|
ED Nail Repair Procedure: Evacuation of subungual hematoma
|
Facility
|
OP
|
$308.00
|
|
|
Service Code
|
CPT 11740
|
| Hospital Charge Code |
5202574
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$274.76 |
| Rate for Payer: Aetna Commercial |
$169.40
|
| Rate for Payer: Aetna Medicare |
$175.23
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$27.72
|
| 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 |
$271.04
|
| Rate for Payer: Cash Price |
$271.04
|
| Rate for Payer: Cash Price |
$271.04
|
| 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 |
$200.20
|
| Rate for Payer: Multiplan Commercial |
$200.20
|
| Rate for Payer: Multiplan Workers Comp |
$200.20
|
| 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 Nail Repair Procedure Evacuation of subungual hematoma BCE
|
Facility
|
OP
|
$308.00
|
|
|
Service Code
|
CPT 11740
|
| Hospital Charge Code |
5202574
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$274.76 |
| Rate for Payer: Aetna Commercial |
$169.40
|
| Rate for Payer: Aetna Medicare |
$175.23
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$27.72
|
| 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 |
$271.04
|
| Rate for Payer: Cash Price |
$271.04
|
| Rate for Payer: Cash Price |
$271.04
|
| 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 |
$200.20
|
| Rate for Payer: Multiplan Commercial |
$200.20
|
| Rate for Payer: Multiplan Workers Comp |
$200.20
|
| 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 Nail Repair Procedure: Nail and Nail Matrix, Excision
|
Facility
|
OP
|
$4,009.00
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
7150818
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$2,605.85 |
| Rate for Payer: Aetna Commercial |
$2,204.95
|
| Rate for Payer: Aetna Medicare |
$547.00
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$360.81
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Amerigroup Medicare |
$364.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$165.75
|
| Rate for Payer: BCBS of TX Blue Essentials |
$198.50
|
| Rate for Payer: BCBS of TX Medicare |
$364.67
|
| Rate for Payer: BCBS of TX PPO |
$250.11
|
| Rate for Payer: Cash Price |
$3,527.92
|
| Rate for Payer: Cash Price |
$3,527.92
|
| Rate for Payer: Cash Price |
$3,527.92
|
| Rate for Payer: Cigna Commercial |
$826.08
|
| Rate for Payer: Cigna Medicaid |
$84.71
|
| 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 |
$84.71
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Molina Medicare |
$364.67
|
| Rate for Payer: Multiplan Auto |
$2,605.85
|
| Rate for Payer: Multiplan Commercial |
$2,605.85
|
| Rate for Payer: Multiplan Workers Comp |
$2,605.85
|
| Rate for Payer: Parkland Medicaid |
$84.71
|
| 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 |
$84.71
|
| 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 Nail Repair Procedure: Nail and Nail Matrix, Excision
|
Facility
|
IP
|
$4,009.00
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
7150818
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$3,527.92
|
|
|
ED Nail Repair Procedure Nail and Nail Matrix, Excision BCE
|
Facility
|
OP
|
$4,009.00
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
7150818
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$2,605.85 |
| Rate for Payer: Aetna Commercial |
$2,204.95
|
| Rate for Payer: Aetna Medicare |
$547.00
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$360.81
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Amerigroup Medicare |
$364.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$165.75
|
| Rate for Payer: BCBS of TX Blue Essentials |
$198.50
|
| Rate for Payer: BCBS of TX Medicare |
$364.67
|
| Rate for Payer: BCBS of TX PPO |
$250.11
|
| Rate for Payer: Cash Price |
$3,527.92
|
| Rate for Payer: Cash Price |
$3,527.92
|
| Rate for Payer: Cash Price |
$3,527.92
|
| Rate for Payer: Cigna Commercial |
$826.08
|
| Rate for Payer: Cigna Medicaid |
$84.71
|
| 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 |
$84.71
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Molina Medicare |
$364.67
|
| Rate for Payer: Multiplan Auto |
$2,605.85
|
| Rate for Payer: Multiplan Commercial |
$2,605.85
|
| Rate for Payer: Multiplan Workers Comp |
$2,605.85
|
| Rate for Payer: Parkland Medicaid |
$84.71
|
| 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 |
$84.71
|
| 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 Nail Repair Procedure: Nail Bed Repair
|
Facility
|
IP
|
$1,062.00
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
5202575
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$934.56
|
|
|
ED Nail Repair Procedure: Nail Bed Repair
|
Facility
|
OP
|
$1,062.00
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
5202575
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$1,301.14 |
| Rate for Payer: Aetna Commercial |
$584.10
|
| Rate for Payer: Aetna Medicare |
$861.57
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$95.58
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$574.38
|
| Rate for Payer: Amerigroup Medicare |
$574.38
|
| Rate for Payer: BCBS of TX Blue Advantage |
$830.02
|
| Rate for Payer: BCBS of TX Blue Essentials |
$994.04
|
| Rate for Payer: BCBS of TX Medicare |
$574.38
|
| Rate for Payer: BCBS of TX PPO |
$1,252.49
|
| Rate for Payer: Cash Price |
$934.56
|
| Rate for Payer: Cash Price |
$934.56
|
| Rate for Payer: Cash Price |
$934.56
|
| Rate for Payer: Cigna Commercial |
$1,301.14
|
| Rate for Payer: Cigna Medicaid |
$105.20
|
| Rate for Payer: Cigna Medicare |
$574.38
|
| Rate for Payer: Employer Direct Commercial |
$574.38
|
| Rate for Payer: Humana Medicare/TRICARE |
$574.38
|
| Rate for Payer: Molina CHIP/Medicaid |
$105.20
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$574.38
|
| Rate for Payer: Molina Medicare |
$574.38
|
| Rate for Payer: Multiplan Auto |
$690.30
|
| Rate for Payer: Multiplan Commercial |
$690.30
|
| Rate for Payer: Multiplan Workers Comp |
$690.30
|
| Rate for Payer: Parkland Medicaid |
$105.20
|
| Rate for Payer: Scott and White EPO/PPO |
$10.27
|
| Rate for Payer: Scott and White Medicare |
$574.38
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$105.20
|
| Rate for Payer: Superior Health Plan EPO |
$574.38
|
| Rate for Payer: Superior Health Plan Medicare |
$574.38
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$574.38
|
| Rate for Payer: Universal American Medicare |
$574.38
|
| Rate for Payer: Wellcare Medicare |
$574.38
|
| Rate for Payer: Wellmed Medicare |
$574.38
|
|
|
ED Nail Repair Procedure Nail Bed Repair BCE
|
Facility
|
OP
|
$1,062.00
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
5202575
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$1,301.14 |
| Rate for Payer: Aetna Commercial |
$584.10
|
| Rate for Payer: Aetna Medicare |
$861.57
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$95.58
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$574.38
|
| Rate for Payer: Amerigroup Medicare |
$574.38
|
| Rate for Payer: BCBS of TX Blue Advantage |
$830.02
|
| Rate for Payer: BCBS of TX Blue Essentials |
$994.04
|
| Rate for Payer: BCBS of TX Medicare |
$574.38
|
| Rate for Payer: BCBS of TX PPO |
$1,252.49
|
| Rate for Payer: Cash Price |
$934.56
|
| Rate for Payer: Cash Price |
$934.56
|
| Rate for Payer: Cash Price |
$934.56
|
| Rate for Payer: Cigna Commercial |
$1,301.14
|
| Rate for Payer: Cigna Medicaid |
$105.20
|
| Rate for Payer: Cigna Medicare |
$574.38
|
| Rate for Payer: Employer Direct Commercial |
$574.38
|
| Rate for Payer: Humana Medicare/TRICARE |
$574.38
|
| Rate for Payer: Molina CHIP/Medicaid |
$105.20
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$574.38
|
| Rate for Payer: Molina Medicare |
$574.38
|
| Rate for Payer: Multiplan Auto |
$690.30
|
| Rate for Payer: Multiplan Commercial |
$690.30
|
| Rate for Payer: Multiplan Workers Comp |
$690.30
|
| Rate for Payer: Parkland Medicaid |
$105.20
|
| Rate for Payer: Scott and White EPO/PPO |
$10.27
|
| Rate for Payer: Scott and White Medicare |
$574.38
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$105.20
|
| Rate for Payer: Superior Health Plan EPO |
$574.38
|
| Rate for Payer: Superior Health Plan Medicare |
$574.38
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$574.38
|
| Rate for Payer: Universal American Medicare |
$574.38
|
| Rate for Payer: Wellcare Medicare |
$574.38
|
| Rate for Payer: Wellmed Medicare |
$574.38
|
|
|
ED Nail Repair Procedure: Nail plate avulsion, single
|
Facility
|
IP
|
$476.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
7150776
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$418.88
|
|
|
ED Nail Repair Procedure: Nail plate avulsion, single
|
Facility
|
OP
|
$476.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
7150776
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$440.32 |
| Rate for Payer: Aetna Commercial |
$261.80
|
| Rate for Payer: Aetna Medicare |
$274.64
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$42.84
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$183.09
|
| Rate for Payer: Amerigroup Medicare |
$183.09
|
| Rate for Payer: BCBS of TX Blue Advantage |
$291.80
|
| Rate for Payer: BCBS of TX Blue Essentials |
$349.46
|
| Rate for Payer: BCBS of TX Medicare |
$183.09
|
| Rate for Payer: BCBS of TX PPO |
$440.32
|
| Rate for Payer: Cash Price |
$418.88
|
| Rate for Payer: Cash Price |
$418.88
|
| Rate for Payer: Cash Price |
$418.88
|
| Rate for Payer: Cigna Commercial |
$414.75
|
| 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 Dual Medicare/Medicaid |
$183.09
|
| Rate for Payer: Molina Medicare |
$183.09
|
| Rate for Payer: Multiplan Auto |
$309.40
|
| Rate for Payer: Multiplan Commercial |
$309.40
|
| Rate for Payer: Multiplan Workers Comp |
$309.40
|
| 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 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 Nail Repair Procedure Nail plate avulsion, single BCE
|
Facility
|
OP
|
$476.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
7150776
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$440.32 |
| Rate for Payer: Aetna Commercial |
$261.80
|
| Rate for Payer: Aetna Medicare |
$274.64
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$42.84
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$183.09
|
| Rate for Payer: Amerigroup Medicare |
$183.09
|
| Rate for Payer: BCBS of TX Blue Advantage |
$291.80
|
| Rate for Payer: BCBS of TX Blue Essentials |
$349.46
|
| Rate for Payer: BCBS of TX Medicare |
$183.09
|
| Rate for Payer: BCBS of TX PPO |
$440.32
|
| Rate for Payer: Cash Price |
$418.88
|
| Rate for Payer: Cash Price |
$418.88
|
| Rate for Payer: Cash Price |
$418.88
|
| Rate for Payer: Cigna Commercial |
$414.75
|
| 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 Dual Medicare/Medicaid |
$183.09
|
| Rate for Payer: Molina Medicare |
$183.09
|
| Rate for Payer: Multiplan Auto |
$309.40
|
| Rate for Payer: Multiplan Commercial |
$309.40
|
| Rate for Payer: Multiplan Workers Comp |
$309.40
|
| 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 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 Nail Repair Procedure: Trim Nondystrophic Nails
|
Facility
|
OP
|
$191.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
7150238
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$138.63 |
| Rate for Payer: Aetna Commercial |
$105.05
|
| Rate for Payer: Aetna Medicare |
$83.91
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$17.19
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$55.94
|
| Rate for Payer: Amerigroup Medicare |
$55.94
|
| Rate for Payer: BCBS of TX Blue Advantage |
$91.87
|
| Rate for Payer: BCBS of TX Blue Essentials |
$110.02
|
| Rate for Payer: BCBS of TX Medicare |
$55.94
|
| Rate for Payer: BCBS of TX PPO |
$138.63
|
| Rate for Payer: Cash Price |
$168.08
|
| Rate for Payer: Cash Price |
$168.08
|
| Rate for Payer: Cash Price |
$168.08
|
| Rate for Payer: Cigna Commercial |
$126.71
|
| Rate for Payer: Cigna Medicare |
$55.94
|
| Rate for Payer: Employer Direct Commercial |
$55.94
|
| Rate for Payer: Humana Medicare/TRICARE |
$55.94
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$55.94
|
| Rate for Payer: Molina Medicare |
$55.94
|
| Rate for Payer: Multiplan Auto |
$124.15
|
| Rate for Payer: Multiplan Commercial |
$124.15
|
| Rate for Payer: Multiplan Workers Comp |
$124.15
|
| Rate for Payer: Scott and White EPO/PPO |
$1.00
|
| Rate for Payer: Scott and White Medicare |
$55.94
|
| Rate for Payer: Superior Health Plan EPO |
$55.94
|
| Rate for Payer: Superior Health Plan Medicare |
$55.94
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$55.94
|
| Rate for Payer: Universal American Medicare |
$55.94
|
| Rate for Payer: Wellcare Medicare |
$55.94
|
| Rate for Payer: Wellmed Medicare |
$55.94
|
|
|
ED Nail Repair Procedure: Trim Nondystrophic Nails
|
Facility
|
IP
|
$191.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
7150238
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$168.08
|
|
|
ED Nail Repair Procedure Trim Nondystrophic Nails BCE
|
Facility
|
OP
|
$191.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
7150238
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$138.63 |
| Rate for Payer: Aetna Commercial |
$105.05
|
| Rate for Payer: Aetna Medicare |
$83.91
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$17.19
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$55.94
|
| Rate for Payer: Amerigroup Medicare |
$55.94
|
| Rate for Payer: BCBS of TX Blue Advantage |
$91.87
|
| Rate for Payer: BCBS of TX Blue Essentials |
$110.02
|
| Rate for Payer: BCBS of TX Medicare |
$55.94
|
| Rate for Payer: BCBS of TX PPO |
$138.63
|
| Rate for Payer: Cash Price |
$168.08
|
| Rate for Payer: Cash Price |
$168.08
|
| Rate for Payer: Cash Price |
$168.08
|
| Rate for Payer: Cigna Commercial |
$126.71
|
| Rate for Payer: Cigna Medicare |
$55.94
|
| Rate for Payer: Employer Direct Commercial |
$55.94
|
| Rate for Payer: Humana Medicare/TRICARE |
$55.94
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$55.94
|
| Rate for Payer: Molina Medicare |
$55.94
|
| Rate for Payer: Multiplan Auto |
$124.15
|
| Rate for Payer: Multiplan Commercial |
$124.15
|
| Rate for Payer: Multiplan Workers Comp |
$124.15
|
| Rate for Payer: Scott and White EPO/PPO |
$1.00
|
| Rate for Payer: Scott and White Medicare |
$55.94
|
| Rate for Payer: Superior Health Plan EPO |
$55.94
|
| Rate for Payer: Superior Health Plan Medicare |
$55.94
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$55.94
|
| Rate for Payer: Universal American Medicare |
$55.94
|
| Rate for Payer: Wellcare Medicare |
$55.94
|
| Rate for Payer: Wellmed Medicare |
$55.94
|
|
|
ED Nosebleed Complexity: Anterior, Simple
|
Facility
|
OP
|
$732.00
|
|
|
Service Code
|
CPT 30901
|
| Hospital Charge Code |
5202576
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$475.80 |
| Rate for Payer: Aetna Commercial |
$402.60
|
| Rate for Payer: Aetna Medicare |
$175.23
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$65.88
|
| 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 |
$644.16
|
| Rate for Payer: Cash Price |
$644.16
|
| Rate for Payer: Cash Price |
$644.16
|
| 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 |
$475.80
|
| Rate for Payer: Multiplan Commercial |
$475.80
|
| Rate for Payer: Multiplan Workers Comp |
$475.80
|
| 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 Nosebleed Complexity Anterior, Simple BCE
|
Facility
|
OP
|
$732.00
|
|
|
Service Code
|
CPT 30901
|
| Hospital Charge Code |
5202576
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$475.80 |
| Rate for Payer: Aetna Commercial |
$402.60
|
| Rate for Payer: Aetna Medicare |
$175.23
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$65.88
|
| 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 |
$644.16
|
| Rate for Payer: Cash Price |
$644.16
|
| Rate for Payer: Cash Price |
$644.16
|
| 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 |
$475.80
|
| Rate for Payer: Multiplan Commercial |
$475.80
|
| Rate for Payer: Multiplan Workers Comp |
$475.80
|
| 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 Nosebleed Complexity Anterior, Simple BCE
|
Facility
|
IP
|
$732.00
|
|
|
Service Code
|
CPT 30901
|
| Hospital Charge Code |
5202576
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$644.16
|
|
|
ED OB/GYN Procedure: Delivery, Vaginal
|
Facility
|
OP
|
$6,737.00
|
|
|
Service Code
|
CPT 59409
|
| Hospital Charge Code |
5202578
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$51.13 |
| Max. Negotiated Rate |
$6,476.93 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$4,288.80
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$606.33
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,859.20
|
| Rate for Payer: Amerigroup Medicare |
$2,859.20
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,171.83
|
| Rate for Payer: BCBS of TX Blue Essentials |
$4,996.20
|
| Rate for Payer: BCBS of TX Medicare |
$2,859.20
|
| Rate for Payer: BCBS of TX PPO |
$6,295.21
|
| Rate for Payer: Cash Price |
$5,928.56
|
| Rate for Payer: Cash Price |
$5,928.56
|
| Rate for Payer: Cash Price |
$5,928.56
|
| Rate for Payer: Cigna Commercial |
$6,476.93
|
| Rate for Payer: Cigna Medicare |
$2,859.20
|
| Rate for Payer: Employer Direct Commercial |
$2,859.20
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,859.20
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,859.20
|
| Rate for Payer: Molina Medicare |
$2,859.20
|
| Rate for Payer: Multiplan Auto |
$4,379.05
|
| Rate for Payer: Multiplan Commercial |
$4,379.05
|
| Rate for Payer: Multiplan Workers Comp |
$4,379.05
|
| Rate for Payer: Scott and White EPO/PPO |
$51.13
|
| Rate for Payer: Scott and White Medicare |
$2,859.20
|
| Rate for Payer: Superior Health Plan EPO |
$2,859.20
|
| Rate for Payer: Superior Health Plan Medicare |
$2,859.20
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,859.20
|
| Rate for Payer: Universal American Medicare |
$2,859.20
|
| Rate for Payer: Wellcare Medicare |
$2,859.20
|
| Rate for Payer: Wellmed Medicare |
$2,859.20
|
|
|
ED OB/GYN Procedure: Delivery, Vaginal
|
Facility
|
IP
|
$6,737.00
|
|
|
Service Code
|
CPT 59409
|
| Hospital Charge Code |
5202578
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$5,928.56
|
|
|
ED OB/GYN Procedure Delivery, Vaginal BCE
|
Facility
|
OP
|
$6,737.00
|
|
|
Service Code
|
CPT 59409
|
| Hospital Charge Code |
5202578
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$51.13 |
| Max. Negotiated Rate |
$6,476.93 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$4,288.80
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$606.33
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,859.20
|
| Rate for Payer: Amerigroup Medicare |
$2,859.20
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,171.83
|
| Rate for Payer: BCBS of TX Blue Essentials |
$4,996.20
|
| Rate for Payer: BCBS of TX Medicare |
$2,859.20
|
| Rate for Payer: BCBS of TX PPO |
$6,295.21
|
| Rate for Payer: Cash Price |
$5,928.56
|
| Rate for Payer: Cash Price |
$5,928.56
|
| Rate for Payer: Cash Price |
$5,928.56
|
| Rate for Payer: Cigna Commercial |
$6,476.93
|
| Rate for Payer: Cigna Medicare |
$2,859.20
|
| Rate for Payer: Employer Direct Commercial |
$2,859.20
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,859.20
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,859.20
|
| Rate for Payer: Molina Medicare |
$2,859.20
|
| Rate for Payer: Multiplan Auto |
$4,379.05
|
| Rate for Payer: Multiplan Commercial |
$4,379.05
|
| Rate for Payer: Multiplan Workers Comp |
$4,379.05
|
| Rate for Payer: Scott and White EPO/PPO |
$51.13
|
| Rate for Payer: Scott and White Medicare |
$2,859.20
|
| Rate for Payer: Superior Health Plan EPO |
$2,859.20
|
| Rate for Payer: Superior Health Plan Medicare |
$2,859.20
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,859.20
|
| Rate for Payer: Universal American Medicare |
$2,859.20
|
| Rate for Payer: Wellcare Medicare |
$2,859.20
|
| Rate for Payer: Wellmed Medicare |
$2,859.20
|
|
|
ED OB/GYN Procedure: Removal of Contraceptive Capsule
|
Facility
|
OP
|
$1,718.00
|
|
|
Service Code
|
CPT 11976
|
| Hospital Charge Code |
5202577
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$11.51 |
| Max. Negotiated Rate |
$1,457.60 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$965.18
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$154.62
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$643.45
|
| Rate for Payer: Amerigroup Medicare |
$643.45
|
| 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 |
$643.45
|
| Rate for Payer: BCBS of TX PPO |
$190.08
|
| Rate for Payer: Cash Price |
$1,511.84
|
| Rate for Payer: Cash Price |
$1,511.84
|
| Rate for Payer: Cash Price |
$1,511.84
|
| Rate for Payer: Cigna Commercial |
$1,457.60
|
| Rate for Payer: Cigna Medicaid |
$61.74
|
| Rate for Payer: Cigna Medicare |
$643.45
|
| Rate for Payer: Employer Direct Commercial |
$643.45
|
| Rate for Payer: Humana Medicare/TRICARE |
$643.45
|
| Rate for Payer: Molina CHIP/Medicaid |
$61.74
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$643.45
|
| Rate for Payer: Molina Medicare |
$643.45
|
| Rate for Payer: Multiplan Auto |
$1,116.70
|
| Rate for Payer: Multiplan Commercial |
$1,116.70
|
| Rate for Payer: Multiplan Workers Comp |
$1,116.70
|
| Rate for Payer: Parkland Medicaid |
$61.74
|
| Rate for Payer: Scott and White EPO/PPO |
$11.51
|
| Rate for Payer: Scott and White Medicare |
$643.45
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$61.74
|
| Rate for Payer: Superior Health Plan EPO |
$643.45
|
| Rate for Payer: Superior Health Plan Medicare |
$643.45
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$643.45
|
| Rate for Payer: Universal American Medicare |
$643.45
|
| Rate for Payer: Wellcare Medicare |
$643.45
|
| Rate for Payer: Wellmed Medicare |
$643.45
|
|
|
ED OB/GYN Procedure: Removal of Contraceptive Capsule
|
Facility
|
IP
|
$1,718.00
|
|
|
Service Code
|
CPT 11976
|
| Hospital Charge Code |
5202577
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,511.84
|
|
|
ED OB/GYN Procedure Removal of Contraceptive Capsule BCE
|
Facility
|
OP
|
$1,718.00
|
|
|
Service Code
|
CPT 11976
|
| Hospital Charge Code |
5202577
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$11.51 |
| Max. Negotiated Rate |
$1,457.60 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$965.18
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$154.62
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$643.45
|
| Rate for Payer: Amerigroup Medicare |
$643.45
|
| 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 |
$643.45
|
| Rate for Payer: BCBS of TX PPO |
$190.08
|
| Rate for Payer: Cash Price |
$1,511.84
|
| Rate for Payer: Cash Price |
$1,511.84
|
| Rate for Payer: Cash Price |
$1,511.84
|
| Rate for Payer: Cigna Commercial |
$1,457.60
|
| Rate for Payer: Cigna Medicaid |
$61.74
|
| Rate for Payer: Cigna Medicare |
$643.45
|
| Rate for Payer: Employer Direct Commercial |
$643.45
|
| Rate for Payer: Humana Medicare/TRICARE |
$643.45
|
| Rate for Payer: Molina CHIP/Medicaid |
$61.74
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$643.45
|
| Rate for Payer: Molina Medicare |
$643.45
|
| Rate for Payer: Multiplan Auto |
$1,116.70
|
| Rate for Payer: Multiplan Commercial |
$1,116.70
|
| Rate for Payer: Multiplan Workers Comp |
$1,116.70
|
| Rate for Payer: Parkland Medicaid |
$61.74
|
| Rate for Payer: Scott and White EPO/PPO |
$11.51
|
| Rate for Payer: Scott and White Medicare |
$643.45
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$61.74
|
| Rate for Payer: Superior Health Plan EPO |
$643.45
|
| Rate for Payer: Superior Health Plan Medicare |
$643.45
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$643.45
|
| Rate for Payer: Universal American Medicare |
$643.45
|
| Rate for Payer: Wellcare Medicare |
$643.45
|
| Rate for Payer: Wellmed Medicare |
$643.45
|
|
|
ED OPEN TX PHALANGEAL SHAFT FX PROXIMAL/MIDDLE PHALANX EA W/
|
Facility
|
IP
|
$11,099.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
8470467
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$9,767.12
|
|
|
ED OPEN TX PHALANGEAL SHAFT FX PROXIMAL/MIDDLE PHALANX EA W/
|
Facility
|
OP
|
$11,099.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
8470467
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$52.94 |
| Max. Negotiated Rate |
$7,214.35 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$4,440.36
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$998.91
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Amerigroup Medicare |
$2,960.24
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,571.54
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,474.90
|
| Rate for Payer: BCBS of TX Medicare |
$2,960.24
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cash Price |
$9,767.12
|
| Rate for Payer: Cash Price |
$9,767.12
|
| Rate for Payer: Cash Price |
$9,767.12
|
| Rate for Payer: Cigna Commercial |
$6,705.80
|
| Rate for Payer: Cigna Medicaid |
$1,088.27
|
| Rate for Payer: Cigna Medicare |
$2,960.24
|
| Rate for Payer: Employer Direct Commercial |
$2,960.24
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,960.24
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Molina Medicare |
$2,960.24
|
| Rate for Payer: Multiplan Auto |
$7,214.35
|
| Rate for Payer: Multiplan Commercial |
$7,214.35
|
| Rate for Payer: Multiplan Workers Comp |
$7,214.35
|
| Rate for Payer: Parkland Medicaid |
$1,088.27
|
| Rate for Payer: Scott and White EPO/PPO |
$52.94
|
| Rate for Payer: Scott and White Medicare |
$2,960.24
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Superior Health Plan EPO |
$2,960.24
|
| Rate for Payer: Superior Health Plan Medicare |
$2,960.24
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Universal American Medicare |
$2,960.24
|
| Rate for Payer: Wellcare Medicare |
$2,960.24
|
| Rate for Payer: Wellmed Medicare |
$2,960.24
|
|
