|
ED GI/GU/Rectal Procedure: Replace G-tube
|
Facility
|
OP
|
$1,457.00
|
|
|
Service Code
|
CPT 49452
|
| Hospital Charge Code |
2181015
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$14.83 |
| Max. Negotiated Rate |
$2,200.00 |
| Rate for Payer: Aetna Commercial |
$2,200.00
|
| Rate for Payer: Aetna Medicare |
$1,243.53
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$131.13
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$829.02
|
| Rate for Payer: Amerigroup Medicare |
$829.02
|
| 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 |
$829.02
|
| Rate for Payer: BCBS of TX PPO |
$1,980.52
|
| Rate for Payer: Cash Price |
$1,282.16
|
| Rate for Payer: Cash Price |
$1,282.16
|
| Rate for Payer: Cash Price |
$1,282.16
|
| Rate for Payer: Cigna Commercial |
$1,877.98
|
| Rate for Payer: Cigna Medicaid |
$334.95
|
| Rate for Payer: Cigna Medicare |
$829.02
|
| Rate for Payer: Employer Direct Commercial |
$829.02
|
| Rate for Payer: Humana Medicare/TRICARE |
$829.02
|
| Rate for Payer: Molina CHIP/Medicaid |
$334.95
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$829.02
|
| Rate for Payer: Molina Medicare |
$829.02
|
| Rate for Payer: Multiplan Auto |
$947.05
|
| Rate for Payer: Multiplan Commercial |
$947.05
|
| Rate for Payer: Multiplan Workers Comp |
$947.05
|
| Rate for Payer: Parkland Medicaid |
$334.95
|
| Rate for Payer: Scott and White EPO/PPO |
$14.83
|
| Rate for Payer: Scott and White Medicare |
$829.02
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$334.95
|
| Rate for Payer: Superior Health Plan EPO |
$829.02
|
| Rate for Payer: Superior Health Plan Medicare |
$829.02
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$829.02
|
| Rate for Payer: Universal American Medicare |
$829.02
|
| Rate for Payer: Wellcare Medicare |
$829.02
|
| Rate for Payer: Wellmed Medicare |
$829.02
|
|
|
ED GI/GU/Rectal Procedures Anoscopy BCE
|
Facility
|
IP
|
$712.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
9330051
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$626.56
|
|
|
ED GI/GU/Rectal Procedures Anoscopy BCE
|
Facility
|
OP
|
$712.00
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
9330051
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$462.80 |
| Rate for Payer: Aetna Commercial |
$391.60
|
| Rate for Payer: Aetna Medicare |
$175.23
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$64.08
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Amerigroup Medicare |
$116.82
|
| 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 |
$116.82
|
| Rate for Payer: BCBS of TX PPO |
$274.76
|
| Rate for Payer: Cash Price |
$626.56
|
| Rate for Payer: Cash Price |
$626.56
|
| Rate for Payer: Cash Price |
$626.56
|
| Rate for Payer: Cigna Commercial |
$264.63
|
| Rate for Payer: Cigna Medicare |
$116.82
|
| Rate for Payer: Employer Direct Commercial |
$116.82
|
| Rate for Payer: Humana Medicare/TRICARE |
$116.82
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Molina Medicare |
$116.82
|
| 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: Scott and White EPO/PPO |
$2.09
|
| Rate for Payer: Scott and White Medicare |
$116.82
|
| Rate for Payer: Superior Health Plan EPO |
$116.82
|
| Rate for Payer: Superior Health Plan Medicare |
$116.82
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Universal American Medicare |
$116.82
|
| Rate for Payer: Wellcare Medicare |
$116.82
|
| Rate for Payer: Wellmed Medicare |
$116.82
|
|
|
ED GI/GU/Rectal Procedures Cystostomy/Foley change BCE
|
Facility
|
OP
|
$2,426.00
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
5202533
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.04 |
| Max. Negotiated Rate |
$1,576.90 |
| Rate for Payer: Aetna Commercial |
$1,334.30
|
| Rate for Payer: Aetna Medicare |
$339.04
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$218.34
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$226.03
|
| Rate for Payer: Amerigroup Medicare |
$226.03
|
| 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 |
$226.03
|
| Rate for Payer: BCBS of TX PPO |
$154.60
|
| Rate for Payer: Cash Price |
$2,134.88
|
| Rate for Payer: Cash Price |
$2,134.88
|
| Rate for Payer: Cash Price |
$2,134.88
|
| Rate for Payer: Cigna Commercial |
$512.01
|
| Rate for Payer: Cigna Medicaid |
$51.77
|
| Rate for Payer: Cigna Medicare |
$226.03
|
| Rate for Payer: Employer Direct Commercial |
$226.03
|
| Rate for Payer: Humana Medicare/TRICARE |
$226.03
|
| Rate for Payer: Molina CHIP/Medicaid |
$51.77
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$226.03
|
| Rate for Payer: Molina Medicare |
$226.03
|
| Rate for Payer: Multiplan Auto |
$1,576.90
|
| Rate for Payer: Multiplan Commercial |
$1,576.90
|
| Rate for Payer: Multiplan Workers Comp |
$1,576.90
|
| Rate for Payer: Parkland Medicaid |
$51.77
|
| Rate for Payer: Scott and White EPO/PPO |
$4.04
|
| Rate for Payer: Scott and White Medicare |
$226.03
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$51.77
|
| Rate for Payer: Superior Health Plan EPO |
$226.03
|
| Rate for Payer: Superior Health Plan Medicare |
$226.03
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$226.03
|
| Rate for Payer: Universal American Medicare |
$226.03
|
| Rate for Payer: Wellcare Medicare |
$226.03
|
| Rate for Payer: Wellmed Medicare |
$226.03
|
|
|
ED GI/GU/Rectal Procedures Cystostomy/Foley change BCE
|
Facility
|
IP
|
$2,426.00
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
5202533
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$2,134.88
|
|
|
ED GI/GU/Rectal Procedures Gastric Intubation w/ Lavage BCE
|
Facility
|
OP
|
$576.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
5210316
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$650.28 |
| Rate for Payer: Aetna Commercial |
$316.80
|
| Rate for Payer: Aetna Medicare |
$430.59
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$51.84
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$287.06
|
| Rate for Payer: Amerigroup Medicare |
$287.06
|
| 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 |
$287.06
|
| Rate for Payer: BCBS of TX PPO |
$637.81
|
| Rate for Payer: Cash Price |
$506.88
|
| Rate for Payer: Cash Price |
$506.88
|
| Rate for Payer: Cash Price |
$506.88
|
| Rate for Payer: Cigna Commercial |
$650.28
|
| Rate for Payer: Cigna Medicare |
$287.06
|
| Rate for Payer: Employer Direct Commercial |
$287.06
|
| Rate for Payer: Humana Medicare/TRICARE |
$287.06
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$287.06
|
| Rate for Payer: Molina Medicare |
$287.06
|
| Rate for Payer: Multiplan Auto |
$374.40
|
| Rate for Payer: Multiplan Commercial |
$374.40
|
| Rate for Payer: Multiplan Workers Comp |
$374.40
|
| Rate for Payer: Scott and White EPO/PPO |
$5.13
|
| Rate for Payer: Scott and White Medicare |
$287.06
|
| Rate for Payer: Superior Health Plan EPO |
$287.06
|
| Rate for Payer: Superior Health Plan Medicare |
$287.06
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$287.06
|
| Rate for Payer: Universal American Medicare |
$287.06
|
| Rate for Payer: Wellcare Medicare |
$287.06
|
| Rate for Payer: Wellmed Medicare |
$287.06
|
|
|
ED GI/GU/Rectal Procedures Gastric Intubation w/ Lavage BCE
|
Facility
|
IP
|
$576.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
5210316
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$506.88
|
|
|
ED GI/GU/Rectal Procedures Paraphimosis treatment BCE
|
Facility
|
IP
|
$2,269.00
|
|
|
Service Code
|
CPT 54450
|
| Hospital Charge Code |
5202534
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,996.72
|
|
|
ED GI/GU/Rectal Procedures Paraphimosis treatment BCE
|
Facility
|
OP
|
$2,269.00
|
|
|
Service Code
|
CPT 54450
|
| Hospital Charge Code |
5202534
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.04 |
| Max. Negotiated Rate |
$1,474.85 |
| Rate for Payer: Aetna Commercial |
$1,247.95
|
| Rate for Payer: Aetna Medicare |
$339.04
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$204.21
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$226.03
|
| Rate for Payer: Amerigroup Medicare |
$226.03
|
| 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 |
$226.03
|
| Rate for Payer: BCBS of TX PPO |
$591.95
|
| Rate for Payer: Cash Price |
$1,996.72
|
| Rate for Payer: Cash Price |
$1,996.72
|
| Rate for Payer: Cash Price |
$1,996.72
|
| Rate for Payer: Cigna Commercial |
$512.01
|
| Rate for Payer: Cigna Medicaid |
$110.15
|
| Rate for Payer: Cigna Medicare |
$226.03
|
| Rate for Payer: Employer Direct Commercial |
$226.03
|
| Rate for Payer: Humana Medicare/TRICARE |
$226.03
|
| Rate for Payer: Molina CHIP/Medicaid |
$110.15
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$226.03
|
| Rate for Payer: Molina Medicare |
$226.03
|
| Rate for Payer: Multiplan Auto |
$1,474.85
|
| Rate for Payer: Multiplan Commercial |
$1,474.85
|
| Rate for Payer: Multiplan Workers Comp |
$1,474.85
|
| Rate for Payer: Parkland Medicaid |
$110.15
|
| Rate for Payer: Scott and White EPO/PPO |
$4.04
|
| Rate for Payer: Scott and White Medicare |
$226.03
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$110.15
|
| Rate for Payer: Superior Health Plan EPO |
$226.03
|
| Rate for Payer: Superior Health Plan Medicare |
$226.03
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$226.03
|
| Rate for Payer: Universal American Medicare |
$226.03
|
| Rate for Payer: Wellcare Medicare |
$226.03
|
| Rate for Payer: Wellmed Medicare |
$226.03
|
|
|
ED GI/GU/Rectal Procedures Removal of hemorrhoid clot BCE
|
Facility
|
OP
|
$6,289.00
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
5202532
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$19.30 |
| Max. Negotiated Rate |
$4,087.85 |
| Rate for Payer: Aetna Commercial |
$2,200.00
|
| Rate for Payer: Aetna Medicare |
$1,618.84
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$566.01
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,079.23
|
| Rate for Payer: Amerigroup Medicare |
$1,079.23
|
| 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 |
$1,079.23
|
| Rate for Payer: BCBS of TX PPO |
$339.22
|
| Rate for Payer: Cash Price |
$5,534.32
|
| Rate for Payer: Cash Price |
$5,534.32
|
| Rate for Payer: Cash Price |
$5,534.32
|
| Rate for Payer: Cigna Commercial |
$2,444.77
|
| Rate for Payer: Cigna Medicaid |
$125.69
|
| Rate for Payer: Cigna Medicare |
$1,079.23
|
| Rate for Payer: Employer Direct Commercial |
$1,079.23
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,079.23
|
| Rate for Payer: Molina CHIP/Medicaid |
$125.69
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,079.23
|
| Rate for Payer: Molina Medicare |
$1,079.23
|
| Rate for Payer: Multiplan Auto |
$4,087.85
|
| Rate for Payer: Multiplan Commercial |
$4,087.85
|
| Rate for Payer: Multiplan Workers Comp |
$4,087.85
|
| Rate for Payer: Parkland Medicaid |
$125.69
|
| Rate for Payer: Scott and White EPO/PPO |
$19.30
|
| Rate for Payer: Scott and White Medicare |
$1,079.23
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$125.69
|
| Rate for Payer: Superior Health Plan EPO |
$1,079.23
|
| Rate for Payer: Superior Health Plan Medicare |
$1,079.23
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,079.23
|
| Rate for Payer: Universal American Medicare |
$1,079.23
|
| Rate for Payer: Wellcare Medicare |
$1,079.23
|
| Rate for Payer: Wellmed Medicare |
$1,079.23
|
|
|
ED GI/GU/Rectal Procedures Removal of hemorrhoid clot BCE
|
Facility
|
IP
|
$6,289.00
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
5202532
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$5,534.32
|
|
|
ED GI/GU/Rectal Procedures Removal of rectal obstruction BCE
|
Facility
|
OP
|
$4,010.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
5202531
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$19.30 |
| Max. Negotiated Rate |
$2,606.50 |
| Rate for Payer: Aetna Commercial |
$2,200.00
|
| Rate for Payer: Aetna Medicare |
$1,618.84
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$360.90
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,079.23
|
| Rate for Payer: Amerigroup Medicare |
$1,079.23
|
| 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 |
$1,079.23
|
| Rate for Payer: BCBS of TX PPO |
$2,530.63
|
| Rate for Payer: Cash Price |
$3,528.80
|
| Rate for Payer: Cash Price |
$3,528.80
|
| Rate for Payer: Cash Price |
$3,528.80
|
| Rate for Payer: Cigna Commercial |
$2,444.77
|
| Rate for Payer: Cigna Medicaid |
$429.26
|
| Rate for Payer: Cigna Medicare |
$1,079.23
|
| Rate for Payer: Employer Direct Commercial |
$1,079.23
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,079.23
|
| Rate for Payer: Molina CHIP/Medicaid |
$429.26
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,079.23
|
| Rate for Payer: Molina Medicare |
$1,079.23
|
| Rate for Payer: Multiplan Auto |
$2,606.50
|
| Rate for Payer: Multiplan Commercial |
$2,606.50
|
| Rate for Payer: Multiplan Workers Comp |
$2,606.50
|
| Rate for Payer: Parkland Medicaid |
$429.26
|
| Rate for Payer: Scott and White EPO/PPO |
$19.30
|
| Rate for Payer: Scott and White Medicare |
$1,079.23
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$429.26
|
| Rate for Payer: Superior Health Plan EPO |
$1,079.23
|
| Rate for Payer: Superior Health Plan Medicare |
$1,079.23
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,079.23
|
| Rate for Payer: Universal American Medicare |
$1,079.23
|
| Rate for Payer: Wellcare Medicare |
$1,079.23
|
| Rate for Payer: Wellmed Medicare |
$1,079.23
|
|
|
ED GI/GU/Rectal Procedures Removal of rectal obstruction BCE
|
Facility
|
IP
|
$4,010.00
|
|
|
Service Code
|
CPT 45915
|
| Hospital Charge Code |
5202531
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$3,528.80
|
|
|
ED GI/GU/Rectal Procedures Replace G-tube BCE
|
Facility
|
IP
|
$1,457.00
|
|
|
Service Code
|
CPT 49452
|
| Hospital Charge Code |
2181015
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,282.16
|
|
|
ED GI/GU/Rectal Procedures Replace G-tube BCE
|
Facility
|
OP
|
$1,457.00
|
|
|
Service Code
|
CPT 49452
|
| Hospital Charge Code |
2181015
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$14.83 |
| Max. Negotiated Rate |
$2,200.00 |
| Rate for Payer: Aetna Commercial |
$2,200.00
|
| Rate for Payer: Aetna Medicare |
$1,243.53
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$131.13
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$829.02
|
| Rate for Payer: Amerigroup Medicare |
$829.02
|
| 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 |
$829.02
|
| Rate for Payer: BCBS of TX PPO |
$1,980.52
|
| Rate for Payer: Cash Price |
$1,282.16
|
| Rate for Payer: Cash Price |
$1,282.16
|
| Rate for Payer: Cash Price |
$1,282.16
|
| Rate for Payer: Cigna Commercial |
$1,877.98
|
| Rate for Payer: Cigna Medicaid |
$334.95
|
| Rate for Payer: Cigna Medicare |
$829.02
|
| Rate for Payer: Employer Direct Commercial |
$829.02
|
| Rate for Payer: Humana Medicare/TRICARE |
$829.02
|
| Rate for Payer: Molina CHIP/Medicaid |
$334.95
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$829.02
|
| Rate for Payer: Molina Medicare |
$829.02
|
| Rate for Payer: Multiplan Auto |
$947.05
|
| Rate for Payer: Multiplan Commercial |
$947.05
|
| Rate for Payer: Multiplan Workers Comp |
$947.05
|
| Rate for Payer: Parkland Medicaid |
$334.95
|
| Rate for Payer: Scott and White EPO/PPO |
$14.83
|
| Rate for Payer: Scott and White Medicare |
$829.02
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$334.95
|
| Rate for Payer: Superior Health Plan EPO |
$829.02
|
| Rate for Payer: Superior Health Plan Medicare |
$829.02
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$829.02
|
| Rate for Payer: Universal American Medicare |
$829.02
|
| Rate for Payer: Wellcare Medicare |
$829.02
|
| Rate for Payer: Wellmed Medicare |
$829.02
|
|
|
ED I AND D OF BARTHOLINS GLND ABS BCE
|
Facility
|
IP
|
$695.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
8398503
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$611.60
|
|
|
ED I AND D OF BARTHOLINS GLND ABS BCE
|
Facility
|
OP
|
$695.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
8398503
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.26 |
| Max. Negotiated Rate |
$451.75 |
| Rate for Payer: Aetna Commercial |
$382.25
|
| Rate for Payer: Aetna Medicare |
$273.36
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$62.55
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$182.24
|
| Rate for Payer: Amerigroup Medicare |
$182.24
|
| 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 |
$182.24
|
| Rate for Payer: BCBS of TX PPO |
$211.43
|
| Rate for Payer: Cash Price |
$611.60
|
| Rate for Payer: Cash Price |
$611.60
|
| Rate for Payer: Cash Price |
$611.60
|
| Rate for Payer: Cigna Commercial |
$412.83
|
| Rate for Payer: Cigna Medicaid |
$70.52
|
| Rate for Payer: Cigna Medicare |
$182.24
|
| Rate for Payer: Employer Direct Commercial |
$182.24
|
| Rate for Payer: Humana Medicare/TRICARE |
$182.24
|
| Rate for Payer: Molina CHIP/Medicaid |
$70.52
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$182.24
|
| Rate for Payer: Molina Medicare |
$182.24
|
| Rate for Payer: Multiplan Auto |
$451.75
|
| Rate for Payer: Multiplan Commercial |
$451.75
|
| Rate for Payer: Multiplan Workers Comp |
$451.75
|
| Rate for Payer: Parkland Medicaid |
$70.52
|
| Rate for Payer: Scott and White EPO/PPO |
$3.26
|
| Rate for Payer: Scott and White Medicare |
$182.24
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$70.52
|
| Rate for Payer: Superior Health Plan EPO |
$182.24
|
| Rate for Payer: Superior Health Plan Medicare |
$182.24
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$182.24
|
| Rate for Payer: Universal American Medicare |
$182.24
|
| Rate for Payer: Wellcare Medicare |
$182.24
|
| Rate for Payer: Wellmed Medicare |
$182.24
|
|
|
ED ID Aspirate Abscess/Cyst/Hematoma BCE
|
Facility
|
OP
|
$895.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
3521001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$826.08 |
| Rate for Payer: Aetna Commercial |
$492.25
|
| Rate for Payer: Aetna Medicare |
$547.00
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$80.55
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Amerigroup Medicare |
$364.67
|
| 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 |
$364.67
|
| Rate for Payer: BCBS of TX PPO |
$210.09
|
| Rate for Payer: Cash Price |
$787.60
|
| Rate for Payer: Cash Price |
$787.60
|
| Rate for Payer: Cash Price |
$787.60
|
| Rate for Payer: Cigna Commercial |
$826.08
|
| Rate for Payer: Cigna Medicaid |
$67.83
|
| Rate for Payer: Cigna Medicare |
$364.67
|
| Rate for Payer: Employer Direct Commercial |
$364.67
|
| Rate for Payer: Humana Medicare/TRICARE |
$364.67
|
| Rate for Payer: Molina CHIP/Medicaid |
$67.83
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Molina Medicare |
$364.67
|
| Rate for Payer: Multiplan Auto |
$581.75
|
| Rate for Payer: Multiplan Commercial |
$581.75
|
| Rate for Payer: Multiplan Workers Comp |
$581.75
|
| Rate for Payer: Parkland Medicaid |
$67.83
|
| Rate for Payer: Scott and White EPO/PPO |
$6.52
|
| Rate for Payer: Scott and White Medicare |
$364.67
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$67.83
|
| Rate for Payer: Superior Health Plan EPO |
$364.67
|
| Rate for Payer: Superior Health Plan Medicare |
$364.67
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Universal American Medicare |
$364.67
|
| Rate for Payer: Wellcare Medicare |
$364.67
|
| Rate for Payer: Wellmed Medicare |
$364.67
|
|
|
ED ID Aspirate Abscess/Cyst/Hematoma BCE
|
Facility
|
IP
|
$895.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
3521001
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$787.60
|
|
|
ED ID Aspirate Arthrocentesis - fingers or toes BCE
|
Facility
|
IP
|
$622.00
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
2100012
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$547.36
|
|
|
ED ID Aspirate Arthrocentesis - fingers or toes BCE
|
Facility
|
OP
|
$622.00
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
2100012
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$613.60 |
| Rate for Payer: Aetna Commercial |
$342.10
|
| Rate for Payer: Aetna Medicare |
$406.30
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$55.98
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Amerigroup Medicare |
$270.87
|
| 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 |
$270.87
|
| Rate for Payer: BCBS of TX PPO |
$62.75
|
| Rate for Payer: Cash Price |
$547.36
|
| Rate for Payer: Cash Price |
$547.36
|
| Rate for Payer: Cash Price |
$547.36
|
| Rate for Payer: Cigna Commercial |
$613.60
|
| Rate for Payer: Cigna Medicaid |
$22.70
|
| Rate for Payer: Cigna Medicare |
$270.87
|
| Rate for Payer: Employer Direct Commercial |
$270.87
|
| Rate for Payer: Humana Medicare/TRICARE |
$270.87
|
| Rate for Payer: Molina CHIP/Medicaid |
$22.70
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Molina Medicare |
$270.87
|
| Rate for Payer: Multiplan Auto |
$404.30
|
| Rate for Payer: Multiplan Commercial |
$404.30
|
| Rate for Payer: Multiplan Workers Comp |
$404.30
|
| Rate for Payer: Parkland Medicaid |
$22.70
|
| Rate for Payer: Scott and White EPO/PPO |
$4.84
|
| Rate for Payer: Scott and White Medicare |
$270.87
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$22.70
|
| Rate for Payer: Superior Health Plan EPO |
$270.87
|
| Rate for Payer: Superior Health Plan Medicare |
$270.87
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Universal American Medicare |
$270.87
|
| Rate for Payer: Wellcare Medicare |
$270.87
|
| Rate for Payer: Wellmed Medicare |
$270.87
|
|
|
ED ID Aspirate Arthrocentesis - shoulder/hip/knee/subacromial bursa BCE
|
Facility
|
OP
|
$1,676.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
6110555
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$1,089.40 |
| Rate for Payer: Aetna Commercial |
$921.80
|
| Rate for Payer: Aetna Medicare |
$406.30
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$150.84
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Amerigroup Medicare |
$270.87
|
| 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 |
$270.87
|
| Rate for Payer: BCBS of TX PPO |
$78.22
|
| Rate for Payer: Cash Price |
$1,474.88
|
| Rate for Payer: Cash Price |
$1,474.88
|
| Rate for Payer: Cash Price |
$1,474.88
|
| Rate for Payer: Cigna Commercial |
$613.60
|
| Rate for Payer: Cigna Medicaid |
$27.96
|
| Rate for Payer: Cigna Medicare |
$270.87
|
| Rate for Payer: Employer Direct Commercial |
$270.87
|
| Rate for Payer: Humana Medicare/TRICARE |
$270.87
|
| Rate for Payer: Molina CHIP/Medicaid |
$27.96
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Molina Medicare |
$270.87
|
| Rate for Payer: Multiplan Auto |
$1,089.40
|
| Rate for Payer: Multiplan Commercial |
$1,089.40
|
| Rate for Payer: Multiplan Workers Comp |
$1,089.40
|
| Rate for Payer: Parkland Medicaid |
$27.96
|
| Rate for Payer: Scott and White EPO/PPO |
$4.84
|
| Rate for Payer: Scott and White Medicare |
$270.87
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$27.96
|
| Rate for Payer: Superior Health Plan EPO |
$270.87
|
| Rate for Payer: Superior Health Plan Medicare |
$270.87
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Universal American Medicare |
$270.87
|
| Rate for Payer: Wellcare Medicare |
$270.87
|
| Rate for Payer: Wellmed Medicare |
$270.87
|
|
|
ED ID Aspirate Arthrocentesis - shoulder/hip/knee/subacromial bursa BCE
|
Facility
|
IP
|
$1,676.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
6110555
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,474.88
|
|
|
ED ID Aspirate Arthro - temporomandibul/AC/wrist/elbow/ankle/olecranon bursa BCE
|
Facility
|
IP
|
$719.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
6110548
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$632.72
|
|
|
ED ID Aspirate Arthro - temporomandibul/AC/wrist/elbow/ankle/olecranon bursa BCE
|
Facility
|
OP
|
$719.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
6110548
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$613.60 |
| Rate for Payer: Aetna Commercial |
$395.45
|
| Rate for Payer: Aetna Medicare |
$406.30
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$64.71
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Amerigroup Medicare |
$270.87
|
| 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 |
$270.87
|
| Rate for Payer: BCBS of TX PPO |
$65.47
|
| Rate for Payer: Cash Price |
$632.72
|
| Rate for Payer: Cash Price |
$632.72
|
| Rate for Payer: Cash Price |
$632.72
|
| Rate for Payer: Cigna Commercial |
$613.60
|
| Rate for Payer: Cigna Medicaid |
$23.54
|
| Rate for Payer: Cigna Medicare |
$270.87
|
| Rate for Payer: Employer Direct Commercial |
$270.87
|
| Rate for Payer: Humana Medicare/TRICARE |
$270.87
|
| Rate for Payer: Molina CHIP/Medicaid |
$23.54
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Molina Medicare |
$270.87
|
| Rate for Payer: Multiplan Auto |
$467.35
|
| Rate for Payer: Multiplan Commercial |
$467.35
|
| Rate for Payer: Multiplan Workers Comp |
$467.35
|
| Rate for Payer: Parkland Medicaid |
$23.54
|
| Rate for Payer: Scott and White EPO/PPO |
$4.84
|
| Rate for Payer: Scott and White Medicare |
$270.87
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$23.54
|
| Rate for Payer: Superior Health Plan EPO |
$270.87
|
| Rate for Payer: Superior Health Plan Medicare |
$270.87
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Universal American Medicare |
$270.87
|
| Rate for Payer: Wellcare Medicare |
$270.87
|
| Rate for Payer: Wellmed Medicare |
$270.87
|
|
