|
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 |
$1,190.38
|
| 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
|
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, 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 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 |
$4,807.56
|
| 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 (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
|
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 (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, infraumbilical panni
|
Facility
|
OP
|
$13,834.85
|
|
|
Service Code
|
HCPCS 15830
|
| Hospital Charge Code |
9900141
|
|
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: Cash Price |
$9,407.70
|
| Rate for Payer: Cash Price |
$9,407.70
|
| Rate for Payer: Cash Price |
$9,407.70
|
| Rate for Payer: Cigna Commercial |
$14,100.07
|
| Rate for Payer: Cigna Medicaid |
$9,961.09
|
| 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 CHIP/Medicaid |
$9,961.09
|
| 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: Parkland Medicaid |
$9,961.09
|
| Rate for Payer: Scott and White EPO/PPO |
$11,033.10
|
| Rate for Payer: Scott and White Medicare |
$6,670.43
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$9,961.09
|
| 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
|
|
|
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 |
$11,033.10
|
| 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) arm
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 15836
|
| Hospital Charge Code |
36015836
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,917.95 |
| Max. Negotiated Rate |
$10,000.00 |
| 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 |
$4,807.56
|
| 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, excessive skin and subcutaneous tissue (includes lipectomy) arm
|
Facility
|
IP
|
$10,333.00
|
|
|
Service Code
|
HCPCS 15836
|
| Hospital Charge Code |
9900143
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$7,026.44
|
|
|
Excision, excessive skin and subcutaneous tissue (includes lipectomy) arm
|
Facility
|
OP
|
$10,333.00
|
|
|
Service Code
|
HCPCS 15836
|
| Hospital Charge Code |
9900143
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$929.97 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$929.97
|
| 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 |
$4,807.56
|
| 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, excessive skin and subcutaneous tissue (includes lipectomy) forearm or hand
|
Facility
|
IP
|
$11,594.45
|
|
|
Service Code
|
HCPCS 15837
|
| Hospital Charge Code |
9900144
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$7,884.23
|
|
|
Excision, excessive skin and subcutaneous tissue (includes lipectomy) forearm or hand
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 15837
|
| Hospital Charge Code |
36015837
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,917.95 |
| Max. Negotiated Rate |
$10,000.00 |
| 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 |
$4,807.56
|
| 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, excessive skin and subcutaneous tissue (includes lipectomy) forearm or hand
|
Facility
|
OP
|
$11,594.45
|
|
|
Service Code
|
HCPCS 15837
|
| Hospital Charge Code |
9900144
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,043.50 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,043.50
|
| 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 |
$7,884.23
|
| Rate for Payer: Cash Price |
$7,884.23
|
| Rate for Payer: Cash Price |
$7,884.23
|
| Rate for Payer: Cigna Commercial |
$6,168.03
|
| Rate for Payer: Cigna Medicaid |
$8,348.00
|
| 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 |
$8,348.00
|
| 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 |
$8,348.00
|
| Rate for Payer: Scott and White EPO/PPO |
$4,807.56
|
| Rate for Payer: Scott and White Medicare |
$2,917.95
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$8,348.00
|
| 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 (includes lipectomy) other area
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 15839
|
| Hospital Charge Code |
36015839
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,917.95 |
| Max. Negotiated Rate |
$10,000.00 |
| 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 |
$4,807.56
|
| 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, excessive skin and subcutaneous tissue (includes lipectomy) other area
|
Facility
|
OP
|
$10,333.00
|
|
|
Service Code
|
HCPCS 15839
|
| Hospital Charge Code |
9900145
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$929.97 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$929.97
|
| 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 |
$4,807.56
|
| 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, excessive skin and subcutaneous tissue (includes lipectomy) other area
|
Facility
|
IP
|
$10,333.00
|
|
|
Service Code
|
HCPCS 15839
|
| Hospital Charge Code |
9900145
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$7,026.44
|
|
|
Excision, excessive skin and subcutaneous tissue (includes lipectomy) thigh
|
Facility
|
IP
|
$12,243.00
|
|
|
Service Code
|
HCPCS 15832
|
| Hospital Charge Code |
9900142
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$8,325.24
|
|
|
Excision, excessive skin and subcutaneous tissue (includes lipectomy) thigh
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 15832
|
| Hospital Charge Code |
36015832
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,917.95 |
| Max. Negotiated Rate |
$10,000.00 |
| 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 |
$4,807.56
|
| 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, excessive skin and subcutaneous tissue (includes lipectomy) thigh
|
Facility
|
OP
|
$12,243.00
|
|
|
Service Code
|
HCPCS 15832
|
| Hospital Charge Code |
9900142
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,101.87 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,101.87
|
| 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 |
$8,325.24
|
| Rate for Payer: Cash Price |
$8,325.24
|
| Rate for Payer: Cash Price |
$8,325.24
|
| Rate for Payer: Cigna Commercial |
$6,168.03
|
| Rate for Payer: Cigna Medicaid |
$8,814.96
|
| 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 |
$8,814.96
|
| 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 |
$8,814.96
|
| Rate for Payer: Scott and White EPO/PPO |
$4,807.56
|
| Rate for Payer: Scott and White Medicare |
$2,917.95
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$8,814.96
|
| 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 exostosis(es), external auditory canal
|
Facility
|
OP
|
$12,570.48
|
|
|
Service Code
|
CPT 69140
|
| Hospital Charge Code |
36069140
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,954.22 |
| Max. Negotiated Rate |
$12,570.48 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,954.22
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Amerigroup Medicare |
$5,946.81
|
| Rate for Payer: BCBS of TX Blue Advantage |
$8,100.39
|
| Rate for Payer: BCBS of TX Blue Essentials |
$9,701.06
|
| Rate for Payer: BCBS of TX Medicare |
$5,946.81
|
| Rate for Payer: BCBS of TX PPO |
$12,223.34
|
| Rate for Payer: Cigna Commercial |
$12,570.48
|
| Rate for Payer: Cigna Medicare |
$5,946.81
|
| Rate for Payer: Employer Direct Commercial |
$5,946.81
|
| Rate for Payer: Humana Medicare/TRICARE |
$5,946.81
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Molina Medicare |
$5,946.81
|
| 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 |
$9,908.12
|
| Rate for Payer: Scott and White Medicare |
$5,946.81
|
| Rate for Payer: Superior Health Plan EPO |
$5,946.81
|
| Rate for Payer: Superior Health Plan Medicare |
$5,946.81
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Universal American Medicare |
$5,946.81
|
| Rate for Payer: Wellcare Medicare |
$5,946.81
|
| Rate for Payer: Wellmed Medicare |
$5,946.81
|
|
|
Excision exostosis(es), external auditory canal
|
Facility
|
OP
|
$17,845.35
|
|
|
Service Code
|
HCPCS 69140
|
| Hospital Charge Code |
9900882
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,954.22 |
| Max. Negotiated Rate |
$12,848.65 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,954.22
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Amerigroup Medicare |
$5,946.81
|
| Rate for Payer: BCBS of TX Blue Advantage |
$8,100.39
|
| Rate for Payer: BCBS of TX Blue Essentials |
$9,701.06
|
| Rate for Payer: BCBS of TX Medicare |
$5,946.81
|
| Rate for Payer: BCBS of TX PPO |
$12,223.34
|
| Rate for Payer: Cash Price |
$12,134.84
|
| Rate for Payer: Cash Price |
$12,134.84
|
| Rate for Payer: Cash Price |
$12,134.84
|
| Rate for Payer: Cigna Commercial |
$12,570.48
|
| Rate for Payer: Cigna Medicaid |
$12,848.65
|
| Rate for Payer: Cigna Medicare |
$5,946.81
|
| Rate for Payer: Employer Direct Commercial |
$5,946.81
|
| Rate for Payer: Humana Medicare/TRICARE |
$5,946.81
|
| Rate for Payer: Molina CHIP/Medicaid |
$12,848.65
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Molina Medicare |
$5,946.81
|
| 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 |
$12,848.65
|
| Rate for Payer: Scott and White EPO/PPO |
$9,908.12
|
| Rate for Payer: Scott and White Medicare |
$5,946.81
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$12,848.65
|
| Rate for Payer: Superior Health Plan EPO |
$5,946.81
|
| Rate for Payer: Superior Health Plan Medicare |
$5,946.81
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Universal American Medicare |
$5,946.81
|
| Rate for Payer: Wellcare Medicare |
$5,946.81
|
| Rate for Payer: Wellmed Medicare |
$5,946.81
|
|
|
Excision exostosis(es), external auditory canal
|
Facility
|
IP
|
$17,845.35
|
|
|
Service Code
|
HCPCS 69140
|
| Hospital Charge Code |
9900882
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$12,134.84
|
|
