|
Excision of ganglion, wrist (dorsal or volar) primary
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 25111
|
| Hospital Charge Code |
36025111
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$593.04 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$593.04
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Amerigroup Medicare |
$1,615.32
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,263.50
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,710.78
|
| Rate for Payer: BCBS of TX Medicare |
$1,615.32
|
| Rate for Payer: BCBS of TX PPO |
$3,415.58
|
| Rate for Payer: Cigna Commercial |
$3,414.49
|
| Rate for Payer: Cigna Medicare |
$1,615.32
|
| Rate for Payer: Employer Direct Commercial |
$1,615.32
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,615.32
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Molina Medicare |
$1,615.32
|
| 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 |
$2,719.24
|
| Rate for Payer: Scott and White Medicare |
$1,615.32
|
| Rate for Payer: Superior Health Plan EPO |
$1,615.32
|
| Rate for Payer: Superior Health Plan Medicare |
$1,615.32
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Universal American Medicare |
$1,615.32
|
| Rate for Payer: Wellcare Medicare |
$1,615.32
|
| Rate for Payer: Wellmed Medicare |
$1,615.32
|
|
|
Excision of ganglion, wrist (dorsal or volar) primary
|
Facility
|
IP
|
$6,961.75
|
|
|
Service Code
|
HCPCS 25111
|
| Hospital Charge Code |
9900271
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,733.99
|
|
|
Excision of hydrocele; unilateral
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
36055040
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,151.54 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,151.54
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,596.72
|
| Rate for Payer: Amerigroup Medicare |
$3,596.72
|
| Rate for Payer: BCBS of TX Blue Advantage |
$5,192.60
|
| Rate for Payer: BCBS of TX Blue Essentials |
$6,218.68
|
| Rate for Payer: BCBS of TX Medicare |
$3,596.72
|
| Rate for Payer: BCBS of TX PPO |
$7,835.54
|
| Rate for Payer: Cigna Commercial |
$7,602.81
|
| Rate for Payer: Cigna Medicare |
$3,596.72
|
| Rate for Payer: Employer Direct Commercial |
$3,596.72
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,596.72
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,596.72
|
| Rate for Payer: Molina Medicare |
$3,596.72
|
| 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: Scott and White EPO/PPO |
$5,853.44
|
| Rate for Payer: Scott and White Medicare |
$3,596.72
|
| Rate for Payer: Superior Health Plan EPO |
$3,596.72
|
| Rate for Payer: Superior Health Plan Medicare |
$3,596.72
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,596.72
|
| Rate for Payer: Universal American Medicare |
$3,596.72
|
| Rate for Payer: Wellcare Medicare |
$3,596.72
|
| Rate for Payer: Wellmed Medicare |
$3,596.72
|
|
|
Excision of hydrocele; unilateral
|
Facility
|
IP
|
$14,167.72
|
|
|
Service Code
|
HCPCS 55040
|
| Hospital Charge Code |
9900731
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$9,634.05
|
|
|
Excision of hydrocele; unilateral
|
Facility
|
OP
|
$14,167.72
|
|
|
Service Code
|
HCPCS 55040
|
| Hospital Charge Code |
9900731
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,151.54 |
| Max. Negotiated Rate |
$10,200.76 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,151.54
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,596.72
|
| Rate for Payer: Amerigroup Medicare |
$3,596.72
|
| Rate for Payer: BCBS of TX Blue Advantage |
$5,192.60
|
| Rate for Payer: BCBS of TX Blue Essentials |
$6,218.68
|
| Rate for Payer: BCBS of TX Medicare |
$3,596.72
|
| Rate for Payer: BCBS of TX PPO |
$7,835.54
|
| Rate for Payer: Cash Price |
$9,634.05
|
| Rate for Payer: Cash Price |
$9,634.05
|
| Rate for Payer: Cash Price |
$9,634.05
|
| Rate for Payer: Cigna Commercial |
$7,602.81
|
| Rate for Payer: Cigna Medicaid |
$10,200.76
|
| Rate for Payer: Cigna Medicare |
$3,596.72
|
| Rate for Payer: Employer Direct Commercial |
$3,596.72
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,596.72
|
| Rate for Payer: Molina CHIP/Medicaid |
$10,200.76
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,596.72
|
| Rate for Payer: Molina Medicare |
$3,596.72
|
| 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 |
$10,200.76
|
| Rate for Payer: Scott and White EPO/PPO |
$5,853.44
|
| Rate for Payer: Scott and White Medicare |
$3,596.72
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$10,200.76
|
| Rate for Payer: Superior Health Plan EPO |
$3,596.72
|
| Rate for Payer: Superior Health Plan Medicare |
$3,596.72
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,596.72
|
| Rate for Payer: Universal American Medicare |
$3,596.72
|
| Rate for Payer: Wellcare Medicare |
$3,596.72
|
| Rate for Payer: Wellmed Medicare |
$3,596.72
|
|
|
Excision of infected graft; extremity
|
Facility
|
IP
|
$12,590.00
|
|
|
Service Code
|
HCPCS 35903
|
| Hospital Charge Code |
994033
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$8,561.20
|
|
|
Excision of infected graft; extremity
|
Facility
|
OP
|
$12,590.00
|
|
|
Service Code
|
HCPCS 35903
|
| Hospital Charge Code |
994033
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,133.10 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,133.10
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,171.87
|
| Rate for Payer: Amerigroup Medicare |
$3,171.87
|
| 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 |
$3,171.87
|
| Rate for Payer: BCBS of TX PPO |
$6,983.63
|
| Rate for Payer: Cash Price |
$8,561.20
|
| Rate for Payer: Cash Price |
$8,561.20
|
| Rate for Payer: Cash Price |
$8,561.20
|
| Rate for Payer: Cigna Commercial |
$6,704.76
|
| Rate for Payer: Cigna Medicaid |
$9,064.80
|
| Rate for Payer: Cigna Medicare |
$3,171.87
|
| Rate for Payer: Employer Direct Commercial |
$3,171.87
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,171.87
|
| Rate for Payer: Molina CHIP/Medicaid |
$9,064.80
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,171.87
|
| Rate for Payer: Molina Medicare |
$3,171.87
|
| 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 |
$9,064.80
|
| Rate for Payer: Scott and White EPO/PPO |
$5,392.94
|
| Rate for Payer: Scott and White Medicare |
$3,171.87
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$9,064.80
|
| Rate for Payer: Superior Health Plan EPO |
$3,171.87
|
| Rate for Payer: Superior Health Plan Medicare |
$3,171.87
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,171.87
|
| Rate for Payer: Universal American Medicare |
$3,171.87
|
| Rate for Payer: Wellcare Medicare |
$3,171.87
|
| Rate for Payer: Wellmed Medicare |
$3,171.87
|
|
|
Excision of lesion, conjunctiva over 1 cm
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 68115
|
| Hospital Charge Code |
36068115
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$698.30 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$698.30
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,388.32
|
| Rate for Payer: Amerigroup Medicare |
$2,388.32
|
| Rate for Payer: BCBS of TX Blue Advantage |
$3,231.78
|
| Rate for Payer: BCBS of TX Blue Essentials |
$3,870.40
|
| Rate for Payer: BCBS of TX Medicare |
$2,388.32
|
| Rate for Payer: BCBS of TX PPO |
$4,876.70
|
| Rate for Payer: Cigna Commercial |
$5,048.47
|
| Rate for Payer: Cigna Medicare |
$2,388.32
|
| Rate for Payer: Employer Direct Commercial |
$2,388.32
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,388.32
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,388.32
|
| Rate for Payer: Molina Medicare |
$2,388.32
|
| 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 |
$3,953.65
|
| Rate for Payer: Scott and White Medicare |
$2,388.32
|
| Rate for Payer: Superior Health Plan EPO |
$2,388.32
|
| Rate for Payer: Superior Health Plan Medicare |
$2,388.32
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,388.32
|
| Rate for Payer: Universal American Medicare |
$2,388.32
|
| Rate for Payer: Wellcare Medicare |
$2,388.32
|
| Rate for Payer: Wellmed Medicare |
$2,388.32
|
|
|
Excision of lesion, conjunctiva over 1 cm
|
Facility
|
OP
|
$5,506.46
|
|
|
Service Code
|
HCPCS 68115
|
| Hospital Charge Code |
9900880
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$698.30 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$698.30
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,388.32
|
| Rate for Payer: Amerigroup Medicare |
$2,388.32
|
| Rate for Payer: BCBS of TX Blue Advantage |
$3,231.78
|
| Rate for Payer: BCBS of TX Blue Essentials |
$3,870.40
|
| Rate for Payer: BCBS of TX Medicare |
$2,388.32
|
| Rate for Payer: BCBS of TX PPO |
$4,876.70
|
| Rate for Payer: Cash Price |
$3,744.39
|
| Rate for Payer: Cash Price |
$3,744.39
|
| Rate for Payer: Cash Price |
$3,744.39
|
| Rate for Payer: Cigna Commercial |
$5,048.47
|
| Rate for Payer: Cigna Medicaid |
$3,964.65
|
| Rate for Payer: Cigna Medicare |
$2,388.32
|
| Rate for Payer: Employer Direct Commercial |
$2,388.32
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,388.32
|
| Rate for Payer: Molina CHIP/Medicaid |
$3,964.65
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,388.32
|
| Rate for Payer: Molina Medicare |
$2,388.32
|
| 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 |
$3,964.65
|
| Rate for Payer: Scott and White EPO/PPO |
$3,953.65
|
| Rate for Payer: Scott and White Medicare |
$2,388.32
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$3,964.65
|
| Rate for Payer: Superior Health Plan EPO |
$2,388.32
|
| Rate for Payer: Superior Health Plan Medicare |
$2,388.32
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,388.32
|
| Rate for Payer: Universal American Medicare |
$2,388.32
|
| Rate for Payer: Wellcare Medicare |
$2,388.32
|
| Rate for Payer: Wellmed Medicare |
$2,388.32
|
|
|
Excision of lesion, conjunctiva over 1 cm
|
Facility
|
IP
|
$5,506.46
|
|
|
Service Code
|
HCPCS 68115
|
| Hospital Charge Code |
9900880
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,744.39
|
|
|
Excision of lesion, conjunctiva; up to 1 cm
|
Facility
|
OP
|
$7,008.23
|
|
|
Service Code
|
HCPCS 68110
|
| Hospital Charge Code |
9900879
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$140.09 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$140.09
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,388.32
|
| Rate for Payer: Amerigroup Medicare |
$2,388.32
|
| Rate for Payer: BCBS of TX Blue Advantage |
$282.06
|
| Rate for Payer: BCBS of TX Blue Essentials |
$337.80
|
| Rate for Payer: BCBS of TX Medicare |
$2,388.32
|
| Rate for Payer: BCBS of TX PPO |
$425.63
|
| Rate for Payer: Cash Price |
$4,765.60
|
| Rate for Payer: Cash Price |
$4,765.60
|
| Rate for Payer: Cash Price |
$4,765.60
|
| Rate for Payer: Cigna Commercial |
$5,048.47
|
| Rate for Payer: Cigna Medicaid |
$5,045.93
|
| Rate for Payer: Cigna Medicare |
$2,388.32
|
| Rate for Payer: Employer Direct Commercial |
$2,388.32
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,388.32
|
| Rate for Payer: Molina CHIP/Medicaid |
$5,045.93
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,388.32
|
| Rate for Payer: Molina Medicare |
$2,388.32
|
| 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 |
$5,045.93
|
| Rate for Payer: Scott and White EPO/PPO |
$3,953.65
|
| Rate for Payer: Scott and White Medicare |
$2,388.32
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$5,045.93
|
| Rate for Payer: Superior Health Plan EPO |
$2,388.32
|
| Rate for Payer: Superior Health Plan Medicare |
$2,388.32
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,388.32
|
| Rate for Payer: Universal American Medicare |
$2,388.32
|
| Rate for Payer: Wellcare Medicare |
$2,388.32
|
| Rate for Payer: Wellmed Medicare |
$2,388.32
|
|
|
Excision of lesion, conjunctiva; up to 1 cm
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 68110
|
| Hospital Charge Code |
36068110
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$140.09 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$140.09
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,388.32
|
| Rate for Payer: Amerigroup Medicare |
$2,388.32
|
| Rate for Payer: BCBS of TX Blue Advantage |
$282.06
|
| Rate for Payer: BCBS of TX Blue Essentials |
$337.80
|
| Rate for Payer: BCBS of TX Medicare |
$2,388.32
|
| Rate for Payer: BCBS of TX PPO |
$425.63
|
| Rate for Payer: Cigna Commercial |
$5,048.47
|
| Rate for Payer: Cigna Medicare |
$2,388.32
|
| Rate for Payer: Employer Direct Commercial |
$2,388.32
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,388.32
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,388.32
|
| Rate for Payer: Molina Medicare |
$2,388.32
|
| 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 |
$3,953.65
|
| Rate for Payer: Scott and White Medicare |
$2,388.32
|
| Rate for Payer: Superior Health Plan EPO |
$2,388.32
|
| Rate for Payer: Superior Health Plan Medicare |
$2,388.32
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,388.32
|
| Rate for Payer: Universal American Medicare |
$2,388.32
|
| Rate for Payer: Wellcare Medicare |
$2,388.32
|
| Rate for Payer: Wellmed Medicare |
$2,388.32
|
|
|
Excision of lesion, conjunctiva; up to 1 cm
|
Facility
|
IP
|
$7,008.23
|
|
|
Service Code
|
HCPCS 68110
|
| Hospital Charge Code |
9900879
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,765.60
|
|
|
Excision of lesion of meniscus or capsule (eg, cyst, ganglion), knee
|
Facility
|
IP
|
$9,906.40
|
|
|
Service Code
|
HCPCS 27347
|
| Hospital Charge Code |
9900398
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,736.35
|
|
|
Excision of lesion of meniscus or capsule (eg, cyst, ganglion), knee
|
Facility
|
OP
|
$9,906.40
|
|
|
Service Code
|
HCPCS 27347
|
| Hospital Charge Code |
9900398
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| 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 |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cash Price |
$6,736.35
|
| Rate for Payer: Cash Price |
$6,736.35
|
| Rate for Payer: Cash Price |
$6,736.35
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$7,132.61
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina CHIP/Medicaid |
$7,132.61
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| 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 |
$7,132.61
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$7,132.61
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Excision of lesion of meniscus or capsule (eg, cyst, ganglion), knee
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 27347
|
| Hospital Charge Code |
36027347
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| 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 |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| 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 |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair
|
Facility
|
OP
|
$5,526.16
|
|
|
Service Code
|
HCPCS 40812
|
| Hospital Charge Code |
9900643
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$164.45 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$164.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,558.65
|
| Rate for Payer: Amerigroup Medicare |
$1,558.65
|
| Rate for Payer: BCBS of TX Blue Advantage |
$335.10
|
| Rate for Payer: BCBS of TX Blue Essentials |
$401.32
|
| Rate for Payer: BCBS of TX Medicare |
$1,558.65
|
| Rate for Payer: BCBS of TX PPO |
$505.66
|
| Rate for Payer: Cash Price |
$3,757.79
|
| Rate for Payer: Cash Price |
$3,757.79
|
| Rate for Payer: Cash Price |
$3,757.79
|
| Rate for Payer: Cigna Commercial |
$3,294.71
|
| Rate for Payer: Cigna Medicaid |
$3,978.84
|
| Rate for Payer: Cigna Medicare |
$1,558.65
|
| Rate for Payer: Employer Direct Commercial |
$1,558.65
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,558.65
|
| Rate for Payer: Molina CHIP/Medicaid |
$3,978.84
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,558.65
|
| Rate for Payer: Molina Medicare |
$1,558.65
|
| 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 |
$3,978.84
|
| Rate for Payer: Scott and White EPO/PPO |
$2,580.23
|
| Rate for Payer: Scott and White Medicare |
$1,558.65
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$3,978.84
|
| Rate for Payer: Superior Health Plan EPO |
$1,558.65
|
| Rate for Payer: Superior Health Plan Medicare |
$1,558.65
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,558.65
|
| Rate for Payer: Universal American Medicare |
$1,558.65
|
| Rate for Payer: Wellcare Medicare |
$1,558.65
|
| Rate for Payer: Wellmed Medicare |
$1,558.65
|
|
|
Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair
|
Facility
|
IP
|
$5,526.16
|
|
|
Service Code
|
HCPCS 40812
|
| Hospital Charge Code |
9900643
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,757.79
|
|
|
Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 40812
|
| Hospital Charge Code |
36040812
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$164.45 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$164.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,558.65
|
| Rate for Payer: Amerigroup Medicare |
$1,558.65
|
| Rate for Payer: BCBS of TX Blue Advantage |
$335.10
|
| Rate for Payer: BCBS of TX Blue Essentials |
$401.32
|
| Rate for Payer: BCBS of TX Medicare |
$1,558.65
|
| Rate for Payer: BCBS of TX PPO |
$505.66
|
| Rate for Payer: Cigna Commercial |
$3,294.71
|
| Rate for Payer: Cigna Medicare |
$1,558.65
|
| Rate for Payer: Employer Direct Commercial |
$1,558.65
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,558.65
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,558.65
|
| Rate for Payer: Molina Medicare |
$1,558.65
|
| 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 |
$2,580.23
|
| Rate for Payer: Scott and White Medicare |
$1,558.65
|
| Rate for Payer: Superior Health Plan EPO |
$1,558.65
|
| Rate for Payer: Superior Health Plan Medicare |
$1,558.65
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,558.65
|
| Rate for Payer: Universal American Medicare |
$1,558.65
|
| Rate for Payer: Wellcare Medicare |
$1,558.65
|
| Rate for Payer: Wellmed Medicare |
$1,558.65
|
|
|
Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle
|
Facility
|
OP
|
$12,336.12
|
|
|
Service Code
|
HCPCS 27630
|
| Hospital Charge Code |
991030
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| 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 |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cash Price |
$8,388.56
|
| Rate for Payer: Cash Price |
$8,388.56
|
| Rate for Payer: Cash Price |
$8,388.56
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$8,882.01
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina CHIP/Medicaid |
$8,882.01
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| 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 |
$8,882.01
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$8,882.01
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle
|
Facility
|
IP
|
$12,336.12
|
|
|
Service Code
|
HCPCS 27630
|
| Hospital Charge Code |
991030
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$8,388.56
|
|
|
Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion), hand or f
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 26160
|
| Hospital Charge Code |
36026160
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$593.04 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$593.04
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Amerigroup Medicare |
$1,615.32
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,263.50
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,710.78
|
| Rate for Payer: BCBS of TX Medicare |
$1,615.32
|
| Rate for Payer: BCBS of TX PPO |
$3,415.58
|
| Rate for Payer: Cigna Commercial |
$3,414.49
|
| Rate for Payer: Cigna Medicare |
$1,615.32
|
| Rate for Payer: Employer Direct Commercial |
$1,615.32
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,615.32
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Molina Medicare |
$1,615.32
|
| 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 |
$2,719.24
|
| Rate for Payer: Scott and White Medicare |
$1,615.32
|
| Rate for Payer: Superior Health Plan EPO |
$1,615.32
|
| Rate for Payer: Superior Health Plan Medicare |
$1,615.32
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Universal American Medicare |
$1,615.32
|
| Rate for Payer: Wellcare Medicare |
$1,615.32
|
| Rate for Payer: Wellmed Medicare |
$1,615.32
|
|
|
Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion), hand or f
|
Facility
|
IP
|
$9,720.00
|
|
|
Service Code
|
HCPCS 26160
|
| Hospital Charge Code |
9900324
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,609.60
|
|
|
Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion), hand or f
|
Facility
|
OP
|
$9,720.00
|
|
|
Service Code
|
HCPCS 26160
|
| Hospital Charge Code |
9900324
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$593.04 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$593.04
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Amerigroup Medicare |
$1,615.32
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,263.50
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,710.78
|
| Rate for Payer: BCBS of TX Medicare |
$1,615.32
|
| Rate for Payer: BCBS of TX PPO |
$3,415.58
|
| Rate for Payer: Cash Price |
$6,609.60
|
| Rate for Payer: Cash Price |
$6,609.60
|
| Rate for Payer: Cash Price |
$6,609.60
|
| Rate for Payer: Cigna Commercial |
$3,414.49
|
| Rate for Payer: Cigna Medicaid |
$6,998.40
|
| Rate for Payer: Cigna Medicare |
$1,615.32
|
| Rate for Payer: Employer Direct Commercial |
$1,615.32
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,615.32
|
| Rate for Payer: Molina CHIP/Medicaid |
$6,998.40
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Molina Medicare |
$1,615.32
|
| 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 |
$6,998.40
|
| Rate for Payer: Scott and White EPO/PPO |
$2,719.24
|
| Rate for Payer: Scott and White Medicare |
$1,615.32
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$6,998.40
|
| Rate for Payer: Superior Health Plan EPO |
$1,615.32
|
| Rate for Payer: Superior Health Plan Medicare |
$1,615.32
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Universal American Medicare |
$1,615.32
|
| Rate for Payer: Wellcare Medicare |
$1,615.32
|
| Rate for Payer: Wellmed Medicare |
$1,615.32
|
|
|
Excision of lesion of tongue with closure; anterior two-thirds
|
Facility
|
OP
|
$9,577.37
|
|
|
Service Code
|
HCPCS 41112
|
| Hospital Charge Code |
9900646
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$886.62 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$886.62
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,330.57
|
| Rate for Payer: Amerigroup Medicare |
$3,330.57
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,374.21
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,238.58
|
| Rate for Payer: BCBS of TX Medicare |
$3,330.57
|
| Rate for Payer: BCBS of TX PPO |
$6,600.61
|
| Rate for Payer: Cash Price |
$6,512.61
|
| Rate for Payer: Cash Price |
$6,512.61
|
| Rate for Payer: Cash Price |
$6,512.61
|
| Rate for Payer: Cigna Commercial |
$7,040.22
|
| Rate for Payer: Cigna Medicaid |
$6,895.71
|
| Rate for Payer: Cigna Medicare |
$3,330.57
|
| Rate for Payer: Employer Direct Commercial |
$3,330.57
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,330.57
|
| Rate for Payer: Molina CHIP/Medicaid |
$6,895.71
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,330.57
|
| Rate for Payer: Molina Medicare |
$3,330.57
|
| 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 |
$6,895.71
|
| Rate for Payer: Scott and White EPO/PPO |
$5,447.31
|
| Rate for Payer: Scott and White Medicare |
$3,330.57
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$6,895.71
|
| Rate for Payer: Superior Health Plan EPO |
$3,330.57
|
| Rate for Payer: Superior Health Plan Medicare |
$3,330.57
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,330.57
|
| Rate for Payer: Universal American Medicare |
$3,330.57
|
| Rate for Payer: Wellcare Medicare |
$3,330.57
|
| Rate for Payer: Wellmed Medicare |
$3,330.57
|
|
