|
ED ID Aspirate For biopsy BCE
|
Facility
|
OP
|
$2,667.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
9250076
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$1,733.55 |
| Rate for Payer: Aetna Commercial |
$1,466.85
|
| Rate for Payer: Aetna Medicare |
$547.00
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$240.03
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Amerigroup Medicare |
$364.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$98.85
|
| Rate for Payer: BCBS of TX Blue Essentials |
$118.38
|
| Rate for Payer: BCBS of TX Medicare |
$364.67
|
| Rate for Payer: BCBS of TX PPO |
$149.16
|
| Rate for Payer: Cash Price |
$2,346.96
|
| Rate for Payer: Cash Price |
$2,346.96
|
| Rate for Payer: Cash Price |
$2,346.96
|
| Rate for Payer: Cigna Commercial |
$826.08
|
| Rate for Payer: Cigna Medicaid |
$51.77
|
| 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 |
$51.77
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Molina Medicare |
$364.67
|
| Rate for Payer: Multiplan Auto |
$1,733.55
|
| Rate for Payer: Multiplan Commercial |
$1,733.55
|
| Rate for Payer: Multiplan Workers Comp |
$1,733.55
|
| Rate for Payer: Parkland Medicaid |
$51.77
|
| 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 |
$51.77
|
| 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 For biopsy BCE
|
Facility
|
IP
|
$2,667.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
9250076
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$2,346.96
|
|
|
ED ID Aspirate Ganglion Cyst BCE
|
Facility
|
IP
|
$628.00
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
5202535
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$552.64
|
|
|
ED ID Aspirate Ganglion Cyst BCE
|
Facility
|
OP
|
$628.00
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
5202535
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$613.60 |
| Rate for Payer: Aetna Commercial |
$345.40
|
| Rate for Payer: Aetna Medicare |
$406.30
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$56.52
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Amerigroup Medicare |
$270.87
|
| 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 |
$270.87
|
| Rate for Payer: BCBS of TX PPO |
$88.23
|
| Rate for Payer: Cash Price |
$552.64
|
| Rate for Payer: Cash Price |
$552.64
|
| Rate for Payer: Cash Price |
$552.64
|
| Rate for Payer: Cigna Commercial |
$613.60
|
| Rate for Payer: Cigna Medicaid |
$30.46
|
| 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 |
$30.46
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Molina Medicare |
$270.87
|
| Rate for Payer: Multiplan Auto |
$408.20
|
| Rate for Payer: Multiplan Commercial |
$408.20
|
| Rate for Payer: Multiplan Workers Comp |
$408.20
|
| Rate for Payer: Parkland Medicaid |
$30.46
|
| 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 |
$30.46
|
| 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 Aspiration: Abscess/Cyst/Hematoma
|
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 Aspiration: Arthrocentesis - fingers or toes
|
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 Aspiration: Arthrocentesis - shoulder, hip, knee, or subacromial bursa
|
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 Aspiration: Arthrocentesis - temporomandibular, AC, wrist, elbow or ankle, or olecranon bursa
|
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
|
|
|
ED ID Aspiration: For biopsy
|
Facility
|
OP
|
$2,667.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
9250076
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$1,733.55 |
| Rate for Payer: Aetna Commercial |
$1,466.85
|
| Rate for Payer: Aetna Medicare |
$547.00
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$240.03
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Amerigroup Medicare |
$364.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$98.85
|
| Rate for Payer: BCBS of TX Blue Essentials |
$118.38
|
| Rate for Payer: BCBS of TX Medicare |
$364.67
|
| Rate for Payer: BCBS of TX PPO |
$149.16
|
| Rate for Payer: Cash Price |
$2,346.96
|
| Rate for Payer: Cash Price |
$2,346.96
|
| Rate for Payer: Cash Price |
$2,346.96
|
| Rate for Payer: Cigna Commercial |
$826.08
|
| Rate for Payer: Cigna Medicaid |
$51.77
|
| 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 |
$51.77
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Molina Medicare |
$364.67
|
| Rate for Payer: Multiplan Auto |
$1,733.55
|
| Rate for Payer: Multiplan Commercial |
$1,733.55
|
| Rate for Payer: Multiplan Workers Comp |
$1,733.55
|
| Rate for Payer: Parkland Medicaid |
$51.77
|
| 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 |
$51.77
|
| 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 Aspiration: Ganglion Cyst
|
Facility
|
OP
|
$628.00
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
5202535
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$613.60 |
| Rate for Payer: Aetna Commercial |
$345.40
|
| Rate for Payer: Aetna Medicare |
$406.30
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$56.52
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Amerigroup Medicare |
$270.87
|
| 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 |
$270.87
|
| Rate for Payer: BCBS of TX PPO |
$88.23
|
| Rate for Payer: Cash Price |
$552.64
|
| Rate for Payer: Cash Price |
$552.64
|
| Rate for Payer: Cash Price |
$552.64
|
| Rate for Payer: Cigna Commercial |
$613.60
|
| Rate for Payer: Cigna Medicaid |
$30.46
|
| 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 |
$30.46
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Molina Medicare |
$270.87
|
| Rate for Payer: Multiplan Auto |
$408.20
|
| Rate for Payer: Multiplan Commercial |
$408.20
|
| Rate for Payer: Multiplan Workers Comp |
$408.20
|
| Rate for Payer: Parkland Medicaid |
$30.46
|
| 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 |
$30.46
|
| 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 Body Site: Finger, complex
|
Facility
|
OP
|
$2,073.00
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
5202538
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$26.52 |
| Max. Negotiated Rate |
$3,458.95 |
| Rate for Payer: Aetna Commercial |
$2,200.00
|
| Rate for Payer: Aetna Medicare |
$2,224.11
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$186.57
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Amerigroup Medicare |
$1,482.74
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,482.74
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cash Price |
$1,824.24
|
| Rate for Payer: Cash Price |
$1,824.24
|
| Rate for Payer: Cash Price |
$1,824.24
|
| Rate for Payer: Cigna Commercial |
$3,358.84
|
| Rate for Payer: Cigna Medicaid |
$486.45
|
| Rate for Payer: Cigna Medicare |
$1,482.74
|
| Rate for Payer: Employer Direct Commercial |
$1,482.74
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,482.74
|
| Rate for Payer: Molina CHIP/Medicaid |
$486.45
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Molina Medicare |
$1,482.74
|
| Rate for Payer: Multiplan Auto |
$1,347.45
|
| Rate for Payer: Multiplan Commercial |
$1,347.45
|
| Rate for Payer: Multiplan Workers Comp |
$1,347.45
|
| Rate for Payer: Parkland Medicaid |
$486.45
|
| Rate for Payer: Scott and White EPO/PPO |
$26.52
|
| Rate for Payer: Scott and White Medicare |
$1,482.74
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$486.45
|
| Rate for Payer: Superior Health Plan EPO |
$1,482.74
|
| Rate for Payer: Superior Health Plan Medicare |
$1,482.74
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Universal American Medicare |
$1,482.74
|
| Rate for Payer: Wellcare Medicare |
$1,482.74
|
| Rate for Payer: Wellmed Medicare |
$1,482.74
|
|
|
ED ID Body Site: Finger, complex
|
Facility
|
IP
|
$2,073.00
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
5202538
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,824.24
|
|
|
ED ID Body Site Finger, complex BCE
|
Facility
|
OP
|
$2,073.00
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
5202538
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$26.52 |
| Max. Negotiated Rate |
$3,458.95 |
| Rate for Payer: Aetna Commercial |
$2,200.00
|
| Rate for Payer: Aetna Medicare |
$2,224.11
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$186.57
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Amerigroup Medicare |
$1,482.74
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,482.74
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cash Price |
$1,824.24
|
| Rate for Payer: Cash Price |
$1,824.24
|
| Rate for Payer: Cash Price |
$1,824.24
|
| Rate for Payer: Cigna Commercial |
$3,358.84
|
| Rate for Payer: Cigna Medicaid |
$486.45
|
| Rate for Payer: Cigna Medicare |
$1,482.74
|
| Rate for Payer: Employer Direct Commercial |
$1,482.74
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,482.74
|
| Rate for Payer: Molina CHIP/Medicaid |
$486.45
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Molina Medicare |
$1,482.74
|
| Rate for Payer: Multiplan Auto |
$1,347.45
|
| Rate for Payer: Multiplan Commercial |
$1,347.45
|
| Rate for Payer: Multiplan Workers Comp |
$1,347.45
|
| Rate for Payer: Parkland Medicaid |
$486.45
|
| Rate for Payer: Scott and White EPO/PPO |
$26.52
|
| Rate for Payer: Scott and White Medicare |
$1,482.74
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$486.45
|
| Rate for Payer: Superior Health Plan EPO |
$1,482.74
|
| Rate for Payer: Superior Health Plan Medicare |
$1,482.74
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Universal American Medicare |
$1,482.74
|
| Rate for Payer: Wellcare Medicare |
$1,482.74
|
| Rate for Payer: Wellmed Medicare |
$1,482.74
|
|
|
ED ID Body Site: Hematoma, Seroma, Fluid collection
|
Facility
|
IP
|
$3,948.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
7150105
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$3,474.24
|
|
|
ED ID Body Site: Hematoma, Seroma, Fluid collection
|
Facility
|
OP
|
$3,948.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
7150105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$26.52 |
| Max. Negotiated Rate |
$3,358.84 |
| Rate for Payer: Aetna Commercial |
$2,200.00
|
| Rate for Payer: Aetna Medicare |
$2,224.11
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$355.32
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Amerigroup Medicare |
$1,482.74
|
| Rate for Payer: BCBS of TX Blue Advantage |
$183.82
|
| Rate for Payer: BCBS of TX Blue Essentials |
$220.14
|
| Rate for Payer: BCBS of TX Medicare |
$1,482.74
|
| Rate for Payer: BCBS of TX PPO |
$277.38
|
| Rate for Payer: Cash Price |
$3,474.24
|
| Rate for Payer: Cash Price |
$3,474.24
|
| Rate for Payer: Cash Price |
$3,474.24
|
| Rate for Payer: Cigna Commercial |
$3,358.84
|
| Rate for Payer: Cigna Medicaid |
$90.81
|
| Rate for Payer: Cigna Medicare |
$1,482.74
|
| Rate for Payer: Employer Direct Commercial |
$1,482.74
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,482.74
|
| Rate for Payer: Molina CHIP/Medicaid |
$90.81
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Molina Medicare |
$1,482.74
|
| Rate for Payer: Multiplan Auto |
$2,566.20
|
| Rate for Payer: Multiplan Commercial |
$2,566.20
|
| Rate for Payer: Multiplan Workers Comp |
$2,566.20
|
| Rate for Payer: Parkland Medicaid |
$90.81
|
| Rate for Payer: Scott and White EPO/PPO |
$26.52
|
| Rate for Payer: Scott and White Medicare |
$1,482.74
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$90.81
|
| Rate for Payer: Superior Health Plan EPO |
$1,482.74
|
| Rate for Payer: Superior Health Plan Medicare |
$1,482.74
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Universal American Medicare |
$1,482.74
|
| Rate for Payer: Wellcare Medicare |
$1,482.74
|
| Rate for Payer: Wellmed Medicare |
$1,482.74
|
|
|
ED ID Body Site Hematoma, Seroma, Fluid collection BCE
|
Facility
|
OP
|
$3,948.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
7150105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$26.52 |
| Max. Negotiated Rate |
$3,358.84 |
| Rate for Payer: Aetna Commercial |
$2,200.00
|
| Rate for Payer: Aetna Medicare |
$2,224.11
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$355.32
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Amerigroup Medicare |
$1,482.74
|
| Rate for Payer: BCBS of TX Blue Advantage |
$183.82
|
| Rate for Payer: BCBS of TX Blue Essentials |
$220.14
|
| Rate for Payer: BCBS of TX Medicare |
$1,482.74
|
| Rate for Payer: BCBS of TX PPO |
$277.38
|
| Rate for Payer: Cash Price |
$3,474.24
|
| Rate for Payer: Cash Price |
$3,474.24
|
| Rate for Payer: Cash Price |
$3,474.24
|
| Rate for Payer: Cigna Commercial |
$3,358.84
|
| Rate for Payer: Cigna Medicaid |
$90.81
|
| Rate for Payer: Cigna Medicare |
$1,482.74
|
| Rate for Payer: Employer Direct Commercial |
$1,482.74
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,482.74
|
| Rate for Payer: Molina CHIP/Medicaid |
$90.81
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Molina Medicare |
$1,482.74
|
| Rate for Payer: Multiplan Auto |
$2,566.20
|
| Rate for Payer: Multiplan Commercial |
$2,566.20
|
| Rate for Payer: Multiplan Workers Comp |
$2,566.20
|
| Rate for Payer: Parkland Medicaid |
$90.81
|
| Rate for Payer: Scott and White EPO/PPO |
$26.52
|
| Rate for Payer: Scott and White Medicare |
$1,482.74
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$90.81
|
| Rate for Payer: Superior Health Plan EPO |
$1,482.74
|
| Rate for Payer: Superior Health Plan Medicare |
$1,482.74
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Universal American Medicare |
$1,482.74
|
| Rate for Payer: Wellcare Medicare |
$1,482.74
|
| Rate for Payer: Wellmed Medicare |
$1,482.74
|
|
|
ED ID Body Site: I&D Abscess/Cyst Complex
|
Facility
|
IP
|
$1,574.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
7150097
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,385.12
|
|
|
ED ID Body Site: I&D Abscess/Cyst Complex
|
Facility
|
OP
|
$1,574.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
7150097
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$1,023.10 |
| Rate for Payer: Aetna Commercial |
$865.70
|
| Rate for Payer: Aetna Medicare |
$547.00
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$141.66
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Amerigroup Medicare |
$364.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$192.87
|
| Rate for Payer: BCBS of TX Blue Essentials |
$230.98
|
| Rate for Payer: BCBS of TX Medicare |
$364.67
|
| Rate for Payer: BCBS of TX PPO |
$291.03
|
| Rate for Payer: Cash Price |
$1,385.12
|
| Rate for Payer: Cash Price |
$1,385.12
|
| Rate for Payer: Cash Price |
$1,385.12
|
| Rate for Payer: Cigna Commercial |
$826.08
|
| Rate for Payer: Cigna Medicaid |
$98.28
|
| 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 |
$98.28
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Molina Medicare |
$364.67
|
| Rate for Payer: Multiplan Auto |
$1,023.10
|
| Rate for Payer: Multiplan Commercial |
$1,023.10
|
| Rate for Payer: Multiplan Workers Comp |
$1,023.10
|
| Rate for Payer: Parkland Medicaid |
$98.28
|
| 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 |
$98.28
|
| 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 Body Site I&D Abscess/Cyst Complex BCE
|
Facility
|
OP
|
$1,574.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
7150097
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$1,023.10 |
| Rate for Payer: Aetna Commercial |
$865.70
|
| Rate for Payer: Aetna Medicare |
$547.00
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$141.66
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Amerigroup Medicare |
$364.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$192.87
|
| Rate for Payer: BCBS of TX Blue Essentials |
$230.98
|
| Rate for Payer: BCBS of TX Medicare |
$364.67
|
| Rate for Payer: BCBS of TX PPO |
$291.03
|
| Rate for Payer: Cash Price |
$1,385.12
|
| Rate for Payer: Cash Price |
$1,385.12
|
| Rate for Payer: Cash Price |
$1,385.12
|
| Rate for Payer: Cigna Commercial |
$826.08
|
| Rate for Payer: Cigna Medicaid |
$98.28
|
| 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 |
$98.28
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Molina Medicare |
$364.67
|
| Rate for Payer: Multiplan Auto |
$1,023.10
|
| Rate for Payer: Multiplan Commercial |
$1,023.10
|
| Rate for Payer: Multiplan Workers Comp |
$1,023.10
|
| Rate for Payer: Parkland Medicaid |
$98.28
|
| 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 |
$98.28
|
| 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 Body Site: I&D Abscess/Cyst Simple
|
Facility
|
OP
|
$821.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
7150089
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$533.65 |
| Rate for Payer: Aetna Commercial |
$451.55
|
| Rate for Payer: Aetna Medicare |
$274.64
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$73.89
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$183.09
|
| Rate for Payer: Amerigroup Medicare |
$183.09
|
| Rate for Payer: BCBS of TX Blue Advantage |
$125.97
|
| Rate for Payer: BCBS of TX Blue Essentials |
$150.86
|
| Rate for Payer: BCBS of TX Medicare |
$183.09
|
| Rate for Payer: BCBS of TX PPO |
$190.08
|
| Rate for Payer: Cash Price |
$722.48
|
| Rate for Payer: Cash Price |
$722.48
|
| Rate for Payer: Cash Price |
$722.48
|
| Rate for Payer: Cigna Commercial |
$414.75
|
| Rate for Payer: Cigna Medicaid |
$65.06
|
| Rate for Payer: Cigna Medicare |
$183.09
|
| Rate for Payer: Employer Direct Commercial |
$183.09
|
| Rate for Payer: Humana Medicare/TRICARE |
$183.09
|
| Rate for Payer: Molina CHIP/Medicaid |
$65.06
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$183.09
|
| Rate for Payer: Molina Medicare |
$183.09
|
| Rate for Payer: Multiplan Auto |
$533.65
|
| Rate for Payer: Multiplan Commercial |
$533.65
|
| Rate for Payer: Multiplan Workers Comp |
$533.65
|
| Rate for Payer: Parkland Medicaid |
$65.06
|
| Rate for Payer: Scott and White EPO/PPO |
$3.27
|
| Rate for Payer: Scott and White Medicare |
$183.09
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$65.06
|
| Rate for Payer: Superior Health Plan EPO |
$183.09
|
| Rate for Payer: Superior Health Plan Medicare |
$183.09
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$183.09
|
| Rate for Payer: Universal American Medicare |
$183.09
|
| Rate for Payer: Wellcare Medicare |
$183.09
|
| Rate for Payer: Wellmed Medicare |
$183.09
|
|
|
ED ID Body Site: I&D Abscess/Cyst Simple
|
Facility
|
IP
|
$821.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
7150089
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$722.48
|
|
|
ED ID Body Site I&D Abscess/Cyst Simple BCE
|
Facility
|
OP
|
$821.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
7150089
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$533.65 |
| Rate for Payer: Aetna Commercial |
$451.55
|
| Rate for Payer: Aetna Medicare |
$274.64
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$73.89
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$183.09
|
| Rate for Payer: Amerigroup Medicare |
$183.09
|
| Rate for Payer: BCBS of TX Blue Advantage |
$125.97
|
| Rate for Payer: BCBS of TX Blue Essentials |
$150.86
|
| Rate for Payer: BCBS of TX Medicare |
$183.09
|
| Rate for Payer: BCBS of TX PPO |
$190.08
|
| Rate for Payer: Cash Price |
$722.48
|
| Rate for Payer: Cash Price |
$722.48
|
| Rate for Payer: Cash Price |
$722.48
|
| Rate for Payer: Cigna Commercial |
$414.75
|
| Rate for Payer: Cigna Medicaid |
$65.06
|
| Rate for Payer: Cigna Medicare |
$183.09
|
| Rate for Payer: Employer Direct Commercial |
$183.09
|
| Rate for Payer: Humana Medicare/TRICARE |
$183.09
|
| Rate for Payer: Molina CHIP/Medicaid |
$65.06
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$183.09
|
| Rate for Payer: Molina Medicare |
$183.09
|
| Rate for Payer: Multiplan Auto |
$533.65
|
| Rate for Payer: Multiplan Commercial |
$533.65
|
| Rate for Payer: Multiplan Workers Comp |
$533.65
|
| Rate for Payer: Parkland Medicaid |
$65.06
|
| Rate for Payer: Scott and White EPO/PPO |
$3.27
|
| Rate for Payer: Scott and White Medicare |
$183.09
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$65.06
|
| Rate for Payer: Superior Health Plan EPO |
$183.09
|
| Rate for Payer: Superior Health Plan Medicare |
$183.09
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$183.09
|
| Rate for Payer: Universal American Medicare |
$183.09
|
| Rate for Payer: Wellcare Medicare |
$183.09
|
| Rate for Payer: Wellmed Medicare |
$183.09
|
|
|
ED ID Body Site: Perianal, superficial
|
Facility
|
OP
|
$1,869.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
5202541
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$14.95 |
| Max. Negotiated Rate |
$1,924.98 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$1,253.79
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$168.21
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$835.86
|
| Rate for Payer: Amerigroup Medicare |
$835.86
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,275.68
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,527.76
|
| Rate for Payer: BCBS of TX Medicare |
$835.86
|
| Rate for Payer: BCBS of TX PPO |
$1,924.98
|
| Rate for Payer: Cash Price |
$1,644.72
|
| Rate for Payer: Cash Price |
$1,644.72
|
| Rate for Payer: Cash Price |
$1,644.72
|
| Rate for Payer: Cigna Commercial |
$1,893.46
|
| Rate for Payer: Cigna Medicaid |
$328.50
|
| Rate for Payer: Cigna Medicare |
$835.86
|
| Rate for Payer: Employer Direct Commercial |
$835.86
|
| Rate for Payer: Humana Medicare/TRICARE |
$835.86
|
| Rate for Payer: Molina CHIP/Medicaid |
$328.50
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$835.86
|
| Rate for Payer: Molina Medicare |
$835.86
|
| Rate for Payer: Multiplan Auto |
$1,214.85
|
| Rate for Payer: Multiplan Commercial |
$1,214.85
|
| Rate for Payer: Multiplan Workers Comp |
$1,214.85
|
| Rate for Payer: Parkland Medicaid |
$328.50
|
| Rate for Payer: Scott and White EPO/PPO |
$14.95
|
| Rate for Payer: Scott and White Medicare |
$835.86
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$328.50
|
| Rate for Payer: Superior Health Plan EPO |
$835.86
|
| Rate for Payer: Superior Health Plan Medicare |
$835.86
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$835.86
|
| Rate for Payer: Universal American Medicare |
$835.86
|
| Rate for Payer: Wellcare Medicare |
$835.86
|
| Rate for Payer: Wellmed Medicare |
$835.86
|
|
|
ED ID Body Site: Perianal, superficial
|
Facility
|
IP
|
$1,869.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
5202541
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,644.72
|
|
|
ED ID Body Site Perianal, superficial BCE
|
Facility
|
OP
|
$1,869.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
5202541
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$14.95 |
| Max. Negotiated Rate |
$1,924.98 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$1,253.79
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$168.21
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$835.86
|
| Rate for Payer: Amerigroup Medicare |
$835.86
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,275.68
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,527.76
|
| Rate for Payer: BCBS of TX Medicare |
$835.86
|
| Rate for Payer: BCBS of TX PPO |
$1,924.98
|
| Rate for Payer: Cash Price |
$1,644.72
|
| Rate for Payer: Cash Price |
$1,644.72
|
| Rate for Payer: Cash Price |
$1,644.72
|
| Rate for Payer: Cigna Commercial |
$1,893.46
|
| Rate for Payer: Cigna Medicaid |
$328.50
|
| Rate for Payer: Cigna Medicare |
$835.86
|
| Rate for Payer: Employer Direct Commercial |
$835.86
|
| Rate for Payer: Humana Medicare/TRICARE |
$835.86
|
| Rate for Payer: Molina CHIP/Medicaid |
$328.50
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$835.86
|
| Rate for Payer: Molina Medicare |
$835.86
|
| Rate for Payer: Multiplan Auto |
$1,214.85
|
| Rate for Payer: Multiplan Commercial |
$1,214.85
|
| Rate for Payer: Multiplan Workers Comp |
$1,214.85
|
| Rate for Payer: Parkland Medicaid |
$328.50
|
| Rate for Payer: Scott and White EPO/PPO |
$14.95
|
| Rate for Payer: Scott and White Medicare |
$835.86
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$328.50
|
| Rate for Payer: Superior Health Plan EPO |
$835.86
|
| Rate for Payer: Superior Health Plan Medicare |
$835.86
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$835.86
|
| Rate for Payer: Universal American Medicare |
$835.86
|
| Rate for Payer: Wellcare Medicare |
$835.86
|
| Rate for Payer: Wellmed Medicare |
$835.86
|
|
