| Rate for Payer: Multiplan Auto |
$1,338.35
|
| Rate for Payer: Multiplan Commercial |
$1,338.35
|
| Rate for Payer: Multiplan Workers Comp |
$1,338.35
|
| Rate for Payer: Parkland Medicaid |
$1,482.48
|
| Rate for Payer: Scott and White EPO/PPO |
$1,029.50
|
| Rate for Payer: Scott and White Medicare |
$443.18
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,482.48
|
| Rate for Payer: Superior Health Plan EPO |
$443.18
|
| Rate for Payer: Superior Health Plan Medicare |
$443.18
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$443.18
|
| Rate for Payer: Universal American Medicare |
$443.18
|
| Rate for Payer: Wellcare Medicare |
$443.18
|
| Rate for Payer: Wellmed Medicare |
$443.18
|
|
|
Blood Administration Charges: -> Blood Administration Complete
|
Facility
|
IP
|
$2,059.00
|
|
|
Service Code
|
HCPCS 36430
|
| Hospital Charge Code |
2408664
|
|
Hospital Revenue Code
|
391
|
| Rate for Payer: Cash Price |
$1,400.12
|
|
|
BLOOD ADMIN SET KENTEC 039600F
|
Facility
|
OP
|
$65.96
|
|
| Hospital Charge Code |
8568497
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.94 |
| Max. Negotiated Rate |
$47.49 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$5.94
|
| Rate for Payer: BCBS of TX Blue Advantage |
$19.79
|
| Rate for Payer: BCBS of TX Blue Essentials |
$23.75
|
| Rate for Payer: BCBS of TX PPO |
$26.38
|
| Rate for Payer: Cash Price |
$44.85
|
| Rate for Payer: Cigna Medicaid |
$47.49
|
| Rate for Payer: Molina CHIP/Medicaid |
$47.49
|
| Rate for Payer: Multiplan Auto |
$42.87
|
| Rate for Payer: Multiplan Commercial |
$42.87
|
| Rate for Payer: Multiplan Workers Comp |
$42.87
|
| Rate for Payer: Parkland Medicaid |
$47.49
|
| Rate for Payer: Scott and White EPO/PPO |
$32.98
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$47.49
|
| Rate for Payer: Superior Health Plan EPO |
$8.97
|
|
|
BLOOD ADMIN SET KENTEC 039600F
|
Facility
|
IP
|
$65.96
|
|
| Hospital Charge Code |
8568497
|
|
Hospital Revenue Code
|
272
|
| Rate for Payer: Cash Price |
$44.85
|
|
|
Blood Agar Plate, 5% Sheep In Tryptic Soy Agar Base, Eh, 15 x 100 mm plate
|
Facility
|
IP
|
$9.65
|
|
| Hospital Charge Code |
993332
|
|
Hospital Revenue Code
|
272
|
| Rate for Payer: Cash Price |
$6.56
|
|
|
Blood Agar Plate, 5% Sheep In Tryptic Soy Agar Base, Eh, 15 x 100 mm plate
|
Facility
|
OP
|
$9.65
|
|
| Hospital Charge Code |
993332
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$6.95 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$0.87
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2.90
|
| Rate for Payer: BCBS of TX Blue Essentials |
$3.47
|
| Rate for Payer: BCBS of TX PPO |
$3.86
|
| Rate for Payer: Cash Price |
$6.56
|
| Rate for Payer: Cigna Medicaid |
$6.95
|
| Rate for Payer: Molina CHIP/Medicaid |
$6.95
|
| Rate for Payer: Multiplan Auto |
$6.27
|
| Rate for Payer: Multiplan Commercial |
$6.27
|
| Rate for Payer: Multiplan Workers Comp |
$6.27
|
| Rate for Payer: Parkland Medicaid |
$6.95
|
| Rate for Payer: Scott and White EPO/PPO |
$4.83
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$6.95
|
| Rate for Payer: Superior Health Plan EPO |
$1.31
|
|
|
Blood Agar Plate Slide, 5% Sheep Blood, Polystyrene Petri, for the Nonselective Cultivation of Microorganisms, Bacteria, Yeast and Fungi
|
Facility
|
OP
|
$3.55
|
|
| Hospital Charge Code |
993340
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.32 |
| Max. Negotiated Rate |
$2.56 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$0.32
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1.06
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1.28
|
| Rate for Payer: BCBS of TX PPO |
$1.42
|
| Rate for Payer: Cash Price |
$2.41
|
| Rate for Payer: Cigna Medicaid |
$2.56
|
| Rate for Payer: Molina CHIP/Medicaid |
$2.56
|
| Rate for Payer: Multiplan Auto |
$2.31
|
| Rate for Payer: Multiplan Commercial |
$2.31
|
| Rate for Payer: Multiplan Workers Comp |
$2.31
|
| Rate for Payer: Parkland Medicaid |
$2.56
|
| Rate for Payer: Scott and White EPO/PPO |
$1.77
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$2.56
|
| Rate for Payer: Superior Health Plan EPO |
$0.48
|
|
|
Blood Agar Plate Slide, 5% Sheep Blood, Polystyrene Petri, for the Nonselective Cultivation of Microorganisms, Bacteria, Yeast and Fungi
|
Facility
|
IP
|
$3.55
|
|
| Hospital Charge Code |
993340
|
|
Hospital Revenue Code
|
272
|
| Rate for Payer: Cash Price |
$2.41
|
|
|
Blood count; complete (CBC), automated
|
Facility
|
OP
|
$243.00
|
|
|
Service Code
|
HCPCS 85027
|
| Hospital Charge Code |
1600477
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.52 |
| Max. Negotiated Rate |
$174.96 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$2.52
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$6.47
|
| Rate for Payer: Amerigroup Medicare |
$6.47
|
| Rate for Payer: BCBS of TX Blue Advantage |
$72.90
|
| Rate for Payer: BCBS of TX Blue Essentials |
$87.48
|
| Rate for Payer: BCBS of TX Medicare |
$6.47
|
| Rate for Payer: BCBS of TX PPO |
$97.20
|
| Rate for Payer: Cash Price |
$165.24
|
| Rate for Payer: Cash Price |
$165.24
|
| Rate for Payer: Cigna Medicaid |
$174.96
|
| Rate for Payer: Cigna Medicare |
$6.47
|
| Rate for Payer: Employer Direct Commercial |
$6.47
|
| Rate for Payer: Humana Medicare/TRICARE |
$6.47
|
| Rate for Payer: Molina CHIP/Medicaid |
$174.96
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$6.47
|
| Rate for Payer: Molina Medicare |
$6.47
|
| Rate for Payer: Multiplan Auto |
$157.95
|
| Rate for Payer: Multiplan Commercial |
$157.95
|
| Rate for Payer: Multiplan Workers Comp |
$157.95
|
| Rate for Payer: Parkland Medicaid |
$174.96
|
| Rate for Payer: Scott and White EPO/PPO |
$8.09
|
| Rate for Payer: Scott and White Medicare |
$6.47
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$174.96
|
| Rate for Payer: Superior Health Plan EPO |
$6.47
|
| Rate for Payer: Superior Health Plan Medicare |
$6.47
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$6.47
|
| Rate for Payer: Universal American Medicare |
$6.47
|
| Rate for Payer: Wellcare Medicare |
$6.47
|
| Rate for Payer: Wellmed Medicare |
$6.47
|
|
|
Blood count; complete (CBC), automated
|
Facility
|
IP
|
$243.00
|
|
|
Service Code
|
HCPCS 85027
|
| Hospital Charge Code |
1600477
|
|
Hospital Revenue Code
|
305
|
| Rate for Payer: Cash Price |
$165.24
|
|
|
Blood Culture
|
Facility
|
OP
|
$391.00
|
|
|
Service Code
|
HCPCS 87040
|
| Hospital Charge Code |
4107040
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.02 |
| Max. Negotiated Rate |
$281.52 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$4.02
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$10.32
|
| Rate for Payer: Amerigroup Medicare |
$10.32
|
| Rate for Payer: BCBS of TX Blue Advantage |
$117.30
|
| Rate for Payer: BCBS of TX Blue Essentials |
$140.76
|
| Rate for Payer: BCBS of TX Medicare |
$10.32
|
| Rate for Payer: BCBS of TX PPO |
$156.40
|
| Rate for Payer: Cash Price |
$265.88
|
| Rate for Payer: Cash Price |
$265.88
|
| Rate for Payer: Cigna Medicaid |
$281.52
|
| Rate for Payer: Cigna Medicare |
$10.32
|
| Rate for Payer: Employer Direct Commercial |
$10.32
|
| Rate for Payer: Humana Medicare/TRICARE |
$10.32
|
| Rate for Payer: Molina CHIP/Medicaid |
$281.52
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$10.32
|
| Rate for Payer: Molina Medicare |
$10.32
|
| Rate for Payer: Multiplan Auto |
$254.15
|
| Rate for Payer: Multiplan Commercial |
$254.15
|
| Rate for Payer: Multiplan Workers Comp |
$254.15
|
| Rate for Payer: Parkland Medicaid |
$281.52
|
| Rate for Payer: Scott and White EPO/PPO |
$12.90
|
| Rate for Payer: Scott and White Medicare |
$10.32
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$281.52
|
| Rate for Payer: Superior Health Plan EPO |
$10.32
|
| Rate for Payer: Superior Health Plan Medicare |
$10.32
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$10.32
|
| Rate for Payer: Universal American Medicare |
$10.32
|
| Rate for Payer: Wellcare Medicare |
$10.32
|
| Rate for Payer: Wellmed Medicare |
$10.32
|
|
|
Blood Culture
|
Facility
|
IP
|
$391.00
|
|
|
Service Code
|
HCPCS 87040
|
| Hospital Charge Code |
4107040
|
|
Hospital Revenue Code
|
306
|
| Rate for Payer: Cash Price |
$265.88
|
|
|
BLOOD INFU ST -- DHF
|
Facility
|
IP
|
$53.29
|
|
| Hospital Charge Code |
80313356
|
|
Hospital Revenue Code
|
272
|
| Rate for Payer: Cash Price |
$36.24
|
|
|
BLOOD INFU ST -- DHF
|
Facility
|
OP
|
$53.29
|
|
| Hospital Charge Code |
80313356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$38.37 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$4.80
|
| Rate for Payer: BCBS of TX Blue Advantage |
$15.99
|
| Rate for Payer: BCBS of TX Blue Essentials |
$19.18
|
| Rate for Payer: BCBS of TX PPO |
$21.32
|
| Rate for Payer: Cash Price |
$36.24
|
| Rate for Payer: Cigna Medicaid |
$38.37
|
| Rate for Payer: Molina CHIP/Medicaid |
$38.37
|
| Rate for Payer: Multiplan Auto |
$34.64
|
| Rate for Payer: Multiplan Commercial |
$34.64
|
| Rate for Payer: Multiplan Workers Comp |
$34.64
|
| Rate for Payer: Parkland Medicaid |
$38.37
|
| Rate for Payer: Scott and White EPO/PPO |
$26.64
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$38.37
|
| Rate for Payer: Superior Health Plan EPO |
$7.25
|
|
|
Blood, occult, by fecal
|
Facility
|
IP
|
$173.60
|
|
|
Service Code
|
HCPCS 82274 QW
|
| Hospital Charge Code |
993995
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$118.05
|
|
|
Blood, occult, by fecal
|
Facility
|
OP
|
$173.60
|
|
|
Service Code
|
HCPCS 82274 QW
|
| Hospital Charge Code |
993995
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.21 |
| Max. Negotiated Rate |
$124.99 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$6.21
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$15.92
|
| Rate for Payer: Amerigroup Medicare |
$15.92
|
| Rate for Payer: BCBS of TX Blue Advantage |
$52.08
|
| Rate for Payer: BCBS of TX Blue Essentials |
$62.50
|
| Rate for Payer: BCBS of TX Medicare |
$15.92
|
| Rate for Payer: BCBS of TX PPO |
$69.44
|
| Rate for Payer: Cash Price |
$118.05
|
| Rate for Payer: Cash Price |
$118.05
|
| Rate for Payer: Cigna Medicaid |
$124.99
|
| Rate for Payer: Cigna Medicare |
$15.92
|
| Rate for Payer: Employer Direct Commercial |
$15.92
|
| Rate for Payer: Humana Medicare/TRICARE |
$15.92
|
| Rate for Payer: Molina CHIP/Medicaid |
$124.99
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$15.92
|
| Rate for Payer: Molina Medicare |
$15.92
|
| Rate for Payer: Multiplan Auto |
$112.84
|
| Rate for Payer: Multiplan Commercial |
$112.84
|
| Rate for Payer: Multiplan Workers Comp |
$112.84
|
| Rate for Payer: Parkland Medicaid |
$124.99
|
| Rate for Payer: Scott and White EPO/PPO |
$19.90
|
| Rate for Payer: Scott and White Medicare |
$15.92
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$124.99
|
| Rate for Payer: Superior Health Plan EPO |
$15.92
|
| Rate for Payer: Superior Health Plan Medicare |
$15.92
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$15.92
|
| Rate for Payer: Universal American Medicare |
$15.92
|
| Rate for Payer: Wellcare Medicare |
$15.92
|
| Rate for Payer: Wellmed Medicare |
$15.92
|
|
|
Blood, occult, by peroxidase activity
|
Facility
|
OP
|
$152.00
|
|
|
Service Code
|
HCPCS 82270
|
| Hospital Charge Code |
1604073
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.71 |
| Max. Negotiated Rate |
$109.44 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1.71
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$4.38
|
| Rate for Payer: Amerigroup Medicare |
$4.38
|
| Rate for Payer: BCBS of TX Blue Advantage |
$45.60
|
| Rate for Payer: BCBS of TX Blue Essentials |
$54.72
|
| Rate for Payer: BCBS of TX Medicare |
$4.38
|
| Rate for Payer: BCBS of TX PPO |
$60.80
|
| Rate for Payer: Cash Price |
$103.36
|
| Rate for Payer: Cash Price |
$103.36
|
| Rate for Payer: Cigna Medicaid |
$109.44
|
| Rate for Payer: Cigna Medicare |
$4.38
|
| Rate for Payer: Employer Direct Commercial |
$4.38
|
| Rate for Payer: Humana Medicare/TRICARE |
$4.38
|
| Rate for Payer: Molina CHIP/Medicaid |
$109.44
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$4.38
|
| Rate for Payer: Molina Medicare |
$4.38
|
| Rate for Payer: Multiplan Auto |
$98.80
|
| Rate for Payer: Multiplan Commercial |
$98.80
|
| Rate for Payer: Multiplan Workers Comp |
$98.80
|
| Rate for Payer: Parkland Medicaid |
$109.44
|
| Rate for Payer: Scott and White EPO/PPO |
$5.47
|
| Rate for Payer: Scott and White Medicare |
$4.38
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$109.44
|
| Rate for Payer: Superior Health Plan EPO |
$4.38
|
| Rate for Payer: Superior Health Plan Medicare |
$4.38
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$4.38
|
| Rate for Payer: Universal American Medicare |
$4.38
|
| Rate for Payer: Wellcare Medicare |
$4.38
|
| Rate for Payer: Wellmed Medicare |
$4.38
|
|
|
Blood, occult, by peroxidase activity
|
Facility
|
OP
|
$152.00
|
|
|
Service Code
|
HCPCS 82270
|
| Hospital Charge Code |
4102270
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.71 |
| Max. Negotiated Rate |
$109.44 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1.71
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$4.38
|
| Rate for Payer: Amerigroup Medicare |
$4.38
|
| Rate for Payer: BCBS of TX Blue Advantage |
$45.60
|
| Rate for Payer: BCBS of TX Blue Essentials |
$54.72
|
| Rate for Payer: BCBS of TX Medicare |
$4.38
|
| Rate for Payer: BCBS of TX PPO |
$60.80
|
| Rate for Payer: Cash Price |
$103.36
|
| Rate for Payer: Cash Price |
$103.36
|
| Rate for Payer: Cigna Medicaid |
$109.44
|
| Rate for Payer: Cigna Medicare |
$4.38
|
| Rate for Payer: Employer Direct Commercial |
$4.38
|
| Rate for Payer: Humana Medicare/TRICARE |
$4.38
|
| Rate for Payer: Molina CHIP/Medicaid |
$109.44
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$4.38
|
| Rate for Payer: Molina Medicare |
$4.38
|
| Rate for Payer: Multiplan Auto |
$98.80
|
| Rate for Payer: Multiplan Commercial |
$98.80
|
| Rate for Payer: Multiplan Workers Comp |
$98.80
|
| Rate for Payer: Parkland Medicaid |
$109.44
|
| Rate for Payer: Scott and White EPO/PPO |
$5.47
|
| Rate for Payer: Scott and White Medicare |
$4.38
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$109.44
|
| Rate for Payer: Superior Health Plan EPO |
$4.38
|
| Rate for Payer: Superior Health Plan Medicare |
$4.38
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$4.38
|
| Rate for Payer: Universal American Medicare |
$4.38
|
| Rate for Payer: Wellcare Medicare |
$4.38
|
| Rate for Payer: Wellmed Medicare |
$4.38
|
|
