|
Arterial Line Activity: Blood Drawn
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
4000345
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$274.76 |
| Rate for Payer: Aetna Commercial |
$84.15
|
| Rate for Payer: Aetna Medicare |
$175.23
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$13.77
|
| 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 |
$134.64
|
| Rate for Payer: Cash Price |
$134.64
|
| Rate for Payer: Cash Price |
$134.64
|
| 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 |
$99.45
|
| Rate for Payer: Multiplan Commercial |
$99.45
|
| Rate for Payer: Multiplan Workers Comp |
$99.45
|
| 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
|
|
|
ARTERIOG CAR NKHD SEL
|
Facility
|
IP
|
$16,514.00
|
|
|
Service Code
|
CPT 36224
|
| Hospital Charge Code |
4616226
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$14,532.32
|
|
|
ARTERIOG CAR NKHD SEL
|
Facility
|
OP
|
$16,514.00
|
|
|
Service Code
|
CPT 36224
|
| Hospital Charge Code |
4616226
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$89.88 |
| Max. Negotiated Rate |
$11,582.40 |
| Rate for Payer: Aetna Commercial |
$7,210.00
|
| Rate for Payer: Aetna Medicare |
$7,538.62
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,486.26
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$5,025.75
|
| Rate for Payer: Amerigroup Medicare |
$5,025.75
|
| Rate for Payer: BCBS of TX Blue Advantage |
$7,675.64
|
| Rate for Payer: BCBS of TX Blue Essentials |
$9,192.38
|
| Rate for Payer: BCBS of TX Medicare |
$5,025.75
|
| Rate for Payer: BCBS of TX PPO |
$11,582.40
|
| Rate for Payer: Cash Price |
$14,532.32
|
| Rate for Payer: Cash Price |
$14,532.32
|
| Rate for Payer: Cash Price |
$14,532.32
|
| Rate for Payer: Cigna Commercial |
$11,384.78
|
| Rate for Payer: Cigna Medicare |
$5,025.75
|
| Rate for Payer: Employer Direct Commercial |
$5,025.75
|
| Rate for Payer: Humana Medicare/TRICARE |
$5,025.75
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$5,025.75
|
| Rate for Payer: Molina Medicare |
$5,025.75
|
| Rate for Payer: Multiplan Auto |
$10,734.10
|
| Rate for Payer: Multiplan Commercial |
$10,734.10
|
| Rate for Payer: Multiplan Workers Comp |
$10,734.10
|
| Rate for Payer: Scott and White EPO/PPO |
$89.88
|
| Rate for Payer: Scott and White Medicare |
$5,025.75
|
| Rate for Payer: Superior Health Plan EPO |
$5,025.75
|
| Rate for Payer: Superior Health Plan Medicare |
$5,025.75
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$5,025.75
|
| Rate for Payer: Universal American Medicare |
$5,025.75
|
| Rate for Payer: Wellcare Medicare |
$5,025.75
|
| Rate for Payer: Wellmed Medicare |
$5,025.75
|
|
|
ARTERIOGR CAR NK SEL
|
Facility
|
IP
|
$9,038.00
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
4616222
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$7,953.44
|
|
|
ARTERIOGR CAR NK SEL
|
Facility
|
OP
|
$9,038.00
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
4616222
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$52.13 |
| Max. Negotiated Rate |
$6,983.63 |
| Rate for Payer: Aetna Commercial |
$4,635.00
|
| Rate for Payer: Aetna Medicare |
$4,372.65
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$813.42
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,915.10
|
| Rate for Payer: Amerigroup Medicare |
$2,915.10
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,628.04
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,542.56
|
| Rate for Payer: BCBS of TX Medicare |
$2,915.10
|
| Rate for Payer: BCBS of TX PPO |
$6,983.63
|
| Rate for Payer: Cash Price |
$7,953.44
|
| Rate for Payer: Cash Price |
$7,953.44
|
| Rate for Payer: Cash Price |
$7,953.44
|
| Rate for Payer: Cigna Commercial |
$6,603.56
|
| Rate for Payer: Cigna Medicare |
$2,915.10
|
| Rate for Payer: Employer Direct Commercial |
$2,915.10
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,915.10
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,915.10
|
| Rate for Payer: Molina Medicare |
$2,915.10
|
| Rate for Payer: Multiplan Auto |
$5,874.70
|
| Rate for Payer: Multiplan Commercial |
$5,874.70
|
| Rate for Payer: Multiplan Workers Comp |
$5,874.70
|
| Rate for Payer: Scott and White EPO/PPO |
$52.13
|
| Rate for Payer: Scott and White Medicare |
$2,915.10
|
| Rate for Payer: Superior Health Plan EPO |
$2,915.10
|
| Rate for Payer: Superior Health Plan Medicare |
$2,915.10
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,915.10
|
| Rate for Payer: Universal American Medicare |
$2,915.10
|
| Rate for Payer: Wellcare Medicare |
$2,915.10
|
| Rate for Payer: Wellmed Medicare |
$2,915.10
|
|
|
ARTERIOG SUBC/INOM
|
Facility
|
OP
|
$7,212.00
|
|
|
Service Code
|
CPT 36225
|
| Hospital Charge Code |
4616228
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$52.13 |
| Max. Negotiated Rate |
$6,983.63 |
| Rate for Payer: Aetna Commercial |
$4,635.00
|
| Rate for Payer: Aetna Medicare |
$4,372.65
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$649.08
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,915.10
|
| Rate for Payer: Amerigroup Medicare |
$2,915.10
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,628.04
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,542.56
|
| Rate for Payer: BCBS of TX Medicare |
$2,915.10
|
| Rate for Payer: BCBS of TX PPO |
$6,983.63
|
| Rate for Payer: Cash Price |
$6,346.56
|
| Rate for Payer: Cash Price |
$6,346.56
|
| Rate for Payer: Cash Price |
$6,346.56
|
| Rate for Payer: Cigna Commercial |
$6,603.56
|
| Rate for Payer: Cigna Medicare |
$2,915.10
|
| Rate for Payer: Employer Direct Commercial |
$2,915.10
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,915.10
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,915.10
|
| Rate for Payer: Molina Medicare |
$2,915.10
|
| Rate for Payer: Multiplan Auto |
$4,687.80
|
| Rate for Payer: Multiplan Commercial |
$4,687.80
|
| Rate for Payer: Multiplan Workers Comp |
$4,687.80
|
| Rate for Payer: Scott and White EPO/PPO |
$52.13
|
| Rate for Payer: Scott and White Medicare |
$2,915.10
|
| Rate for Payer: Superior Health Plan EPO |
$2,915.10
|
| Rate for Payer: Superior Health Plan Medicare |
$2,915.10
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,915.10
|
| Rate for Payer: Universal American Medicare |
$2,915.10
|
| Rate for Payer: Wellcare Medicare |
$2,915.10
|
| Rate for Payer: Wellmed Medicare |
$2,915.10
|
|
|
ARTERIOG SUBC/INOM
|
Facility
|
IP
|
$7,212.00
|
|
|
Service Code
|
CPT 36225
|
| Hospital Charge Code |
4616228
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$6,346.56
|
|
|
ARTEROGRAM ARCH NON SEL
|
Facility
|
OP
|
$6,863.00
|
|
|
Service Code
|
CPT 36221
|
| Hospital Charge Code |
4616221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$64.30 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$4,635.00
|
| Rate for Payer: Aetna Medicare |
$4,372.65
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$617.67
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,915.10
|
| Rate for Payer: Amerigroup Medicare |
$2,915.10
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,628.04
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,542.56
|
| Rate for Payer: BCBS of TX Medicare |
$2,915.10
|
| Rate for Payer: BCBS of TX PPO |
$6,983.63
|
| Rate for Payer: Cash Price |
$6,039.44
|
| Rate for Payer: Cash Price |
$6,039.44
|
| Rate for Payer: Cash Price |
$6,039.44
|
| Rate for Payer: Cigna Commercial |
$6,603.56
|
| Rate for Payer: Cigna Medicare |
$2,915.10
|
| Rate for Payer: Employer Direct Commercial |
$2,915.10
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,915.10
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,915.10
|
| Rate for Payer: Molina Medicare |
$2,915.10
|
| 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 |
$64.30
|
| Rate for Payer: Scott and White Medicare |
$2,915.10
|
| Rate for Payer: Superior Health Plan EPO |
$2,915.10
|
| Rate for Payer: Superior Health Plan Medicare |
$2,915.10
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,915.10
|
| Rate for Payer: Universal American Medicare |
$2,915.10
|
| Rate for Payer: Wellcare Medicare |
$2,915.10
|
| Rate for Payer: Wellmed Medicare |
$2,915.10
|
|
|
ARTEROGRAM ARCH NON SEL
|
Facility
|
IP
|
$6,863.00
|
|
|
Service Code
|
CPT 36221
|
| Hospital Charge Code |
4616221
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$6,039.44
|
|
|
Arthrocentesis, aspiration an..
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36020610
|
|
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 |
$27.96
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Amerigroup Medicare |
$270.87
|
| Rate for Payer: BCBS of TX Blue Advantage |
$51.84
|
| Rate for Payer: BCBS of TX Blue Essentials |
$62.08
|
| Rate for Payer: BCBS of TX Medicare |
$270.87
|
| Rate for Payer: BCBS of TX PPO |
$78.22
|
| Rate for Payer: Cigna Commercial |
$613.60
|
| Rate for Payer: Cigna Medicaid |
$27.96
|
| Rate for Payer: Cigna Medicare |
$270.87
|
| Rate for Payer: Employer Direct Commercial |
$270.87
|
| Rate for Payer: Humana Medicare/TRICARE |
$270.87
|
| Rate for Payer: Molina CHIP/Medicaid |
$27.96
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Molina Medicare |
$270.87
|
| Rate for Payer: Multiplan Auto |
$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 |
$27.96
|
| 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 |
$27.96
|
| Rate for Payer: Superior Health Plan EPO |
$270.87
|
| Rate for Payer: Superior Health Plan Medicare |
$270.87
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Universal American Medicare |
$270.87
|
| Rate for Payer: Wellcare Medicare |
$270.87
|
| Rate for Payer: Wellmed Medicare |
$270.87
|
|
|
Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acr
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36020605
|
|
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 |
$23.54
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Amerigroup Medicare |
$270.87
|
| Rate for Payer: BCBS of TX Blue Advantage |
$43.39
|
| Rate for Payer: BCBS of TX Blue Essentials |
$51.96
|
| Rate for Payer: BCBS of TX Medicare |
$270.87
|
| Rate for Payer: BCBS of TX PPO |
$65.47
|
| Rate for Payer: Cigna Commercial |
$613.60
|
| Rate for Payer: Cigna Medicaid |
$23.54
|
| Rate for Payer: Cigna Medicare |
$270.87
|
| Rate for Payer: Employer Direct Commercial |
$270.87
|
| Rate for Payer: Humana Medicare/TRICARE |
$270.87
|
| Rate for Payer: Molina CHIP/Medicaid |
$23.54
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Molina Medicare |
$270.87
|
| Rate for Payer: Multiplan Auto |
$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 |
$23.54
|
| 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 |
$23.54
|
| Rate for Payer: Superior Health Plan EPO |
$270.87
|
| Rate for Payer: Superior Health Plan Medicare |
$270.87
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Universal American Medicare |
$270.87
|
| Rate for Payer: Wellcare Medicare |
$270.87
|
| Rate for Payer: Wellmed Medicare |
$270.87
|
|
|
Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acr
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36020606
|
|
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 |
$42.36
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Amerigroup Medicare |
$632.45
|
| Rate for Payer: BCBS of TX Blue Advantage |
$77.76
|
| Rate for Payer: BCBS of TX Blue Essentials |
$93.12
|
| Rate for Payer: BCBS of TX Medicare |
$632.45
|
| Rate for Payer: BCBS of TX PPO |
$117.33
|
| Rate for Payer: Cigna Commercial |
$1,432.68
|
| Rate for Payer: Cigna Medicaid |
$42.36
|
| 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 |
$42.36
|
| 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 |
$42.36
|
| 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 |
$42.36
|
| 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
|
|
|
Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacrom
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
36020611
|
|
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 |
$47.34
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Amerigroup Medicare |
$270.87
|
| Rate for Payer: BCBS of TX Blue Advantage |
$87.39
|
| Rate for Payer: BCBS of TX Blue Essentials |
$104.66
|
| Rate for Payer: BCBS of TX Medicare |
$270.87
|
| Rate for Payer: BCBS of TX PPO |
$131.87
|
| Rate for Payer: Cigna Commercial |
$613.60
|
| Rate for Payer: Cigna Medicaid |
$47.34
|
| 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 |
$47.34
|
| 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 |
$47.34
|
| 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 |
$47.34
|
| 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
|
|
|
Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes) without ultra
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36020600
|
|
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 |
$22.70
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Amerigroup Medicare |
$270.87
|
| Rate for Payer: BCBS of TX Blue Advantage |
$41.58
|
| Rate for Payer: BCBS of TX Blue Essentials |
$49.80
|
| Rate for Payer: BCBS of TX Medicare |
$270.87
|
| Rate for Payer: BCBS of TX PPO |
$62.75
|
| Rate for Payer: Cigna Commercial |
$613.60
|
| Rate for Payer: Cigna Medicaid |
$22.70
|
| Rate for Payer: Cigna Medicare |
$270.87
|
| Rate for Payer: Employer Direct Commercial |
$270.87
|
| Rate for Payer: Humana Medicare/TRICARE |
$270.87
|
| Rate for Payer: Molina CHIP/Medicaid |
$22.70
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Molina Medicare |
$270.87
|
| Rate for Payer: Multiplan Auto |
$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 |
$22.70
|
| 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 |
$22.70
|
| Rate for Payer: Superior Health Plan EPO |
$270.87
|
| Rate for Payer: Superior Health Plan Medicare |
$270.87
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$270.87
|
| Rate for Payer: Universal American Medicare |
$270.87
|
| Rate for Payer: Wellcare Medicare |
$270.87
|
| Rate for Payer: Wellmed Medicare |
$270.87
|
|
|
Arthrodesis, ankle, open
|
Facility
|
OP
|
$29,989.79
|
|
|
Service Code
|
CPT 27870
|
| Hospital Charge Code |
36027870
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$265.49 |
| Max. Negotiated Rate |
$29,989.79 |
| Rate for Payer: Aetna Commercial |
$7,210.00
|
| Rate for Payer: Aetna Medicare |
$18,054.70
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$7,120.60
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Amerigroup Medicare |
$12,036.47
|
| Rate for Payer: BCBS of TX Blue Advantage |
$19,874.19
|
| Rate for Payer: BCBS of TX Blue Essentials |
$23,801.42
|
| Rate for Payer: BCBS of TX Medicare |
$12,036.47
|
| Rate for Payer: BCBS of TX PPO |
$29,989.79
|
| Rate for Payer: Cigna Commercial |
$27,266.10
|
| Rate for Payer: Cigna Medicaid |
$7,120.60
|
| Rate for Payer: Cigna Medicare |
$12,036.47
|
| Rate for Payer: Employer Direct Commercial |
$12,036.47
|
| Rate for Payer: Humana Medicare/TRICARE |
$12,036.47
|
| Rate for Payer: Molina CHIP/Medicaid |
$7,120.60
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Molina Medicare |
$12,036.47
|
| 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 |
$7,120.60
|
| Rate for Payer: Scott and White EPO/PPO |
$265.49
|
| Rate for Payer: Scott and White Medicare |
$12,036.47
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$7,120.60
|
| Rate for Payer: Superior Health Plan EPO |
$12,036.47
|
| Rate for Payer: Superior Health Plan Medicare |
$12,036.47
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Universal American Medicare |
$12,036.47
|
| Rate for Payer: Wellcare Medicare |
$12,036.47
|
| Rate for Payer: Wellmed Medicare |
$12,036.47
|
|
|
Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation
|
Facility
|
OP
|
$15,074.51
|
|
|
Service Code
|
CPT 26841
|
| Hospital Charge Code |
36026841
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$144.31 |
| Max. Negotiated Rate |
$15,074.51 |
| Rate for Payer: Aetna Commercial |
$4,635.00
|
| Rate for Payer: Aetna Medicare |
$9,814.08
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$2,398.52
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Amerigroup Medicare |
$6,542.72
|
| 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 |
$6,542.72
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cigna Commercial |
$14,821.16
|
| Rate for Payer: Cigna Medicaid |
$2,398.52
|
| Rate for Payer: Cigna Medicare |
$6,542.72
|
| Rate for Payer: Employer Direct Commercial |
$6,542.72
|
| Rate for Payer: Humana Medicare/TRICARE |
$6,542.72
|
| Rate for Payer: Molina CHIP/Medicaid |
$2,398.52
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Molina Medicare |
$6,542.72
|
| 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 |
$2,398.52
|
| Rate for Payer: Scott and White EPO/PPO |
$144.31
|
| Rate for Payer: Scott and White Medicare |
$6,542.72
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$2,398.52
|
| Rate for Payer: Superior Health Plan EPO |
$6,542.72
|
| Rate for Payer: Superior Health Plan Medicare |
$6,542.72
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Universal American Medicare |
$6,542.72
|
| Rate for Payer: Wellcare Medicare |
$6,542.72
|
| Rate for Payer: Wellmed Medicare |
$6,542.72
|
|
|
Arthrodesis, great toe interphalangeal joint
|
Facility
|
OP
|
$15,074.51
|
|
|
Service Code
|
CPT 28755
|
| Hospital Charge Code |
36028755
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$144.31 |
| Max. Negotiated Rate |
$15,074.51 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$9,814.08
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$2,398.52
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Amerigroup Medicare |
$6,542.72
|
| 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 |
$6,542.72
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cigna Commercial |
$14,821.16
|
| Rate for Payer: Cigna Medicaid |
$2,398.52
|
| Rate for Payer: Cigna Medicare |
$6,542.72
|
| Rate for Payer: Employer Direct Commercial |
$6,542.72
|
| Rate for Payer: Humana Medicare/TRICARE |
$6,542.72
|
| Rate for Payer: Molina CHIP/Medicaid |
$2,398.52
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Molina Medicare |
$6,542.72
|
| 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 |
$2,398.52
|
| Rate for Payer: Scott and White EPO/PPO |
$144.31
|
| Rate for Payer: Scott and White Medicare |
$6,542.72
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$2,398.52
|
| Rate for Payer: Superior Health Plan EPO |
$6,542.72
|
| Rate for Payer: Superior Health Plan Medicare |
$6,542.72
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Universal American Medicare |
$6,542.72
|
| Rate for Payer: Wellcare Medicare |
$6,542.72
|
| Rate for Payer: Wellmed Medicare |
$6,542.72
|
|
|
Arthrodesis, great toe metatarsophalangeal joint
|
Facility
|
OP
|
$15,074.51
|
|
|
Service Code
|
CPT 28750
|
| Hospital Charge Code |
36028750
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$144.31 |
| Max. Negotiated Rate |
$15,074.51 |
| Rate for Payer: Aetna Commercial |
$7,210.00
|
| Rate for Payer: Aetna Medicare |
$9,814.08
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,471.48
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Amerigroup Medicare |
$6,542.72
|
| 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 |
$6,542.72
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cigna Commercial |
$14,821.16
|
| Rate for Payer: Cigna Medicaid |
$3,471.48
|
| Rate for Payer: Cigna Medicare |
$6,542.72
|
| Rate for Payer: Employer Direct Commercial |
$6,542.72
|
| Rate for Payer: Humana Medicare/TRICARE |
$6,542.72
|
| Rate for Payer: Molina CHIP/Medicaid |
$3,471.48
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Molina Medicare |
$6,542.72
|
| 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 |
$3,471.48
|
| Rate for Payer: Scott and White EPO/PPO |
$144.31
|
| Rate for Payer: Scott and White Medicare |
$6,542.72
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$3,471.48
|
| Rate for Payer: Superior Health Plan EPO |
$6,542.72
|
| Rate for Payer: Superior Health Plan Medicare |
$6,542.72
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Universal American Medicare |
$6,542.72
|
| Rate for Payer: Wellcare Medicare |
$6,542.72
|
| Rate for Payer: Wellmed Medicare |
$6,542.72
|
|
|
Arthrodesis, interphalangeal joint, with or without internal fixation
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 26860
|
| Hospital Charge Code |
36026860
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$65.29 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$4,635.00
|
| Rate for Payer: Aetna Medicare |
$4,440.36
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| 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: 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 |
$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 |
$1,088.27
|
| Rate for Payer: Scott and White EPO/PPO |
$65.29
|
| 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
|
|
|
Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse
|
Facility
|
OP
|
$29,989.79
|
|
|
Service Code
|
CPT 28730
|
| Hospital Charge Code |
36028730
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$265.49 |
| Max. Negotiated Rate |
$29,989.79 |
| Rate for Payer: Aetna Commercial |
$7,210.00
|
| Rate for Payer: Aetna Medicare |
$18,054.70
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$7,382.01
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Amerigroup Medicare |
$12,036.47
|
| Rate for Payer: BCBS of TX Blue Advantage |
$19,874.19
|
| Rate for Payer: BCBS of TX Blue Essentials |
$23,801.42
|
| Rate for Payer: BCBS of TX Medicare |
$12,036.47
|
| Rate for Payer: BCBS of TX PPO |
$29,989.79
|
| Rate for Payer: Cigna Commercial |
$27,266.10
|
| Rate for Payer: Cigna Medicaid |
$7,382.01
|
| Rate for Payer: Cigna Medicare |
$12,036.47
|
| Rate for Payer: Employer Direct Commercial |
$12,036.47
|
| Rate for Payer: Humana Medicare/TRICARE |
$12,036.47
|
| Rate for Payer: Molina CHIP/Medicaid |
$7,382.01
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Molina Medicare |
$12,036.47
|
| 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 |
$7,382.01
|
| Rate for Payer: Scott and White EPO/PPO |
$265.49
|
| Rate for Payer: Scott and White Medicare |
$12,036.47
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$7,382.01
|
| Rate for Payer: Superior Health Plan EPO |
$12,036.47
|
| Rate for Payer: Superior Health Plan Medicare |
$12,036.47
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Universal American Medicare |
$12,036.47
|
| Rate for Payer: Wellcare Medicare |
$12,036.47
|
| Rate for Payer: Wellmed Medicare |
$12,036.47
|
|
|
Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot corr
|
Facility
|
OP
|
$29,989.79
|
|
|
Service Code
|
CPT 28735
|
| Hospital Charge Code |
36028735
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$265.49 |
| Max. Negotiated Rate |
$29,989.79 |
| Rate for Payer: Aetna Commercial |
$7,210.00
|
| Rate for Payer: Aetna Medicare |
$18,054.70
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$7,505.68
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Amerigroup Medicare |
$12,036.47
|
| Rate for Payer: BCBS of TX Blue Advantage |
$19,874.19
|
| Rate for Payer: BCBS of TX Blue Essentials |
$23,801.42
|
| Rate for Payer: BCBS of TX Medicare |
$12,036.47
|
| Rate for Payer: BCBS of TX PPO |
$29,989.79
|
| Rate for Payer: Cigna Commercial |
$27,266.10
|
| Rate for Payer: Cigna Medicaid |
$7,505.68
|
| Rate for Payer: Cigna Medicare |
$12,036.47
|
| Rate for Payer: Employer Direct Commercial |
$12,036.47
|
| Rate for Payer: Humana Medicare/TRICARE |
$12,036.47
|
| Rate for Payer: Molina CHIP/Medicaid |
$7,505.68
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Molina Medicare |
$12,036.47
|
| 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 |
$7,505.68
|
| Rate for Payer: Scott and White EPO/PPO |
$265.49
|
| Rate for Payer: Scott and White Medicare |
$12,036.47
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$7,505.68
|
| Rate for Payer: Superior Health Plan EPO |
$12,036.47
|
| Rate for Payer: Superior Health Plan Medicare |
$12,036.47
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Universal American Medicare |
$12,036.47
|
| Rate for Payer: Wellcare Medicare |
$12,036.47
|
| Rate for Payer: Wellmed Medicare |
$12,036.47
|
|
|
Arthrodesis, midtarsal or tarsometatarsal, single joint
|
Facility
|
OP
|
$15,074.51
|
|
|
Service Code
|
CPT 28740
|
| Hospital Charge Code |
36028740
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$144.31 |
| Max. Negotiated Rate |
$15,074.51 |
| Rate for Payer: Aetna Commercial |
$7,210.00
|
| Rate for Payer: Aetna Medicare |
$9,814.08
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,600.17
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Amerigroup Medicare |
$6,542.72
|
| 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 |
$6,542.72
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cigna Commercial |
$14,821.16
|
| Rate for Payer: Cigna Medicaid |
$3,600.17
|
| Rate for Payer: Cigna Medicare |
$6,542.72
|
| Rate for Payer: Employer Direct Commercial |
$6,542.72
|
| Rate for Payer: Humana Medicare/TRICARE |
$6,542.72
|
| Rate for Payer: Molina CHIP/Medicaid |
$3,600.17
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Molina Medicare |
$6,542.72
|
| 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 |
$3,600.17
|
| Rate for Payer: Scott and White EPO/PPO |
$144.31
|
| Rate for Payer: Scott and White Medicare |
$6,542.72
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$3,600.17
|
| Rate for Payer: Superior Health Plan EPO |
$6,542.72
|
| Rate for Payer: Superior Health Plan Medicare |
$6,542.72
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Universal American Medicare |
$6,542.72
|
| Rate for Payer: Wellcare Medicare |
$6,542.72
|
| Rate for Payer: Wellmed Medicare |
$6,542.72
|
|
|
Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse
|
Facility
|
OP
|
$38,608.57
|
|
|
Service Code
|
CPT 22612
|
| Hospital Charge Code |
36022612
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$375.93 |
| Max. Negotiated Rate |
$38,608.57 |
| Rate for Payer: Aetna Commercial |
$7,210.00
|
| Rate for Payer: Aetna Medicare |
$25,565.31
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$7,051.26
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$17,043.54
|
| Rate for Payer: Amerigroup Medicare |
$17,043.54
|
| Rate for Payer: BCBS of TX Blue Advantage |
$19,874.19
|
| Rate for Payer: BCBS of TX Blue Essentials |
$23,801.42
|
| Rate for Payer: BCBS of TX Medicare |
$17,043.54
|
| Rate for Payer: BCBS of TX PPO |
$29,989.79
|
| Rate for Payer: Cigna Commercial |
$38,608.57
|
| Rate for Payer: Cigna Medicaid |
$7,051.26
|
| Rate for Payer: Cigna Medicare |
$17,043.54
|
| Rate for Payer: Employer Direct Commercial |
$17,043.54
|
| Rate for Payer: Humana Medicare/TRICARE |
$17,043.54
|
| Rate for Payer: Molina CHIP/Medicaid |
$7,051.26
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$17,043.54
|
| Rate for Payer: Molina Medicare |
$17,043.54
|
| 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 |
$7,051.26
|
| Rate for Payer: Scott and White EPO/PPO |
$375.93
|
| Rate for Payer: Scott and White Medicare |
$17,043.54
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$7,051.26
|
| Rate for Payer: Superior Health Plan EPO |
$17,043.54
|
| Rate for Payer: Superior Health Plan Medicare |
$17,043.54
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$17,043.54
|
| Rate for Payer: Universal American Medicare |
$17,043.54
|
| Rate for Payer: Wellcare Medicare |
$17,043.54
|
| Rate for Payer: Wellmed Medicare |
$17,043.54
|
|
|
Arthrodesis subtalar
|
Facility
|
OP
|
$29,989.79
|
|
|
Service Code
|
CPT 28725
|
| Hospital Charge Code |
36028725
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$265.49 |
| Max. Negotiated Rate |
$29,989.79 |
| Rate for Payer: Aetna Commercial |
$7,210.00
|
| Rate for Payer: Aetna Medicare |
$18,054.70
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$6,953.35
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Amerigroup Medicare |
$12,036.47
|
| Rate for Payer: BCBS of TX Blue Advantage |
$19,874.19
|
| Rate for Payer: BCBS of TX Blue Essentials |
$23,801.42
|
| Rate for Payer: BCBS of TX Medicare |
$12,036.47
|
| Rate for Payer: BCBS of TX PPO |
$29,989.79
|
| Rate for Payer: Cigna Commercial |
$27,266.10
|
| Rate for Payer: Cigna Medicaid |
$6,953.35
|
| Rate for Payer: Cigna Medicare |
$12,036.47
|
| Rate for Payer: Employer Direct Commercial |
$12,036.47
|
| Rate for Payer: Humana Medicare/TRICARE |
$12,036.47
|
| Rate for Payer: Molina CHIP/Medicaid |
$6,953.35
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Molina Medicare |
$12,036.47
|
| 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 |
$6,953.35
|
| Rate for Payer: Scott and White EPO/PPO |
$265.49
|
| Rate for Payer: Scott and White Medicare |
$12,036.47
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$6,953.35
|
| Rate for Payer: Superior Health Plan EPO |
$12,036.47
|
| Rate for Payer: Superior Health Plan Medicare |
$12,036.47
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Universal American Medicare |
$12,036.47
|
| Rate for Payer: Wellcare Medicare |
$12,036.47
|
| Rate for Payer: Wellmed Medicare |
$12,036.47
|
|
|
Arthrodesis; triple
|
Facility
|
OP
|
$29,989.79
|
|
|
Service Code
|
CPT 28715
|
| Hospital Charge Code |
36028715
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$265.49 |
| Max. Negotiated Rate |
$29,989.79 |
| Rate for Payer: Aetna Commercial |
$7,210.00
|
| Rate for Payer: Aetna Medicare |
$18,054.70
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$7,350.15
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Amerigroup Medicare |
$12,036.47
|
| Rate for Payer: BCBS of TX Blue Advantage |
$19,874.19
|
| Rate for Payer: BCBS of TX Blue Essentials |
$23,801.42
|
| Rate for Payer: BCBS of TX Medicare |
$12,036.47
|
| Rate for Payer: BCBS of TX PPO |
$29,989.79
|
| Rate for Payer: Cigna Commercial |
$27,266.10
|
| Rate for Payer: Cigna Medicaid |
$7,350.15
|
| Rate for Payer: Cigna Medicare |
$12,036.47
|
| Rate for Payer: Employer Direct Commercial |
$12,036.47
|
| Rate for Payer: Humana Medicare/TRICARE |
$12,036.47
|
| Rate for Payer: Molina CHIP/Medicaid |
$7,350.15
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Molina Medicare |
$12,036.47
|
| 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 |
$7,350.15
|
| Rate for Payer: Scott and White EPO/PPO |
$265.49
|
| Rate for Payer: Scott and White Medicare |
$12,036.47
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$7,350.15
|
| Rate for Payer: Superior Health Plan EPO |
$12,036.47
|
| Rate for Payer: Superior Health Plan Medicare |
$12,036.47
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Universal American Medicare |
$12,036.47
|
| Rate for Payer: Wellcare Medicare |
$12,036.47
|
| Rate for Payer: Wellmed Medicare |
$12,036.47
|
|
