|
INSERT TUNNELED CV CATH
|
Facility
|
OP
|
$6,847.00
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
2300770
|
|
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 |
$1,118.22
|
| 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 |
$6,025.36
|
| Rate for Payer: Cash Price |
$6,025.36
|
| Rate for Payer: Cigna Commercial |
$6,603.56
|
| Rate for Payer: Cigna Medicaid |
$1,118.22
|
| 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 CHIP/Medicaid |
$1,118.22
|
| 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: Parkland Medicaid |
$1,118.22
|
| 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 CHIP/Medicaid |
$1,118.22
|
| 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
|
|
|
Insj stablj dev w/o dcmprn
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 22870
|
| Hospital Charge Code |
36022870
|
|
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
|
|
|
Insj stablj dev w/o dcmprn
|
Facility
|
OP
|
$29,989.79
|
|
|
Service Code
|
CPT 22869
|
| Hospital Charge Code |
36022869
|
|
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 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 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 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: Scott and White EPO/PPO |
$265.49
|
| Rate for Payer: Scott and White Medicare |
$12,036.47
|
| 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
|
|
|
INS/RPL PPM LDLESS VENT
|
Facility
|
OP
|
$31,613.00
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
2300306
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$393.05 |
| Max. Negotiated Rate |
$40,367.76 |
| Rate for Payer: Aetna Commercial |
$13,390.00
|
| Rate for Payer: Aetna Medicare |
$26,730.21
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$2,845.17
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$17,820.14
|
| Rate for Payer: Amerigroup Medicare |
$17,820.14
|
| Rate for Payer: BCBS of TX Blue Advantage |
$26,619.75
|
| Rate for Payer: BCBS of TX Blue Essentials |
$31,879.94
|
| Rate for Payer: BCBS of TX Medicare |
$17,820.14
|
| Rate for Payer: BCBS of TX PPO |
$40,168.72
|
| Rate for Payer: Cash Price |
$27,819.44
|
| Rate for Payer: Cash Price |
$27,819.44
|
| Rate for Payer: Cash Price |
$27,819.44
|
| Rate for Payer: Cigna Commercial |
$40,367.76
|
| Rate for Payer: Cigna Medicare |
$17,820.14
|
| Rate for Payer: Employer Direct Commercial |
$17,820.14
|
| Rate for Payer: Humana Medicare/TRICARE |
$17,820.14
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$17,820.14
|
| Rate for Payer: Molina Medicare |
$17,820.14
|
| 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
|
| Rate for Payer: Scott and White EPO/PPO |
$393.05
|
| Rate for Payer: Scott and White Medicare |
$17,820.14
|
| Rate for Payer: Superior Health Plan EPO |
$17,820.14
|
| Rate for Payer: Superior Health Plan Medicare |
$17,820.14
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$17,820.14
|
| Rate for Payer: Universal American Medicare |
$17,820.14
|
| Rate for Payer: Wellcare Medicare |
$17,820.14
|
| Rate for Payer: Wellmed Medicare |
$17,820.14
|
|
|
INS/RPL PPM LDLESS VENT
|
Facility
|
IP
|
$31,613.00
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
2300306
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$27,819.44
|
|
|
INSRT CVAD W PRT 5YRS >
|
Facility
|
OP
|
$6,499.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
4616571
|
|
Hospital Revenue Code
|
360
|
| 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 |
$1,118.22
|
| 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 |
$5,719.12
|
| Rate for Payer: Cash Price |
$5,719.12
|
| Rate for Payer: Cigna Commercial |
$6,603.56
|
| Rate for Payer: Cigna Medicaid |
$1,118.22
|
| 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 CHIP/Medicaid |
$1,118.22
|
| 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: Parkland Medicaid |
$1,118.22
|
| 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 CHIP/Medicaid |
$1,118.22
|
| 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
|
|
|
INSRT CVAD W PRT 5YRS >
|
Facility
|
IP
|
$6,499.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
4616571
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$5,719.12
|
|
|
INSRT DUAL CHAMBER AICD GENERATOR
|
Facility
|
IP
|
$52,602.00
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
2312650
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$46,289.76
|
|
|
INSRT DUAL CHAMBER AICD GENERATOR
|
Facility
|
OP
|
$52,602.00
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
2312650
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$385.53 |
| Max. Negotiated Rate |
$57,236.48 |
| Rate for Payer: Aetna Commercial |
$28,931.10
|
| Rate for Payer: Aetna Medicare |
$32,335.74
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$4,734.18
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$21,557.16
|
| Rate for Payer: Amerigroup Medicare |
$21,557.16
|
| Rate for Payer: BCBS of TX Blue Advantage |
$37,930.53
|
| Rate for Payer: BCBS of TX Blue Essentials |
$45,425.78
|
| Rate for Payer: BCBS of TX Medicare |
$21,557.16
|
| Rate for Payer: BCBS of TX PPO |
$57,236.48
|
| Rate for Payer: Cash Price |
$46,289.76
|
| Rate for Payer: Cash Price |
$46,289.76
|
| Rate for Payer: Cash Price |
$46,289.76
|
| Rate for Payer: Cigna Commercial |
$48,833.21
|
| Rate for Payer: Cigna Medicaid |
$16,654.19
|
| Rate for Payer: Cigna Medicare |
$21,557.16
|
| Rate for Payer: Employer Direct Commercial |
$21,557.16
|
| Rate for Payer: Humana Medicare/TRICARE |
$21,557.16
|
| Rate for Payer: Molina CHIP/Medicaid |
$16,654.19
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$21,557.16
|
| Rate for Payer: Molina Medicare |
$21,557.16
|
| Rate for Payer: Multiplan Auto |
$34,191.30
|
| Rate for Payer: Multiplan Commercial |
$34,191.30
|
| Rate for Payer: Multiplan Workers Comp |
$34,191.30
|
| Rate for Payer: Parkland Medicaid |
$16,654.19
|
| Rate for Payer: Scott and White EPO/PPO |
$385.53
|
| Rate for Payer: Scott and White Medicare |
$21,557.16
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$16,654.19
|
| Rate for Payer: Superior Health Plan EPO |
$21,557.16
|
| Rate for Payer: Superior Health Plan Medicare |
$21,557.16
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$21,557.16
|
| Rate for Payer: Universal American Medicare |
$21,557.16
|
| Rate for Payer: Wellcare Medicare |
$21,557.16
|
| Rate for Payer: Wellmed Medicare |
$21,557.16
|
|
|
INSRT PICC NO PRT/PMP>5 NO IMG
|
Facility
|
OP
|
$4,307.00
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
2303451
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$32.31 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$2,197.02
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$446.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,464.68
|
| Rate for Payer: Amerigroup Medicare |
$1,464.68
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,723.99
|
| Rate for Payer: BCBS of TX Blue Essentials |
$3,262.26
|
| Rate for Payer: BCBS of TX Medicare |
$1,464.68
|
| Rate for Payer: BCBS of TX PPO |
$4,110.45
|
| Rate for Payer: Cash Price |
$3,790.16
|
| Rate for Payer: Cash Price |
$3,790.16
|
| Rate for Payer: Cigna Commercial |
$3,317.93
|
| Rate for Payer: Cigna Medicaid |
$446.27
|
| Rate for Payer: Cigna Medicare |
$1,464.68
|
| Rate for Payer: Employer Direct Commercial |
$1,464.68
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,464.68
|
| Rate for Payer: Molina CHIP/Medicaid |
$446.27
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,464.68
|
| Rate for Payer: Molina Medicare |
$1,464.68
|
| 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 |
$446.27
|
| Rate for Payer: Scott and White EPO/PPO |
$32.31
|
| Rate for Payer: Scott and White Medicare |
$1,464.68
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$446.27
|
| Rate for Payer: Superior Health Plan EPO |
$1,464.68
|
| Rate for Payer: Superior Health Plan Medicare |
$1,464.68
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,464.68
|
| Rate for Payer: Universal American Medicare |
$1,464.68
|
| Rate for Payer: Wellcare Medicare |
$1,464.68
|
| Rate for Payer: Wellmed Medicare |
$1,464.68
|
|
|
INSRT PICC NO PRT/PMP>5 NO IMG
|
Facility
|
IP
|
$4,307.00
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
2303451
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$3,790.16
|
|
|
INSRT PICC W/IMG 5+YR
|
Facility
|
OP
|
$2,825.00
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
4616573
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$32.31 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$2,200.00
|
| Rate for Payer: Aetna Medicare |
$2,197.02
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$446.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,464.68
|
| Rate for Payer: Amerigroup Medicare |
$1,464.68
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,723.99
|
| Rate for Payer: BCBS of TX Blue Essentials |
$3,262.26
|
| Rate for Payer: BCBS of TX Medicare |
$1,464.68
|
| Rate for Payer: BCBS of TX PPO |
$4,110.45
|
| Rate for Payer: Cash Price |
$2,486.00
|
| Rate for Payer: Cash Price |
$2,486.00
|
| Rate for Payer: Cigna Commercial |
$3,317.93
|
| Rate for Payer: Cigna Medicaid |
$446.27
|
| Rate for Payer: Cigna Medicare |
$1,464.68
|
| Rate for Payer: Employer Direct Commercial |
$1,464.68
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,464.68
|
| Rate for Payer: Molina CHIP/Medicaid |
$446.27
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,464.68
|
| Rate for Payer: Molina Medicare |
$1,464.68
|
| 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 |
$446.27
|
| Rate for Payer: Scott and White EPO/PPO |
$32.31
|
| Rate for Payer: Scott and White Medicare |
$1,464.68
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$446.27
|
| Rate for Payer: Superior Health Plan EPO |
$1,464.68
|
| Rate for Payer: Superior Health Plan Medicare |
$1,464.68
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,464.68
|
| Rate for Payer: Universal American Medicare |
$1,464.68
|
| Rate for Payer: Wellcare Medicare |
$1,464.68
|
| Rate for Payer: Wellmed Medicare |
$1,464.68
|
|
|
INSRT PICC W/IMG 5+YR
|
Facility
|
IP
|
$2,825.00
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
4616573
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$2,486.00
|
|
|
INSRT/REPLC PERM PACER,ATRIAL LEAD
|
Facility
|
OP
|
$19,520.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
2302404
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$174.65 |
| Max. Negotiated Rate |
$25,834.89 |
| Rate for Payer: Aetna Commercial |
$8,755.00
|
| Rate for Payer: Aetna Medicare |
$14,648.66
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,756.80
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$9,765.77
|
| Rate for Payer: Amerigroup Medicare |
$9,765.77
|
| Rate for Payer: BCBS of TX Blue Advantage |
$17,120.74
|
| Rate for Payer: BCBS of TX Blue Essentials |
$20,503.88
|
| Rate for Payer: BCBS of TX Medicare |
$9,765.77
|
| Rate for Payer: BCBS of TX PPO |
$25,834.89
|
| Rate for Payer: Cash Price |
$17,177.60
|
| Rate for Payer: Cash Price |
$17,177.60
|
| Rate for Payer: Cash Price |
$17,177.60
|
| Rate for Payer: Cigna Commercial |
$22,122.29
|
| Rate for Payer: Cigna Medicaid |
$6,235.66
|
| Rate for Payer: Cigna Medicare |
$9,765.77
|
| Rate for Payer: Employer Direct Commercial |
$9,765.77
|
| Rate for Payer: Humana Medicare/TRICARE |
$9,765.77
|
| Rate for Payer: Molina CHIP/Medicaid |
$6,235.66
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$9,765.77
|
| Rate for Payer: Molina Medicare |
$9,765.77
|
| Rate for Payer: Multiplan Auto |
$12,688.00
|
| Rate for Payer: Multiplan Commercial |
$12,688.00
|
| Rate for Payer: Multiplan Workers Comp |
$12,688.00
|
| Rate for Payer: Parkland Medicaid |
$6,235.66
|
| Rate for Payer: Scott and White EPO/PPO |
$174.65
|
| Rate for Payer: Scott and White Medicare |
$9,765.77
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$6,235.66
|
| Rate for Payer: Superior Health Plan EPO |
$9,765.77
|
| Rate for Payer: Superior Health Plan Medicare |
$9,765.77
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$9,765.77
|
| Rate for Payer: Universal American Medicare |
$9,765.77
|
| Rate for Payer: Wellcare Medicare |
$9,765.77
|
| Rate for Payer: Wellmed Medicare |
$9,765.77
|
|
|
INSRT/REPLC PERM PACER,ATRIAL LEAD
|
Facility
|
IP
|
$19,520.00
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
2302404
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$17,177.60
|
|
|
INSRT/REPLC PERM PACER, A&V LEAD
|
Facility
|
IP
|
$22,224.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
2302420
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$19,557.12
|
|
|
INSRT/REPLC PERM PACER, A&V LEAD
|
Facility
|
OP
|
$22,224.00
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
2302420
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$174.65 |
| Max. Negotiated Rate |
$25,834.89 |
| Rate for Payer: Aetna Commercial |
$10,300.00
|
| Rate for Payer: Aetna Medicare |
$14,648.66
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$2,000.16
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$9,765.77
|
| Rate for Payer: Amerigroup Medicare |
$9,765.77
|
| Rate for Payer: BCBS of TX Blue Advantage |
$17,120.74
|
| Rate for Payer: BCBS of TX Blue Essentials |
$20,503.88
|
| Rate for Payer: BCBS of TX Medicare |
$9,765.77
|
| Rate for Payer: BCBS of TX PPO |
$25,834.89
|
| Rate for Payer: Cash Price |
$19,557.12
|
| Rate for Payer: Cash Price |
$19,557.12
|
| Rate for Payer: Cash Price |
$19,557.12
|
| Rate for Payer: Cigna Commercial |
$22,122.29
|
| Rate for Payer: Cigna Medicaid |
$6,450.90
|
| Rate for Payer: Cigna Medicare |
$9,765.77
|
| Rate for Payer: Employer Direct Commercial |
$9,765.77
|
| Rate for Payer: Humana Medicare/TRICARE |
$9,765.77
|
| Rate for Payer: Molina CHIP/Medicaid |
$6,450.90
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$9,765.77
|
| Rate for Payer: Molina Medicare |
$9,765.77
|
| Rate for Payer: Multiplan Auto |
$14,445.60
|
| Rate for Payer: Multiplan Commercial |
$14,445.60
|
| Rate for Payer: Multiplan Workers Comp |
$14,445.60
|
| Rate for Payer: Parkland Medicaid |
$6,450.90
|
| Rate for Payer: Scott and White EPO/PPO |
$174.65
|
| Rate for Payer: Scott and White Medicare |
$9,765.77
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$6,450.90
|
| Rate for Payer: Superior Health Plan EPO |
$9,765.77
|
| Rate for Payer: Superior Health Plan Medicare |
$9,765.77
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$9,765.77
|
| Rate for Payer: Universal American Medicare |
$9,765.77
|
| Rate for Payer: Wellcare Medicare |
$9,765.77
|
| Rate for Payer: Wellmed Medicare |
$9,765.77
|
|
|
INSRT/REPLC PERM PACER, DUAL GEN
|
Facility
|
IP
|
$18,041.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
2302446
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$15,876.08
|
|
|
INSRT/REPLC PERM PACER, DUAL GEN
|
Facility
|
OP
|
$18,041.00
|
|
|
Service Code
|
CPT 33213
|
| Hospital Charge Code |
2302446
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$215.40 |
| Max. Negotiated Rate |
$25,834.89 |
| Rate for Payer: Aetna Commercial |
$8,755.00
|
| Rate for Payer: Aetna Medicare |
$14,648.66
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$6,437.50
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$9,765.77
|
| Rate for Payer: Amerigroup Medicare |
$9,765.77
|
| Rate for Payer: BCBS of TX Blue Advantage |
$17,120.74
|
| Rate for Payer: BCBS of TX Blue Essentials |
$20,503.88
|
| Rate for Payer: BCBS of TX Medicare |
$9,765.77
|
| Rate for Payer: BCBS of TX PPO |
$25,834.89
|
| Rate for Payer: Cash Price |
$15,876.08
|
| Rate for Payer: Cash Price |
$15,876.08
|
| Rate for Payer: Cigna Commercial |
$22,122.29
|
| Rate for Payer: Cigna Medicaid |
$6,437.50
|
| Rate for Payer: Cigna Medicare |
$9,765.77
|
| Rate for Payer: Employer Direct Commercial |
$9,765.77
|
| Rate for Payer: Humana Medicare/TRICARE |
$9,765.77
|
| Rate for Payer: Molina CHIP/Medicaid |
$6,437.50
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$9,765.77
|
| Rate for Payer: Molina Medicare |
$9,765.77
|
| 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 |
$6,437.50
|
| Rate for Payer: Scott and White EPO/PPO |
$215.40
|
| Rate for Payer: Scott and White Medicare |
$9,765.77
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$6,437.50
|
| Rate for Payer: Superior Health Plan EPO |
$9,765.77
|
| Rate for Payer: Superior Health Plan Medicare |
$9,765.77
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$9,765.77
|
| Rate for Payer: Universal American Medicare |
$9,765.77
|
| Rate for Payer: Wellcare Medicare |
$9,765.77
|
| Rate for Payer: Wellmed Medicare |
$9,765.77
|
|
|
INSRT/REPLC PERM PACER SNGL GEN
|
Facility
|
IP
|
$16,509.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
2302438
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$14,527.92
|
|
|
INSRT/REPLC PERM PACER SNGL GEN
|
Facility
|
OP
|
$16,509.00
|
|
|
Service Code
|
CPT 33212
|
| Hospital Charge Code |
2302438
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$138.95 |
| Max. Negotiated Rate |
$19,257.46 |
| Rate for Payer: Aetna Commercial |
$8,755.00
|
| Rate for Payer: Aetna Medicare |
$11,654.54
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,485.81
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,769.69
|
| Rate for Payer: Amerigroup Medicare |
$7,769.69
|
| Rate for Payer: BCBS of TX Blue Advantage |
$12,761.89
|
| Rate for Payer: BCBS of TX Blue Essentials |
$15,283.70
|
| Rate for Payer: BCBS of TX Medicare |
$7,769.69
|
| Rate for Payer: BCBS of TX PPO |
$19,257.46
|
| Rate for Payer: Cash Price |
$14,527.92
|
| Rate for Payer: Cash Price |
$14,527.92
|
| Rate for Payer: Cash Price |
$14,527.92
|
| Rate for Payer: Cigna Commercial |
$17,600.59
|
| Rate for Payer: Cigna Medicaid |
$5,499.92
|
| Rate for Payer: Cigna Medicare |
$7,769.69
|
| Rate for Payer: Employer Direct Commercial |
$7,769.69
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,769.69
|
| Rate for Payer: Molina CHIP/Medicaid |
$5,499.92
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,769.69
|
| Rate for Payer: Molina Medicare |
$7,769.69
|
| Rate for Payer: Multiplan Auto |
$10,730.85
|
| Rate for Payer: Multiplan Commercial |
$10,730.85
|
| Rate for Payer: Multiplan Workers Comp |
$10,730.85
|
| Rate for Payer: Parkland Medicaid |
$5,499.92
|
| Rate for Payer: Scott and White EPO/PPO |
$138.95
|
| Rate for Payer: Scott and White Medicare |
$7,769.69
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$5,499.92
|
| Rate for Payer: Superior Health Plan EPO |
$7,769.69
|
| Rate for Payer: Superior Health Plan Medicare |
$7,769.69
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,769.69
|
| Rate for Payer: Universal American Medicare |
$7,769.69
|
| Rate for Payer: Wellcare Medicare |
$7,769.69
|
| Rate for Payer: Wellmed Medicare |
$7,769.69
|
|
|
INSRT/REPLC PERM PACER, VENT LEAD
|
Facility
|
OP
|
$20,365.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
2302412
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$174.65 |
| Max. Negotiated Rate |
$25,834.89 |
| Rate for Payer: Aetna Commercial |
$8,755.00
|
| Rate for Payer: Aetna Medicare |
$14,648.66
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,832.85
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$9,765.77
|
| Rate for Payer: Amerigroup Medicare |
$9,765.77
|
| Rate for Payer: BCBS of TX Blue Advantage |
$17,120.74
|
| Rate for Payer: BCBS of TX Blue Essentials |
$20,503.88
|
| Rate for Payer: BCBS of TX Medicare |
$9,765.77
|
| Rate for Payer: BCBS of TX PPO |
$25,834.89
|
| Rate for Payer: Cash Price |
$17,921.20
|
| Rate for Payer: Cash Price |
$17,921.20
|
| Rate for Payer: Cash Price |
$17,921.20
|
| Rate for Payer: Cigna Commercial |
$22,122.29
|
| Rate for Payer: Cigna Medicaid |
$6,323.37
|
| Rate for Payer: Cigna Medicare |
$9,765.77
|
| Rate for Payer: Employer Direct Commercial |
$9,765.77
|
| Rate for Payer: Humana Medicare/TRICARE |
$9,765.77
|
| Rate for Payer: Molina CHIP/Medicaid |
$6,323.37
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$9,765.77
|
| Rate for Payer: Molina Medicare |
$9,765.77
|
| Rate for Payer: Multiplan Auto |
$13,237.25
|
| Rate for Payer: Multiplan Commercial |
$13,237.25
|
| Rate for Payer: Multiplan Workers Comp |
$13,237.25
|
| Rate for Payer: Parkland Medicaid |
$6,323.37
|
| Rate for Payer: Scott and White EPO/PPO |
$174.65
|
| Rate for Payer: Scott and White Medicare |
$9,765.77
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$6,323.37
|
| Rate for Payer: Superior Health Plan EPO |
$9,765.77
|
| Rate for Payer: Superior Health Plan Medicare |
$9,765.77
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$9,765.77
|
| Rate for Payer: Universal American Medicare |
$9,765.77
|
| Rate for Payer: Wellcare Medicare |
$9,765.77
|
| Rate for Payer: Wellmed Medicare |
$9,765.77
|
|
|
INSRT/REPLC PERM PACER, VENT LEAD
|
Facility
|
IP
|
$20,365.00
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
2302412
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$17,921.20
|
|
|
INSRT/REPOSIT SINGL CHAMBER LEAD
|
Facility
|
IP
|
$13,918.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
2302255
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$12,247.84
|
|
|
INSRT/REPOSIT SINGL CHAMBER LEAD
|
Facility
|
OP
|
$13,918.00
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
2302255
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$138.95 |
| Max. Negotiated Rate |
$19,257.46 |
| Rate for Payer: Aetna Commercial |
$7,210.00
|
| Rate for Payer: Aetna Medicare |
$11,654.54
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,252.62
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,769.69
|
| Rate for Payer: Amerigroup Medicare |
$7,769.69
|
| Rate for Payer: BCBS of TX Blue Advantage |
$12,761.89
|
| Rate for Payer: BCBS of TX Blue Essentials |
$15,283.70
|
| Rate for Payer: BCBS of TX Medicare |
$7,769.69
|
| Rate for Payer: BCBS of TX PPO |
$19,257.46
|
| Rate for Payer: Cash Price |
$12,247.84
|
| Rate for Payer: Cash Price |
$12,247.84
|
| Rate for Payer: Cash Price |
$12,247.84
|
| Rate for Payer: Cigna Commercial |
$17,600.59
|
| Rate for Payer: Cigna Medicaid |
$4,538.30
|
| Rate for Payer: Cigna Medicare |
$7,769.69
|
| Rate for Payer: Employer Direct Commercial |
$7,769.69
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,769.69
|
| Rate for Payer: Molina CHIP/Medicaid |
$4,538.30
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,769.69
|
| Rate for Payer: Molina Medicare |
$7,769.69
|
| Rate for Payer: Multiplan Auto |
$9,046.70
|
| Rate for Payer: Multiplan Commercial |
$9,046.70
|
| Rate for Payer: Multiplan Workers Comp |
$9,046.70
|
| Rate for Payer: Parkland Medicaid |
$4,538.30
|
| Rate for Payer: Scott and White EPO/PPO |
$138.95
|
| Rate for Payer: Scott and White Medicare |
$7,769.69
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$4,538.30
|
| Rate for Payer: Superior Health Plan EPO |
$7,769.69
|
| Rate for Payer: Superior Health Plan Medicare |
$7,769.69
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,769.69
|
| Rate for Payer: Universal American Medicare |
$7,769.69
|
| Rate for Payer: Wellcare Medicare |
$7,769.69
|
| Rate for Payer: Wellmed Medicare |
$7,769.69
|
|
