|
Injection, anesthetic agent celiac plexus, with or without radiologic monitoring
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36064530
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$18.39 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$1,250.38
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$340.77
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Amerigroup Medicare |
$833.59
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,356.12
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,624.10
|
| Rate for Payer: BCBS of TX Medicare |
$833.59
|
| Rate for Payer: BCBS of TX PPO |
$2,046.37
|
| Rate for Payer: Cigna Commercial |
$1,888.32
|
| Rate for Payer: Cigna Medicaid |
$340.77
|
| Rate for Payer: Cigna Medicare |
$833.59
|
| Rate for Payer: Employer Direct Commercial |
$833.59
|
| Rate for Payer: Humana Medicare/TRICARE |
$833.59
|
| Rate for Payer: Molina CHIP/Medicaid |
$340.77
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Molina Medicare |
$833.59
|
| 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 |
$340.77
|
| Rate for Payer: Scott and White EPO/PPO |
$18.39
|
| Rate for Payer: Scott and White Medicare |
$833.59
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$340.77
|
| Rate for Payer: Superior Health Plan EPO |
$833.59
|
| Rate for Payer: Superior Health Plan Medicare |
$833.59
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Universal American Medicare |
$833.59
|
| Rate for Payer: Wellcare Medicare |
$833.59
|
| Rate for Payer: Wellmed Medicare |
$833.59
|
|
|
Injection, anesthetic agent lumbar or thoracic (paravertebral sympathetic)
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 64520
|
| Hospital Charge Code |
36064520
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$18.39 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$1,250.38
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$340.77
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Amerigroup Medicare |
$833.59
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,356.12
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,624.10
|
| Rate for Payer: BCBS of TX Medicare |
$833.59
|
| Rate for Payer: BCBS of TX PPO |
$2,046.37
|
| Rate for Payer: Cigna Commercial |
$1,888.32
|
| Rate for Payer: Cigna Medicaid |
$340.77
|
| Rate for Payer: Cigna Medicare |
$833.59
|
| Rate for Payer: Employer Direct Commercial |
$833.59
|
| Rate for Payer: Humana Medicare/TRICARE |
$833.59
|
| Rate for Payer: Molina CHIP/Medicaid |
$340.77
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Molina Medicare |
$833.59
|
| 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 |
$340.77
|
| Rate for Payer: Scott and White EPO/PPO |
$18.39
|
| Rate for Payer: Scott and White Medicare |
$833.59
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$340.77
|
| Rate for Payer: Superior Health Plan EPO |
$833.59
|
| Rate for Payer: Superior Health Plan Medicare |
$833.59
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Universal American Medicare |
$833.59
|
| Rate for Payer: Wellcare Medicare |
$833.59
|
| Rate for Payer: Wellmed Medicare |
$833.59
|
|
|
Injection, anesthetic agent stellate ganglion (cervical sympathetic)
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 64510
|
| Hospital Charge Code |
36064510
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$18.39 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$1,250.38
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$340.77
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Amerigroup Medicare |
$833.59
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,356.12
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,624.10
|
| Rate for Payer: BCBS of TX Medicare |
$833.59
|
| Rate for Payer: BCBS of TX PPO |
$2,046.37
|
| Rate for Payer: Cigna Commercial |
$1,888.32
|
| Rate for Payer: Cigna Medicaid |
$340.77
|
| Rate for Payer: Cigna Medicare |
$833.59
|
| Rate for Payer: Employer Direct Commercial |
$833.59
|
| Rate for Payer: Humana Medicare/TRICARE |
$833.59
|
| Rate for Payer: Molina CHIP/Medicaid |
$340.77
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Molina Medicare |
$833.59
|
| 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 |
$340.77
|
| Rate for Payer: Scott and White EPO/PPO |
$18.39
|
| Rate for Payer: Scott and White Medicare |
$833.59
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$340.77
|
| Rate for Payer: Superior Health Plan EPO |
$833.59
|
| Rate for Payer: Superior Health Plan Medicare |
$833.59
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Universal American Medicare |
$833.59
|
| Rate for Payer: Wellcare Medicare |
$833.59
|
| Rate for Payer: Wellmed Medicare |
$833.59
|
|
|
Injection, anesthetic agent superior hypogastric plexus
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 64517
|
| Hospital Charge Code |
36064517
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$18.39 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$1,250.38
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$340.77
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Amerigroup Medicare |
$833.59
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,356.12
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,624.10
|
| Rate for Payer: BCBS of TX Medicare |
$833.59
|
| Rate for Payer: BCBS of TX PPO |
$2,046.37
|
| Rate for Payer: Cigna Commercial |
$1,888.32
|
| Rate for Payer: Cigna Medicaid |
$340.77
|
| Rate for Payer: Cigna Medicare |
$833.59
|
| Rate for Payer: Employer Direct Commercial |
$833.59
|
| Rate for Payer: Humana Medicare/TRICARE |
$833.59
|
| Rate for Payer: Molina CHIP/Medicaid |
$340.77
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Molina Medicare |
$833.59
|
| 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 |
$340.77
|
| Rate for Payer: Scott and White EPO/PPO |
$18.39
|
| Rate for Payer: Scott and White Medicare |
$833.59
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$340.77
|
| Rate for Payer: Superior Health Plan EPO |
$833.59
|
| Rate for Payer: Superior Health Plan Medicare |
$833.59
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Universal American Medicare |
$833.59
|
| Rate for Payer: Wellcare Medicare |
$833.59
|
| Rate for Payer: Wellmed Medicare |
$833.59
|
|
|
Injection Blood Patch Epidural
|
Facility
|
OP
|
$1,339.00
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
10157
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13.95 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$948.68
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$262.86
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Amerigroup Medicare |
$632.45
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,043.83
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,250.10
|
| Rate for Payer: BCBS of TX Medicare |
$632.45
|
| Rate for Payer: BCBS of TX PPO |
$1,575.13
|
| Rate for Payer: Cash Price |
$1,178.32
|
| Rate for Payer: Cash Price |
$1,178.32
|
| Rate for Payer: Cigna Commercial |
$1,432.68
|
| Rate for Payer: Cigna Medicaid |
$262.86
|
| Rate for Payer: Cigna Medicare |
$632.45
|
| Rate for Payer: Employer Direct Commercial |
$632.45
|
| Rate for Payer: Humana Medicare/TRICARE |
$632.45
|
| Rate for Payer: Molina CHIP/Medicaid |
$262.86
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Molina Medicare |
$632.45
|
| 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 |
$262.86
|
| Rate for Payer: Scott and White EPO/PPO |
$13.95
|
| Rate for Payer: Scott and White Medicare |
$632.45
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$262.86
|
| Rate for Payer: Superior Health Plan EPO |
$632.45
|
| Rate for Payer: Superior Health Plan Medicare |
$632.45
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Universal American Medicare |
$632.45
|
| Rate for Payer: Wellcare Medicare |
$632.45
|
| Rate for Payer: Wellmed Medicare |
$632.45
|
|
|
Injection Blood Patch Epidural
|
Facility
|
IP
|
$1,339.00
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
10157
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$1,178.32
|
|
|
Injection, epidural, of blood or clot patch
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
36062273
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$13.95 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$948.68
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$262.86
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Amerigroup Medicare |
$632.45
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,043.83
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,250.10
|
| Rate for Payer: BCBS of TX Medicare |
$632.45
|
| Rate for Payer: BCBS of TX PPO |
$1,575.13
|
| Rate for Payer: Cigna Commercial |
$1,432.68
|
| Rate for Payer: Cigna Medicaid |
$262.86
|
| Rate for Payer: Cigna Medicare |
$632.45
|
| Rate for Payer: Employer Direct Commercial |
$632.45
|
| Rate for Payer: Humana Medicare/TRICARE |
$632.45
|
| Rate for Payer: Molina CHIP/Medicaid |
$262.86
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Molina Medicare |
$632.45
|
| 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 |
$262.86
|
| Rate for Payer: Scott and White EPO/PPO |
$13.95
|
| Rate for Payer: Scott and White Medicare |
$632.45
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$262.86
|
| Rate for Payer: Superior Health Plan EPO |
$632.45
|
| Rate for Payer: Superior Health Plan Medicare |
$632.45
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Universal American Medicare |
$632.45
|
| Rate for Payer: Wellcare Medicare |
$632.45
|
| Rate for Payer: Wellmed Medicare |
$632.45
|
|
|
Injection, intralesional up to and including 7 lesions
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 11900
|
| Hospital Charge Code |
36011900
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4.04 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Medicare |
$274.64
|
| 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: 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 |
$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 |
$4.04
|
| 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
|
|
|
Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersio
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 36466
|
| Hospital Charge Code |
36036466
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$36.79 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$2,200.00
|
| Rate for Payer: Aetna Medicare |
$2,501.68
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$709.01
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,667.79
|
| Rate for Payer: Amerigroup Medicare |
$1,667.79
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,369.32
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,639.90
|
| Rate for Payer: BCBS of TX Medicare |
$1,667.79
|
| Rate for Payer: BCBS of TX PPO |
$2,066.27
|
| Rate for Payer: Cigna Commercial |
$3,778.02
|
| Rate for Payer: Cigna Medicaid |
$709.01
|
| Rate for Payer: Cigna Medicare |
$1,667.79
|
| Rate for Payer: Employer Direct Commercial |
$1,667.79
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,667.79
|
| Rate for Payer: Molina CHIP/Medicaid |
$709.01
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,667.79
|
| Rate for Payer: Molina Medicare |
$1,667.79
|
| 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 |
$709.01
|
| Rate for Payer: Scott and White EPO/PPO |
$36.79
|
| Rate for Payer: Scott and White Medicare |
$1,667.79
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$709.01
|
| Rate for Payer: Superior Health Plan EPO |
$1,667.79
|
| Rate for Payer: Superior Health Plan Medicare |
$1,667.79
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,667.79
|
| Rate for Payer: Universal American Medicare |
$1,667.79
|
| Rate for Payer: Wellcare Medicare |
$1,667.79
|
| Rate for Payer: Wellmed Medicare |
$1,667.79
|
|
|
Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersio
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 36465
|
| Hospital Charge Code |
36036465
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$36.79 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$2,200.00
|
| Rate for Payer: Aetna Medicare |
$2,501.68
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$709.01
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,667.79
|
| Rate for Payer: Amerigroup Medicare |
$1,667.79
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,369.32
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,639.90
|
| Rate for Payer: BCBS of TX Medicare |
$1,667.79
|
| Rate for Payer: BCBS of TX PPO |
$2,066.27
|
| Rate for Payer: Cigna Commercial |
$3,778.02
|
| Rate for Payer: Cigna Medicaid |
$709.01
|
| Rate for Payer: Cigna Medicare |
$1,667.79
|
| Rate for Payer: Employer Direct Commercial |
$1,667.79
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,667.79
|
| Rate for Payer: Molina CHIP/Medicaid |
$709.01
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,667.79
|
| Rate for Payer: Molina Medicare |
$1,667.79
|
| 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 |
$709.01
|
| Rate for Payer: Scott and White EPO/PPO |
$36.79
|
| Rate for Payer: Scott and White Medicare |
$1,667.79
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$709.01
|
| Rate for Payer: Superior Health Plan EPO |
$1,667.79
|
| Rate for Payer: Superior Health Plan Medicare |
$1,667.79
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,667.79
|
| Rate for Payer: Universal American Medicare |
$1,667.79
|
| Rate for Payer: Wellcare Medicare |
$1,667.79
|
| Rate for Payer: Wellmed Medicare |
$1,667.79
|
|
|
Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 36471
|
| Hospital Charge Code |
36036471
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$8.04 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Medicare |
$547.00
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$116.28
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Amerigroup Medicare |
$364.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$229.62
|
| Rate for Payer: BCBS of TX Blue Essentials |
$275.00
|
| Rate for Payer: BCBS of TX Medicare |
$364.67
|
| Rate for Payer: BCBS of TX PPO |
$346.50
|
| Rate for Payer: Cigna Commercial |
$826.08
|
| Rate for Payer: Cigna Medicaid |
$116.28
|
| 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 |
$116.28
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Molina Medicare |
$364.67
|
| 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 |
$116.28
|
| Rate for Payer: Scott and White EPO/PPO |
$8.04
|
| Rate for Payer: Scott and White Medicare |
$364.67
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$116.28
|
| 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
|
|
|
Injection procedure for discography, each level; lumbar
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 62290
|
| Hospital Charge Code |
36062290
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$10,000.00 |
| 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
|
|
|
Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36027096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$143.24 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: BCBS of TX Blue Advantage |
$143.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$171.54
|
| Rate for Payer: BCBS of TX PPO |
$216.14
|
| 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
|
|
|
Injection procedure for sacroiliac joint provision of anesthetic, steroid and/o
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT G0260
|
| Hospital Charge Code |
360G0260
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$11.31 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$948.68
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Amerigroup Medicare |
$632.45
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,043.83
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,250.10
|
| Rate for Payer: BCBS of TX Medicare |
$632.45
|
| Rate for Payer: BCBS of TX PPO |
$1,575.13
|
| Rate for Payer: Cigna Commercial |
$1,432.68
|
| Rate for Payer: Cigna Medicare |
$632.45
|
| Rate for Payer: Employer Direct Commercial |
$632.45
|
| Rate for Payer: Humana Medicare/TRICARE |
$632.45
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Molina Medicare |
$632.45
|
| 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 |
$11.31
|
| Rate for Payer: Scott and White Medicare |
$632.45
|
| Rate for Payer: Superior Health Plan EPO |
$632.45
|
| Rate for Payer: Superior Health Plan Medicare |
$632.45
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Universal American Medicare |
$632.45
|
| Rate for Payer: Wellcare Medicare |
$632.45
|
| Rate for Payer: Wellmed Medicare |
$632.45
|
|
|
Injection procedure for wrist arthrography
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 25246
|
| Hospital Charge Code |
36025246
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$10,000.00 |
| 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
|
|
|
Injection(s), anesthetic agent and/or steroid, plantar common digital nerve(s) (eg, Morton's neuroma
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 64455
|
| Hospital Charge Code |
36064455
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Medicare |
$406.30
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$17.99
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Amerigroup Medicare |
$270.87
|
| Rate for Payer: BCBS of TX Blue Advantage |
$34.35
|
| Rate for Payer: BCBS of TX Blue Essentials |
$41.14
|
| Rate for Payer: BCBS of TX Medicare |
$270.87
|
| Rate for Payer: BCBS of TX PPO |
$51.84
|
| Rate for Payer: Cigna Commercial |
$613.60
|
| Rate for Payer: Cigna Medicaid |
$17.99
|
| 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 |
$17.99
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Molina Medicare |
$270.87
|
| 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 |
$17.99
|
| Rate for Payer: Scott and White EPO/PPO |
$5.97
|
| Rate for Payer: Scott and White Medicare |
$270.87
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$17.99
|
| 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
|
|
|
Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluor
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 64479
|
| Hospital Charge Code |
36064479
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$18.39 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$1,250.38
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$340.77
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Amerigroup Medicare |
$833.59
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,356.12
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,624.10
|
| Rate for Payer: BCBS of TX Medicare |
$833.59
|
| Rate for Payer: BCBS of TX PPO |
$2,046.37
|
| Rate for Payer: Cigna Commercial |
$1,888.32
|
| Rate for Payer: Cigna Medicaid |
$340.77
|
| Rate for Payer: Cigna Medicare |
$833.59
|
| Rate for Payer: Employer Direct Commercial |
$833.59
|
| Rate for Payer: Humana Medicare/TRICARE |
$833.59
|
| Rate for Payer: Molina CHIP/Medicaid |
$340.77
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Molina Medicare |
$833.59
|
| 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 |
$340.77
|
| Rate for Payer: Scott and White EPO/PPO |
$18.39
|
| Rate for Payer: Scott and White Medicare |
$833.59
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$340.77
|
| Rate for Payer: Superior Health Plan EPO |
$833.59
|
| Rate for Payer: Superior Health Plan Medicare |
$833.59
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Universal American Medicare |
$833.59
|
| Rate for Payer: Wellcare Medicare |
$833.59
|
| Rate for Payer: Wellmed Medicare |
$833.59
|
|
|
Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluor
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 64480
|
| Hospital Charge Code |
36064480
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$10,000.00 |
| 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
|
|
|
Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluor
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 64483
|
| Hospital Charge Code |
36064483
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$18.39 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$1,250.38
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$340.77
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Amerigroup Medicare |
$833.59
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,356.12
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,624.10
|
| Rate for Payer: BCBS of TX Medicare |
$833.59
|
| Rate for Payer: BCBS of TX PPO |
$2,046.37
|
| Rate for Payer: Cigna Commercial |
$1,888.32
|
| Rate for Payer: Cigna Medicaid |
$340.77
|
| Rate for Payer: Cigna Medicare |
$833.59
|
| Rate for Payer: Employer Direct Commercial |
$833.59
|
| Rate for Payer: Humana Medicare/TRICARE |
$833.59
|
| Rate for Payer: Molina CHIP/Medicaid |
$340.77
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Molina Medicare |
$833.59
|
| 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 |
$340.77
|
| Rate for Payer: Scott and White EPO/PPO |
$18.39
|
| Rate for Payer: Scott and White Medicare |
$833.59
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$340.77
|
| Rate for Payer: Superior Health Plan EPO |
$833.59
|
| Rate for Payer: Superior Health Plan Medicare |
$833.59
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Universal American Medicare |
$833.59
|
| Rate for Payer: Wellcare Medicare |
$833.59
|
| Rate for Payer: Wellmed Medicare |
$833.59
|
|
|
Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluor
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 64484
|
| Hospital Charge Code |
36064484
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$10,000.00 |
| 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
|
|
|
Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluor
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 62325
|
| Hospital Charge Code |
36062325
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$18.39 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$1,250.38
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$340.77
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Amerigroup Medicare |
$833.59
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,356.12
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,624.10
|
| Rate for Payer: BCBS of TX Medicare |
$833.59
|
| Rate for Payer: BCBS of TX PPO |
$2,046.37
|
| Rate for Payer: Cigna Commercial |
$1,888.32
|
| Rate for Payer: Cigna Medicaid |
$340.77
|
| Rate for Payer: Cigna Medicare |
$833.59
|
| Rate for Payer: Employer Direct Commercial |
$833.59
|
| Rate for Payer: Humana Medicare/TRICARE |
$833.59
|
| Rate for Payer: Molina CHIP/Medicaid |
$340.77
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Molina Medicare |
$833.59
|
| 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 |
$340.77
|
| Rate for Payer: Scott and White EPO/PPO |
$18.39
|
| Rate for Payer: Scott and White Medicare |
$833.59
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$340.77
|
| Rate for Payer: Superior Health Plan EPO |
$833.59
|
| Rate for Payer: Superior Health Plan Medicare |
$833.59
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Universal American Medicare |
$833.59
|
| Rate for Payer: Wellcare Medicare |
$833.59
|
| Rate for Payer: Wellmed Medicare |
$833.59
|
|
|
Injection(s), anesthetic agent(s) and/or steroid; axillary nerve, including imaging guidance, when p
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 64417
|
| Hospital Charge Code |
36064417
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$18.39 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$1,250.38
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$340.77
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Amerigroup Medicare |
$833.59
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,356.12
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,624.10
|
| Rate for Payer: BCBS of TX Medicare |
$833.59
|
| Rate for Payer: BCBS of TX PPO |
$2,046.37
|
| Rate for Payer: Cigna Commercial |
$1,888.32
|
| Rate for Payer: Cigna Medicaid |
$340.77
|
| Rate for Payer: Cigna Medicare |
$833.59
|
| Rate for Payer: Employer Direct Commercial |
$833.59
|
| Rate for Payer: Humana Medicare/TRICARE |
$833.59
|
| Rate for Payer: Molina CHIP/Medicaid |
$340.77
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Molina Medicare |
$833.59
|
| 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 |
$340.77
|
| Rate for Payer: Scott and White EPO/PPO |
$18.39
|
| Rate for Payer: Scott and White Medicare |
$833.59
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$340.77
|
| Rate for Payer: Superior Health Plan EPO |
$833.59
|
| Rate for Payer: Superior Health Plan Medicare |
$833.59
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$833.59
|
| Rate for Payer: Universal American Medicare |
$833.59
|
| Rate for Payer: Wellcare Medicare |
$833.59
|
| Rate for Payer: Wellmed Medicare |
$833.59
|
|
|
Injection(s), anesthetic agent(s) and/or steroid; femoral nerve
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 64447
|
| Hospital Charge Code |
36064447
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$13.95 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$948.68
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$39.86
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Amerigroup Medicare |
$632.45
|
| Rate for Payer: BCBS of TX Blue Advantage |
$80.76
|
| Rate for Payer: BCBS of TX Blue Essentials |
$96.72
|
| Rate for Payer: BCBS of TX Medicare |
$632.45
|
| Rate for Payer: BCBS of TX PPO |
$121.87
|
| Rate for Payer: Cigna Commercial |
$1,432.68
|
| Rate for Payer: Cigna Medicaid |
$39.86
|
| Rate for Payer: Cigna Medicare |
$632.45
|
| Rate for Payer: Employer Direct Commercial |
$632.45
|
| Rate for Payer: Humana Medicare/TRICARE |
$632.45
|
| Rate for Payer: Molina CHIP/Medicaid |
$39.86
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Molina Medicare |
$632.45
|
| 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 |
$39.86
|
| Rate for Payer: Scott and White EPO/PPO |
$13.95
|
| Rate for Payer: Scott and White Medicare |
$632.45
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$39.86
|
| Rate for Payer: Superior Health Plan EPO |
$632.45
|
| Rate for Payer: Superior Health Plan Medicare |
$632.45
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Universal American Medicare |
$632.45
|
| Rate for Payer: Wellcare Medicare |
$632.45
|
| Rate for Payer: Wellmed Medicare |
$632.45
|
|
|
Injection(s), anesthetic agent(s) and/or steroid genicular nerve branches, including imaging guidan
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 64454
|
| Hospital Charge Code |
36064454
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$13.95 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$948.68
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$139.81
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Amerigroup Medicare |
$632.45
|
| Rate for Payer: BCBS of TX Blue Advantage |
$263.98
|
| Rate for Payer: BCBS of TX Blue Essentials |
$316.14
|
| Rate for Payer: BCBS of TX Medicare |
$632.45
|
| Rate for Payer: BCBS of TX PPO |
$398.34
|
| Rate for Payer: Cigna Commercial |
$1,432.68
|
| Rate for Payer: Cigna Medicaid |
$139.81
|
| Rate for Payer: Cigna Medicare |
$632.45
|
| Rate for Payer: Employer Direct Commercial |
$632.45
|
| Rate for Payer: Humana Medicare/TRICARE |
$632.45
|
| Rate for Payer: Molina CHIP/Medicaid |
$139.81
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Molina Medicare |
$632.45
|
| 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 |
$139.81
|
| Rate for Payer: Scott and White EPO/PPO |
$13.95
|
| Rate for Payer: Scott and White Medicare |
$632.45
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$139.81
|
| Rate for Payer: Superior Health Plan EPO |
$632.45
|
| Rate for Payer: Superior Health Plan Medicare |
$632.45
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Universal American Medicare |
$632.45
|
| Rate for Payer: Wellcare Medicare |
$632.45
|
| Rate for Payer: Wellmed Medicare |
$632.45
|
|
|
Injection(s), anesthetic agent(s) and/or steroid greater occipital nerve
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 64405
|
| Hospital Charge Code |
36064405
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Medicare |
$406.30
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$30.18
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Amerigroup Medicare |
$270.87
|
| Rate for Payer: BCBS of TX Blue Advantage |
$55.44
|
| Rate for Payer: BCBS of TX Blue Essentials |
$66.40
|
| Rate for Payer: BCBS of TX Medicare |
$270.87
|
| Rate for Payer: BCBS of TX PPO |
$83.66
|
| Rate for Payer: Cigna Commercial |
$613.60
|
| Rate for Payer: Cigna Medicaid |
$30.18
|
| 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 |
$30.18
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Molina Medicare |
$270.87
|
| 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 |
$30.18
|
| Rate for Payer: Scott and White EPO/PPO |
$5.97
|
| Rate for Payer: Scott and White Medicare |
$270.87
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$30.18
|
| 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
|
|
