|
CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE
|
Facility
|
IP
|
$41,349.95
|
|
|
Service Code
|
MSDRG 325
|
| Min. Negotiated Rate |
$28,289.18 |
| Max. Negotiated Rate |
$41,349.95 |
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$28,289.18
|
| Rate for Payer: Amerigroup Medicare |
$28,289.18
|
| Rate for Payer: BCBS of TX Medicare |
$28,289.18
|
| Rate for Payer: Cigna Commercial |
$41,349.95
|
| Rate for Payer: Cigna Medicare |
$28,289.18
|
| Rate for Payer: Employer Direct Commercial |
$28,289.18
|
| Rate for Payer: Humana Medicare/TRICARE |
$28,289.18
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$28,289.18
|
| Rate for Payer: Molina Medicare |
$28,289.18
|
| Rate for Payer: Scott and White Medicare |
$28,289.18
|
| Rate for Payer: Superior Health Plan EPO |
$28,289.18
|
| Rate for Payer: Superior Health Plan Medicare |
$28,289.18
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$28,289.18
|
| Rate for Payer: Universal American Medicare |
$28,289.18
|
| Rate for Payer: Wellcare Medicare |
$28,289.18
|
| Rate for Payer: Wellmed Medicare |
$28,289.18
|
|
|
CORO REVAS D-E STENT/ACUT MI 1 ART
|
Facility
|
IP
|
$22,708.00
|
|
| Hospital Charge Code |
2350066
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$15,441.44
|
|
|
CORO REVAS D-E STENT/ACUT MI 1 ART
|
Facility
|
OP
|
$22,708.00
|
|
| Hospital Charge Code |
2350066
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,043.72 |
| Max. Negotiated Rate |
$16,349.76 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$2,043.72
|
| Rate for Payer: BCBS of TX Blue Advantage |
$6,812.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$8,174.88
|
| Rate for Payer: BCBS of TX PPO |
$9,083.20
|
| Rate for Payer: Cash Price |
$15,441.44
|
| Rate for Payer: Cigna Medicaid |
$16,349.76
|
| Rate for Payer: Molina CHIP/Medicaid |
$16,349.76
|
| Rate for Payer: Multiplan Auto |
$14,760.20
|
| Rate for Payer: Multiplan Commercial |
$14,760.20
|
| Rate for Payer: Multiplan Workers Comp |
$14,760.20
|
| Rate for Payer: Parkland Medicaid |
$16,349.76
|
| Rate for Payer: Scott and White EPO/PPO |
$11,354.00
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$16,349.76
|
| Rate for Payer: Superior Health Plan EPO |
$3,088.29
|
|
|
CORO STENT W ANGIOPLASTY 1ST ART
|
Facility
|
OP
|
$14,349.00
|
|
|
Service Code
|
HCPCS 92928
|
| Hospital Charge Code |
2350034
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$697.11 |
| Max. Negotiated Rate |
$24,969.37 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,291.41
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$11,596.79
|
| Rate for Payer: Amerigroup Medicare |
$11,596.79
|
| Rate for Payer: BCBS of TX Blue Advantage |
$16,547.16
|
| Rate for Payer: BCBS of TX Blue Essentials |
$19,816.96
|
| Rate for Payer: BCBS of TX Medicare |
$11,596.79
|
| Rate for Payer: BCBS of TX PPO |
$24,969.37
|
| Rate for Payer: Cash Price |
$9,757.32
|
| Rate for Payer: Cash Price |
$9,757.32
|
| Rate for Payer: Cash Price |
$9,757.32
|
| Rate for Payer: Cigna Commercial |
$24,513.51
|
| Rate for Payer: Cigna Medicaid |
$10,331.28
|
| Rate for Payer: Cigna Medicare |
$11,596.79
|
| Rate for Payer: Employer Direct Commercial |
$11,596.79
|
| Rate for Payer: Humana Medicare/TRICARE |
$11,596.79
|
| Rate for Payer: Molina CHIP/Medicaid |
$10,331.28
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$11,596.79
|
| Rate for Payer: Molina Medicare |
$11,596.79
|
| Rate for Payer: Multiplan Auto |
$9,326.85
|
| Rate for Payer: Multiplan Commercial |
$9,326.85
|
| Rate for Payer: Multiplan Workers Comp |
$9,326.85
|
| Rate for Payer: Parkland Medicaid |
$10,331.28
|
| Rate for Payer: Scott and White EPO/PPO |
$697.11
|
| Rate for Payer: Scott and White Medicare |
$11,596.79
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$10,331.28
|
| Rate for Payer: Superior Health Plan EPO |
$11,596.79
|
| Rate for Payer: Superior Health Plan Medicare |
$11,596.79
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$11,596.79
|
| Rate for Payer: Universal American Medicare |
$11,596.79
|
| Rate for Payer: Wellcare Medicare |
$11,596.79
|
| Rate for Payer: Wellmed Medicare |
$11,596.79
|
|
|
CORO STENT W ANGIOPLASTY 1ST ART
|
Facility
|
IP
|
$14,349.00
|
|
|
Service Code
|
HCPCS 92928
|
| Hospital Charge Code |
2350034
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$9,757.32
|
|
|
CORO STENT W ANGIOPLASTY EA AD ART
|
Facility
|
OP
|
$8,615.00
|
|
|
Service Code
|
HCPCS 92929
|
| Hospital Charge Code |
2350035
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$775.35 |
| Max. Negotiated Rate |
$6,202.80 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$775.35
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,584.50
|
| Rate for Payer: BCBS of TX Blue Essentials |
$3,101.40
|
| Rate for Payer: BCBS of TX PPO |
$3,446.00
|
| Rate for Payer: Cash Price |
$5,858.20
|
| Rate for Payer: Cigna Medicaid |
$6,202.80
|
| Rate for Payer: Molina CHIP/Medicaid |
$6,202.80
|
| Rate for Payer: Multiplan Auto |
$5,599.75
|
| Rate for Payer: Multiplan Commercial |
$5,599.75
|
| Rate for Payer: Multiplan Workers Comp |
$5,599.75
|
| Rate for Payer: Parkland Medicaid |
$6,202.80
|
| Rate for Payer: Scott and White EPO/PPO |
$4,307.50
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$6,202.80
|
| Rate for Payer: Superior Health Plan EPO |
$1,171.64
|
|
|
CORO STENT W ANGIOPLASTY EA AD ART
|
Facility
|
IP
|
$8,615.00
|
|
|
Service Code
|
HCPCS 92929
|
| Hospital Charge Code |
2350035
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$5,858.20
|
|
|
Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed with distal metatarsa
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 28296
|
| Hospital Charge Code |
36028296
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| 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 |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed with distal metatarsa
|
Facility
|
IP
|
$8,491.20
|
|
|
Service Code
|
HCPCS 28296
|
| Hospital Charge Code |
9900503
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$5,774.02
|
|
|
Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed with distal metatarsa
|
Facility
|
OP
|
$8,491.20
|
|
|
Service Code
|
HCPCS 28296
|
| Hospital Charge Code |
9900503
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| 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 |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cash Price |
$5,774.02
|
| Rate for Payer: Cash Price |
$5,774.02
|
| Rate for Payer: Cash Price |
$5,774.02
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$6,113.66
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina CHIP/Medicaid |
$6,113.66
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Parkland Medicaid |
$6,113.66
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$6,113.66
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed with double osteotomy
|
Facility
|
OP
|
$16,403.00
|
|
|
Service Code
|
HCPCS 28299
|
| Hospital Charge Code |
9900506
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,132.58 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,132.58
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,289.28
|
| Rate for Payer: Amerigroup Medicare |
$7,289.28
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,989.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,963.90
|
| Rate for Payer: BCBS of TX Medicare |
$7,289.28
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cash Price |
$11,154.04
|
| Rate for Payer: Cash Price |
$11,154.04
|
| Rate for Payer: Cash Price |
$11,154.04
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| Rate for Payer: Cigna Medicaid |
$11,810.16
|
| Rate for Payer: Cigna Medicare |
$7,289.28
|
| Rate for Payer: Employer Direct Commercial |
$7,289.28
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,289.28
|
| Rate for Payer: Molina CHIP/Medicaid |
$11,810.16
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,289.28
|
| Rate for Payer: Molina Medicare |
$7,289.28
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Parkland Medicaid |
$11,810.16
|
| Rate for Payer: Scott and White EPO/PPO |
$12,104.03
|
| Rate for Payer: Scott and White Medicare |
$7,289.28
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$11,810.16
|
| Rate for Payer: Superior Health Plan EPO |
$7,289.28
|
| Rate for Payer: Superior Health Plan Medicare |
$7,289.28
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,289.28
|
| Rate for Payer: Universal American Medicare |
$7,289.28
|
| Rate for Payer: Wellcare Medicare |
$7,289.28
|
| Rate for Payer: Wellmed Medicare |
$7,289.28
|
|
|
Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed with double osteotomy
|
Facility
|
OP
|
$15,408.22
|
|
|
Service Code
|
CPT 28299
|
| Hospital Charge Code |
36028299
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,132.58 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,132.58
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,289.28
|
| Rate for Payer: Amerigroup Medicare |
$7,289.28
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,989.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,963.90
|
| Rate for Payer: BCBS of TX Medicare |
$7,289.28
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| Rate for Payer: Cigna Medicare |
$7,289.28
|
| Rate for Payer: Employer Direct Commercial |
$7,289.28
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,289.28
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,289.28
|
| Rate for Payer: Molina Medicare |
$7,289.28
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$12,104.03
|
| Rate for Payer: Scott and White Medicare |
$7,289.28
|
| Rate for Payer: Superior Health Plan EPO |
$7,289.28
|
| Rate for Payer: Superior Health Plan Medicare |
$7,289.28
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,289.28
|
| Rate for Payer: Universal American Medicare |
$7,289.28
|
| Rate for Payer: Wellcare Medicare |
$7,289.28
|
| Rate for Payer: Wellmed Medicare |
$7,289.28
|
|
|
Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed with double osteotomy
|
Facility
|
IP
|
$16,403.00
|
|
|
Service Code
|
HCPCS 28299
|
| Hospital Charge Code |
9900506
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$11,154.04
|
|
|
Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed with first metatarsal
|
Facility
|
OP
|
$15,662.38
|
|
|
Service Code
|
HCPCS 28297
|
| Hospital Charge Code |
9900504
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,508.38 |
| Max. Negotiated Rate |
$27,262.32 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,508.38
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,897.19
|
| Rate for Payer: Amerigroup Medicare |
$12,897.19
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,989.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,963.90
|
| Rate for Payer: BCBS of TX Medicare |
$12,897.19
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cash Price |
$10,650.42
|
| Rate for Payer: Cash Price |
$10,650.42
|
| Rate for Payer: Cash Price |
$10,650.42
|
| Rate for Payer: Cigna Commercial |
$27,262.32
|
| Rate for Payer: Cigna Medicaid |
$11,276.91
|
| Rate for Payer: Cigna Medicare |
$12,897.19
|
| Rate for Payer: Employer Direct Commercial |
$12,897.19
|
| Rate for Payer: Humana Medicare/TRICARE |
$12,897.19
|
| Rate for Payer: Molina CHIP/Medicaid |
$11,276.91
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$12,897.19
|
| Rate for Payer: Molina Medicare |
$12,897.19
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Parkland Medicaid |
$11,276.91
|
| Rate for Payer: Scott and White EPO/PPO |
$12,104.03
|
| Rate for Payer: Scott and White Medicare |
$12,897.19
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$11,276.91
|
| Rate for Payer: Superior Health Plan EPO |
$12,897.19
|
| Rate for Payer: Superior Health Plan Medicare |
$12,897.19
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$12,897.19
|
| Rate for Payer: Universal American Medicare |
$12,897.19
|
| Rate for Payer: Wellcare Medicare |
$12,897.19
|
| Rate for Payer: Wellmed Medicare |
$12,897.19
|
|
|
Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed with first metatarsal
|
Facility
|
OP
|
$27,262.32
|
|
|
Service Code
|
CPT 28297
|
| Hospital Charge Code |
36028297
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,508.38 |
| Max. Negotiated Rate |
$27,262.32 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,508.38
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,897.19
|
| Rate for Payer: Amerigroup Medicare |
$12,897.19
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,989.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,963.90
|
| Rate for Payer: BCBS of TX Medicare |
$12,897.19
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cigna Commercial |
$27,262.32
|
| Rate for Payer: Cigna Medicare |
$12,897.19
|
| Rate for Payer: Employer Direct Commercial |
$12,897.19
|
| Rate for Payer: Humana Medicare/TRICARE |
$12,897.19
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$12,897.19
|
| Rate for Payer: Molina Medicare |
$12,897.19
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$12,104.03
|
| Rate for Payer: Scott and White Medicare |
$12,897.19
|
| Rate for Payer: Superior Health Plan EPO |
$12,897.19
|
| Rate for Payer: Superior Health Plan Medicare |
$12,897.19
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$12,897.19
|
| Rate for Payer: Universal American Medicare |
$12,897.19
|
| Rate for Payer: Wellcare Medicare |
$12,897.19
|
| Rate for Payer: Wellmed Medicare |
$12,897.19
|
|
|
Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed with first metatarsal
|
Facility
|
IP
|
$15,662.38
|
|
|
Service Code
|
HCPCS 28297
|
| Hospital Charge Code |
9900504
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$10,650.42
|
|
|
Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed with proximal phalanx
|
Facility
|
IP
|
$16,403.00
|
|
|
Service Code
|
HCPCS 28298
|
| Hospital Charge Code |
9900505
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$11,154.04
|
|
|
Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed with proximal phalanx
|
Facility
|
OP
|
$16,403.00
|
|
|
Service Code
|
HCPCS 28298
|
| Hospital Charge Code |
9900505
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,103.16 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,103.16
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,289.28
|
| Rate for Payer: Amerigroup Medicare |
$7,289.28
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,989.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,963.90
|
| Rate for Payer: BCBS of TX Medicare |
$7,289.28
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cash Price |
$11,154.04
|
| Rate for Payer: Cash Price |
$11,154.04
|
| Rate for Payer: Cash Price |
$11,154.04
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| Rate for Payer: Cigna Medicaid |
$11,810.16
|
| Rate for Payer: Cigna Medicare |
$7,289.28
|
| Rate for Payer: Employer Direct Commercial |
$7,289.28
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,289.28
|
| Rate for Payer: Molina CHIP/Medicaid |
$11,810.16
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,289.28
|
| Rate for Payer: Molina Medicare |
$7,289.28
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Parkland Medicaid |
$11,810.16
|
| Rate for Payer: Scott and White EPO/PPO |
$12,104.03
|
| Rate for Payer: Scott and White Medicare |
$7,289.28
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$11,810.16
|
| Rate for Payer: Superior Health Plan EPO |
$7,289.28
|
| Rate for Payer: Superior Health Plan Medicare |
$7,289.28
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,289.28
|
| Rate for Payer: Universal American Medicare |
$7,289.28
|
| Rate for Payer: Wellcare Medicare |
$7,289.28
|
| Rate for Payer: Wellmed Medicare |
$7,289.28
|
|
|
Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed with proximal phalanx
|
Facility
|
OP
|
$15,408.22
|
|
|
Service Code
|
CPT 28298
|
| Hospital Charge Code |
36028298
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,103.16 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,103.16
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,289.28
|
| Rate for Payer: Amerigroup Medicare |
$7,289.28
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,989.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,963.90
|
| Rate for Payer: BCBS of TX Medicare |
$7,289.28
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| Rate for Payer: Cigna Medicare |
$7,289.28
|
| Rate for Payer: Employer Direct Commercial |
$7,289.28
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,289.28
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,289.28
|
| Rate for Payer: Molina Medicare |
$7,289.28
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$12,104.03
|
| Rate for Payer: Scott and White Medicare |
$7,289.28
|
| Rate for Payer: Superior Health Plan EPO |
$7,289.28
|
| Rate for Payer: Superior Health Plan Medicare |
$7,289.28
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,289.28
|
| Rate for Payer: Universal American Medicare |
$7,289.28
|
| Rate for Payer: Wellcare Medicare |
$7,289.28
|
| Rate for Payer: Wellmed Medicare |
$7,289.28
|
|
|
Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed with resection of pro
|
Facility
|
OP
|
$8,491.20
|
|
|
Service Code
|
HCPCS 28292
|
| Hospital Charge Code |
9900502
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| 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 |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cash Price |
$5,774.02
|
| Rate for Payer: Cash Price |
$5,774.02
|
| Rate for Payer: Cash Price |
$5,774.02
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$6,113.66
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina CHIP/Medicaid |
$6,113.66
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Parkland Medicaid |
$6,113.66
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$6,113.66
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed with resection of pro
|
Facility
|
IP
|
$8,491.20
|
|
|
Service Code
|
HCPCS 28292
|
| Hospital Charge Code |
9900502
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$5,774.02
|
|
|
Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed with resection of pro
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 28292
|
| Hospital Charge Code |
36028292
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| 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 |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)
|
Facility
|
OP
|
$14,352.00
|
|
|
Service Code
|
HCPCS 28285
|
| Hospital Charge Code |
9900498
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,333.44 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| 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 |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cash Price |
$9,759.36
|
| Rate for Payer: Cash Price |
$9,759.36
|
| Rate for Payer: Cash Price |
$9,759.36
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$10,333.44
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina CHIP/Medicaid |
$10,333.44
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Parkland Medicaid |
$10,333.44
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$10,333.44
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)
|
Facility
|
IP
|
$14,352.00
|
|
|
Service Code
|
HCPCS 28285
|
| Hospital Charge Code |
9900498
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$9,759.36
|
|
|
Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 28285
|
| Hospital Charge Code |
36028285
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| 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 |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
