|
Ostectomy, calcaneus
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 28118
|
| Hospital Charge Code |
36028118
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$65.29 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$4,440.36
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Amerigroup Medicare |
$2,960.24
|
| 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 |
$2,960.24
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,705.80
|
| Rate for Payer: Cigna Medicaid |
$1,088.27
|
| Rate for Payer: Cigna Medicare |
$2,960.24
|
| Rate for Payer: Employer Direct Commercial |
$2,960.24
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,960.24
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Molina Medicare |
$2,960.24
|
| 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 |
$1,088.27
|
| Rate for Payer: Scott and White EPO/PPO |
$65.29
|
| Rate for Payer: Scott and White Medicare |
$2,960.24
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Superior Health Plan EPO |
$2,960.24
|
| Rate for Payer: Superior Health Plan Medicare |
$2,960.24
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Universal American Medicare |
$2,960.24
|
| Rate for Payer: Wellcare Medicare |
$2,960.24
|
| Rate for Payer: Wellmed Medicare |
$2,960.24
|
|
|
Ostectomy, calcaneus for spur, with or without plantar fascial release
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 28119
|
| Hospital Charge Code |
36028119
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$65.29 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$4,440.36
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Amerigroup Medicare |
$2,960.24
|
| 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 |
$2,960.24
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,705.80
|
| Rate for Payer: Cigna Medicaid |
$1,088.27
|
| Rate for Payer: Cigna Medicare |
$2,960.24
|
| Rate for Payer: Employer Direct Commercial |
$2,960.24
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,960.24
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Molina Medicare |
$2,960.24
|
| 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 |
$1,088.27
|
| Rate for Payer: Scott and White EPO/PPO |
$65.29
|
| Rate for Payer: Scott and White Medicare |
$2,960.24
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Superior Health Plan EPO |
$2,960.24
|
| Rate for Payer: Superior Health Plan Medicare |
$2,960.24
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Universal American Medicare |
$2,960.24
|
| Rate for Payer: Wellcare Medicare |
$2,960.24
|
| Rate for Payer: Wellmed Medicare |
$2,960.24
|
|
|
Ostectomy, complete excision; fifth metatarsal head
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 28113
|
| Hospital Charge Code |
36028113
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$65.29 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$4,440.36
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Amerigroup Medicare |
$2,960.24
|
| 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 |
$2,960.24
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,705.80
|
| Rate for Payer: Cigna Medicaid |
$1,088.27
|
| Rate for Payer: Cigna Medicare |
$2,960.24
|
| Rate for Payer: Employer Direct Commercial |
$2,960.24
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,960.24
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Molina Medicare |
$2,960.24
|
| 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 |
$1,088.27
|
| Rate for Payer: Scott and White EPO/PPO |
$65.29
|
| Rate for Payer: Scott and White Medicare |
$2,960.24
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Superior Health Plan EPO |
$2,960.24
|
| Rate for Payer: Superior Health Plan Medicare |
$2,960.24
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Universal American Medicare |
$2,960.24
|
| Rate for Payer: Wellcare Medicare |
$2,960.24
|
| Rate for Payer: Wellmed Medicare |
$2,960.24
|
|
|
Ostectomy, complete excision first metatarsal head
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 28111
|
| Hospital Charge Code |
36028111
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$65.29 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$4,440.36
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Amerigroup Medicare |
$2,960.24
|
| 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 |
$2,960.24
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,705.80
|
| Rate for Payer: Cigna Medicaid |
$1,088.27
|
| Rate for Payer: Cigna Medicare |
$2,960.24
|
| Rate for Payer: Employer Direct Commercial |
$2,960.24
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,960.24
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Molina Medicare |
$2,960.24
|
| 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 |
$1,088.27
|
| Rate for Payer: Scott and White EPO/PPO |
$65.29
|
| Rate for Payer: Scott and White Medicare |
$2,960.24
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Superior Health Plan EPO |
$2,960.24
|
| Rate for Payer: Superior Health Plan Medicare |
$2,960.24
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Universal American Medicare |
$2,960.24
|
| Rate for Payer: Wellcare Medicare |
$2,960.24
|
| Rate for Payer: Wellmed Medicare |
$2,960.24
|
|
|
Ostectomy, complete excision; other metatarsal head (second, third or fourth)
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 28112
|
| Hospital Charge Code |
36028112
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$65.29 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$4,440.36
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Amerigroup Medicare |
$2,960.24
|
| 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 |
$2,960.24
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,705.80
|
| Rate for Payer: Cigna Medicaid |
$1,088.27
|
| Rate for Payer: Cigna Medicare |
$2,960.24
|
| Rate for Payer: Employer Direct Commercial |
$2,960.24
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,960.24
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Molina Medicare |
$2,960.24
|
| 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 |
$1,088.27
|
| Rate for Payer: Scott and White EPO/PPO |
$65.29
|
| Rate for Payer: Scott and White Medicare |
$2,960.24
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Superior Health Plan EPO |
$2,960.24
|
| Rate for Payer: Superior Health Plan Medicare |
$2,960.24
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Universal American Medicare |
$2,960.24
|
| Rate for Payer: Wellcare Medicare |
$2,960.24
|
| Rate for Payer: Wellmed Medicare |
$2,960.24
|
|
|
Ostectomy, excision of tarsal coalition
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 28116
|
| Hospital Charge Code |
36028116
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$65.29 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$4,440.36
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Amerigroup Medicare |
$2,960.24
|
| 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 |
$2,960.24
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,705.80
|
| Rate for Payer: Cigna Medicaid |
$1,088.27
|
| Rate for Payer: Cigna Medicare |
$2,960.24
|
| Rate for Payer: Employer Direct Commercial |
$2,960.24
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,960.24
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Molina Medicare |
$2,960.24
|
| 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 |
$1,088.27
|
| Rate for Payer: Scott and White EPO/PPO |
$65.29
|
| Rate for Payer: Scott and White Medicare |
$2,960.24
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Superior Health Plan EPO |
$2,960.24
|
| Rate for Payer: Superior Health Plan Medicare |
$2,960.24
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Universal American Medicare |
$2,960.24
|
| Rate for Payer: Wellcare Medicare |
$2,960.24
|
| Rate for Payer: Wellmed Medicare |
$2,960.24
|
|
|
Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure)
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 28110
|
| Hospital Charge Code |
36028110
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$65.29 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$4,440.36
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Amerigroup Medicare |
$2,960.24
|
| 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 |
$2,960.24
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,705.80
|
| Rate for Payer: Cigna Medicaid |
$1,088.27
|
| Rate for Payer: Cigna Medicare |
$2,960.24
|
| Rate for Payer: Employer Direct Commercial |
$2,960.24
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,960.24
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Molina Medicare |
$2,960.24
|
| 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 |
$1,088.27
|
| Rate for Payer: Scott and White EPO/PPO |
$65.29
|
| Rate for Payer: Scott and White Medicare |
$2,960.24
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Superior Health Plan EPO |
$2,960.24
|
| Rate for Payer: Superior Health Plan Medicare |
$2,960.24
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Universal American Medicare |
$2,960.24
|
| Rate for Payer: Wellcare Medicare |
$2,960.24
|
| Rate for Payer: Wellmed Medicare |
$2,960.24
|
|
|
Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 28288
|
| Hospital Charge Code |
36028288
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$65.29 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$4,440.36
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Amerigroup Medicare |
$2,960.24
|
| 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 |
$2,960.24
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,705.80
|
| Rate for Payer: Cigna Medicaid |
$1,088.27
|
| Rate for Payer: Cigna Medicare |
$2,960.24
|
| Rate for Payer: Employer Direct Commercial |
$2,960.24
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,960.24
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Molina Medicare |
$2,960.24
|
| 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 |
$1,088.27
|
| Rate for Payer: Scott and White EPO/PPO |
$65.29
|
| Rate for Payer: Scott and White Medicare |
$2,960.24
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Superior Health Plan EPO |
$2,960.24
|
| Rate for Payer: Superior Health Plan Medicare |
$2,960.24
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Universal American Medicare |
$2,960.24
|
| Rate for Payer: Wellcare Medicare |
$2,960.24
|
| Rate for Payer: Wellmed Medicare |
$2,960.24
|
|
|
Osteochondral allograft, knee, open
|
Facility
|
OP
|
$29,989.79
|
|
|
Service Code
|
CPT 27415
|
| Hospital Charge Code |
36027415
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$265.49 |
| Max. Negotiated Rate |
$29,989.79 |
| Rate for Payer: Aetna Commercial |
$7,210.00
|
| Rate for Payer: Aetna Medicare |
$18,054.70
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$8,311.46
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Amerigroup Medicare |
$12,036.47
|
| Rate for Payer: BCBS of TX Blue Advantage |
$19,874.19
|
| Rate for Payer: BCBS of TX Blue Essentials |
$23,801.42
|
| Rate for Payer: BCBS of TX Medicare |
$12,036.47
|
| Rate for Payer: BCBS of TX PPO |
$29,989.79
|
| Rate for Payer: Cigna Commercial |
$27,266.10
|
| Rate for Payer: Cigna Medicaid |
$8,311.46
|
| Rate for Payer: Cigna Medicare |
$12,036.47
|
| Rate for Payer: Employer Direct Commercial |
$12,036.47
|
| Rate for Payer: Humana Medicare/TRICARE |
$12,036.47
|
| Rate for Payer: Molina CHIP/Medicaid |
$8,311.46
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Molina Medicare |
$12,036.47
|
| 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 |
$8,311.46
|
| Rate for Payer: Scott and White EPO/PPO |
$265.49
|
| Rate for Payer: Scott and White Medicare |
$12,036.47
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$8,311.46
|
| Rate for Payer: Superior Health Plan EPO |
$12,036.47
|
| Rate for Payer: Superior Health Plan Medicare |
$12,036.47
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Universal American Medicare |
$12,036.47
|
| Rate for Payer: Wellcare Medicare |
$12,036.47
|
| Rate for Payer: Wellmed Medicare |
$12,036.47
|
|
|
OSTEOMYELITIS WITH CC
|
Facility
|
IP
|
$24,665.80
|
|
|
Service Code
|
MSDRG 540
|
| Min. Negotiated Rate |
$11,302.12 |
| Max. Negotiated Rate |
$24,665.80 |
| Rate for Payer: Aetna Commercial |
$14,604.75
|
| Rate for Payer: Aetna Medicare |
$18,178.23
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,118.82
|
| Rate for Payer: Amerigroup Medicare |
$12,118.82
|
| Rate for Payer: BCBS of TX Blue Advantage |
$11,302.12
|
| Rate for Payer: BCBS of TX Blue Essentials |
$13,382.71
|
| Rate for Payer: BCBS of TX Medicare |
$12,118.82
|
| Rate for Payer: BCBS of TX PPO |
$14,870.26
|
| Rate for Payer: Cigna Commercial |
$16,720.82
|
| Rate for Payer: Cigna Medicare |
$12,118.82
|
| Rate for Payer: Employer Direct Commercial |
$12,118.82
|
| Rate for Payer: Humana Medicare/TRICARE |
$12,118.82
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$12,118.82
|
| Rate for Payer: Molina Medicare |
$12,118.82
|
| Rate for Payer: Multiplan Auto |
$24,665.80
|
| Rate for Payer: Multiplan Commercial |
$24,665.80
|
| Rate for Payer: Multiplan Workers Comp |
$24,665.80
|
| Rate for Payer: Scott and White EPO/PPO |
$11,359.25
|
| Rate for Payer: Scott and White Medicare |
$12,118.82
|
| Rate for Payer: Superior Health Plan EPO |
$12,118.82
|
| Rate for Payer: Superior Health Plan Medicare |
$12,118.82
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$12,118.82
|
| Rate for Payer: Universal American Medicare |
$12,118.82
|
| Rate for Payer: Wellcare Medicare |
$12,118.82
|
| Rate for Payer: Wellmed Medicare |
$12,118.82
|
|
|
OSTEOMYELITIS WITH MCC
|
Facility
|
IP
|
$37,703.60
|
|
|
Service Code
|
MSDRG 539
|
| Min. Negotiated Rate |
$16,671.10 |
| Max. Negotiated Rate |
$37,703.60 |
| Rate for Payer: Aetna Commercial |
$22,324.50
|
| Rate for Payer: Aetna Medicare |
$25,523.34
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$17,015.56
|
| Rate for Payer: Amerigroup Medicare |
$17,015.56
|
| Rate for Payer: BCBS of TX Blue Advantage |
$16,671.10
|
| Rate for Payer: BCBS of TX Blue Essentials |
$20,836.12
|
| Rate for Payer: BCBS of TX Medicare |
$17,015.56
|
| Rate for Payer: BCBS of TX PPO |
$23,152.15
|
| Rate for Payer: Cigna Commercial |
$25,559.07
|
| Rate for Payer: Cigna Medicare |
$17,015.56
|
| Rate for Payer: Employer Direct Commercial |
$17,015.56
|
| Rate for Payer: Humana Medicare/TRICARE |
$17,015.56
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$17,015.56
|
| Rate for Payer: Molina Medicare |
$17,015.56
|
| Rate for Payer: Multiplan Auto |
$37,703.60
|
| Rate for Payer: Multiplan Commercial |
$37,703.60
|
| Rate for Payer: Multiplan Workers Comp |
$37,703.60
|
| Rate for Payer: Scott and White EPO/PPO |
$17,363.50
|
| Rate for Payer: Scott and White Medicare |
$17,015.56
|
| Rate for Payer: Superior Health Plan EPO |
$17,015.56
|
| Rate for Payer: Superior Health Plan Medicare |
$17,015.56
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$17,015.56
|
| Rate for Payer: Universal American Medicare |
$17,015.56
|
| Rate for Payer: Wellcare Medicare |
$17,015.56
|
| Rate for Payer: Wellmed Medicare |
$17,015.56
|
|
|
OSTEOMYELITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$16,300.10
|
|
|
Service Code
|
MSDRG 541
|
| Min. Negotiated Rate |
$7,506.62 |
| Max. Negotiated Rate |
$16,300.10 |
| Rate for Payer: Aetna Commercial |
$9,651.38
|
| Rate for Payer: Aetna Medicare |
$13,465.22
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$8,976.81
|
| Rate for Payer: Amerigroup Medicare |
$8,976.81
|
| Rate for Payer: BCBS of TX Blue Advantage |
$8,285.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$9,108.58
|
| Rate for Payer: BCBS of TX Medicare |
$8,976.81
|
| Rate for Payer: BCBS of TX PPO |
$10,121.04
|
| Rate for Payer: Cigna Commercial |
$11,049.75
|
| Rate for Payer: Cigna Medicare |
$8,976.81
|
| Rate for Payer: Employer Direct Commercial |
$8,976.81
|
| Rate for Payer: Humana Medicare/TRICARE |
$8,976.81
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$8,976.81
|
| Rate for Payer: Molina Medicare |
$8,976.81
|
| Rate for Payer: Multiplan Auto |
$16,300.10
|
| Rate for Payer: Multiplan Commercial |
$16,300.10
|
| Rate for Payer: Multiplan Workers Comp |
$16,300.10
|
| Rate for Payer: Scott and White EPO/PPO |
$7,506.62
|
| Rate for Payer: Scott and White Medicare |
$8,976.81
|
| Rate for Payer: Superior Health Plan EPO |
$8,976.81
|
| Rate for Payer: Superior Health Plan Medicare |
$8,976.81
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$8,976.81
|
| Rate for Payer: Universal American Medicare |
$8,976.81
|
| Rate for Payer: Wellcare Medicare |
$8,976.81
|
| Rate for Payer: Wellmed Medicare |
$8,976.81
|
|
|
OSTEOSPARX 10CC BONE PUTTY
|
Facility
|
IP
|
$6,159.04
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8394480
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,539.76 |
| Max. Negotiated Rate |
$3,079.52 |
| Rate for Payer: Aetna Commercial |
$1,847.71
|
| Rate for Payer: Cash Price |
$5,419.96
|
| Rate for Payer: Cigna Commercial |
$1,539.76
|
| Rate for Payer: Multiplan Auto |
$3,079.52
|
| Rate for Payer: Multiplan Commercial |
$3,079.52
|
| Rate for Payer: Multiplan Workers Comp |
$3,079.52
|
| Rate for Payer: Scott and White EPO/PPO |
$3,079.52
|
|
|
OSTEOSPARX 10CC BONE PUTTY
|
Facility
|
OP
|
$6,159.04
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8394480
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$554.31 |
| Max. Negotiated Rate |
$3,079.52 |
| Rate for Payer: Aetna Commercial |
$1,847.71
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$554.31
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,847.71
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,217.25
|
| Rate for Payer: BCBS of TX PPO |
$2,463.62
|
| Rate for Payer: Cash Price |
$5,419.96
|
| Rate for Payer: Multiplan Auto |
$3,079.52
|
| Rate for Payer: Multiplan Commercial |
$3,079.52
|
| Rate for Payer: Multiplan Workers Comp |
$3,079.52
|
| Rate for Payer: Scott and White EPO/PPO |
$3,079.52
|
| Rate for Payer: Superior Health Plan EPO |
$837.63
|
|
|
OSTEOSPARX CANCELLOUS CRUSH 30CC
|
Facility
|
IP
|
$2,342.17
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
130361
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$585.54 |
| Max. Negotiated Rate |
$1,171.08 |
| Rate for Payer: Aetna Commercial |
$702.65
|
| Rate for Payer: Cash Price |
$2,061.11
|
| Rate for Payer: Cigna Commercial |
$585.54
|
| Rate for Payer: Multiplan Auto |
$1,171.08
|
| Rate for Payer: Multiplan Commercial |
$1,171.08
|
| Rate for Payer: Multiplan Workers Comp |
$1,171.08
|
| Rate for Payer: Scott and White EPO/PPO |
$1,171.08
|
|
|
OSTEOSPARX CANCELLOUS CRUSH 30CC
|
Facility
|
OP
|
$2,342.17
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
130361
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$210.80 |
| Max. Negotiated Rate |
$1,171.08 |
| Rate for Payer: Aetna Commercial |
$702.65
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$210.80
|
| Rate for Payer: BCBS of TX Blue Advantage |
$702.65
|
| Rate for Payer: BCBS of TX Blue Essentials |
$843.18
|
| Rate for Payer: BCBS of TX PPO |
$936.87
|
| Rate for Payer: Cash Price |
$2,061.11
|
| Rate for Payer: Multiplan Auto |
$1,171.08
|
| Rate for Payer: Multiplan Commercial |
$1,171.08
|
| Rate for Payer: Multiplan Workers Comp |
$1,171.08
|
| Rate for Payer: Scott and White EPO/PPO |
$1,171.08
|
| Rate for Payer: Superior Health Plan EPO |
$318.54
|
|
|
Osteotomy; calcaneus (eg, Dwyer or Chambers type procedure), with or without internal fixation
|
Facility
|
OP
|
$15,074.51
|
|
|
Service Code
|
CPT 28300
|
| Hospital Charge Code |
36028300
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$144.31 |
| Max. Negotiated Rate |
$15,074.51 |
| Rate for Payer: Aetna Commercial |
$7,210.00
|
| Rate for Payer: Aetna Medicare |
$9,814.08
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,382.73
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Amerigroup Medicare |
$6,542.72
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,989.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,963.90
|
| Rate for Payer: BCBS of TX Medicare |
$6,542.72
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cigna Commercial |
$14,821.16
|
| Rate for Payer: Cigna Medicaid |
$3,382.73
|
| Rate for Payer: Cigna Medicare |
$6,542.72
|
| Rate for Payer: Employer Direct Commercial |
$6,542.72
|
| Rate for Payer: Humana Medicare/TRICARE |
$6,542.72
|
| Rate for Payer: Molina CHIP/Medicaid |
$3,382.73
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Molina Medicare |
$6,542.72
|
| 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 |
$3,382.73
|
| Rate for Payer: Scott and White EPO/PPO |
$144.31
|
| Rate for Payer: Scott and White Medicare |
$6,542.72
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$3,382.73
|
| Rate for Payer: Superior Health Plan EPO |
$6,542.72
|
| Rate for Payer: Superior Health Plan Medicare |
$6,542.72
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Universal American Medicare |
$6,542.72
|
| Rate for Payer: Wellcare Medicare |
$6,542.72
|
| Rate for Payer: Wellmed Medicare |
$6,542.72
|
|
|
Osteotomy, clavicle, with or without internal fixation; with bone graft for nonunion or malunion (in
|
Facility
|
OP
|
$29,989.79
|
|
|
Service Code
|
CPT 23485
|
| Hospital Charge Code |
36023485
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$265.49 |
| Max. Negotiated Rate |
$29,989.79 |
| Rate for Payer: Aetna Commercial |
$7,210.00
|
| Rate for Payer: Aetna Medicare |
$18,054.70
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$6,757.06
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Amerigroup Medicare |
$12,036.47
|
| Rate for Payer: BCBS of TX Blue Advantage |
$19,874.19
|
| Rate for Payer: BCBS of TX Blue Essentials |
$23,801.42
|
| Rate for Payer: BCBS of TX Medicare |
$12,036.47
|
| Rate for Payer: BCBS of TX PPO |
$29,989.79
|
| Rate for Payer: Cigna Commercial |
$27,266.10
|
| Rate for Payer: Cigna Medicaid |
$6,757.06
|
| Rate for Payer: Cigna Medicare |
$12,036.47
|
| Rate for Payer: Employer Direct Commercial |
$12,036.47
|
| Rate for Payer: Humana Medicare/TRICARE |
$12,036.47
|
| Rate for Payer: Molina CHIP/Medicaid |
$6,757.06
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Molina Medicare |
$12,036.47
|
| 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 |
$6,757.06
|
| Rate for Payer: Scott and White EPO/PPO |
$265.49
|
| Rate for Payer: Scott and White Medicare |
$12,036.47
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$6,757.06
|
| Rate for Payer: Superior Health Plan EPO |
$12,036.47
|
| Rate for Payer: Superior Health Plan Medicare |
$12,036.47
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Universal American Medicare |
$12,036.47
|
| Rate for Payer: Wellcare Medicare |
$12,036.47
|
| Rate for Payer: Wellmed Medicare |
$12,036.47
|
|
|
Osteotomy, femur, shaft or supracondylar; with fixation
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 27450
|
| Hospital Charge Code |
36027450
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,763.44 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$7,210.00
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,763.44
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,111.90
|
| Rate for Payer: BCBS of TX PPO |
$2,660.99
|
| 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
|
|
|
Osteotomy, iliac, acetabular or innominate bone
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 27146
|
| Hospital Charge Code |
36027146
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,217.23 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$7,210.00
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,217.23
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,655.36
|
| Rate for Payer: BCBS of TX PPO |
$3,345.75
|
| 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
|
|
|
Osteotomy radius AND ulna
|
Facility
|
OP
|
$29,989.79
|
|
|
Service Code
|
CPT 25365
|
| Hospital Charge Code |
36025365
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$265.49 |
| Max. Negotiated Rate |
$29,989.79 |
| Rate for Payer: Aetna Commercial |
$6,077.00
|
| Rate for Payer: Aetna Medicare |
$18,054.70
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$4,811.02
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Amerigroup Medicare |
$12,036.47
|
| Rate for Payer: BCBS of TX Blue Advantage |
$19,874.19
|
| Rate for Payer: BCBS of TX Blue Essentials |
$23,801.42
|
| Rate for Payer: BCBS of TX Medicare |
$12,036.47
|
| Rate for Payer: BCBS of TX PPO |
$29,989.79
|
| Rate for Payer: Cigna Commercial |
$27,266.10
|
| Rate for Payer: Cigna Medicaid |
$4,811.02
|
| Rate for Payer: Cigna Medicare |
$12,036.47
|
| Rate for Payer: Employer Direct Commercial |
$12,036.47
|
| Rate for Payer: Humana Medicare/TRICARE |
$12,036.47
|
| Rate for Payer: Molina CHIP/Medicaid |
$4,811.02
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Molina Medicare |
$12,036.47
|
| 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 |
$4,811.02
|
| Rate for Payer: Scott and White EPO/PPO |
$265.49
|
| Rate for Payer: Scott and White Medicare |
$12,036.47
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$4,811.02
|
| Rate for Payer: Superior Health Plan EPO |
$12,036.47
|
| Rate for Payer: Superior Health Plan Medicare |
$12,036.47
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$12,036.47
|
| Rate for Payer: Universal American Medicare |
$12,036.47
|
| Rate for Payer: Wellcare Medicare |
$12,036.47
|
| Rate for Payer: Wellmed Medicare |
$12,036.47
|
|
|
Osteotomy, radius; distal third
|
Facility
|
OP
|
$15,074.51
|
|
|
Service Code
|
CPT 25350
|
| Hospital Charge Code |
36025350
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$144.31 |
| Max. Negotiated Rate |
$15,074.51 |
| Rate for Payer: Aetna Commercial |
$6,077.00
|
| Rate for Payer: Aetna Medicare |
$9,814.08
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,385.99
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Amerigroup Medicare |
$6,542.72
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,989.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,963.90
|
| Rate for Payer: BCBS of TX Medicare |
$6,542.72
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cigna Commercial |
$14,821.16
|
| Rate for Payer: Cigna Medicaid |
$3,385.99
|
| Rate for Payer: Cigna Medicare |
$6,542.72
|
| Rate for Payer: Employer Direct Commercial |
$6,542.72
|
| Rate for Payer: Humana Medicare/TRICARE |
$6,542.72
|
| Rate for Payer: Molina CHIP/Medicaid |
$3,385.99
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Molina Medicare |
$6,542.72
|
| 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 |
$3,385.99
|
| Rate for Payer: Scott and White EPO/PPO |
$144.31
|
| Rate for Payer: Scott and White Medicare |
$6,542.72
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$3,385.99
|
| Rate for Payer: Superior Health Plan EPO |
$6,542.72
|
| Rate for Payer: Superior Health Plan Medicare |
$6,542.72
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Universal American Medicare |
$6,542.72
|
| Rate for Payer: Wellcare Medicare |
$6,542.72
|
| Rate for Payer: Wellmed Medicare |
$6,542.72
|
|
|
Osteotomy, shortening, angular or rotational correction proximal phalanx, first toe (separate proce
|
Facility
|
OP
|
$15,074.51
|
|
|
Service Code
|
CPT 28310
|
| Hospital Charge Code |
36028310
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$144.31 |
| Max. Negotiated Rate |
$15,074.51 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$9,814.08
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$2,398.52
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Amerigroup Medicare |
$6,542.72
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,989.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,963.90
|
| Rate for Payer: BCBS of TX Medicare |
$6,542.72
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cigna Commercial |
$14,821.16
|
| Rate for Payer: Cigna Medicaid |
$2,398.52
|
| Rate for Payer: Cigna Medicare |
$6,542.72
|
| Rate for Payer: Employer Direct Commercial |
$6,542.72
|
| Rate for Payer: Humana Medicare/TRICARE |
$6,542.72
|
| Rate for Payer: Molina CHIP/Medicaid |
$2,398.52
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Molina Medicare |
$6,542.72
|
| 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 |
$2,398.52
|
| Rate for Payer: Scott and White EPO/PPO |
$144.31
|
| Rate for Payer: Scott and White Medicare |
$6,542.72
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$2,398.52
|
| Rate for Payer: Superior Health Plan EPO |
$6,542.72
|
| Rate for Payer: Superior Health Plan Medicare |
$6,542.72
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Universal American Medicare |
$6,542.72
|
| Rate for Payer: Wellcare Medicare |
$6,542.72
|
| Rate for Payer: Wellmed Medicare |
$6,542.72
|
|
|
Osteotomy, tarsal bones, other than calcaneus or talus
|
Facility
|
OP
|
$15,074.51
|
|
|
Service Code
|
CPT 28304
|
| Hospital Charge Code |
36028304
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$144.31 |
| Max. Negotiated Rate |
$15,074.51 |
| Rate for Payer: Aetna Commercial |
$7,210.00
|
| Rate for Payer: Aetna Medicare |
$9,814.08
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$2,398.52
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Amerigroup Medicare |
$6,542.72
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,989.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,963.90
|
| Rate for Payer: BCBS of TX Medicare |
$6,542.72
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cigna Commercial |
$14,821.16
|
| Rate for Payer: Cigna Medicaid |
$2,398.52
|
| Rate for Payer: Cigna Medicare |
$6,542.72
|
| Rate for Payer: Employer Direct Commercial |
$6,542.72
|
| Rate for Payer: Humana Medicare/TRICARE |
$6,542.72
|
| Rate for Payer: Molina CHIP/Medicaid |
$2,398.52
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Molina Medicare |
$6,542.72
|
| 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 |
$2,398.52
|
| Rate for Payer: Scott and White EPO/PPO |
$144.31
|
| Rate for Payer: Scott and White Medicare |
$6,542.72
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$2,398.52
|
| Rate for Payer: Superior Health Plan EPO |
$6,542.72
|
| Rate for Payer: Superior Health Plan Medicare |
$6,542.72
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Universal American Medicare |
$6,542.72
|
| Rate for Payer: Wellcare Medicare |
$6,542.72
|
| Rate for Payer: Wellmed Medicare |
$6,542.72
|
|
|
Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatars
|
Facility
|
OP
|
$15,074.51
|
|
|
Service Code
|
CPT 28307
|
| Hospital Charge Code |
36028307
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$144.31 |
| Max. Negotiated Rate |
$15,074.51 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$9,814.08
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$2,398.52
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Amerigroup Medicare |
$6,542.72
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,989.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,963.90
|
| Rate for Payer: BCBS of TX Medicare |
$6,542.72
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cigna Commercial |
$14,821.16
|
| Rate for Payer: Cigna Medicaid |
$2,398.52
|
| Rate for Payer: Cigna Medicare |
$6,542.72
|
| Rate for Payer: Employer Direct Commercial |
$6,542.72
|
| Rate for Payer: Humana Medicare/TRICARE |
$6,542.72
|
| Rate for Payer: Molina CHIP/Medicaid |
$2,398.52
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Molina Medicare |
$6,542.72
|
| 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 |
$2,398.52
|
| Rate for Payer: Scott and White EPO/PPO |
$144.31
|
| Rate for Payer: Scott and White Medicare |
$6,542.72
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$2,398.52
|
| Rate for Payer: Superior Health Plan EPO |
$6,542.72
|
| Rate for Payer: Superior Health Plan Medicare |
$6,542.72
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$6,542.72
|
| Rate for Payer: Universal American Medicare |
$6,542.72
|
| Rate for Payer: Wellcare Medicare |
$6,542.72
|
| Rate for Payer: Wellmed Medicare |
$6,542.72
|
|
