|
Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); less than 5 cm
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 27328
|
| Hospital Charge Code |
36027328
|
|
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, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular) 5 cm or gre
|
Facility
|
OP
|
$11,891.45
|
|
|
Service Code
|
HCPCS 24073
|
| Hospital Charge Code |
9900237
|
|
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 |
$8,086.19
|
| Rate for Payer: Cash Price |
$8,086.19
|
| Rate for Payer: Cash Price |
$8,086.19
|
| Rate for Payer: Cigna Commercial |
$6,168.03
|
| Rate for Payer: Cigna Medicaid |
$8,561.84
|
| 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 |
$8,561.84
|
| 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 |
$8,561.84
|
| 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 |
$8,561.84
|
| 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, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular) 5 cm or gre
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 24073
|
| Hospital Charge Code |
36024073
|
|
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, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular) 5 cm or gre
|
Facility
|
IP
|
$11,891.45
|
|
|
Service Code
|
HCPCS 24073
|
| Hospital Charge Code |
9900237
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$8,086.19
|
|
|
Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); less than 5
|
Facility
|
IP
|
$8,295.04
|
|
|
Service Code
|
HCPCS 24076
|
| Hospital Charge Code |
9900238
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$5,640.63
|
|
|
Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); less than 5
|
Facility
|
OP
|
$8,295.04
|
|
|
Service Code
|
HCPCS 24076
|
| Hospital Charge Code |
9900238
|
|
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 |
$5,640.63
|
| Rate for Payer: Cash Price |
$5,640.63
|
| Rate for Payer: Cash Price |
$5,640.63
|
| Rate for Payer: Cigna Commercial |
$6,168.03
|
| Rate for Payer: Cigna Medicaid |
$5,972.43
|
| 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 |
$5,972.43
|
| 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 |
$5,972.43
|
| 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 |
$5,972.43
|
| 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, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); less than 5
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
36024076
|
|
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, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramusc
|
Facility
|
OP
|
$8,442.00
|
|
|
Service Code
|
HCPCS 26116
|
| Hospital Charge Code |
9900317
|
|
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 |
$5,740.56
|
| Rate for Payer: Cash Price |
$5,740.56
|
| Rate for Payer: Cash Price |
$5,740.56
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$6,078.24
|
| 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 |
$6,078.24
|
| 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 |
$6,078.24
|
| Rate for Payer: Scott and White EPO/PPO |
$2,743.07
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$6,078.24
|
| 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, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramusc
|
Facility
|
IP
|
$8,442.00
|
|
|
Service Code
|
HCPCS 26116
|
| Hospital Charge Code |
9900317
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$5,740.56
|
|
|
Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramusc
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 26116
|
| Hospital Charge Code |
36026116
|
|
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 |
$2,743.07
|
| 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, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramusc
|
Facility
|
OP
|
$7,035.00
|
|
|
Service Code
|
HCPCS 26113
|
| Hospital Charge Code |
9900315
|
|
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 |
$4,783.80
|
| Rate for Payer: Cash Price |
$4,783.80
|
| Rate for Payer: Cash Price |
$4,783.80
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$5,065.20
|
| 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 |
$5,065.20
|
| 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 |
$5,065.20
|
| Rate for Payer: Scott and White EPO/PPO |
$2,743.07
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$5,065.20
|
| 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, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramusc
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 26113
|
| Hospital Charge Code |
36026113
|
|
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 |
$2,743.07
|
| 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, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramusc
|
Facility
|
IP
|
$7,035.00
|
|
|
Service Code
|
HCPCS 26113
|
| Hospital Charge Code |
9900315
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,783.80
|
|
|
EX FIX FOOT PLATE EXTENSION 6 HOLE
|
Facility
|
IP
|
$1,242.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
146351
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$310.50 |
| Max. Negotiated Rate |
$621.00 |
| Rate for Payer: Cash Price |
$844.56
|
| Rate for Payer: Cigna Commercial |
$310.50
|
| Rate for Payer: Multiplan Auto |
$621.00
|
| Rate for Payer: Multiplan Commercial |
$621.00
|
| Rate for Payer: Multiplan Workers Comp |
$621.00
|
| Rate for Payer: Scott and White EPO/PPO |
$621.00
|
|
|
EX FIX FOOT PLATE EXTENSION 6 HOLE
|
Facility
|
OP
|
$1,242.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
146351
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$111.78 |
| Max. Negotiated Rate |
$894.24 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$111.78
|
| Rate for Payer: BCBS of TX Blue Advantage |
$372.60
|
| Rate for Payer: BCBS of TX Blue Essentials |
$447.12
|
| Rate for Payer: BCBS of TX PPO |
$496.80
|
| Rate for Payer: Cash Price |
$844.56
|
| Rate for Payer: Cigna Medicaid |
$894.24
|
| Rate for Payer: Molina CHIP/Medicaid |
$894.24
|
| Rate for Payer: Multiplan Auto |
$621.00
|
| Rate for Payer: Multiplan Commercial |
$621.00
|
| Rate for Payer: Multiplan Workers Comp |
$621.00
|
| Rate for Payer: Parkland Medicaid |
$894.24
|
| Rate for Payer: Scott and White EPO/PPO |
$621.00
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$894.24
|
| Rate for Payer: Superior Health Plan EPO |
$168.91
|
|
|
EX FIX ROD, THREADED 165MM
|
Facility
|
IP
|
$239.67
|
|
| Hospital Charge Code |
146208
|
|
Hospital Revenue Code
|
272
|
| Rate for Payer: Cash Price |
$162.98
|
|
|
EX FIX ROD, THREADED 165MM
|
Facility
|
OP
|
$239.67
|
|
| Hospital Charge Code |
146208
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.57 |
| Max. Negotiated Rate |
$172.56 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$21.57
|
| Rate for Payer: BCBS of TX Blue Advantage |
$71.90
|
| Rate for Payer: BCBS of TX Blue Essentials |
$86.28
|
| Rate for Payer: BCBS of TX PPO |
$95.87
|
| Rate for Payer: Cash Price |
$162.98
|
| Rate for Payer: Cigna Medicaid |
$172.56
|
| Rate for Payer: Molina CHIP/Medicaid |
$172.56
|
| Rate for Payer: Multiplan Auto |
$155.79
|
| Rate for Payer: Multiplan Commercial |
$155.79
|
| Rate for Payer: Multiplan Workers Comp |
$155.79
|
| Rate for Payer: Parkland Medicaid |
$172.56
|
| Rate for Payer: Scott and White EPO/PPO |
$119.83
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$172.56
|
| Rate for Payer: Superior Health Plan EPO |
$32.60
|
|
|
exfx 10mm nut qty 20
|
Facility
|
IP
|
$144.37
|
|
| Hospital Charge Code |
130818
|
|
Hospital Revenue Code
|
272
|
| Rate for Payer: Cash Price |
$98.17
|
|
|
exfx 10mm nut qty 20
|
Facility
|
OP
|
$144.37
|
|
| Hospital Charge Code |
130818
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.99 |
| Max. Negotiated Rate |
$103.95 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$12.99
|
| Rate for Payer: BCBS of TX Blue Advantage |
$43.31
|
| Rate for Payer: BCBS of TX Blue Essentials |
$51.97
|
| Rate for Payer: BCBS of TX PPO |
$57.75
|
| Rate for Payer: Cash Price |
$98.17
|
| Rate for Payer: Cigna Medicaid |
$103.95
|
| Rate for Payer: Molina CHIP/Medicaid |
$103.95
|
| Rate for Payer: Multiplan Auto |
$93.84
|
| Rate for Payer: Multiplan Commercial |
$93.84
|
| Rate for Payer: Multiplan Workers Comp |
$93.84
|
| Rate for Payer: Parkland Medicaid |
$103.95
|
| Rate for Payer: Scott and White EPO/PPO |
$72.19
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$103.95
|
| Rate for Payer: Superior Health Plan EPO |
$19.63
|
|
|
EXFX 1.6 THREADED WIRES 4/PK
|
Facility
|
OP
|
$700.20
|
|
| Hospital Charge Code |
145206
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$63.02 |
| Max. Negotiated Rate |
$504.14 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$63.02
|
| Rate for Payer: BCBS of TX Blue Advantage |
$210.06
|
| Rate for Payer: BCBS of TX Blue Essentials |
$252.07
|
| Rate for Payer: BCBS of TX PPO |
$280.08
|
| Rate for Payer: Cash Price |
$476.14
|
| Rate for Payer: Cigna Medicaid |
$504.14
|
| Rate for Payer: Molina CHIP/Medicaid |
$504.14
|
| Rate for Payer: Multiplan Auto |
$455.13
|
| Rate for Payer: Multiplan Commercial |
$455.13
|
| Rate for Payer: Multiplan Workers Comp |
$455.13
|
| Rate for Payer: Parkland Medicaid |
$504.14
|
| Rate for Payer: Scott and White EPO/PPO |
$350.10
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$504.14
|
| Rate for Payer: Superior Health Plan EPO |
$95.23
|
|
|
EXFX 1.6 THREADED WIRES 4/PK
|
Facility
|
IP
|
$700.20
|
|
| Hospital Charge Code |
145206
|
|
Hospital Revenue Code
|
272
|
| Rate for Payer: Cash Price |
$476.14
|
|
|
EXFX 3 HOLE POST
|
Facility
|
IP
|
$765.17
|
|
| Hospital Charge Code |
138244
|
|
Hospital Revenue Code
|
272
|
| Rate for Payer: Cash Price |
$520.32
|
|
|
EXFX 3 HOLE POST
|
Facility
|
OP
|
$765.17
|
|
| Hospital Charge Code |
138244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.87 |
| Max. Negotiated Rate |
$550.92 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$68.87
|
| Rate for Payer: BCBS of TX Blue Advantage |
$229.55
|
| Rate for Payer: BCBS of TX Blue Essentials |
$275.46
|
| Rate for Payer: BCBS of TX PPO |
$306.07
|
| Rate for Payer: Cash Price |
$520.32
|
| Rate for Payer: Cigna Medicaid |
$550.92
|
| Rate for Payer: Molina CHIP/Medicaid |
$550.92
|
| Rate for Payer: Multiplan Auto |
$497.36
|
| Rate for Payer: Multiplan Commercial |
$497.36
|
| Rate for Payer: Multiplan Workers Comp |
$497.36
|
| Rate for Payer: Parkland Medicaid |
$550.92
|
| Rate for Payer: Scott and White EPO/PPO |
$382.58
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$550.92
|
| Rate for Payer: Superior Health Plan EPO |
$104.06
|
|
|
EXFX ALLAN WRENCH
|
Facility
|
OP
|
$422.22
|
|
| Hospital Charge Code |
145209
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.00 |
| Max. Negotiated Rate |
$304.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$38.00
|
| Rate for Payer: BCBS of TX Blue Advantage |
$126.67
|
| Rate for Payer: BCBS of TX Blue Essentials |
$152.00
|
| Rate for Payer: BCBS of TX PPO |
$168.89
|
| Rate for Payer: Cash Price |
$287.11
|
| Rate for Payer: Cigna Medicaid |
$304.00
|
| Rate for Payer: Molina CHIP/Medicaid |
$304.00
|
| Rate for Payer: Multiplan Auto |
$274.44
|
| Rate for Payer: Multiplan Commercial |
$274.44
|
| Rate for Payer: Multiplan Workers Comp |
$274.44
|
| Rate for Payer: Parkland Medicaid |
$304.00
|
| Rate for Payer: Scott and White EPO/PPO |
$211.11
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$304.00
|
| Rate for Payer: Superior Health Plan EPO |
$57.42
|
|
|
EXFX ALLAN WRENCH
|
Facility
|
IP
|
$422.22
|
|
| Hospital Charge Code |
145209
|
|
Hospital Revenue Code
|
272
|
| Rate for Payer: Cash Price |
$287.11
|
|
