|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, h
|
Facility
|
IP
|
$4,920.00
|
|
|
Service Code
|
HCPCS 11420
|
| Hospital Charge Code |
9900090
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,345.60
|
|
|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, h
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
36011420
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$74.19 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$74.19
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$148.26
|
| Rate for Payer: BCBS of TX Blue Essentials |
$177.56
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$223.73
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| 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 |
$3,069.37
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, h
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 11426
|
| Hospital Charge Code |
36011426
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$815.20 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$815.20
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Amerigroup Medicare |
$2,917.95
|
| Rate for Payer: BCBS of TX Blue Advantage |
$3,872.55
|
| Rate for Payer: BCBS of TX Blue Essentials |
$4,637.78
|
| Rate for Payer: BCBS of TX Medicare |
$2,917.95
|
| Rate for Payer: BCBS of TX PPO |
$5,843.60
|
| Rate for Payer: Cigna Commercial |
$6,168.03
|
| Rate for Payer: Cigna Medicare |
$2,917.95
|
| Rate for Payer: Employer Direct Commercial |
$2,917.95
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,917.95
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Molina Medicare |
$2,917.95
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$5,398.21
|
| Rate for Payer: Scott and White Medicare |
$2,917.95
|
| Rate for Payer: Superior Health Plan EPO |
$2,917.95
|
| Rate for Payer: Superior Health Plan Medicare |
$2,917.95
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Universal American Medicare |
$2,917.95
|
| Rate for Payer: Wellcare Medicare |
$2,917.95
|
| Rate for Payer: Wellmed Medicare |
$2,917.95
|
|
|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, h
|
Facility
|
OP
|
$10,333.00
|
|
|
Service Code
|
HCPCS 11426
|
| Hospital Charge Code |
9900093
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$815.20 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$815.20
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Amerigroup Medicare |
$2,917.95
|
| Rate for Payer: BCBS of TX Blue Advantage |
$3,872.55
|
| Rate for Payer: BCBS of TX Blue Essentials |
$4,637.78
|
| Rate for Payer: BCBS of TX Medicare |
$2,917.95
|
| Rate for Payer: BCBS of TX PPO |
$5,843.60
|
| Rate for Payer: Cash Price |
$7,026.44
|
| Rate for Payer: Cash Price |
$7,026.44
|
| Rate for Payer: Cash Price |
$7,026.44
|
| Rate for Payer: Cigna Commercial |
$6,168.03
|
| Rate for Payer: Cigna Medicaid |
$7,439.76
|
| Rate for Payer: Cigna Medicare |
$2,917.95
|
| Rate for Payer: Employer Direct Commercial |
$2,917.95
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,917.95
|
| Rate for Payer: Molina CHIP/Medicaid |
$7,439.76
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Molina Medicare |
$2,917.95
|
| 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 |
$7,439.76
|
| Rate for Payer: Scott and White EPO/PPO |
$5,398.21
|
| Rate for Payer: Scott and White Medicare |
$2,917.95
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$7,439.76
|
| Rate for Payer: Superior Health Plan EPO |
$2,917.95
|
| Rate for Payer: Superior Health Plan Medicare |
$2,917.95
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Universal American Medicare |
$2,917.95
|
| Rate for Payer: Wellcare Medicare |
$2,917.95
|
| Rate for Payer: Wellmed Medicare |
$2,917.95
|
|
|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, h
|
Facility
|
IP
|
$1,871.00
|
|
|
Service Code
|
HCPCS 11422
|
| Hospital Charge Code |
9900091
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,272.28
|
|
|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, h
|
Facility
|
OP
|
$1,871.00
|
|
|
Service Code
|
HCPCS 11422
|
| Hospital Charge Code |
9900091
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$95.79 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$95.79
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$192.87
|
| Rate for Payer: BCBS of TX Blue Essentials |
$230.98
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$291.03
|
| Rate for Payer: Cash Price |
$1,272.28
|
| Rate for Payer: Cash Price |
$1,272.28
|
| Rate for Payer: Cash Price |
$1,272.28
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$1,347.12
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,347.12
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| 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 |
$1,347.12
|
| Rate for Payer: Scott and White EPO/PPO |
$3,069.37
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,347.12
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, h
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
36011422
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$95.79 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$95.79
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$192.87
|
| Rate for Payer: BCBS of TX Blue Essentials |
$230.98
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$291.03
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| 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 |
$3,069.37
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, h
|
Facility
|
IP
|
$10,333.00
|
|
|
Service Code
|
HCPCS 11426
|
| Hospital Charge Code |
9900093
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$7,026.44
|
|
|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, h
|
Facility
|
OP
|
$4,920.00
|
|
|
Service Code
|
HCPCS 11420
|
| Hospital Charge Code |
9900090
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$74.19 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$74.19
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$148.26
|
| Rate for Payer: BCBS of TX Blue Essentials |
$177.56
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$223.73
|
| Rate for Payer: Cash Price |
$3,345.60
|
| Rate for Payer: Cash Price |
$3,345.60
|
| Rate for Payer: Cash Price |
$3,345.60
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$3,542.40
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina CHIP/Medicaid |
$3,542.40
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| 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 |
$3,542.40
|
| Rate for Payer: Scott and White EPO/PPO |
$3,069.37
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$3,542.40
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or
|
Facility
|
OP
|
$4,310.97
|
|
|
Service Code
|
HCPCS 11404
|
| Hospital Charge Code |
9900088
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$486.45 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$486.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cash Price |
$2,931.46
|
| Rate for Payer: Cash Price |
$2,931.46
|
| Rate for Payer: Cash Price |
$2,931.46
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$3,103.90
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina CHIP/Medicaid |
$3,103.90
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| 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 |
$3,103.90
|
| Rate for Payer: Scott and White EPO/PPO |
$3,069.37
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$3,103.90
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or
|
Facility
|
IP
|
$1,906.62
|
|
|
Service Code
|
HCPCS 11400
|
| Hospital Charge Code |
9900086
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,296.50
|
|
|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or
|
Facility
|
IP
|
$4,310.97
|
|
|
Service Code
|
HCPCS 11404
|
| Hospital Charge Code |
9900088
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$2,931.46
|
|
|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or
|
Facility
|
IP
|
$27,009.00
|
|
|
Service Code
|
HCPCS 11406
|
| Hospital Charge Code |
9900089
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$18,366.12
|
|
|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or
|
Facility
|
OP
|
$27,009.00
|
|
|
Service Code
|
HCPCS 11406
|
| Hospital Charge Code |
9900089
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$486.45 |
| Max. Negotiated Rate |
$19,446.48 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$486.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cash Price |
$18,366.12
|
| Rate for Payer: Cash Price |
$18,366.12
|
| Rate for Payer: Cash Price |
$18,366.12
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$19,446.48
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina CHIP/Medicaid |
$19,446.48
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| 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 |
$19,446.48
|
| Rate for Payer: Scott and White EPO/PPO |
$3,069.37
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$19,446.48
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or
|
Facility
|
OP
|
$1,906.62
|
|
|
Service Code
|
HCPCS 11400
|
| Hospital Charge Code |
9900086
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$77.79 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$77.79
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$711.36
|
| Rate for Payer: Amerigroup Medicare |
$711.36
|
| Rate for Payer: BCBS of TX Blue Advantage |
$154.29
|
| Rate for Payer: BCBS of TX Blue Essentials |
$184.78
|
| Rate for Payer: BCBS of TX Medicare |
$711.36
|
| Rate for Payer: BCBS of TX PPO |
$232.82
|
| Rate for Payer: Cash Price |
$1,296.50
|
| Rate for Payer: Cash Price |
$1,296.50
|
| Rate for Payer: Cash Price |
$1,296.50
|
| Rate for Payer: Cigna Commercial |
$1,503.68
|
| Rate for Payer: Cigna Medicaid |
$1,372.77
|
| Rate for Payer: Cigna Medicare |
$711.36
|
| Rate for Payer: Employer Direct Commercial |
$711.36
|
| Rate for Payer: Humana Medicare/TRICARE |
$711.36
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,372.77
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$711.36
|
| Rate for Payer: Molina Medicare |
$711.36
|
| 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 |
$1,372.77
|
| Rate for Payer: Scott and White EPO/PPO |
$1,316.02
|
| Rate for Payer: Scott and White Medicare |
$711.36
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,372.77
|
| Rate for Payer: Superior Health Plan EPO |
$711.36
|
| Rate for Payer: Superior Health Plan Medicare |
$711.36
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$711.36
|
| Rate for Payer: Universal American Medicare |
$711.36
|
| Rate for Payer: Wellcare Medicare |
$711.36
|
| Rate for Payer: Wellmed Medicare |
$711.36
|
|
|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
36011404
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$486.45 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$486.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| 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 |
$3,069.37
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
36011400
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$77.79 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$77.79
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$711.36
|
| Rate for Payer: Amerigroup Medicare |
$711.36
|
| Rate for Payer: BCBS of TX Blue Advantage |
$154.29
|
| Rate for Payer: BCBS of TX Blue Essentials |
$184.78
|
| Rate for Payer: BCBS of TX Medicare |
$711.36
|
| Rate for Payer: BCBS of TX PPO |
$232.82
|
| Rate for Payer: Cigna Commercial |
$1,503.68
|
| Rate for Payer: Cigna Medicare |
$711.36
|
| Rate for Payer: Employer Direct Commercial |
$711.36
|
| Rate for Payer: Humana Medicare/TRICARE |
$711.36
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$711.36
|
| Rate for Payer: Molina Medicare |
$711.36
|
| 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 |
$1,316.02
|
| Rate for Payer: Scott and White Medicare |
$711.36
|
| Rate for Payer: Superior Health Plan EPO |
$711.36
|
| Rate for Payer: Superior Health Plan Medicare |
$711.36
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$711.36
|
| Rate for Payer: Universal American Medicare |
$711.36
|
| Rate for Payer: Wellcare Medicare |
$711.36
|
| Rate for Payer: Wellmed Medicare |
$711.36
|
|
|
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
36011406
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$486.45 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$486.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| 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 |
$3,069.37
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
Excision, excessive skin and subcutaneous tissue buttock
|
Facility
|
OP
|
$11,448.20
|
|
|
Service Code
|
HCPCS 15835
|
| Hospital Charge Code |
994150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,030.34 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,030.34
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Amerigroup Medicare |
$2,917.95
|
| Rate for Payer: BCBS of TX Blue Advantage |
$3,872.55
|
| Rate for Payer: BCBS of TX Blue Essentials |
$4,637.78
|
| Rate for Payer: BCBS of TX Medicare |
$2,917.95
|
| Rate for Payer: BCBS of TX PPO |
$5,843.60
|
| Rate for Payer: Cash Price |
$7,784.78
|
| Rate for Payer: Cash Price |
$7,784.78
|
| Rate for Payer: Cash Price |
$7,784.78
|
| Rate for Payer: Cigna Commercial |
$6,168.03
|
| Rate for Payer: Cigna Medicaid |
$8,242.70
|
| Rate for Payer: Cigna Medicare |
$2,917.95
|
| Rate for Payer: Employer Direct Commercial |
$2,917.95
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,917.95
|
| Rate for Payer: Molina CHIP/Medicaid |
$8,242.70
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Molina Medicare |
$2,917.95
|
| 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 |
$8,242.70
|
| Rate for Payer: Scott and White EPO/PPO |
$5,398.21
|
| Rate for Payer: Scott and White Medicare |
$2,917.95
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$8,242.70
|
| Rate for Payer: Superior Health Plan EPO |
$2,917.95
|
| Rate for Payer: Superior Health Plan Medicare |
$2,917.95
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Universal American Medicare |
$2,917.95
|
| Rate for Payer: Wellcare Medicare |
$2,917.95
|
| Rate for Payer: Wellmed Medicare |
$2,917.95
|
|
|
Excision, excessive skin and subcutaneous tissue buttock
|
Facility
|
IP
|
$11,448.20
|
|
|
Service Code
|
HCPCS 15835
|
| Hospital Charge Code |
994150
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$7,784.78
|
|
|
Excision, excessive skin and subcutaneous tissue (includes lipectomy), abdomen (eg, abdominoplasty)
|
Facility
|
OP
|
$15,304.24
|
|
|
Service Code
|
HCPCS 15847
|
| Hospital Charge Code |
9900146
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,377.38 |
| Max. Negotiated Rate |
$11,019.05 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,377.38
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,591.27
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,509.53
|
| Rate for Payer: BCBS of TX PPO |
$6,121.70
|
| Rate for Payer: Cash Price |
$10,406.88
|
| Rate for Payer: Cash Price |
$10,406.88
|
| Rate for Payer: Cigna Medicaid |
$11,019.05
|
| Rate for Payer: Molina CHIP/Medicaid |
$11,019.05
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Parkland Medicaid |
$11,019.05
|
| Rate for Payer: Scott and White EPO/PPO |
$7,652.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$11,019.05
|
| Rate for Payer: Superior Health Plan EPO |
$2,081.38
|
|
|
Excision, excessive skin and subcutaneous tissue (includes lipectomy), abdomen (eg, abdominoplasty)
|
Facility
|
IP
|
$15,304.24
|
|
|
Service Code
|
HCPCS 15847
|
| Hospital Charge Code |
9900146
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$10,406.88
|
|
|
Excision, excessive skin and subcutaneous tissue (includes lipectomy), abdomen (eg, abdominoplasty)
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 15847
|
| Hospital Charge Code |
36015847
|
|
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
|
|
|
Excision, excessive skin and subcutaneous tissue (includes lipectomy) abdomen, infraumbilical panni
|
Facility
|
OP
|
$14,100.07
|
|
|
Service Code
|
CPT 15830
|
| Hospital Charge Code |
36015830
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,845.21 |
| Max. Negotiated Rate |
$14,100.07 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,845.21
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$6,670.43
|
| Rate for Payer: Amerigroup Medicare |
$6,670.43
|
| Rate for Payer: BCBS of TX Blue Advantage |
$8,746.27
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,474.58
|
| Rate for Payer: BCBS of TX Medicare |
$6,670.43
|
| Rate for Payer: BCBS of TX PPO |
$13,197.97
|
| Rate for Payer: Cigna Commercial |
$14,100.07
|
| Rate for Payer: Cigna Medicare |
$6,670.43
|
| Rate for Payer: Employer Direct Commercial |
$6,670.43
|
| Rate for Payer: Humana Medicare/TRICARE |
$6,670.43
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$6,670.43
|
| Rate for Payer: Molina Medicare |
$6,670.43
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$12,340.30
|
| Rate for Payer: Scott and White Medicare |
$6,670.43
|
| Rate for Payer: Superior Health Plan EPO |
$6,670.43
|
| Rate for Payer: Superior Health Plan Medicare |
$6,670.43
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$6,670.43
|
| Rate for Payer: Universal American Medicare |
$6,670.43
|
| Rate for Payer: Wellcare Medicare |
$6,670.43
|
| Rate for Payer: Wellmed Medicare |
$6,670.43
|
|
|
Excision, excessive skin and subcutaneous tissue (includes lipectomy) abdomen, infraumbilical panni
|
Facility
|
IP
|
$13,834.85
|
|
|
Service Code
|
HCPCS 15830
|
| Hospital Charge Code |
9900141
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$9,407.70
|
|
