|
Excision of neuroma hand or foot, except digital nerve
|
Facility
|
IP
|
$16,645.00
|
|
|
Service Code
|
HCPCS 64782
|
| Hospital Charge Code |
9900846
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$11,318.60
|
|
|
Excision of neuroma; major peripheral nerve, except sciatic
|
Facility
|
OP
|
$7,173.24
|
|
|
Service Code
|
HCPCS 64784
|
| Hospital Charge Code |
9900847
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$659.94 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$659.94
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,961.62
|
| Rate for Payer: Amerigroup Medicare |
$1,961.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,871.31
|
| Rate for Payer: BCBS of TX Blue Essentials |
$3,438.70
|
| Rate for Payer: BCBS of TX Medicare |
$1,961.62
|
| Rate for Payer: BCBS of TX PPO |
$4,332.76
|
| Rate for Payer: Cash Price |
$4,877.80
|
| Rate for Payer: Cash Price |
$4,877.80
|
| Rate for Payer: Cash Price |
$4,877.80
|
| Rate for Payer: Cigna Commercial |
$4,146.52
|
| Rate for Payer: Cigna Medicaid |
$5,164.73
|
| Rate for Payer: Cigna Medicare |
$1,961.62
|
| Rate for Payer: Employer Direct Commercial |
$1,961.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,961.62
|
| Rate for Payer: Molina CHIP/Medicaid |
$5,164.73
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,961.62
|
| Rate for Payer: Molina Medicare |
$1,961.62
|
| 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 |
$5,164.73
|
| Rate for Payer: Scott and White EPO/PPO |
$3,266.71
|
| Rate for Payer: Scott and White Medicare |
$1,961.62
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$5,164.73
|
| Rate for Payer: Superior Health Plan EPO |
$1,961.62
|
| Rate for Payer: Superior Health Plan Medicare |
$1,961.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,961.62
|
| Rate for Payer: Universal American Medicare |
$1,961.62
|
| Rate for Payer: Wellcare Medicare |
$1,961.62
|
| Rate for Payer: Wellmed Medicare |
$1,961.62
|
|
|
Excision of neuroma; major peripheral nerve, except sciatic
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 64784
|
| Hospital Charge Code |
36064784
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$659.94 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$659.94
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,961.62
|
| Rate for Payer: Amerigroup Medicare |
$1,961.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,871.31
|
| Rate for Payer: BCBS of TX Blue Essentials |
$3,438.70
|
| Rate for Payer: BCBS of TX Medicare |
$1,961.62
|
| Rate for Payer: BCBS of TX PPO |
$4,332.76
|
| Rate for Payer: Cigna Commercial |
$4,146.52
|
| Rate for Payer: Cigna Medicare |
$1,961.62
|
| Rate for Payer: Employer Direct Commercial |
$1,961.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,961.62
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,961.62
|
| Rate for Payer: Molina Medicare |
$1,961.62
|
| 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 |
$3,266.71
|
| Rate for Payer: Scott and White Medicare |
$1,961.62
|
| Rate for Payer: Superior Health Plan EPO |
$1,961.62
|
| Rate for Payer: Superior Health Plan Medicare |
$1,961.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,961.62
|
| Rate for Payer: Universal American Medicare |
$1,961.62
|
| Rate for Payer: Wellcare Medicare |
$1,961.62
|
| Rate for Payer: Wellmed Medicare |
$1,961.62
|
|
|
Excision of neuroma; major peripheral nerve, except sciatic
|
Facility
|
IP
|
$7,173.24
|
|
|
Service Code
|
HCPCS 64784
|
| Hospital Charge Code |
9900847
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,877.80
|
|
|
Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial
|
Facility
|
OP
|
$17,801.18
|
|
|
Service Code
|
HCPCS 42415
|
| Hospital Charge Code |
9900653
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,954.22 |
| Max. Negotiated Rate |
$12,816.85 |
| 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 |
$12,104.80
|
| Rate for Payer: Cash Price |
$12,104.80
|
| Rate for Payer: Cash Price |
$12,104.80
|
| Rate for Payer: Cigna Commercial |
$12,570.48
|
| Rate for Payer: Cigna Medicaid |
$12,816.85
|
| 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 |
$12,816.85
|
| 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 |
$12,816.85
|
| 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 |
$12,816.85
|
| 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 of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial
|
Facility
|
OP
|
$12,570.48
|
|
|
Service Code
|
CPT 42415
|
| Hospital Charge Code |
36042415
|
|
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 of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial
|
Facility
|
IP
|
$17,801.18
|
|
|
Service Code
|
HCPCS 42415
|
| Hospital Charge Code |
9900653
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$12,104.80
|
|
|
Excision of parotid tumor or parotid gland total, with dissection and preservation of facial nerve
|
Facility
|
OP
|
$18,468.60
|
|
|
Service Code
|
HCPCS 42420
|
| Hospital Charge Code |
9900654
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,954.22 |
| Max. Negotiated Rate |
$13,297.39 |
| 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 |
$12,558.65
|
| Rate for Payer: Cash Price |
$12,558.65
|
| Rate for Payer: Cash Price |
$12,558.65
|
| Rate for Payer: Cigna Commercial |
$12,570.48
|
| Rate for Payer: Cigna Medicaid |
$13,297.39
|
| 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 |
$13,297.39
|
| 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 |
$13,297.39
|
| 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 |
$13,297.39
|
| 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 of parotid tumor or parotid gland total, with dissection and preservation of facial nerve
|
Facility
|
IP
|
$18,468.60
|
|
|
Service Code
|
HCPCS 42420
|
| Hospital Charge Code |
9900654
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$12,558.65
|
|
|
Excision of parotid tumor or parotid gland total, with dissection and preservation of facial nerve
|
Facility
|
OP
|
$12,570.48
|
|
|
Service Code
|
CPT 42420
|
| Hospital Charge Code |
36042420
|
|
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 of pilonidal cyst or sinus; complicated
|
Facility
|
IP
|
$11,448.20
|
|
|
Service Code
|
HCPCS 11772
|
| Hospital Charge Code |
994081
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$7,784.78
|
|
|
Excision of pilonidal cyst or sinus; complicated
|
Facility
|
OP
|
$11,448.20
|
|
|
Service Code
|
HCPCS 11772
|
| Hospital Charge Code |
994081
|
|
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 |
$7,784.78
|
| 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 of pilonidal cyst or sinus; extensive
|
Facility
|
OP
|
$11,448.20
|
|
|
Service Code
|
HCPCS 11771
|
| Hospital Charge Code |
991213
|
|
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 |
$7,784.78
|
| 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 of pilonidal cyst or sinus; extensive
|
Facility
|
IP
|
$11,448.20
|
|
|
Service Code
|
HCPCS 11771
|
| Hospital Charge Code |
991213
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$7,784.78
|
|
|
Excision of skin and subcutaneous tissue for hidradenitis, axillary with complex repair
|
Facility
|
OP
|
$41,384.57
|
|
|
Service Code
|
HCPCS 11451
|
| Hospital Charge Code |
9900096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$815.20 |
| Max. Negotiated Rate |
$29,796.89 |
| 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 |
$28,141.51
|
| Rate for Payer: Cash Price |
$28,141.51
|
| Rate for Payer: Cash Price |
$28,141.51
|
| Rate for Payer: Cigna Commercial |
$6,168.03
|
| Rate for Payer: Cigna Medicaid |
$29,796.89
|
| 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 |
$29,796.89
|
| 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 |
$29,796.89
|
| 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 |
$29,796.89
|
| 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 of skin and subcutaneous tissue for hidradenitis, axillary with complex repair
|
Facility
|
IP
|
$41,384.57
|
|
|
Service Code
|
HCPCS 11451
|
| Hospital Charge Code |
9900096
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$28,141.51
|
|
|
Excision of skin and subcutaneous tissue for hidradenitis, axillary with complex repair
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 11451
|
| Hospital Charge Code |
36011451
|
|
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 |
$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 of skin and subcutaneous tissue for hidradenitis, inguinal with complex repair
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 11463
|
| Hospital Charge Code |
36011463
|
|
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 |
$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 of skin and subcutaneous tissue for hidradenitis, inguinal with complex repair
|
Facility
|
IP
|
$41,384.57
|
|
|
Service Code
|
HCPCS 11463
|
| Hospital Charge Code |
9900097
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$28,141.51
|
|
|
Excision of skin and subcutaneous tissue for hidradenitis, inguinal with complex repair
|
Facility
|
OP
|
$41,384.57
|
|
|
Service Code
|
HCPCS 11463
|
| Hospital Charge Code |
9900097
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$815.20 |
| Max. Negotiated Rate |
$29,796.89 |
| 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 |
$28,141.51
|
| Rate for Payer: Cash Price |
$28,141.51
|
| Rate for Payer: Cash Price |
$28,141.51
|
| Rate for Payer: Cigna Commercial |
$6,168.03
|
| Rate for Payer: Cigna Medicaid |
$29,796.89
|
| 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 |
$29,796.89
|
| 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 |
$29,796.89
|
| 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 |
$29,796.89
|
| 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 of sublingual gland
|
Facility
|
IP
|
$12,312.42
|
|
|
Service Code
|
HCPCS 42450
|
| Hospital Charge Code |
9900656
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$8,372.45
|
|
|
Excision of sublingual gland
|
Facility
|
OP
|
$12,570.48
|
|
|
Service Code
|
CPT 42450
|
| Hospital Charge Code |
36042450
|
|
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 of sublingual gland
|
Facility
|
OP
|
$12,312.42
|
|
|
Service Code
|
HCPCS 42450
|
| Hospital Charge Code |
9900656
|
|
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: Cash Price |
$8,372.45
|
| Rate for Payer: Cash Price |
$8,372.45
|
| Rate for Payer: Cash Price |
$8,372.45
|
| Rate for Payer: Cigna Commercial |
$12,570.48
|
| Rate for Payer: Cigna Medicaid |
$8,864.94
|
| 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 |
$8,864.94
|
| 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 |
$8,864.94
|
| 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 |
$8,864.94
|
| 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 of submandibular (submaxillary) gland
|
Facility
|
IP
|
$12,312.42
|
|
|
Service Code
|
HCPCS 42440
|
| Hospital Charge Code |
9900655
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$8,372.45
|
|
|
Excision of submandibular (submaxillary) gland
|
Facility
|
OP
|
$12,570.48
|
|
|
Service Code
|
CPT 42440
|
| Hospital Charge Code |
36042440
|
|
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
|
|
