|
CHED GI/GU/Rectal Procedures Anoscopy BCE
|
Facility
|
OP
|
$712.00
|
|
|
Service Code
|
HCPCS 46600
|
| Hospital Charge Code |
8912612
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$50.73 |
| Max. Negotiated Rate |
$512.64 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$64.08
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$133.65
|
| Rate for Payer: Amerigroup Medicare |
$133.65
|
| Rate for Payer: BCBS of TX Blue Advantage |
$182.08
|
| Rate for Payer: BCBS of TX Blue Essentials |
$218.06
|
| Rate for Payer: BCBS of TX Medicare |
$133.65
|
| Rate for Payer: BCBS of TX PPO |
$274.76
|
| Rate for Payer: Cash Price |
$484.16
|
| Rate for Payer: Cash Price |
$484.16
|
| Rate for Payer: Cash Price |
$484.16
|
| Rate for Payer: Cigna Commercial |
$282.53
|
| Rate for Payer: Cigna Medicaid |
$512.64
|
| Rate for Payer: Cigna Medicare |
$133.65
|
| Rate for Payer: Employer Direct Commercial |
$133.65
|
| Rate for Payer: Humana Medicare/TRICARE |
$133.65
|
| Rate for Payer: Molina CHIP/Medicaid |
$512.64
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$133.65
|
| Rate for Payer: Molina Medicare |
$133.65
|
| Rate for Payer: Multiplan Auto |
$462.80
|
| Rate for Payer: Multiplan Commercial |
$462.80
|
| Rate for Payer: Multiplan Workers Comp |
$462.80
|
| Rate for Payer: Parkland Medicaid |
$512.64
|
| Rate for Payer: Scott and White EPO/PPO |
$50.73
|
| Rate for Payer: Scott and White Medicare |
$133.65
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$512.64
|
| Rate for Payer: Superior Health Plan EPO |
$133.65
|
| Rate for Payer: Superior Health Plan Medicare |
$133.65
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$133.65
|
| Rate for Payer: Universal American Medicare |
$133.65
|
| Rate for Payer: Wellcare Medicare |
$133.65
|
| Rate for Payer: Wellmed Medicare |
$133.65
|
|
|
CHED GI/GU/Rectal Procedures Cystostomy/Foley change BCE
|
Facility
|
IP
|
$4,852.86
|
|
|
Service Code
|
HCPCS 51705
|
| Hospital Charge Code |
5202533
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$3,299.94
|
|
|
CHED GI/GU/Rectal Procedures Cystostomy/Foley change BCE
|
Facility
|
OP
|
$4,852.86
|
|
|
Service Code
|
HCPCS 51705
|
| Hospital Charge Code |
5202533
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$63.04 |
| Max. Negotiated Rate |
$3,494.06 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$436.76
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$250.99
|
| Rate for Payer: Amerigroup Medicare |
$250.99
|
| Rate for Payer: BCBS of TX Blue Advantage |
$102.45
|
| Rate for Payer: BCBS of TX Blue Essentials |
$122.70
|
| Rate for Payer: BCBS of TX Medicare |
$250.99
|
| Rate for Payer: BCBS of TX PPO |
$154.60
|
| Rate for Payer: Cash Price |
$3,299.94
|
| Rate for Payer: Cash Price |
$3,299.94
|
| Rate for Payer: Cash Price |
$3,299.94
|
| Rate for Payer: Cigna Commercial |
$530.54
|
| Rate for Payer: Cigna Medicaid |
$3,494.06
|
| Rate for Payer: Cigna Medicare |
$250.99
|
| Rate for Payer: Employer Direct Commercial |
$250.99
|
| Rate for Payer: Humana Medicare/TRICARE |
$250.99
|
| Rate for Payer: Molina CHIP/Medicaid |
$3,494.06
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$250.99
|
| Rate for Payer: Molina Medicare |
$250.99
|
| Rate for Payer: Multiplan Auto |
$3,154.36
|
| Rate for Payer: Multiplan Commercial |
$3,154.36
|
| Rate for Payer: Multiplan Workers Comp |
$3,154.36
|
| Rate for Payer: Parkland Medicaid |
$3,494.06
|
| Rate for Payer: Scott and White EPO/PPO |
$63.04
|
| Rate for Payer: Scott and White Medicare |
$250.99
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$3,494.06
|
| Rate for Payer: Superior Health Plan EPO |
$250.99
|
| Rate for Payer: Superior Health Plan Medicare |
$250.99
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$250.99
|
| Rate for Payer: Universal American Medicare |
$250.99
|
| Rate for Payer: Wellcare Medicare |
$250.99
|
| Rate for Payer: Wellmed Medicare |
$250.99
|
|
|
CHED GI/GU/Rectal Procedures Gastric Intubation w/ Lavage BCE
|
Facility
|
OP
|
$576.32
|
|
|
Service Code
|
HCPCS 43753
|
| Hospital Charge Code |
8912608
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$26.02 |
| Max. Negotiated Rate |
$637.81 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$51.87
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$216.91
|
| Rate for Payer: Amerigroup Medicare |
$216.91
|
| Rate for Payer: BCBS of TX Blue Advantage |
$422.68
|
| Rate for Payer: BCBS of TX Blue Essentials |
$506.20
|
| Rate for Payer: BCBS of TX Medicare |
$216.91
|
| Rate for Payer: BCBS of TX PPO |
$637.81
|
| Rate for Payer: Cash Price |
$391.90
|
| Rate for Payer: Cash Price |
$391.90
|
| Rate for Payer: Cash Price |
$391.90
|
| Rate for Payer: Cigna Commercial |
$458.51
|
| Rate for Payer: Cigna Medicaid |
$414.95
|
| Rate for Payer: Cigna Medicare |
$216.91
|
| Rate for Payer: Employer Direct Commercial |
$216.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$216.91
|
| Rate for Payer: Molina CHIP/Medicaid |
$414.95
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$216.91
|
| Rate for Payer: Molina Medicare |
$216.91
|
| Rate for Payer: Multiplan Auto |
$374.61
|
| Rate for Payer: Multiplan Commercial |
$374.61
|
| Rate for Payer: Multiplan Workers Comp |
$374.61
|
| Rate for Payer: Parkland Medicaid |
$414.95
|
| Rate for Payer: Scott and White EPO/PPO |
$26.02
|
| Rate for Payer: Scott and White Medicare |
$216.91
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$414.95
|
| Rate for Payer: Superior Health Plan EPO |
$216.91
|
| Rate for Payer: Superior Health Plan Medicare |
$216.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$216.91
|
| Rate for Payer: Universal American Medicare |
$216.91
|
| Rate for Payer: Wellcare Medicare |
$216.91
|
| Rate for Payer: Wellmed Medicare |
$216.91
|
|
|
CHED GI/GU/Rectal Procedures Gastric Intubation w/ Lavage BCE
|
Facility
|
IP
|
$576.32
|
|
|
Service Code
|
HCPCS 43753
|
| Hospital Charge Code |
8912608
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$391.90
|
|
|
CHED GI/GU/Rectal Procedures Paraphimosis treatment BCE
|
Facility
|
OP
|
$2,269.06
|
|
|
Service Code
|
HCPCS 54450
|
| Hospital Charge Code |
8912609
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$69.10 |
| Max. Negotiated Rate |
$1,633.72 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$204.22
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$250.99
|
| Rate for Payer: Amerigroup Medicare |
$250.99
|
| Rate for Payer: BCBS of TX Blue Advantage |
$392.28
|
| Rate for Payer: BCBS of TX Blue Essentials |
$469.80
|
| Rate for Payer: BCBS of TX Medicare |
$250.99
|
| Rate for Payer: BCBS of TX PPO |
$591.95
|
| Rate for Payer: Cash Price |
$1,542.96
|
| Rate for Payer: Cash Price |
$1,542.96
|
| Rate for Payer: Cash Price |
$1,542.96
|
| Rate for Payer: Cigna Commercial |
$530.54
|
| Rate for Payer: Cigna Medicaid |
$1,633.72
|
| Rate for Payer: Cigna Medicare |
$250.99
|
| Rate for Payer: Employer Direct Commercial |
$250.99
|
| Rate for Payer: Humana Medicare/TRICARE |
$250.99
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,633.72
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$250.99
|
| Rate for Payer: Molina Medicare |
$250.99
|
| Rate for Payer: Multiplan Auto |
$1,474.89
|
| Rate for Payer: Multiplan Commercial |
$1,474.89
|
| Rate for Payer: Multiplan Workers Comp |
$1,474.89
|
| Rate for Payer: Parkland Medicaid |
$1,633.72
|
| Rate for Payer: Scott and White EPO/PPO |
$69.10
|
| Rate for Payer: Scott and White Medicare |
$250.99
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,633.72
|
| Rate for Payer: Superior Health Plan EPO |
$250.99
|
| Rate for Payer: Superior Health Plan Medicare |
$250.99
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$250.99
|
| Rate for Payer: Universal American Medicare |
$250.99
|
| Rate for Payer: Wellcare Medicare |
$250.99
|
| Rate for Payer: Wellmed Medicare |
$250.99
|
|
|
CHED GI/GU/Rectal Procedures Paraphimosis treatment BCE
|
Facility
|
IP
|
$2,269.06
|
|
|
Service Code
|
HCPCS 54450
|
| Hospital Charge Code |
8912609
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,542.96
|
|
|
CHED GI/GU/Rectal Procedures Removal of hemorrhoid clot BCE
|
Facility
|
OP
|
$6,289.13
|
|
|
Service Code
|
HCPCS 46320
|
| Hospital Charge Code |
8912610
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.10 |
| Max. Negotiated Rate |
$4,528.17 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$566.02
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,202.09
|
| Rate for Payer: Amerigroup Medicare |
$1,202.09
|
| Rate for Payer: BCBS of TX Blue Advantage |
$224.80
|
| Rate for Payer: BCBS of TX Blue Essentials |
$269.22
|
| Rate for Payer: BCBS of TX Medicare |
$1,202.09
|
| Rate for Payer: BCBS of TX PPO |
$339.22
|
| Rate for Payer: Cash Price |
$4,276.61
|
| Rate for Payer: Cash Price |
$4,276.61
|
| Rate for Payer: Cash Price |
$4,276.61
|
| Rate for Payer: Cigna Commercial |
$2,541.00
|
| Rate for Payer: Cigna Medicaid |
$4,528.17
|
| Rate for Payer: Cigna Medicare |
$1,202.09
|
| Rate for Payer: Employer Direct Commercial |
$1,202.09
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,202.09
|
| Rate for Payer: Molina CHIP/Medicaid |
$4,528.17
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,202.09
|
| Rate for Payer: Molina Medicare |
$1,202.09
|
| Rate for Payer: Multiplan Auto |
$4,087.93
|
| Rate for Payer: Multiplan Commercial |
$4,087.93
|
| Rate for Payer: Multiplan Workers Comp |
$4,087.93
|
| Rate for Payer: Parkland Medicaid |
$4,528.17
|
| Rate for Payer: Scott and White EPO/PPO |
$140.10
|
| Rate for Payer: Scott and White Medicare |
$1,202.09
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$4,528.17
|
| Rate for Payer: Superior Health Plan EPO |
$1,202.09
|
| Rate for Payer: Superior Health Plan Medicare |
$1,202.09
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,202.09
|
| Rate for Payer: Universal American Medicare |
$1,202.09
|
| Rate for Payer: Wellcare Medicare |
$1,202.09
|
| Rate for Payer: Wellmed Medicare |
$1,202.09
|
|
|
CHED GI/GU/Rectal Procedures Removal of hemorrhoid clot BCE
|
Facility
|
IP
|
$6,289.13
|
|
|
Service Code
|
HCPCS 46320
|
| Hospital Charge Code |
8912610
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$4,276.61
|
|
|
CHED GI/GU/Rectal Procedures Removal of rectal obstruction BCE
|
Facility
|
IP
|
$8,019.00
|
|
|
Service Code
|
HCPCS 45915
|
| Hospital Charge Code |
8912611
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$5,452.92
|
|
|
CHED GI/GU/Rectal Procedures Removal of rectal obstruction BCE
|
Facility
|
OP
|
$8,019.00
|
|
|
Service Code
|
HCPCS 45915
|
| Hospital Charge Code |
8912611
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$281.31 |
| Max. Negotiated Rate |
$5,773.68 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$721.71
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,202.09
|
| Rate for Payer: Amerigroup Medicare |
$1,202.09
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,677.05
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,008.44
|
| Rate for Payer: BCBS of TX Medicare |
$1,202.09
|
| Rate for Payer: BCBS of TX PPO |
$2,530.63
|
| Rate for Payer: Cash Price |
$5,452.92
|
| Rate for Payer: Cash Price |
$5,452.92
|
| Rate for Payer: Cash Price |
$5,452.92
|
| Rate for Payer: Cigna Commercial |
$2,541.00
|
| Rate for Payer: Cigna Medicaid |
$5,773.68
|
| Rate for Payer: Cigna Medicare |
$1,202.09
|
| Rate for Payer: Employer Direct Commercial |
$1,202.09
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,202.09
|
| Rate for Payer: Molina CHIP/Medicaid |
$5,773.68
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,202.09
|
| Rate for Payer: Molina Medicare |
$1,202.09
|
| Rate for Payer: Multiplan Auto |
$5,212.35
|
| Rate for Payer: Multiplan Commercial |
$5,212.35
|
| Rate for Payer: Multiplan Workers Comp |
$5,212.35
|
| Rate for Payer: Parkland Medicaid |
$5,773.68
|
| Rate for Payer: Scott and White EPO/PPO |
$281.31
|
| Rate for Payer: Scott and White Medicare |
$1,202.09
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$5,773.68
|
| Rate for Payer: Superior Health Plan EPO |
$1,202.09
|
| Rate for Payer: Superior Health Plan Medicare |
$1,202.09
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,202.09
|
| Rate for Payer: Universal American Medicare |
$1,202.09
|
| Rate for Payer: Wellcare Medicare |
$1,202.09
|
| Rate for Payer: Wellmed Medicare |
$1,202.09
|
|
|
CHED GI/GU/Rectal Procedures Replace G-tube BCE
|
Facility
|
IP
|
$1,324.10
|
|
|
Service Code
|
HCPCS 49452
|
| Hospital Charge Code |
8912613
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$900.39
|
|
|
CHED GI/GU/Rectal Procedures Replace G-tube BCE
|
Facility
|
OP
|
$1,324.10
|
|
|
Service Code
|
HCPCS 49452
|
| Hospital Charge Code |
8912613
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$119.17 |
| Max. Negotiated Rate |
$1,980.52 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$119.17
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$911.12
|
| Rate for Payer: Amerigroup Medicare |
$911.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,312.49
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,571.84
|
| Rate for Payer: BCBS of TX Medicare |
$911.12
|
| Rate for Payer: BCBS of TX PPO |
$1,980.52
|
| Rate for Payer: Cash Price |
$900.39
|
| Rate for Payer: Cash Price |
$900.39
|
| Rate for Payer: Cash Price |
$900.39
|
| Rate for Payer: Cigna Commercial |
$1,925.93
|
| Rate for Payer: Cigna Medicaid |
$953.35
|
| Rate for Payer: Cigna Medicare |
$911.12
|
| Rate for Payer: Employer Direct Commercial |
$911.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$911.12
|
| Rate for Payer: Molina CHIP/Medicaid |
$953.35
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$911.12
|
| Rate for Payer: Molina Medicare |
$911.12
|
| Rate for Payer: Multiplan Auto |
$860.66
|
| Rate for Payer: Multiplan Commercial |
$860.66
|
| Rate for Payer: Multiplan Workers Comp |
$860.66
|
| Rate for Payer: Parkland Medicaid |
$953.35
|
| Rate for Payer: Scott and White EPO/PPO |
$162.50
|
| Rate for Payer: Scott and White Medicare |
$911.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$953.35
|
| Rate for Payer: Superior Health Plan EPO |
$911.12
|
| Rate for Payer: Superior Health Plan Medicare |
$911.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$911.12
|
| Rate for Payer: Universal American Medicare |
$911.12
|
| Rate for Payer: Wellcare Medicare |
$911.12
|
| Rate for Payer: Wellmed Medicare |
$911.12
|
|
|
CHED I AND D OF BARTHOLINS GLND ABS BCE
|
Facility
|
OP
|
$994.45
|
|
|
Service Code
|
HCPCS 56420
|
| Hospital Charge Code |
8680562
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$89.50 |
| Max. Negotiated Rate |
$716.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$89.50
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$203.09
|
| Rate for Payer: Amerigroup Medicare |
$203.09
|
| Rate for Payer: BCBS of TX Blue Advantage |
$140.11
|
| Rate for Payer: BCBS of TX Blue Essentials |
$167.80
|
| Rate for Payer: BCBS of TX Medicare |
$203.09
|
| Rate for Payer: BCBS of TX PPO |
$211.43
|
| Rate for Payer: Cash Price |
$676.23
|
| Rate for Payer: Cash Price |
$676.23
|
| Rate for Payer: Cash Price |
$676.23
|
| Rate for Payer: Cigna Commercial |
$429.31
|
| Rate for Payer: Cigna Medicaid |
$716.00
|
| Rate for Payer: Cigna Medicare |
$203.09
|
| Rate for Payer: Employer Direct Commercial |
$203.09
|
| Rate for Payer: Humana Medicare/TRICARE |
$203.09
|
| Rate for Payer: Molina CHIP/Medicaid |
$716.00
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$203.09
|
| Rate for Payer: Molina Medicare |
$203.09
|
| Rate for Payer: Multiplan Auto |
$646.39
|
| Rate for Payer: Multiplan Commercial |
$646.39
|
| Rate for Payer: Multiplan Workers Comp |
$646.39
|
| Rate for Payer: Parkland Medicaid |
$716.00
|
| Rate for Payer: Scott and White EPO/PPO |
$137.04
|
| Rate for Payer: Scott and White Medicare |
$203.09
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$716.00
|
| Rate for Payer: Superior Health Plan EPO |
$203.09
|
| Rate for Payer: Superior Health Plan Medicare |
$203.09
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$203.09
|
| Rate for Payer: Universal American Medicare |
$203.09
|
| Rate for Payer: Wellcare Medicare |
$203.09
|
| Rate for Payer: Wellmed Medicare |
$203.09
|
|
|
CHED I AND D OF BARTHOLINS GLND ABS BCE
|
Facility
|
IP
|
$994.45
|
|
|
Service Code
|
HCPCS 56420
|
| Hospital Charge Code |
8680562
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$676.23
|
|
|
CHED ID Aspirate Abscess/Cyst/Hematoma BCE
|
Facility
|
OP
|
$1,638.67
|
|
|
Service Code
|
HCPCS 10160
|
| Hospital Charge Code |
8912615
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$119.30 |
| Max. Negotiated Rate |
$1,179.84 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$147.48
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$408.37
|
| Rate for Payer: Amerigroup Medicare |
$408.37
|
| Rate for Payer: BCBS of TX Blue Advantage |
$139.23
|
| Rate for Payer: BCBS of TX Blue Essentials |
$166.74
|
| Rate for Payer: BCBS of TX Medicare |
$408.37
|
| Rate for Payer: BCBS of TX PPO |
$210.09
|
| Rate for Payer: Cash Price |
$1,114.30
|
| Rate for Payer: Cash Price |
$1,114.30
|
| Rate for Payer: Cash Price |
$1,114.30
|
| Rate for Payer: Cigna Commercial |
$863.21
|
| Rate for Payer: Cigna Medicaid |
$1,179.84
|
| Rate for Payer: Cigna Medicare |
$408.37
|
| Rate for Payer: Employer Direct Commercial |
$408.37
|
| Rate for Payer: Humana Medicare/TRICARE |
$408.37
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,179.84
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$408.37
|
| Rate for Payer: Molina Medicare |
$408.37
|
| Rate for Payer: Multiplan Auto |
$1,065.14
|
| Rate for Payer: Multiplan Commercial |
$1,065.14
|
| Rate for Payer: Multiplan Workers Comp |
$1,065.14
|
| Rate for Payer: Parkland Medicaid |
$1,179.84
|
| Rate for Payer: Scott and White EPO/PPO |
$119.30
|
| Rate for Payer: Scott and White Medicare |
$408.37
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,179.84
|
| Rate for Payer: Superior Health Plan EPO |
$408.37
|
| Rate for Payer: Superior Health Plan Medicare |
$408.37
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$408.37
|
| Rate for Payer: Universal American Medicare |
$408.37
|
| Rate for Payer: Wellcare Medicare |
$408.37
|
| Rate for Payer: Wellmed Medicare |
$408.37
|
|
|
CHED ID Aspirate Abscess/Cyst/Hematoma BCE
|
Facility
|
OP
|
$1,638.67
|
|
|
Service Code
|
HCPCS 10160
|
| Hospital Charge Code |
5061160
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$119.30 |
| Max. Negotiated Rate |
$1,179.84 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$147.48
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$408.37
|
| Rate for Payer: Amerigroup Medicare |
$408.37
|
| Rate for Payer: BCBS of TX Blue Advantage |
$139.23
|
| Rate for Payer: BCBS of TX Blue Essentials |
$166.74
|
| Rate for Payer: BCBS of TX Medicare |
$408.37
|
| Rate for Payer: BCBS of TX PPO |
$210.09
|
| Rate for Payer: Cash Price |
$1,114.30
|
| Rate for Payer: Cash Price |
$1,114.30
|
| Rate for Payer: Cash Price |
$1,114.30
|
| Rate for Payer: Cigna Commercial |
$863.21
|
| Rate for Payer: Cigna Medicaid |
$1,179.84
|
| Rate for Payer: Cigna Medicare |
$408.37
|
| Rate for Payer: Employer Direct Commercial |
$408.37
|
| Rate for Payer: Humana Medicare/TRICARE |
$408.37
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,179.84
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$408.37
|
| Rate for Payer: Molina Medicare |
$408.37
|
| Rate for Payer: Multiplan Auto |
$1,065.14
|
| Rate for Payer: Multiplan Commercial |
$1,065.14
|
| Rate for Payer: Multiplan Workers Comp |
$1,065.14
|
| Rate for Payer: Parkland Medicaid |
$1,179.84
|
| Rate for Payer: Scott and White EPO/PPO |
$119.30
|
| Rate for Payer: Scott and White Medicare |
$408.37
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,179.84
|
| Rate for Payer: Superior Health Plan EPO |
$408.37
|
| Rate for Payer: Superior Health Plan Medicare |
$408.37
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$408.37
|
| Rate for Payer: Universal American Medicare |
$408.37
|
| Rate for Payer: Wellcare Medicare |
$408.37
|
| Rate for Payer: Wellmed Medicare |
$408.37
|
|
|
CHED ID Aspirate Abscess/Cyst/Hematoma BCE
|
Facility
|
IP
|
$1,638.67
|
|
|
Service Code
|
HCPCS 10160
|
| Hospital Charge Code |
8912615
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,114.30
|
|
|
CHED ID Aspirate Abscess/Cyst/Hematoma BCE
|
Facility
|
IP
|
$1,638.67
|
|
|
Service Code
|
HCPCS 10160
|
| Hospital Charge Code |
5061160
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,114.30
|
|
|
CHED ID Aspirate Arthrocentesis - fingers or toes BCE
|
Facility
|
OP
|
$1,343.27
|
|
|
Service Code
|
HCPCS 20600
|
| Hospital Charge Code |
8912616
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$41.58 |
| Max. Negotiated Rate |
$967.15 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$120.89
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$308.35
|
| Rate for Payer: Amerigroup Medicare |
$308.35
|
| Rate for Payer: BCBS of TX Blue Advantage |
$41.58
|
| Rate for Payer: BCBS of TX Blue Essentials |
$49.80
|
| Rate for Payer: BCBS of TX Medicare |
$308.35
|
| Rate for Payer: BCBS of TX PPO |
$62.75
|
| Rate for Payer: Cash Price |
$913.42
|
| Rate for Payer: Cash Price |
$913.42
|
| Rate for Payer: Cash Price |
$913.42
|
| Rate for Payer: Cigna Commercial |
$651.79
|
| Rate for Payer: Cigna Medicaid |
$967.15
|
| Rate for Payer: Cigna Medicare |
$308.35
|
| Rate for Payer: Employer Direct Commercial |
$308.35
|
| Rate for Payer: Humana Medicare/TRICARE |
$308.35
|
| Rate for Payer: Molina CHIP/Medicaid |
$967.15
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$308.35
|
| Rate for Payer: Molina Medicare |
$308.35
|
| Rate for Payer: Multiplan Auto |
$873.13
|
| Rate for Payer: Multiplan Commercial |
$873.13
|
| Rate for Payer: Multiplan Workers Comp |
$873.13
|
| Rate for Payer: Parkland Medicaid |
$967.15
|
| Rate for Payer: Scott and White EPO/PPO |
$43.73
|
| Rate for Payer: Scott and White Medicare |
$308.35
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$967.15
|
| Rate for Payer: Superior Health Plan EPO |
$308.35
|
| Rate for Payer: Superior Health Plan Medicare |
$308.35
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$308.35
|
| Rate for Payer: Universal American Medicare |
$308.35
|
| Rate for Payer: Wellcare Medicare |
$308.35
|
| Rate for Payer: Wellmed Medicare |
$308.35
|
|
|
CHED ID Aspirate Arthrocentesis - fingers or toes BCE
|
Facility
|
IP
|
$1,343.27
|
|
|
Service Code
|
HCPCS 20600
|
| Hospital Charge Code |
8912616
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$913.42
|
|
|
CHED ID Aspirate Arthrocentesis - shoulder/hip/knee/subacromial bursa BCE
|
Facility
|
IP
|
$1,594.93
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
8914600
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,084.55
|
|
|
CHED ID Aspirate Arthrocentesis - shoulder/hip/knee/subacromial bursa BCE
|
Facility
|
OP
|
$1,594.93
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
8914600
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$51.84 |
| Max. Negotiated Rate |
$1,148.35 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$143.54
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$308.35
|
| Rate for Payer: Amerigroup Medicare |
$308.35
|
| Rate for Payer: BCBS of TX Blue Advantage |
$51.84
|
| Rate for Payer: BCBS of TX Blue Essentials |
$62.08
|
| Rate for Payer: BCBS of TX Medicare |
$308.35
|
| Rate for Payer: BCBS of TX PPO |
$78.22
|
| Rate for Payer: Cash Price |
$1,084.55
|
| Rate for Payer: Cash Price |
$1,084.55
|
| Rate for Payer: Cash Price |
$1,084.55
|
| Rate for Payer: Cigna Commercial |
$651.79
|
| Rate for Payer: Cigna Medicaid |
$1,148.35
|
| Rate for Payer: Cigna Medicare |
$308.35
|
| Rate for Payer: Employer Direct Commercial |
$308.35
|
| Rate for Payer: Humana Medicare/TRICARE |
$308.35
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,148.35
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$308.35
|
| Rate for Payer: Molina Medicare |
$308.35
|
| Rate for Payer: Multiplan Auto |
$1,036.70
|
| Rate for Payer: Multiplan Commercial |
$1,036.70
|
| Rate for Payer: Multiplan Workers Comp |
$1,036.70
|
| Rate for Payer: Parkland Medicaid |
$1,148.35
|
| Rate for Payer: Scott and White EPO/PPO |
$55.49
|
| Rate for Payer: Scott and White Medicare |
$308.35
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,148.35
|
| Rate for Payer: Superior Health Plan EPO |
$308.35
|
| Rate for Payer: Superior Health Plan Medicare |
$308.35
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$308.35
|
| Rate for Payer: Universal American Medicare |
$308.35
|
| Rate for Payer: Wellcare Medicare |
$308.35
|
| Rate for Payer: Wellmed Medicare |
$308.35
|
|
|
CHED ID Aspirate Arthro - temporomandibul/AC/wrist/elbow/ankle/olecranon bursa BCE
|
Facility
|
IP
|
$479.42
|
|
|
Service Code
|
HCPCS 20605
|
| Hospital Charge Code |
8914601
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$326.01
|
|
|
CHED ID Aspirate Arthro - temporomandibul/AC/wrist/elbow/ankle/olecranon bursa BCE
|
Facility
|
OP
|
$479.42
|
|
|
Service Code
|
HCPCS 20605
|
| Hospital Charge Code |
8914601
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$43.15 |
| Max. Negotiated Rate |
$651.79 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$43.15
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$308.35
|
| Rate for Payer: Amerigroup Medicare |
$308.35
|
| Rate for Payer: BCBS of TX Blue Advantage |
$43.39
|
| Rate for Payer: BCBS of TX Blue Essentials |
$51.96
|
| Rate for Payer: BCBS of TX Medicare |
$308.35
|
| Rate for Payer: BCBS of TX PPO |
$65.47
|
| Rate for Payer: Cash Price |
$326.01
|
| Rate for Payer: Cash Price |
$326.01
|
| Rate for Payer: Cash Price |
$326.01
|
| Rate for Payer: Cigna Commercial |
$651.79
|
| Rate for Payer: Cigna Medicaid |
$345.18
|
| Rate for Payer: Cigna Medicare |
$308.35
|
| Rate for Payer: Employer Direct Commercial |
$308.35
|
| Rate for Payer: Humana Medicare/TRICARE |
$308.35
|
| Rate for Payer: Molina CHIP/Medicaid |
$345.18
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$308.35
|
| Rate for Payer: Molina Medicare |
$308.35
|
| Rate for Payer: Multiplan Auto |
$311.62
|
| Rate for Payer: Multiplan Commercial |
$311.62
|
| Rate for Payer: Multiplan Workers Comp |
$311.62
|
| Rate for Payer: Parkland Medicaid |
$345.18
|
| Rate for Payer: Scott and White EPO/PPO |
$44.98
|
| Rate for Payer: Scott and White Medicare |
$308.35
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$345.18
|
| Rate for Payer: Superior Health Plan EPO |
$308.35
|
| Rate for Payer: Superior Health Plan Medicare |
$308.35
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$308.35
|
| Rate for Payer: Universal American Medicare |
$308.35
|
| Rate for Payer: Wellcare Medicare |
$308.35
|
| Rate for Payer: Wellmed Medicare |
$308.35
|
|
