|
NM Thyroid Imaging BCE
|
Facility
|
OP
|
$1,026.00
|
|
|
Service Code
|
CPT 78013
|
| Hospital Charge Code |
3450001
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$854.47 |
| Rate for Payer: Aetna Commercial |
$191.52
|
| Rate for Payer: Aetna Medicare |
$565.80
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$178.43
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Amerigroup Medicare |
$377.20
|
| Rate for Payer: BCBS of TX Blue Advantage |
$298.52
|
| Rate for Payer: BCBS of TX Blue Essentials |
$358.22
|
| Rate for Payer: BCBS of TX Medicare |
$377.20
|
| Rate for Payer: BCBS of TX PPO |
$399.83
|
| Rate for Payer: Cash Price |
$902.88
|
| Rate for Payer: Cash Price |
$902.88
|
| Rate for Payer: Cash Price |
$902.88
|
| Rate for Payer: Cigna Commercial |
$854.47
|
| Rate for Payer: Cigna Medicaid |
$178.43
|
| Rate for Payer: Cigna Medicare |
$377.20
|
| Rate for Payer: Employer Direct Commercial |
$377.20
|
| Rate for Payer: Humana Medicare/TRICARE |
$377.20
|
| Rate for Payer: Molina CHIP/Medicaid |
$178.43
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Molina Medicare |
$377.20
|
| Rate for Payer: Multiplan Auto |
$666.90
|
| Rate for Payer: Multiplan Commercial |
$666.90
|
| Rate for Payer: Multiplan Workers Comp |
$666.90
|
| Rate for Payer: Parkland Medicaid |
$178.43
|
| Rate for Payer: Scott and White EPO/PPO |
$6.75
|
| Rate for Payer: Scott and White Medicare |
$377.20
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$178.43
|
| Rate for Payer: Superior Health Plan EPO |
$377.20
|
| Rate for Payer: Superior Health Plan Medicare |
$377.20
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Universal American Medicare |
$377.20
|
| Rate for Payer: Wellcare Medicare |
$377.20
|
| Rate for Payer: Wellmed Medicare |
$377.20
|
|
|
NM Thyroid Single/Multi Measure Delay 1 BCE
|
Facility
|
OP
|
$1,140.00
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
3450000
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$854.47 |
| Rate for Payer: Aetna Commercial |
$81.34
|
| Rate for Payer: Aetna Medicare |
$565.80
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$80.86
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Amerigroup Medicare |
$377.20
|
| Rate for Payer: BCBS of TX Blue Advantage |
$123.09
|
| Rate for Payer: BCBS of TX Blue Essentials |
$147.71
|
| Rate for Payer: BCBS of TX Medicare |
$377.20
|
| Rate for Payer: BCBS of TX PPO |
$164.87
|
| Rate for Payer: Cash Price |
$1,003.20
|
| Rate for Payer: Cash Price |
$1,003.20
|
| Rate for Payer: Cash Price |
$1,003.20
|
| Rate for Payer: Cigna Commercial |
$854.47
|
| Rate for Payer: Cigna Medicaid |
$80.86
|
| Rate for Payer: Cigna Medicare |
$377.20
|
| Rate for Payer: Employer Direct Commercial |
$377.20
|
| Rate for Payer: Humana Medicare/TRICARE |
$377.20
|
| Rate for Payer: Molina CHIP/Medicaid |
$80.86
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Molina Medicare |
$377.20
|
| Rate for Payer: Multiplan Auto |
$741.00
|
| Rate for Payer: Multiplan Commercial |
$741.00
|
| Rate for Payer: Multiplan Workers Comp |
$741.00
|
| Rate for Payer: Parkland Medicaid |
$80.86
|
| Rate for Payer: Scott and White EPO/PPO |
$6.75
|
| Rate for Payer: Scott and White Medicare |
$377.20
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$80.86
|
| Rate for Payer: Superior Health Plan EPO |
$377.20
|
| Rate for Payer: Superior Health Plan Medicare |
$377.20
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Universal American Medicare |
$377.20
|
| Rate for Payer: Wellcare Medicare |
$377.20
|
| Rate for Payer: Wellmed Medicare |
$377.20
|
|
|
NM Thyroid Single/Multi Measure Delay 1 BCE
|
Facility
|
IP
|
$1,140.00
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
3450000
|
|
Hospital Revenue Code
|
341
|
| Rate for Payer: Cash Price |
$1,003.20
|
|
|
NM Thyroid Uptake Single/Multi Measure
|
Facility
|
OP
|
$1,140.00
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
3450000
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$854.47 |
| Rate for Payer: Aetna Commercial |
$81.34
|
| Rate for Payer: Aetna Medicare |
$565.80
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$80.86
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Amerigroup Medicare |
$377.20
|
| Rate for Payer: BCBS of TX Blue Advantage |
$123.09
|
| Rate for Payer: BCBS of TX Blue Essentials |
$147.71
|
| Rate for Payer: BCBS of TX Medicare |
$377.20
|
| Rate for Payer: BCBS of TX PPO |
$164.87
|
| Rate for Payer: Cash Price |
$1,003.20
|
| Rate for Payer: Cash Price |
$1,003.20
|
| Rate for Payer: Cash Price |
$1,003.20
|
| Rate for Payer: Cigna Commercial |
$854.47
|
| Rate for Payer: Cigna Medicaid |
$80.86
|
| Rate for Payer: Cigna Medicare |
$377.20
|
| Rate for Payer: Employer Direct Commercial |
$377.20
|
| Rate for Payer: Humana Medicare/TRICARE |
$377.20
|
| Rate for Payer: Molina CHIP/Medicaid |
$80.86
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Molina Medicare |
$377.20
|
| Rate for Payer: Multiplan Auto |
$741.00
|
| Rate for Payer: Multiplan Commercial |
$741.00
|
| Rate for Payer: Multiplan Workers Comp |
$741.00
|
| Rate for Payer: Parkland Medicaid |
$80.86
|
| Rate for Payer: Scott and White EPO/PPO |
$6.75
|
| Rate for Payer: Scott and White Medicare |
$377.20
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$80.86
|
| Rate for Payer: Superior Health Plan EPO |
$377.20
|
| Rate for Payer: Superior Health Plan Medicare |
$377.20
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Universal American Medicare |
$377.20
|
| Rate for Payer: Wellcare Medicare |
$377.20
|
| Rate for Payer: Wellmed Medicare |
$377.20
|
|
|
NM Tumor Loc Limited
|
Facility
|
OP
|
$1,895.00
|
|
|
Service Code
|
CPT 78800
|
| Hospital Charge Code |
3400355
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$1,231.75 |
| Rate for Payer: Aetna Commercial |
$241.20
|
| Rate for Payer: Aetna Medicare |
$565.80
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$235.56
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Amerigroup Medicare |
$377.20
|
| Rate for Payer: BCBS of TX Blue Advantage |
$275.91
|
| Rate for Payer: BCBS of TX Blue Essentials |
$331.10
|
| Rate for Payer: BCBS of TX Medicare |
$377.20
|
| Rate for Payer: BCBS of TX PPO |
$369.56
|
| Rate for Payer: Cash Price |
$1,667.60
|
| Rate for Payer: Cash Price |
$1,667.60
|
| Rate for Payer: Cash Price |
$1,667.60
|
| Rate for Payer: Cigna Commercial |
$854.47
|
| Rate for Payer: Cigna Medicaid |
$235.56
|
| Rate for Payer: Cigna Medicare |
$377.20
|
| Rate for Payer: Employer Direct Commercial |
$377.20
|
| Rate for Payer: Humana Medicare/TRICARE |
$377.20
|
| Rate for Payer: Molina CHIP/Medicaid |
$235.56
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Molina Medicare |
$377.20
|
| Rate for Payer: Multiplan Auto |
$1,231.75
|
| Rate for Payer: Multiplan Commercial |
$1,231.75
|
| Rate for Payer: Multiplan Workers Comp |
$1,231.75
|
| Rate for Payer: Parkland Medicaid |
$235.56
|
| Rate for Payer: Scott and White EPO/PPO |
$6.75
|
| Rate for Payer: Scott and White Medicare |
$377.20
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$235.56
|
| Rate for Payer: Superior Health Plan EPO |
$377.20
|
| Rate for Payer: Superior Health Plan Medicare |
$377.20
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Universal American Medicare |
$377.20
|
| Rate for Payer: Wellcare Medicare |
$377.20
|
| Rate for Payer: Wellmed Medicare |
$377.20
|
|
|
NM Tumor Loc Limited Delay 1 BCE
|
Facility
|
IP
|
$1,895.00
|
|
|
Service Code
|
CPT 78800
|
| Hospital Charge Code |
3400355
|
|
Hospital Revenue Code
|
341
|
| Rate for Payer: Cash Price |
$1,667.60
|
|
|
NM Tumor Loc Limited Delay 1 BCE
|
Facility
|
OP
|
$1,895.00
|
|
|
Service Code
|
CPT 78800
|
| Hospital Charge Code |
3400355
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$1,231.75 |
| Rate for Payer: Aetna Commercial |
$241.20
|
| Rate for Payer: Aetna Medicare |
$565.80
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$235.56
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Amerigroup Medicare |
$377.20
|
| Rate for Payer: BCBS of TX Blue Advantage |
$275.91
|
| Rate for Payer: BCBS of TX Blue Essentials |
$331.10
|
| Rate for Payer: BCBS of TX Medicare |
$377.20
|
| Rate for Payer: BCBS of TX PPO |
$369.56
|
| Rate for Payer: Cash Price |
$1,667.60
|
| Rate for Payer: Cash Price |
$1,667.60
|
| Rate for Payer: Cash Price |
$1,667.60
|
| Rate for Payer: Cigna Commercial |
$854.47
|
| Rate for Payer: Cigna Medicaid |
$235.56
|
| Rate for Payer: Cigna Medicare |
$377.20
|
| Rate for Payer: Employer Direct Commercial |
$377.20
|
| Rate for Payer: Humana Medicare/TRICARE |
$377.20
|
| Rate for Payer: Molina CHIP/Medicaid |
$235.56
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Molina Medicare |
$377.20
|
| Rate for Payer: Multiplan Auto |
$1,231.75
|
| Rate for Payer: Multiplan Commercial |
$1,231.75
|
| Rate for Payer: Multiplan Workers Comp |
$1,231.75
|
| Rate for Payer: Parkland Medicaid |
$235.56
|
| Rate for Payer: Scott and White EPO/PPO |
$6.75
|
| Rate for Payer: Scott and White Medicare |
$377.20
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$235.56
|
| Rate for Payer: Superior Health Plan EPO |
$377.20
|
| Rate for Payer: Superior Health Plan Medicare |
$377.20
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Universal American Medicare |
$377.20
|
| Rate for Payer: Wellcare Medicare |
$377.20
|
| Rate for Payer: Wellmed Medicare |
$377.20
|
|
|
NM Tumor Loc Multiple Areas
|
Facility
|
OP
|
$2,052.00
|
|
|
Service Code
|
CPT 78801
|
| Hospital Charge Code |
3400004
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$1,333.80 |
| Rate for Payer: Aetna Commercial |
$261.24
|
| Rate for Payer: Aetna Medicare |
$565.80
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$255.61
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Amerigroup Medicare |
$377.20
|
| Rate for Payer: BCBS of TX Blue Advantage |
$374.63
|
| Rate for Payer: BCBS of TX Blue Essentials |
$449.56
|
| Rate for Payer: BCBS of TX Medicare |
$377.20
|
| Rate for Payer: BCBS of TX PPO |
$501.78
|
| Rate for Payer: Cash Price |
$1,805.76
|
| Rate for Payer: Cash Price |
$1,805.76
|
| Rate for Payer: Cash Price |
$1,805.76
|
| Rate for Payer: Cigna Commercial |
$854.47
|
| Rate for Payer: Cigna Medicaid |
$255.61
|
| Rate for Payer: Cigna Medicare |
$377.20
|
| Rate for Payer: Employer Direct Commercial |
$377.20
|
| Rate for Payer: Humana Medicare/TRICARE |
$377.20
|
| Rate for Payer: Molina CHIP/Medicaid |
$255.61
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Molina Medicare |
$377.20
|
| Rate for Payer: Multiplan Auto |
$1,333.80
|
| Rate for Payer: Multiplan Commercial |
$1,333.80
|
| Rate for Payer: Multiplan Workers Comp |
$1,333.80
|
| Rate for Payer: Parkland Medicaid |
$255.61
|
| Rate for Payer: Scott and White EPO/PPO |
$6.75
|
| Rate for Payer: Scott and White Medicare |
$377.20
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$255.61
|
| Rate for Payer: Superior Health Plan EPO |
$377.20
|
| Rate for Payer: Superior Health Plan Medicare |
$377.20
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Universal American Medicare |
$377.20
|
| Rate for Payer: Wellcare Medicare |
$377.20
|
| Rate for Payer: Wellmed Medicare |
$377.20
|
|
|
NM Tumor Loc Multiple Areas Delay 1 BCE
|
Facility
|
OP
|
$2,052.00
|
|
|
Service Code
|
CPT 78801
|
| Hospital Charge Code |
3400004
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$1,333.80 |
| Rate for Payer: Aetna Commercial |
$261.24
|
| Rate for Payer: Aetna Medicare |
$565.80
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$255.61
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Amerigroup Medicare |
$377.20
|
| Rate for Payer: BCBS of TX Blue Advantage |
$374.63
|
| Rate for Payer: BCBS of TX Blue Essentials |
$449.56
|
| Rate for Payer: BCBS of TX Medicare |
$377.20
|
| Rate for Payer: BCBS of TX PPO |
$501.78
|
| Rate for Payer: Cash Price |
$1,805.76
|
| Rate for Payer: Cash Price |
$1,805.76
|
| Rate for Payer: Cash Price |
$1,805.76
|
| Rate for Payer: Cigna Commercial |
$854.47
|
| Rate for Payer: Cigna Medicaid |
$255.61
|
| Rate for Payer: Cigna Medicare |
$377.20
|
| Rate for Payer: Employer Direct Commercial |
$377.20
|
| Rate for Payer: Humana Medicare/TRICARE |
$377.20
|
| Rate for Payer: Molina CHIP/Medicaid |
$255.61
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Molina Medicare |
$377.20
|
| Rate for Payer: Multiplan Auto |
$1,333.80
|
| Rate for Payer: Multiplan Commercial |
$1,333.80
|
| Rate for Payer: Multiplan Workers Comp |
$1,333.80
|
| Rate for Payer: Parkland Medicaid |
$255.61
|
| Rate for Payer: Scott and White EPO/PPO |
$6.75
|
| Rate for Payer: Scott and White Medicare |
$377.20
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$255.61
|
| Rate for Payer: Superior Health Plan EPO |
$377.20
|
| Rate for Payer: Superior Health Plan Medicare |
$377.20
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Universal American Medicare |
$377.20
|
| Rate for Payer: Wellcare Medicare |
$377.20
|
| Rate for Payer: Wellmed Medicare |
$377.20
|
|
|
NM Tumor Loc Multiple Areas Delay 1 BCE
|
Facility
|
IP
|
$2,052.00
|
|
|
Service Code
|
CPT 78801
|
| Hospital Charge Code |
3400004
|
|
Hospital Revenue Code
|
341
|
| Rate for Payer: Cash Price |
$1,805.76
|
|
|
NM Tumor Loc WB 1 Day Delay 1 BCE
|
Facility
|
OP
|
$2,321.00
|
|
|
Service Code
|
CPT 78802
|
| Hospital Charge Code |
3400058
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$23.22 |
| Max. Negotiated Rate |
$2,941.75 |
| Rate for Payer: Aetna Commercial |
$295.52
|
| Rate for Payer: Aetna Medicare |
$1,947.93
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$288.69
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,298.62
|
| Rate for Payer: Amerigroup Medicare |
$1,298.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$482.26
|
| Rate for Payer: BCBS of TX Blue Essentials |
$578.71
|
| Rate for Payer: BCBS of TX Medicare |
$1,298.62
|
| Rate for Payer: BCBS of TX PPO |
$645.94
|
| Rate for Payer: Cash Price |
$2,042.48
|
| Rate for Payer: Cash Price |
$2,042.48
|
| Rate for Payer: Cash Price |
$2,042.48
|
| Rate for Payer: Cigna Commercial |
$2,941.75
|
| Rate for Payer: Cigna Medicaid |
$288.69
|
| Rate for Payer: Cigna Medicare |
$1,298.62
|
| Rate for Payer: Employer Direct Commercial |
$1,298.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,298.62
|
| Rate for Payer: Molina CHIP/Medicaid |
$288.69
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,298.62
|
| Rate for Payer: Molina Medicare |
$1,298.62
|
| Rate for Payer: Multiplan Auto |
$1,508.65
|
| Rate for Payer: Multiplan Commercial |
$1,508.65
|
| Rate for Payer: Multiplan Workers Comp |
$1,508.65
|
| Rate for Payer: Parkland Medicaid |
$288.69
|
| Rate for Payer: Scott and White EPO/PPO |
$23.22
|
| Rate for Payer: Scott and White Medicare |
$1,298.62
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$288.69
|
| Rate for Payer: Superior Health Plan EPO |
$1,298.62
|
| Rate for Payer: Superior Health Plan Medicare |
$1,298.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,298.62
|
| Rate for Payer: Universal American Medicare |
$1,298.62
|
| Rate for Payer: Wellcare Medicare |
$1,298.62
|
| Rate for Payer: Wellmed Medicare |
$1,298.62
|
|
|
NM Tumor Loc WB 1 Day Delay 1 BCE
|
Facility
|
IP
|
$2,321.00
|
|
|
Service Code
|
CPT 78802
|
| Hospital Charge Code |
3400058
|
|
Hospital Revenue Code
|
341
|
| Rate for Payer: Cash Price |
$2,042.48
|
|
|
NM Tumor Loc WB 2+ Days Delay 1 BCE
|
Facility
|
OP
|
$4,039.00
|
|
|
Service Code
|
CPT 78804
|
| Hospital Charge Code |
3400007
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$23.22 |
| Max. Negotiated Rate |
$2,941.75 |
| Rate for Payer: Aetna Commercial |
$657.53
|
| Rate for Payer: Aetna Medicare |
$1,947.93
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$602.44
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,298.62
|
| Rate for Payer: Amerigroup Medicare |
$1,298.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$886.02
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,063.22
|
| Rate for Payer: BCBS of TX Medicare |
$1,298.62
|
| Rate for Payer: BCBS of TX PPO |
$1,186.73
|
| Rate for Payer: Cash Price |
$3,554.32
|
| Rate for Payer: Cash Price |
$3,554.32
|
| Rate for Payer: Cash Price |
$3,554.32
|
| Rate for Payer: Cigna Commercial |
$2,941.75
|
| Rate for Payer: Cigna Medicaid |
$602.44
|
| Rate for Payer: Cigna Medicare |
$1,298.62
|
| Rate for Payer: Employer Direct Commercial |
$1,298.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,298.62
|
| Rate for Payer: Molina CHIP/Medicaid |
$602.44
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,298.62
|
| Rate for Payer: Molina Medicare |
$1,298.62
|
| Rate for Payer: Multiplan Auto |
$2,625.35
|
| Rate for Payer: Multiplan Commercial |
$2,625.35
|
| Rate for Payer: Multiplan Workers Comp |
$2,625.35
|
| Rate for Payer: Parkland Medicaid |
$602.44
|
| Rate for Payer: Scott and White EPO/PPO |
$23.22
|
| Rate for Payer: Scott and White Medicare |
$1,298.62
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$602.44
|
| Rate for Payer: Superior Health Plan EPO |
$1,298.62
|
| Rate for Payer: Superior Health Plan Medicare |
$1,298.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,298.62
|
| Rate for Payer: Universal American Medicare |
$1,298.62
|
| Rate for Payer: Wellcare Medicare |
$1,298.62
|
| Rate for Payer: Wellmed Medicare |
$1,298.62
|
|
|
NM Tumor Loc WB 2+ Days Delay 1 BCE
|
Facility
|
IP
|
$4,039.00
|
|
|
Service Code
|
CPT 78804
|
| Hospital Charge Code |
3400007
|
|
Hospital Revenue Code
|
341
|
| Rate for Payer: Cash Price |
$3,554.32
|
|
|
NM Tumor Loc Whole Body 1 Day
|
Facility
|
OP
|
$2,321.00
|
|
|
Service Code
|
CPT 78802
|
| Hospital Charge Code |
3400058
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$23.22 |
| Max. Negotiated Rate |
$2,941.75 |
| Rate for Payer: Aetna Commercial |
$295.52
|
| Rate for Payer: Aetna Medicare |
$1,947.93
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$288.69
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,298.62
|
| Rate for Payer: Amerigroup Medicare |
$1,298.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$482.26
|
| Rate for Payer: BCBS of TX Blue Essentials |
$578.71
|
| Rate for Payer: BCBS of TX Medicare |
$1,298.62
|
| Rate for Payer: BCBS of TX PPO |
$645.94
|
| Rate for Payer: Cash Price |
$2,042.48
|
| Rate for Payer: Cash Price |
$2,042.48
|
| Rate for Payer: Cash Price |
$2,042.48
|
| Rate for Payer: Cigna Commercial |
$2,941.75
|
| Rate for Payer: Cigna Medicaid |
$288.69
|
| Rate for Payer: Cigna Medicare |
$1,298.62
|
| Rate for Payer: Employer Direct Commercial |
$1,298.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,298.62
|
| Rate for Payer: Molina CHIP/Medicaid |
$288.69
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,298.62
|
| Rate for Payer: Molina Medicare |
$1,298.62
|
| Rate for Payer: Multiplan Auto |
$1,508.65
|
| Rate for Payer: Multiplan Commercial |
$1,508.65
|
| Rate for Payer: Multiplan Workers Comp |
$1,508.65
|
| Rate for Payer: Parkland Medicaid |
$288.69
|
| Rate for Payer: Scott and White EPO/PPO |
$23.22
|
| Rate for Payer: Scott and White Medicare |
$1,298.62
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$288.69
|
| Rate for Payer: Superior Health Plan EPO |
$1,298.62
|
| Rate for Payer: Superior Health Plan Medicare |
$1,298.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,298.62
|
| Rate for Payer: Universal American Medicare |
$1,298.62
|
| Rate for Payer: Wellcare Medicare |
$1,298.62
|
| Rate for Payer: Wellmed Medicare |
$1,298.62
|
|
|
NM Tumor Loc Whole Body 2+ Days
|
Facility
|
OP
|
$4,039.00
|
|
|
Service Code
|
CPT 78804
|
| Hospital Charge Code |
3400007
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$23.22 |
| Max. Negotiated Rate |
$2,941.75 |
| Rate for Payer: Aetna Commercial |
$657.53
|
| Rate for Payer: Aetna Medicare |
$1,947.93
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$602.44
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,298.62
|
| Rate for Payer: Amerigroup Medicare |
$1,298.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$886.02
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,063.22
|
| Rate for Payer: BCBS of TX Medicare |
$1,298.62
|
| Rate for Payer: BCBS of TX PPO |
$1,186.73
|
| Rate for Payer: Cash Price |
$3,554.32
|
| Rate for Payer: Cash Price |
$3,554.32
|
| Rate for Payer: Cash Price |
$3,554.32
|
| Rate for Payer: Cigna Commercial |
$2,941.75
|
| Rate for Payer: Cigna Medicaid |
$602.44
|
| Rate for Payer: Cigna Medicare |
$1,298.62
|
| Rate for Payer: Employer Direct Commercial |
$1,298.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,298.62
|
| Rate for Payer: Molina CHIP/Medicaid |
$602.44
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,298.62
|
| Rate for Payer: Molina Medicare |
$1,298.62
|
| Rate for Payer: Multiplan Auto |
$2,625.35
|
| Rate for Payer: Multiplan Commercial |
$2,625.35
|
| Rate for Payer: Multiplan Workers Comp |
$2,625.35
|
| Rate for Payer: Parkland Medicaid |
$602.44
|
| Rate for Payer: Scott and White EPO/PPO |
$23.22
|
| Rate for Payer: Scott and White Medicare |
$1,298.62
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$602.44
|
| Rate for Payer: Superior Health Plan EPO |
$1,298.62
|
| Rate for Payer: Superior Health Plan Medicare |
$1,298.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,298.62
|
| Rate for Payer: Universal American Medicare |
$1,298.62
|
| Rate for Payer: Wellcare Medicare |
$1,298.62
|
| Rate for Payer: Wellmed Medicare |
$1,298.62
|
|
|
NM Ureteral Reflux Study
|
Facility
|
OP
|
$1,787.00
|
|
|
Service Code
|
CPT 78740
|
| Hospital Charge Code |
3400132
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$1,161.55 |
| Rate for Payer: Aetna Commercial |
$207.69
|
| Rate for Payer: Aetna Medicare |
$565.80
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$203.83
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Amerigroup Medicare |
$377.20
|
| Rate for Payer: BCBS of TX Blue Advantage |
$327.66
|
| Rate for Payer: BCBS of TX Blue Essentials |
$393.19
|
| Rate for Payer: BCBS of TX Medicare |
$377.20
|
| Rate for Payer: BCBS of TX PPO |
$438.86
|
| Rate for Payer: Cash Price |
$1,572.56
|
| Rate for Payer: Cash Price |
$1,572.56
|
| Rate for Payer: Cash Price |
$1,572.56
|
| Rate for Payer: Cigna Commercial |
$854.47
|
| Rate for Payer: Cigna Medicaid |
$203.83
|
| Rate for Payer: Cigna Medicare |
$377.20
|
| Rate for Payer: Employer Direct Commercial |
$377.20
|
| Rate for Payer: Humana Medicare/TRICARE |
$377.20
|
| Rate for Payer: Molina CHIP/Medicaid |
$203.83
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Molina Medicare |
$377.20
|
| Rate for Payer: Multiplan Auto |
$1,161.55
|
| Rate for Payer: Multiplan Commercial |
$1,161.55
|
| Rate for Payer: Multiplan Workers Comp |
$1,161.55
|
| Rate for Payer: Parkland Medicaid |
$203.83
|
| Rate for Payer: Scott and White EPO/PPO |
$6.75
|
| Rate for Payer: Scott and White Medicare |
$377.20
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$203.83
|
| Rate for Payer: Superior Health Plan EPO |
$377.20
|
| Rate for Payer: Superior Health Plan Medicare |
$377.20
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Universal American Medicare |
$377.20
|
| Rate for Payer: Wellcare Medicare |
$377.20
|
| Rate for Payer: Wellmed Medicare |
$377.20
|
|
|
NM Ureteral Reflux Study BCE
|
Facility
|
OP
|
$1,787.00
|
|
|
Service Code
|
CPT 78740
|
| Hospital Charge Code |
3400132
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$1,161.55 |
| Rate for Payer: Aetna Commercial |
$207.69
|
| Rate for Payer: Aetna Medicare |
$565.80
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$203.83
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Amerigroup Medicare |
$377.20
|
| Rate for Payer: BCBS of TX Blue Advantage |
$327.66
|
| Rate for Payer: BCBS of TX Blue Essentials |
$393.19
|
| Rate for Payer: BCBS of TX Medicare |
$377.20
|
| Rate for Payer: BCBS of TX PPO |
$438.86
|
| Rate for Payer: Cash Price |
$1,572.56
|
| Rate for Payer: Cash Price |
$1,572.56
|
| Rate for Payer: Cash Price |
$1,572.56
|
| Rate for Payer: Cigna Commercial |
$854.47
|
| Rate for Payer: Cigna Medicaid |
$203.83
|
| Rate for Payer: Cigna Medicare |
$377.20
|
| Rate for Payer: Employer Direct Commercial |
$377.20
|
| Rate for Payer: Humana Medicare/TRICARE |
$377.20
|
| Rate for Payer: Molina CHIP/Medicaid |
$203.83
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Molina Medicare |
$377.20
|
| Rate for Payer: Multiplan Auto |
$1,161.55
|
| Rate for Payer: Multiplan Commercial |
$1,161.55
|
| Rate for Payer: Multiplan Workers Comp |
$1,161.55
|
| Rate for Payer: Parkland Medicaid |
$203.83
|
| Rate for Payer: Scott and White EPO/PPO |
$6.75
|
| Rate for Payer: Scott and White Medicare |
$377.20
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$203.83
|
| Rate for Payer: Superior Health Plan EPO |
$377.20
|
| Rate for Payer: Superior Health Plan Medicare |
$377.20
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$377.20
|
| Rate for Payer: Universal American Medicare |
$377.20
|
| Rate for Payer: Wellcare Medicare |
$377.20
|
| Rate for Payer: Wellmed Medicare |
$377.20
|
|
|
NM Ureteral Reflux Study BCE
|
Facility
|
IP
|
$1,787.00
|
|
|
Service Code
|
CPT 78740
|
| Hospital Charge Code |
3400132
|
|
Hospital Revenue Code
|
341
|
| Rate for Payer: Cash Price |
$1,572.56
|
|
|
.Nocardia Susceptibility Broth 18285 SO
|
Facility
|
OP
|
$251.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
1604610
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.37 |
| Max. Negotiated Rate |
$163.15 |
| Rate for Payer: Aetna Commercial |
$9.08
|
| Rate for Payer: Aetna Medicare |
$12.98
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3.37
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$8.65
|
| Rate for Payer: Amerigroup Medicare |
$8.65
|
| Rate for Payer: BCBS of TX Blue Advantage |
$14.27
|
| Rate for Payer: BCBS of TX Blue Essentials |
$17.13
|
| Rate for Payer: BCBS of TX Medicare |
$8.65
|
| Rate for Payer: BCBS of TX PPO |
$19.12
|
| Rate for Payer: Cash Price |
$220.88
|
| Rate for Payer: Cash Price |
$220.88
|
| Rate for Payer: Cigna Medicaid |
$8.65
|
| Rate for Payer: Cigna Medicare |
$8.65
|
| Rate for Payer: Employer Direct Commercial |
$8.65
|
| Rate for Payer: Humana Medicare/TRICARE |
$8.65
|
| Rate for Payer: Molina CHIP/Medicaid |
$8.65
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$8.65
|
| Rate for Payer: Molina Medicare |
$8.65
|
| Rate for Payer: Multiplan Auto |
$163.15
|
| Rate for Payer: Multiplan Commercial |
$163.15
|
| Rate for Payer: Multiplan Workers Comp |
$163.15
|
| Rate for Payer: Parkland Medicaid |
$8.65
|
| Rate for Payer: Scott and White EPO/PPO |
$10.81
|
| Rate for Payer: Scott and White Medicare |
$8.65
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$8.65
|
| Rate for Payer: Superior Health Plan EPO |
$8.65
|
| Rate for Payer: Superior Health Plan Medicare |
$8.65
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$8.65
|
| Rate for Payer: Universal American Medicare |
$8.65
|
| Rate for Payer: Wellcare Medicare |
$8.65
|
| Rate for Payer: Wellmed Medicare |
$8.65
|
|
|
NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC
|
Facility
|
IP
|
$40,935.50
|
|
|
Service Code
|
MSDRG 098
|
| Min. Negotiated Rate |
$15,600.40 |
| Max. Negotiated Rate |
$40,935.50 |
| Rate for Payer: Aetna Commercial |
$24,238.12
|
| Rate for Payer: Aetna Medicare |
$27,344.14
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$18,229.43
|
| Rate for Payer: Amerigroup Medicare |
$18,229.43
|
| Rate for Payer: BCBS of TX Blue Advantage |
$15,600.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$19,095.31
|
| Rate for Payer: BCBS of TX Medicare |
$18,229.43
|
| Rate for Payer: BCBS of TX PPO |
$21,217.83
|
| Rate for Payer: Cigna Commercial |
$27,749.96
|
| Rate for Payer: Cigna Medicare |
$18,229.43
|
| Rate for Payer: Employer Direct Commercial |
$18,229.43
|
| Rate for Payer: Humana Medicare/TRICARE |
$18,229.43
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$18,229.43
|
| Rate for Payer: Molina Medicare |
$18,229.43
|
| Rate for Payer: Multiplan Auto |
$40,935.50
|
| Rate for Payer: Multiplan Commercial |
$40,935.50
|
| Rate for Payer: Multiplan Workers Comp |
$40,935.50
|
| Rate for Payer: Scott and White EPO/PPO |
$18,851.88
|
| Rate for Payer: Scott and White Medicare |
$18,229.43
|
| Rate for Payer: Superior Health Plan EPO |
$18,229.43
|
| Rate for Payer: Superior Health Plan Medicare |
$18,229.43
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$18,229.43
|
| Rate for Payer: Universal American Medicare |
$18,229.43
|
| Rate for Payer: Wellcare Medicare |
$18,229.43
|
| Rate for Payer: Wellmed Medicare |
$18,229.43
|
|
|
NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC
|
Facility
|
IP
|
$69,101.10
|
|
|
Service Code
|
MSDRG 097
|
| Min. Negotiated Rate |
$26,693.54 |
| Max. Negotiated Rate |
$69,101.10 |
| Rate for Payer: Aetna Commercial |
$40,915.12
|
| Rate for Payer: Aetna Medicare |
$43,211.88
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$28,807.92
|
| Rate for Payer: Amerigroup Medicare |
$28,807.92
|
| Rate for Payer: BCBS of TX Blue Advantage |
$26,693.54
|
| Rate for Payer: BCBS of TX Blue Essentials |
$36,517.91
|
| Rate for Payer: BCBS of TX Medicare |
$28,807.92
|
| Rate for Payer: BCBS of TX PPO |
$40,577.03
|
| Rate for Payer: Cigna Commercial |
$46,843.27
|
| Rate for Payer: Cigna Medicare |
$28,807.92
|
| Rate for Payer: Employer Direct Commercial |
$28,807.92
|
| Rate for Payer: Humana Medicare/TRICARE |
$28,807.92
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$28,807.92
|
| Rate for Payer: Molina Medicare |
$28,807.92
|
| Rate for Payer: Multiplan Auto |
$69,101.10
|
| Rate for Payer: Multiplan Commercial |
$69,101.10
|
| Rate for Payer: Multiplan Workers Comp |
$69,101.10
|
| Rate for Payer: Scott and White EPO/PPO |
$31,822.88
|
| Rate for Payer: Scott and White Medicare |
$28,807.92
|
| Rate for Payer: Superior Health Plan EPO |
$28,807.92
|
| Rate for Payer: Superior Health Plan Medicare |
$28,807.92
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$28,807.92
|
| Rate for Payer: Universal American Medicare |
$28,807.92
|
| Rate for Payer: Wellcare Medicare |
$28,807.92
|
| Rate for Payer: Wellmed Medicare |
$28,807.92
|
|
|
NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$25,083.80
|
|
|
Service Code
|
MSDRG 099
|
| Min. Negotiated Rate |
$10,977.90 |
| Max. Negotiated Rate |
$25,083.80 |
| Rate for Payer: Aetna Commercial |
$14,852.25
|
| Rate for Payer: Aetna Medicare |
$18,413.72
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,275.81
|
| Rate for Payer: Amerigroup Medicare |
$12,275.81
|
| Rate for Payer: BCBS of TX Blue Advantage |
$10,977.90
|
| Rate for Payer: BCBS of TX Blue Essentials |
$13,135.06
|
| Rate for Payer: BCBS of TX Medicare |
$12,275.81
|
| Rate for Payer: BCBS of TX PPO |
$14,595.07
|
| Rate for Payer: Cigna Commercial |
$17,004.18
|
| Rate for Payer: Cigna Medicare |
$12,275.81
|
| Rate for Payer: Employer Direct Commercial |
$12,275.81
|
| Rate for Payer: Humana Medicare/TRICARE |
$12,275.81
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$12,275.81
|
| Rate for Payer: Molina Medicare |
$12,275.81
|
| Rate for Payer: Multiplan Auto |
$25,083.80
|
| Rate for Payer: Multiplan Commercial |
$25,083.80
|
| Rate for Payer: Multiplan Workers Comp |
$25,083.80
|
| Rate for Payer: Scott and White EPO/PPO |
$11,551.75
|
| Rate for Payer: Scott and White Medicare |
$12,275.81
|
| Rate for Payer: Superior Health Plan EPO |
$12,275.81
|
| Rate for Payer: Superior Health Plan Medicare |
$12,275.81
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$12,275.81
|
| Rate for Payer: Universal American Medicare |
$12,275.81
|
| Rate for Payer: Wellcare Medicare |
$12,275.81
|
| Rate for Payer: Wellmed Medicare |
$12,275.81
|
|
|
NON-EXTENSIVE BURNS
|
Facility
|
IP
|
$38,780.90
|
|
|
Service Code
|
MSDRG 935
|
| Min. Negotiated Rate |
$14,306.10 |
| Max. Negotiated Rate |
$38,780.90 |
| Rate for Payer: Aetna Commercial |
$22,962.38
|
| Rate for Payer: Aetna Medicare |
$26,130.28
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$17,420.19
|
| Rate for Payer: Amerigroup Medicare |
$17,420.19
|
| Rate for Payer: BCBS of TX Blue Advantage |
$14,306.10
|
| Rate for Payer: BCBS of TX Blue Essentials |
$18,798.12
|
| Rate for Payer: BCBS of TX Medicare |
$17,420.19
|
| Rate for Payer: BCBS of TX PPO |
$20,887.61
|
| Rate for Payer: Cigna Commercial |
$26,289.37
|
| Rate for Payer: Cigna Medicare |
$17,420.19
|
| Rate for Payer: Employer Direct Commercial |
$17,420.19
|
| Rate for Payer: Humana Medicare/TRICARE |
$17,420.19
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$17,420.19
|
| Rate for Payer: Molina Medicare |
$17,420.19
|
| Rate for Payer: Multiplan Auto |
$38,780.90
|
| Rate for Payer: Multiplan Commercial |
$38,780.90
|
| Rate for Payer: Multiplan Workers Comp |
$38,780.90
|
| Rate for Payer: Scott and White EPO/PPO |
$17,859.62
|
| Rate for Payer: Scott and White Medicare |
$17,420.19
|
| Rate for Payer: Superior Health Plan EPO |
$17,420.19
|
| Rate for Payer: Superior Health Plan Medicare |
$17,420.19
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$17,420.19
|
| Rate for Payer: Universal American Medicare |
$17,420.19
|
| Rate for Payer: Wellcare Medicare |
$17,420.19
|
| Rate for Payer: Wellmed Medicare |
$17,420.19
|
|
|
NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC
|
Facility
|
IP
|
$32,243.00
|
|
|
Service Code
|
MSDRG 988
|
| Min. Negotiated Rate |
$14,767.06 |
| Max. Negotiated Rate |
$32,243.00 |
| Rate for Payer: Aetna Commercial |
$19,091.25
|
| Rate for Payer: Aetna Medicare |
$22,447.02
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$14,964.68
|
| Rate for Payer: Amerigroup Medicare |
$14,964.68
|
| Rate for Payer: BCBS of TX Blue Advantage |
$14,767.06
|
| Rate for Payer: BCBS of TX Blue Essentials |
$17,471.10
|
| Rate for Payer: BCBS of TX Medicare |
$14,964.68
|
| Rate for Payer: BCBS of TX PPO |
$19,413.08
|
| Rate for Payer: Cigna Commercial |
$21,857.36
|
| Rate for Payer: Cigna Medicare |
$14,964.68
|
| Rate for Payer: Employer Direct Commercial |
$14,964.68
|
| Rate for Payer: Humana Medicare/TRICARE |
$14,964.68
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$14,964.68
|
| Rate for Payer: Molina Medicare |
$14,964.68
|
| Rate for Payer: Multiplan Auto |
$32,243.00
|
| Rate for Payer: Multiplan Commercial |
$32,243.00
|
| Rate for Payer: Multiplan Workers Comp |
$32,243.00
|
| Rate for Payer: Scott and White EPO/PPO |
$14,848.75
|
| Rate for Payer: Scott and White Medicare |
$14,964.68
|
| Rate for Payer: Superior Health Plan EPO |
$14,964.68
|
| Rate for Payer: Superior Health Plan Medicare |
$14,964.68
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$14,964.68
|
| Rate for Payer: Universal American Medicare |
$14,964.68
|
| Rate for Payer: Wellcare Medicare |
$14,964.68
|
| Rate for Payer: Wellmed Medicare |
$14,964.68
|
|
