|
OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC
|
Facility
|
IP
|
$70,262.00
|
|
|
Service Code
|
MSDRG 673
|
| Min. Negotiated Rate |
$28,748.08 |
| Max. Negotiated Rate |
$70,262.00 |
| Rate for Payer: Aetna Commercial |
$41,602.50
|
| Rate for Payer: Aetna Medicare |
$43,865.90
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$29,243.93
|
| Rate for Payer: Amerigroup Medicare |
$29,243.93
|
| Rate for Payer: BCBS of TX Blue Advantage |
$28,748.08
|
| Rate for Payer: BCBS of TX Blue Essentials |
$36,914.16
|
| Rate for Payer: BCBS of TX Medicare |
$29,243.93
|
| Rate for Payer: BCBS of TX PPO |
$41,017.32
|
| Rate for Payer: Cigna Commercial |
$47,630.24
|
| Rate for Payer: Cigna Medicare |
$29,243.93
|
| Rate for Payer: Employer Direct Commercial |
$29,243.93
|
| Rate for Payer: Humana Medicare/TRICARE |
$29,243.93
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$29,243.93
|
| Rate for Payer: Molina Medicare |
$29,243.93
|
| Rate for Payer: Multiplan Auto |
$70,262.00
|
| Rate for Payer: Multiplan Commercial |
$70,262.00
|
| Rate for Payer: Multiplan Workers Comp |
$70,262.00
|
| Rate for Payer: Scott and White EPO/PPO |
$32,357.50
|
| Rate for Payer: Scott and White Medicare |
$29,243.93
|
| Rate for Payer: Superior Health Plan EPO |
$29,243.93
|
| Rate for Payer: Superior Health Plan Medicare |
$29,243.93
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$29,243.93
|
| Rate for Payer: Universal American Medicare |
$29,243.93
|
| Rate for Payer: Wellcare Medicare |
$29,243.93
|
| Rate for Payer: Wellmed Medicare |
$29,243.93
|
|
|
OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$30,143.50
|
|
|
Service Code
|
MSDRG 675
|
| Min. Negotiated Rate |
$13,310.22 |
| Max. Negotiated Rate |
$30,143.50 |
| Rate for Payer: Aetna Commercial |
$17,848.12
|
| Rate for Payer: Aetna Medicare |
$21,264.20
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$14,176.13
|
| Rate for Payer: Amerigroup Medicare |
$14,176.13
|
| Rate for Payer: BCBS of TX Blue Advantage |
$13,310.22
|
| Rate for Payer: BCBS of TX Blue Essentials |
$16,771.47
|
| Rate for Payer: BCBS of TX Medicare |
$14,176.13
|
| Rate for Payer: BCBS of TX PPO |
$18,635.69
|
| Rate for Payer: Cigna Commercial |
$20,434.12
|
| Rate for Payer: Cigna Medicare |
$14,176.13
|
| Rate for Payer: Employer Direct Commercial |
$14,176.13
|
| Rate for Payer: Humana Medicare/TRICARE |
$14,176.13
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$14,176.13
|
| Rate for Payer: Molina Medicare |
$14,176.13
|
| Rate for Payer: Multiplan Auto |
$30,143.50
|
| Rate for Payer: Multiplan Commercial |
$30,143.50
|
| Rate for Payer: Multiplan Workers Comp |
$30,143.50
|
| Rate for Payer: Scott and White EPO/PPO |
$13,881.88
|
| Rate for Payer: Scott and White Medicare |
$14,176.13
|
| Rate for Payer: Superior Health Plan EPO |
$14,176.13
|
| Rate for Payer: Superior Health Plan Medicare |
$14,176.13
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$14,176.13
|
| Rate for Payer: Universal American Medicare |
$14,176.13
|
| Rate for Payer: Wellcare Medicare |
$14,176.13
|
| Rate for Payer: Wellmed Medicare |
$14,176.13
|
|
|
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC
|
Facility
|
IP
|
$65,667.80
|
|
|
Service Code
|
MSDRG 271
|
| Min. Negotiated Rate |
$26,893.92 |
| Max. Negotiated Rate |
$65,667.80 |
| Rate for Payer: Aetna Commercial |
$38,882.25
|
| Rate for Payer: Aetna Medicare |
$41,277.66
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$27,518.44
|
| Rate for Payer: Amerigroup Medicare |
$27,518.44
|
| Rate for Payer: BCBS of TX Blue Advantage |
$26,893.92
|
| Rate for Payer: BCBS of TX Blue Essentials |
$36,052.52
|
| Rate for Payer: BCBS of TX Medicare |
$27,518.44
|
| Rate for Payer: BCBS of TX PPO |
$40,059.91
|
| Rate for Payer: Cigna Commercial |
$44,515.86
|
| Rate for Payer: Cigna Medicare |
$27,518.44
|
| Rate for Payer: Employer Direct Commercial |
$27,518.44
|
| Rate for Payer: Humana Medicare/TRICARE |
$27,518.44
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$27,518.44
|
| Rate for Payer: Molina Medicare |
$27,518.44
|
| Rate for Payer: Multiplan Auto |
$65,667.80
|
| Rate for Payer: Multiplan Commercial |
$65,667.80
|
| Rate for Payer: Multiplan Workers Comp |
$65,667.80
|
| Rate for Payer: Scott and White EPO/PPO |
$30,241.75
|
| Rate for Payer: Scott and White Medicare |
$27,518.44
|
| Rate for Payer: Superior Health Plan EPO |
$27,518.44
|
| Rate for Payer: Superior Health Plan Medicare |
$27,518.44
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$27,518.44
|
| Rate for Payer: Universal American Medicare |
$27,518.44
|
| Rate for Payer: Wellcare Medicare |
$27,518.44
|
| Rate for Payer: Wellmed Medicare |
$27,518.44
|
|
|
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC
|
Facility
|
IP
|
$96,081.10
|
|
|
Service Code
|
MSDRG 270
|
| Min. Negotiated Rate |
$38,941.12 |
| Max. Negotiated Rate |
$96,081.10 |
| Rate for Payer: Aetna Commercial |
$56,890.12
|
| Rate for Payer: Aetna Medicare |
$58,411.68
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$38,941.12
|
| Rate for Payer: Amerigroup Medicare |
$38,941.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$40,926.54
|
| Rate for Payer: BCBS of TX Blue Essentials |
$52,231.68
|
| Rate for Payer: BCBS of TX Medicare |
$38,941.12
|
| Rate for Payer: BCBS of TX PPO |
$58,037.45
|
| Rate for Payer: Cigna Commercial |
$65,132.87
|
| Rate for Payer: Cigna Medicare |
$38,941.12
|
| Rate for Payer: Employer Direct Commercial |
$38,941.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$38,941.12
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$38,941.12
|
| Rate for Payer: Molina Medicare |
$38,941.12
|
| Rate for Payer: Multiplan Auto |
$96,081.10
|
| Rate for Payer: Multiplan Commercial |
$96,081.10
|
| Rate for Payer: Multiplan Workers Comp |
$96,081.10
|
| Rate for Payer: Scott and White EPO/PPO |
$44,247.88
|
| Rate for Payer: Scott and White Medicare |
$38,941.12
|
| Rate for Payer: Superior Health Plan EPO |
$38,941.12
|
| Rate for Payer: Superior Health Plan Medicare |
$38,941.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$38,941.12
|
| Rate for Payer: Universal American Medicare |
$38,941.12
|
| Rate for Payer: Wellcare Medicare |
$38,941.12
|
| Rate for Payer: Wellmed Medicare |
$38,941.12
|
|
|
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$46,350.50
|
|
|
Service Code
|
MSDRG 272
|
| Min. Negotiated Rate |
$19,883.20 |
| Max. Negotiated Rate |
$46,350.50 |
| Rate for Payer: Aetna Commercial |
$27,444.38
|
| Rate for Payer: Aetna Medicare |
$30,394.78
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$20,263.19
|
| Rate for Payer: Amerigroup Medicare |
$20,263.19
|
| Rate for Payer: BCBS of TX Blue Advantage |
$19,883.20
|
| Rate for Payer: BCBS of TX Blue Essentials |
$27,016.17
|
| Rate for Payer: BCBS of TX Medicare |
$20,263.19
|
| Rate for Payer: BCBS of TX PPO |
$30,019.13
|
| Rate for Payer: Cigna Commercial |
$31,420.76
|
| Rate for Payer: Cigna Medicare |
$20,263.19
|
| Rate for Payer: Employer Direct Commercial |
$20,263.19
|
| Rate for Payer: Humana Medicare/TRICARE |
$20,263.19
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$20,263.19
|
| Rate for Payer: Molina Medicare |
$20,263.19
|
| Rate for Payer: Multiplan Auto |
$46,350.50
|
| Rate for Payer: Multiplan Commercial |
$46,350.50
|
| Rate for Payer: Multiplan Workers Comp |
$46,350.50
|
| Rate for Payer: Scott and White EPO/PPO |
$21,345.62
|
| Rate for Payer: Scott and White Medicare |
$20,263.19
|
| Rate for Payer: Superior Health Plan EPO |
$20,263.19
|
| Rate for Payer: Superior Health Plan Medicare |
$20,263.19
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$20,263.19
|
| Rate for Payer: Universal American Medicare |
$20,263.19
|
| Rate for Payer: Wellcare Medicare |
$20,263.19
|
| Rate for Payer: Wellmed Medicare |
$20,263.19
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC
|
Facility
|
IP
|
$19,074.10
|
|
|
Service Code
|
MSDRG 729
|
| Min. Negotiated Rate |
$8,784.12 |
| Max. Negotiated Rate |
$19,074.10 |
| Rate for Payer: Aetna Commercial |
$11,293.88
|
| Rate for Payer: Aetna Medicare |
$15,028.00
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$10,018.67
|
| Rate for Payer: Amerigroup Medicare |
$10,018.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,215.76
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,165.16
|
| Rate for Payer: BCBS of TX Medicare |
$10,018.67
|
| Rate for Payer: BCBS of TX PPO |
$12,406.21
|
| Rate for Payer: Cigna Commercial |
$12,930.23
|
| Rate for Payer: Cigna Medicare |
$10,018.67
|
| Rate for Payer: Employer Direct Commercial |
$10,018.67
|
| Rate for Payer: Humana Medicare/TRICARE |
$10,018.67
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$10,018.67
|
| Rate for Payer: Molina Medicare |
$10,018.67
|
| Rate for Payer: Multiplan Auto |
$19,074.10
|
| Rate for Payer: Multiplan Commercial |
$19,074.10
|
| Rate for Payer: Multiplan Workers Comp |
$19,074.10
|
| Rate for Payer: Scott and White EPO/PPO |
$8,784.12
|
| Rate for Payer: Scott and White Medicare |
$10,018.67
|
| Rate for Payer: Superior Health Plan EPO |
$10,018.67
|
| Rate for Payer: Superior Health Plan Medicare |
$10,018.67
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$10,018.67
|
| Rate for Payer: Universal American Medicare |
$10,018.67
|
| Rate for Payer: Wellcare Medicare |
$10,018.67
|
| Rate for Payer: Wellmed Medicare |
$10,018.67
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$11,810.40
|
|
|
Service Code
|
MSDRG 730
|
| Min. Negotiated Rate |
$5,439.00 |
| Max. Negotiated Rate |
$11,810.40 |
| Rate for Payer: Aetna Commercial |
$6,993.00
|
| Rate for Payer: Aetna Medicare |
$10,935.82
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,290.55
|
| Rate for Payer: Amerigroup Medicare |
$7,290.55
|
| Rate for Payer: BCBS of TX Blue Advantage |
$5,634.72
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,865.32
|
| Rate for Payer: BCBS of TX Medicare |
$7,290.55
|
| Rate for Payer: BCBS of TX PPO |
$6,517.27
|
| Rate for Payer: Cigna Commercial |
$8,006.21
|
| Rate for Payer: Cigna Medicare |
$7,290.55
|
| Rate for Payer: Employer Direct Commercial |
$7,290.55
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,290.55
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,290.55
|
| Rate for Payer: Molina Medicare |
$7,290.55
|
| Rate for Payer: Multiplan Auto |
$11,810.40
|
| Rate for Payer: Multiplan Commercial |
$11,810.40
|
| Rate for Payer: Multiplan Workers Comp |
$11,810.40
|
| Rate for Payer: Scott and White EPO/PPO |
$5,439.00
|
| Rate for Payer: Scott and White Medicare |
$7,290.55
|
| Rate for Payer: Superior Health Plan EPO |
$7,290.55
|
| Rate for Payer: Superior Health Plan Medicare |
$7,290.55
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,290.55
|
| Rate for Payer: Universal American Medicare |
$7,290.55
|
| Rate for Payer: Wellcare Medicare |
$7,290.55
|
| Rate for Payer: Wellmed Medicare |
$7,290.55
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$34,460.30
|
|
|
Service Code
|
MSDRG 717
|
| Min. Negotiated Rate |
$14,129.80 |
| Max. Negotiated Rate |
$34,460.30 |
| Rate for Payer: Aetna Commercial |
$20,404.12
|
| Rate for Payer: Aetna Medicare |
$23,696.18
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$15,797.45
|
| Rate for Payer: Amerigroup Medicare |
$15,797.45
|
| Rate for Payer: BCBS of TX Blue Advantage |
$14,129.80
|
| Rate for Payer: BCBS of TX Blue Essentials |
$20,166.42
|
| Rate for Payer: BCBS of TX Medicare |
$15,797.45
|
| Rate for Payer: BCBS of TX PPO |
$22,408.00
|
| Rate for Payer: Cigna Commercial |
$23,360.46
|
| Rate for Payer: Cigna Medicare |
$15,797.45
|
| Rate for Payer: Employer Direct Commercial |
$15,797.45
|
| Rate for Payer: Humana Medicare/TRICARE |
$15,797.45
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$15,797.45
|
| Rate for Payer: Molina Medicare |
$15,797.45
|
| Rate for Payer: Multiplan Auto |
$34,460.30
|
| Rate for Payer: Multiplan Commercial |
$34,460.30
|
| Rate for Payer: Multiplan Workers Comp |
$34,460.30
|
| Rate for Payer: Scott and White EPO/PPO |
$15,869.88
|
| Rate for Payer: Scott and White Medicare |
$15,797.45
|
| Rate for Payer: Superior Health Plan EPO |
$15,797.45
|
| Rate for Payer: Superior Health Plan Medicare |
$15,797.45
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$15,797.45
|
| Rate for Payer: Universal American Medicare |
$15,797.45
|
| Rate for Payer: Wellcare Medicare |
$15,797.45
|
| Rate for Payer: Wellmed Medicare |
$15,797.45
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$22,340.20
|
|
|
Service Code
|
MSDRG 718
|
| Min. Negotiated Rate |
$8,965.50 |
| Max. Negotiated Rate |
$22,340.20 |
| Rate for Payer: Aetna Commercial |
$13,227.75
|
| Rate for Payer: Aetna Medicare |
$16,868.04
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$11,245.36
|
| Rate for Payer: Amerigroup Medicare |
$11,245.36
|
| Rate for Payer: BCBS of TX Blue Advantage |
$8,965.50
|
| Rate for Payer: BCBS of TX Blue Essentials |
$12,719.20
|
| Rate for Payer: BCBS of TX Medicare |
$11,245.36
|
| Rate for Payer: BCBS of TX PPO |
$14,132.99
|
| Rate for Payer: Cigna Commercial |
$15,144.30
|
| Rate for Payer: Cigna Medicare |
$11,245.36
|
| Rate for Payer: Employer Direct Commercial |
$11,245.36
|
| Rate for Payer: Humana Medicare/TRICARE |
$11,245.36
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$11,245.36
|
| Rate for Payer: Molina Medicare |
$11,245.36
|
| Rate for Payer: Multiplan Auto |
$22,340.20
|
| Rate for Payer: Multiplan Commercial |
$22,340.20
|
| Rate for Payer: Multiplan Workers Comp |
$22,340.20
|
| Rate for Payer: Scott and White EPO/PPO |
$10,288.25
|
| Rate for Payer: Scott and White Medicare |
$11,245.36
|
| Rate for Payer: Superior Health Plan EPO |
$11,245.36
|
| Rate for Payer: Superior Health Plan Medicare |
$11,245.36
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$11,245.36
|
| Rate for Payer: Universal American Medicare |
$11,245.36
|
| Rate for Payer: Wellcare Medicare |
$11,245.36
|
| Rate for Payer: Wellmed Medicare |
$11,245.36
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$41,942.50
|
|
|
Service Code
|
MSDRG 715
|
| Min. Negotiated Rate |
$17,765.02 |
| Max. Negotiated Rate |
$41,942.50 |
| Rate for Payer: Aetna Commercial |
$24,834.38
|
| Rate for Payer: Aetna Medicare |
$27,911.44
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$18,607.63
|
| Rate for Payer: Amerigroup Medicare |
$18,607.63
|
| Rate for Payer: BCBS of TX Blue Advantage |
$17,765.02
|
| Rate for Payer: BCBS of TX Blue Essentials |
$22,803.96
|
| Rate for Payer: BCBS of TX Medicare |
$18,607.63
|
| Rate for Payer: BCBS of TX PPO |
$25,338.71
|
| Rate for Payer: Cigna Commercial |
$28,432.60
|
| Rate for Payer: Cigna Medicare |
$18,607.63
|
| Rate for Payer: Employer Direct Commercial |
$18,607.63
|
| Rate for Payer: Humana Medicare/TRICARE |
$18,607.63
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$18,607.63
|
| Rate for Payer: Molina Medicare |
$18,607.63
|
| Rate for Payer: Multiplan Auto |
$41,942.50
|
| Rate for Payer: Multiplan Commercial |
$41,942.50
|
| Rate for Payer: Multiplan Workers Comp |
$41,942.50
|
| Rate for Payer: Scott and White EPO/PPO |
$19,315.62
|
| Rate for Payer: Scott and White Medicare |
$18,607.63
|
| Rate for Payer: Superior Health Plan EPO |
$18,607.63
|
| Rate for Payer: Superior Health Plan Medicare |
$18,607.63
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$18,607.63
|
| Rate for Payer: Universal American Medicare |
$18,607.63
|
| Rate for Payer: Wellcare Medicare |
$18,607.63
|
| Rate for Payer: Wellmed Medicare |
$18,607.63
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$27,021.80
|
|
|
Service Code
|
MSDRG 716
|
| Min. Negotiated Rate |
$10,403.42 |
| Max. Negotiated Rate |
$27,021.80 |
| Rate for Payer: Aetna Commercial |
$15,999.75
|
| Rate for Payer: Aetna Medicare |
$19,505.52
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$13,003.68
|
| Rate for Payer: Amerigroup Medicare |
$13,003.68
|
| Rate for Payer: BCBS of TX Blue Advantage |
$10,403.42
|
| Rate for Payer: BCBS of TX Blue Essentials |
$15,096.70
|
| Rate for Payer: BCBS of TX Medicare |
$13,003.68
|
| Rate for Payer: BCBS of TX PPO |
$16,774.76
|
| Rate for Payer: Cigna Commercial |
$18,317.94
|
| Rate for Payer: Cigna Medicare |
$13,003.68
|
| Rate for Payer: Employer Direct Commercial |
$13,003.68
|
| Rate for Payer: Humana Medicare/TRICARE |
$13,003.68
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$13,003.68
|
| Rate for Payer: Molina Medicare |
$13,003.68
|
| Rate for Payer: Multiplan Auto |
$27,021.80
|
| Rate for Payer: Multiplan Commercial |
$27,021.80
|
| Rate for Payer: Multiplan Workers Comp |
$27,021.80
|
| Rate for Payer: Scott and White EPO/PPO |
$12,444.25
|
| Rate for Payer: Scott and White Medicare |
$13,003.68
|
| Rate for Payer: Superior Health Plan EPO |
$13,003.68
|
| Rate for Payer: Superior Health Plan Medicare |
$13,003.68
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$13,003.68
|
| Rate for Payer: Universal American Medicare |
$13,003.68
|
| Rate for Payer: Wellcare Medicare |
$13,003.68
|
| Rate for Payer: Wellmed Medicare |
$13,003.68
|
|
|
OTHER MENTAL DISORDER DIAGNOSES
|
Facility
|
IP
|
$24,616.40
|
|
|
Service Code
|
MSDRG 887
|
| Min. Negotiated Rate |
$8,666.22 |
| Max. Negotiated Rate |
$24,616.40 |
| Rate for Payer: Aetna Commercial |
$14,575.50
|
| Rate for Payer: Aetna Medicare |
$18,150.39
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,100.26
|
| Rate for Payer: Amerigroup Medicare |
$12,100.26
|
| Rate for Payer: BCBS of TX Blue Advantage |
$8,666.22
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,984.58
|
| Rate for Payer: BCBS of TX Medicare |
$12,100.26
|
| Rate for Payer: BCBS of TX PPO |
$12,205.56
|
| Rate for Payer: Cigna Commercial |
$16,687.33
|
| Rate for Payer: Cigna Medicare |
$12,100.26
|
| Rate for Payer: Employer Direct Commercial |
$12,100.26
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$12,100.26
|
| Rate for Payer: Molina Medicare |
$12,100.26
|
| Rate for Payer: Multiplan Auto |
$24,616.40
|
| Rate for Payer: Multiplan Commercial |
$24,616.40
|
| Rate for Payer: Multiplan Workers Comp |
$24,616.40
|
| Rate for Payer: Scott and White EPO/PPO |
$11,336.50
|
| Rate for Payer: Scott and White Medicare |
$12,100.26
|
| Rate for Payer: Superior Health Plan EPO |
$12,100.26
|
| Rate for Payer: Superior Health Plan Medicare |
$12,100.26
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$12,100.26
|
| Rate for Payer: Universal American Medicare |
$12,100.26
|
| Rate for Payer: Wellcare Medicare |
$12,100.26
|
| Rate for Payer: Wellmed Medicare |
$12,100.26
|
|
|
OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC
|
Facility
|
IP
|
$28,519.00
|
|
|
Service Code
|
MSDRG 964
|
| Min. Negotiated Rate |
$12,192.22 |
| Max. Negotiated Rate |
$28,519.00 |
| Rate for Payer: Aetna Commercial |
$16,886.25
|
| Rate for Payer: Aetna Medicare |
$20,349.00
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$13,566.00
|
| Rate for Payer: Amerigroup Medicare |
$13,566.00
|
| Rate for Payer: BCBS of TX Blue Advantage |
$12,192.22
|
| Rate for Payer: BCBS of TX Blue Essentials |
$15,219.49
|
| Rate for Payer: BCBS of TX Medicare |
$13,566.00
|
| Rate for Payer: BCBS of TX PPO |
$16,911.20
|
| Rate for Payer: Cigna Commercial |
$19,332.88
|
| Rate for Payer: Cigna Medicare |
$13,566.00
|
| Rate for Payer: Employer Direct Commercial |
$13,566.00
|
| Rate for Payer: Humana Medicare/TRICARE |
$13,566.00
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$13,566.00
|
| Rate for Payer: Molina Medicare |
$13,566.00
|
| Rate for Payer: Multiplan Auto |
$28,519.00
|
| Rate for Payer: Multiplan Commercial |
$28,519.00
|
| Rate for Payer: Multiplan Workers Comp |
$28,519.00
|
| Rate for Payer: Scott and White EPO/PPO |
$13,133.75
|
| Rate for Payer: Scott and White Medicare |
$13,566.00
|
| Rate for Payer: Superior Health Plan EPO |
$13,566.00
|
| Rate for Payer: Superior Health Plan Medicare |
$13,566.00
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$13,566.00
|
| Rate for Payer: Universal American Medicare |
$13,566.00
|
| Rate for Payer: Wellcare Medicare |
$13,566.00
|
| Rate for Payer: Wellmed Medicare |
$13,566.00
|
|
|
OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC
|
Facility
|
IP
|
$51,951.70
|
|
|
Service Code
|
MSDRG 963
|
| Min. Negotiated Rate |
$22,206.92 |
| Max. Negotiated Rate |
$51,951.70 |
| Rate for Payer: Aetna Commercial |
$30,760.88
|
| Rate for Payer: Aetna Medicare |
$33,550.36
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$22,366.91
|
| Rate for Payer: Amerigroup Medicare |
$22,366.91
|
| Rate for Payer: BCBS of TX Blue Advantage |
$22,206.92
|
| Rate for Payer: BCBS of TX Blue Essentials |
$28,841.60
|
| Rate for Payer: BCBS of TX Medicare |
$22,366.91
|
| Rate for Payer: BCBS of TX PPO |
$32,047.47
|
| Rate for Payer: Cigna Commercial |
$35,217.78
|
| Rate for Payer: Cigna Medicare |
$22,366.91
|
| Rate for Payer: Employer Direct Commercial |
$22,366.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$22,366.91
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$22,366.91
|
| Rate for Payer: Molina Medicare |
$22,366.91
|
| Rate for Payer: Multiplan Auto |
$51,951.70
|
| Rate for Payer: Multiplan Commercial |
$51,951.70
|
| Rate for Payer: Multiplan Workers Comp |
$51,951.70
|
| Rate for Payer: Scott and White EPO/PPO |
$23,925.12
|
| Rate for Payer: Scott and White Medicare |
$22,366.91
|
| Rate for Payer: Superior Health Plan EPO |
$22,366.91
|
| Rate for Payer: Superior Health Plan Medicare |
$22,366.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$22,366.91
|
| Rate for Payer: Universal American Medicare |
$22,366.91
|
| Rate for Payer: Wellcare Medicare |
$22,366.91
|
| Rate for Payer: Wellmed Medicare |
$22,366.91
|
|
|
OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC
|
Facility
|
IP
|
$18,162.10
|
|
|
Service Code
|
MSDRG 965
|
| Min. Negotiated Rate |
$8,329.96 |
| Max. Negotiated Rate |
$18,162.10 |
| Rate for Payer: Aetna Commercial |
$10,753.88
|
| Rate for Payer: Aetna Medicare |
$14,514.21
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$9,676.14
|
| Rate for Payer: Amerigroup Medicare |
$9,676.14
|
| Rate for Payer: BCBS of TX Blue Advantage |
$8,329.96
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,053.80
|
| Rate for Payer: BCBS of TX Medicare |
$9,676.14
|
| Rate for Payer: BCBS of TX PPO |
$11,171.32
|
| Rate for Payer: Cigna Commercial |
$12,311.99
|
| Rate for Payer: Cigna Medicare |
$9,676.14
|
| Rate for Payer: Employer Direct Commercial |
$9,676.14
|
| Rate for Payer: Humana Medicare/TRICARE |
$9,676.14
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$9,676.14
|
| Rate for Payer: Molina Medicare |
$9,676.14
|
| Rate for Payer: Multiplan Auto |
$18,162.10
|
| Rate for Payer: Multiplan Commercial |
$18,162.10
|
| Rate for Payer: Multiplan Workers Comp |
$18,162.10
|
| Rate for Payer: Scott and White EPO/PPO |
$8,364.12
|
| Rate for Payer: Scott and White Medicare |
$9,676.14
|
| Rate for Payer: Superior Health Plan EPO |
$9,676.14
|
| Rate for Payer: Superior Health Plan Medicare |
$9,676.14
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$9,676.14
|
| Rate for Payer: Universal American Medicare |
$9,676.14
|
| Rate for Payer: Wellcare Medicare |
$9,676.14
|
| Rate for Payer: Wellmed Medicare |
$9,676.14
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC
|
Facility
|
IP
|
$18,988.60
|
|
|
Service Code
|
MSDRG 565
|
| Min. Negotiated Rate |
$8,307.60 |
| Max. Negotiated Rate |
$18,988.60 |
| Rate for Payer: Aetna Commercial |
$11,243.25
|
| Rate for Payer: Aetna Medicare |
$14,979.86
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$9,986.57
|
| Rate for Payer: Amerigroup Medicare |
$9,986.57
|
| Rate for Payer: BCBS of TX Blue Advantage |
$8,307.60
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,069.28
|
| Rate for Payer: BCBS of TX Medicare |
$9,986.57
|
| Rate for Payer: BCBS of TX PPO |
$11,188.52
|
| Rate for Payer: Cigna Commercial |
$12,872.27
|
| Rate for Payer: Cigna Medicare |
$9,986.57
|
| Rate for Payer: Employer Direct Commercial |
$9,986.57
|
| Rate for Payer: Humana Medicare/TRICARE |
$9,986.57
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$9,986.57
|
| Rate for Payer: Molina Medicare |
$9,986.57
|
| Rate for Payer: Multiplan Auto |
$18,988.60
|
| Rate for Payer: Multiplan Commercial |
$18,988.60
|
| Rate for Payer: Multiplan Workers Comp |
$18,988.60
|
| Rate for Payer: Scott and White EPO/PPO |
$8,744.75
|
| Rate for Payer: Scott and White Medicare |
$9,986.57
|
| Rate for Payer: Superior Health Plan EPO |
$9,986.57
|
| Rate for Payer: Superior Health Plan Medicare |
$9,986.57
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$9,986.57
|
| Rate for Payer: Universal American Medicare |
$9,986.57
|
| Rate for Payer: Wellcare Medicare |
$9,986.57
|
| Rate for Payer: Wellmed Medicare |
$9,986.57
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC
|
Facility
|
IP
|
$29,676.10
|
|
|
Service Code
|
MSDRG 564
|
| Min. Negotiated Rate |
$13,665.40 |
| Max. Negotiated Rate |
$29,676.10 |
| Rate for Payer: Aetna Commercial |
$17,571.38
|
| Rate for Payer: Aetna Medicare |
$21,000.87
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$14,000.58
|
| Rate for Payer: Amerigroup Medicare |
$14,000.58
|
| Rate for Payer: BCBS of TX Blue Advantage |
$13,665.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$16,223.53
|
| Rate for Payer: BCBS of TX Medicare |
$14,000.58
|
| Rate for Payer: BCBS of TX PPO |
$18,026.85
|
| Rate for Payer: Cigna Commercial |
$20,117.27
|
| Rate for Payer: Cigna Medicare |
$14,000.58
|
| Rate for Payer: Employer Direct Commercial |
$14,000.58
|
| Rate for Payer: Humana Medicare/TRICARE |
$14,000.58
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$14,000.58
|
| Rate for Payer: Molina Medicare |
$14,000.58
|
| Rate for Payer: Multiplan Auto |
$29,676.10
|
| Rate for Payer: Multiplan Commercial |
$29,676.10
|
| Rate for Payer: Multiplan Workers Comp |
$29,676.10
|
| Rate for Payer: Scott and White EPO/PPO |
$13,666.62
|
| Rate for Payer: Scott and White Medicare |
$14,000.58
|
| Rate for Payer: Superior Health Plan EPO |
$14,000.58
|
| Rate for Payer: Superior Health Plan Medicare |
$14,000.58
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$14,000.58
|
| Rate for Payer: Universal American Medicare |
$14,000.58
|
| Rate for Payer: Wellcare Medicare |
$14,000.58
|
| Rate for Payer: Wellmed Medicare |
$14,000.58
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$14,259.50
|
|
|
Service Code
|
MSDRG 566
|
| Min. Negotiated Rate |
$6,232.42 |
| Max. Negotiated Rate |
$14,259.50 |
| Rate for Payer: Multiplan Commercial |
$14,259.50
|
| Rate for Payer: Multiplan Workers Comp |
$14,259.50
|
| Rate for Payer: Scott and White EPO/PPO |
$6,566.88
|
| Rate for Payer: Aetna Commercial |
$8,443.12
|
| Rate for Payer: Aetna Medicare |
$12,315.60
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$8,210.40
|
| Rate for Payer: Amerigroup Medicare |
$8,210.40
|
| Rate for Payer: BCBS of TX Blue Advantage |
$6,232.42
|
| Rate for Payer: BCBS of TX Blue Essentials |
$7,866.17
|
| Rate for Payer: BCBS of TX Medicare |
$8,210.40
|
| Rate for Payer: BCBS of TX PPO |
$8,740.53
|
| Rate for Payer: Cigna Commercial |
$9,666.44
|
| Rate for Payer: Cigna Medicare |
$8,210.40
|
| Rate for Payer: Employer Direct Commercial |
$8,210.40
|
| Rate for Payer: Humana Medicare/TRICARE |
$8,210.40
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$8,210.40
|
| Rate for Payer: Molina Medicare |
$8,210.40
|
| Rate for Payer: Multiplan Auto |
$14,259.50
|
| Rate for Payer: Scott and White Medicare |
$8,210.40
|
| Rate for Payer: Superior Health Plan EPO |
$8,210.40
|
| Rate for Payer: Superior Health Plan Medicare |
$8,210.40
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$8,210.40
|
| Rate for Payer: Universal American Medicare |
$8,210.40
|
| Rate for Payer: Wellcare Medicare |
$8,210.40
|
| Rate for Payer: Wellmed Medicare |
$8,210.40
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$38,775.20
|
|
|
Service Code
|
MSDRG 516
|
| Min. Negotiated Rate |
$17,418.05 |
| Max. Negotiated Rate |
$38,775.20 |
| Rate for Payer: Aetna Commercial |
$22,959.00
|
| Rate for Payer: Aetna Medicare |
$26,127.08
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$17,418.05
|
| Rate for Payer: Amerigroup Medicare |
$17,418.05
|
| Rate for Payer: BCBS of TX Blue Advantage |
$17,809.74
|
| Rate for Payer: BCBS of TX Blue Essentials |
$19,455.44
|
| Rate for Payer: BCBS of TX Medicare |
$17,418.05
|
| Rate for Payer: BCBS of TX PPO |
$21,618.00
|
| Rate for Payer: Cigna Commercial |
$26,285.50
|
| Rate for Payer: Cigna Medicare |
$17,418.05
|
| Rate for Payer: Employer Direct Commercial |
$17,418.05
|
| Rate for Payer: Humana Medicare/TRICARE |
$17,418.05
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$17,418.05
|
| Rate for Payer: Molina Medicare |
$17,418.05
|
| Rate for Payer: Multiplan Auto |
$38,775.20
|
| Rate for Payer: Multiplan Commercial |
$38,775.20
|
| Rate for Payer: Multiplan Workers Comp |
$38,775.20
|
| Rate for Payer: Scott and White EPO/PPO |
$17,857.00
|
| Rate for Payer: Scott and White Medicare |
$17,418.05
|
| Rate for Payer: Superior Health Plan EPO |
$17,418.05
|
| Rate for Payer: Superior Health Plan Medicare |
$17,418.05
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$17,418.05
|
| Rate for Payer: Universal American Medicare |
$17,418.05
|
| Rate for Payer: Wellcare Medicare |
$17,418.05
|
| Rate for Payer: Wellmed Medicare |
$17,418.05
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$60,068.50
|
|
|
Service Code
|
MSDRG 515
|
| Min. Negotiated Rate |
$25,415.43 |
| Max. Negotiated Rate |
$60,068.50 |
| Rate for Payer: Aetna Commercial |
$35,566.88
|
| Rate for Payer: Aetna Medicare |
$38,123.14
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$25,415.43
|
| Rate for Payer: Amerigroup Medicare |
$25,415.43
|
| Rate for Payer: BCBS of TX Blue Advantage |
$26,965.30
|
| Rate for Payer: BCBS of TX Blue Essentials |
$31,803.16
|
| Rate for Payer: BCBS of TX Medicare |
$25,415.43
|
| Rate for Payer: BCBS of TX PPO |
$35,338.21
|
| Rate for Payer: Cigna Commercial |
$40,720.12
|
| Rate for Payer: Cigna Medicare |
$25,415.43
|
| Rate for Payer: Employer Direct Commercial |
$25,415.43
|
| Rate for Payer: Humana Medicare/TRICARE |
$25,415.43
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$25,415.43
|
| Rate for Payer: Molina Medicare |
$25,415.43
|
| Rate for Payer: Multiplan Auto |
$60,068.50
|
| Rate for Payer: Multiplan Commercial |
$60,068.50
|
| Rate for Payer: Multiplan Workers Comp |
$60,068.50
|
| Rate for Payer: Scott and White EPO/PPO |
$27,663.12
|
| Rate for Payer: Scott and White Medicare |
$25,415.43
|
| Rate for Payer: Superior Health Plan EPO |
$25,415.43
|
| Rate for Payer: Superior Health Plan Medicare |
$25,415.43
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$25,415.43
|
| Rate for Payer: Universal American Medicare |
$25,415.43
|
| Rate for Payer: Wellcare Medicare |
$25,415.43
|
| Rate for Payer: Wellmed Medicare |
$25,415.43
|
|
|
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$28,393.60
|
|
|
Service Code
|
MSDRG 517
|
| Min. Negotiated Rate |
$13,076.00 |
| Max. Negotiated Rate |
$28,393.60 |
| Rate for Payer: Aetna Commercial |
$16,812.00
|
| Rate for Payer: Aetna Medicare |
$20,278.36
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$13,518.91
|
| Rate for Payer: Amerigroup Medicare |
$13,518.91
|
| Rate for Payer: BCBS of TX Blue Advantage |
$15,437.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$14,249.51
|
| Rate for Payer: BCBS of TX Medicare |
$13,518.91
|
| Rate for Payer: BCBS of TX PPO |
$15,833.40
|
| Rate for Payer: Cigna Commercial |
$19,247.87
|
| Rate for Payer: Cigna Medicare |
$13,518.91
|
| Rate for Payer: Employer Direct Commercial |
$13,518.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$13,518.91
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$13,518.91
|
| Rate for Payer: Molina Medicare |
$13,518.91
|
| Rate for Payer: Multiplan Auto |
$28,393.60
|
| Rate for Payer: Multiplan Commercial |
$28,393.60
|
| Rate for Payer: Multiplan Workers Comp |
$28,393.60
|
| Rate for Payer: Scott and White EPO/PPO |
$13,076.00
|
| Rate for Payer: Scott and White Medicare |
$13,518.91
|
| Rate for Payer: Superior Health Plan EPO |
$13,518.91
|
| Rate for Payer: Superior Health Plan Medicare |
$13,518.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$13,518.91
|
| Rate for Payer: Universal American Medicare |
$13,518.91
|
| Rate for Payer: Wellcare Medicare |
$13,518.91
|
| Rate for Payer: Wellmed Medicare |
$13,518.91
|
|
|
OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC
|
Facility
|
IP
|
$21,986.80
|
|
|
Service Code
|
MSDRG 844
|
| Min. Negotiated Rate |
$10,125.50 |
| Max. Negotiated Rate |
$21,986.80 |
| Rate for Payer: Aetna Commercial |
$13,018.50
|
| Rate for Payer: Aetna Medicare |
$16,668.94
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$11,112.63
|
| Rate for Payer: Amerigroup Medicare |
$11,112.63
|
| Rate for Payer: BCBS of TX Blue Advantage |
$10,162.62
|
| Rate for Payer: BCBS of TX Blue Essentials |
$12,164.04
|
| Rate for Payer: BCBS of TX Medicare |
$11,112.63
|
| Rate for Payer: BCBS of TX PPO |
$13,516.12
|
| Rate for Payer: Cigna Commercial |
$14,904.74
|
| Rate for Payer: Cigna Medicare |
$11,112.63
|
| Rate for Payer: Employer Direct Commercial |
$11,112.63
|
| Rate for Payer: Humana Medicare/TRICARE |
$11,112.63
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$11,112.63
|
| Rate for Payer: Molina Medicare |
$11,112.63
|
| Rate for Payer: Multiplan Auto |
$21,986.80
|
| Rate for Payer: Multiplan Commercial |
$21,986.80
|
| Rate for Payer: Multiplan Workers Comp |
$21,986.80
|
| Rate for Payer: Scott and White EPO/PPO |
$10,125.50
|
| Rate for Payer: Scott and White Medicare |
$11,112.63
|
| Rate for Payer: Superior Health Plan EPO |
$11,112.63
|
| Rate for Payer: Superior Health Plan Medicare |
$11,112.63
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$11,112.63
|
| Rate for Payer: Universal American Medicare |
$11,112.63
|
| Rate for Payer: Wellcare Medicare |
$11,112.63
|
| Rate for Payer: Wellmed Medicare |
$11,112.63
|
|
|
OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC
|
Facility
|
IP
|
$35,351.40
|
|
|
Service Code
|
MSDRG 843
|
| Min. Negotiated Rate |
$15,507.52 |
| Max. Negotiated Rate |
$35,351.40 |
| Rate for Payer: Aetna Commercial |
$20,931.75
|
| Rate for Payer: Aetna Medicare |
$24,198.20
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$16,132.13
|
| Rate for Payer: Amerigroup Medicare |
$16,132.13
|
| Rate for Payer: BCBS of TX Blue Advantage |
$15,507.52
|
| Rate for Payer: BCBS of TX Blue Essentials |
$19,048.87
|
| Rate for Payer: BCBS of TX Medicare |
$16,132.13
|
| Rate for Payer: BCBS of TX PPO |
$21,166.24
|
| Rate for Payer: Cigna Commercial |
$23,964.53
|
| Rate for Payer: Cigna Medicare |
$16,132.13
|
| Rate for Payer: Employer Direct Commercial |
$16,132.13
|
| Rate for Payer: Humana Medicare/TRICARE |
$16,132.13
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$16,132.13
|
| Rate for Payer: Molina Medicare |
$16,132.13
|
| Rate for Payer: Multiplan Auto |
$35,351.40
|
| Rate for Payer: Multiplan Commercial |
$35,351.40
|
| Rate for Payer: Multiplan Workers Comp |
$35,351.40
|
| Rate for Payer: Scott and White EPO/PPO |
$16,280.25
|
| Rate for Payer: Scott and White Medicare |
$16,132.13
|
| Rate for Payer: Superior Health Plan EPO |
$16,132.13
|
| Rate for Payer: Superior Health Plan Medicare |
$16,132.13
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$16,132.13
|
| Rate for Payer: Universal American Medicare |
$16,132.13
|
| Rate for Payer: Wellcare Medicare |
$16,132.13
|
| Rate for Payer: Wellmed Medicare |
$16,132.13
|
|
|
OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$16,433.10
|
|
|
Service Code
|
MSDRG 845
|
| Min. Negotiated Rate |
$7,326.34 |
| Max. Negotiated Rate |
$16,433.10 |
| Rate for Payer: Aetna Commercial |
$9,730.12
|
| Rate for Payer: Aetna Medicare |
$13,540.12
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$9,026.75
|
| Rate for Payer: Amerigroup Medicare |
$9,026.75
|
| Rate for Payer: BCBS of TX Blue Advantage |
$7,326.34
|
| Rate for Payer: BCBS of TX Blue Essentials |
$8,938.32
|
| Rate for Payer: BCBS of TX Medicare |
$9,026.75
|
| Rate for Payer: BCBS of TX PPO |
$9,931.85
|
| Rate for Payer: Cigna Commercial |
$11,139.91
|
| Rate for Payer: Cigna Medicare |
$9,026.75
|
| Rate for Payer: Employer Direct Commercial |
$9,026.75
|
| Rate for Payer: Humana Medicare/TRICARE |
$9,026.75
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$9,026.75
|
| Rate for Payer: Molina Medicare |
$9,026.75
|
| Rate for Payer: Multiplan Auto |
$16,433.10
|
| Rate for Payer: Multiplan Commercial |
$16,433.10
|
| Rate for Payer: Multiplan Workers Comp |
$16,433.10
|
| Rate for Payer: Scott and White EPO/PPO |
$7,567.88
|
| Rate for Payer: Scott and White Medicare |
$9,026.75
|
| Rate for Payer: Superior Health Plan EPO |
$9,026.75
|
| Rate for Payer: Superior Health Plan Medicare |
$9,026.75
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$9,026.75
|
| Rate for Payer: Universal American Medicare |
$9,026.75
|
| Rate for Payer: Wellcare Medicare |
$9,026.75
|
| Rate for Payer: Wellmed Medicare |
$9,026.75
|
|
|
OTHER O.R. PROCEDURES FOR INJURIES WITH CC
|
Facility
|
IP
|
$38,077.90
|
|
|
Service Code
|
MSDRG 908
|
| Min. Negotiated Rate |
$17,156.17 |
| Max. Negotiated Rate |
$38,077.90 |
| Rate for Payer: Aetna Commercial |
$22,546.12
|
| Rate for Payer: Aetna Medicare |
$25,734.26
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$17,156.17
|
| Rate for Payer: Amerigroup Medicare |
$17,156.17
|
| Rate for Payer: BCBS of TX Blue Advantage |
$17,702.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$20,563.70
|
| Rate for Payer: BCBS of TX Medicare |
$17,156.17
|
| Rate for Payer: BCBS of TX PPO |
$22,849.44
|
| Rate for Payer: Cigna Commercial |
$25,812.81
|
| Rate for Payer: Cigna Medicare |
$17,156.17
|
| Rate for Payer: Employer Direct Commercial |
$17,156.17
|
| Rate for Payer: Humana Medicare/TRICARE |
$17,156.17
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$17,156.17
|
| Rate for Payer: Molina Medicare |
$17,156.17
|
| Rate for Payer: Multiplan Auto |
$38,077.90
|
| Rate for Payer: Multiplan Commercial |
$38,077.90
|
| Rate for Payer: Multiplan Workers Comp |
$38,077.90
|
| Rate for Payer: Scott and White EPO/PPO |
$17,535.88
|
| Rate for Payer: Scott and White Medicare |
$17,156.17
|
| Rate for Payer: Superior Health Plan EPO |
$17,156.17
|
| Rate for Payer: Superior Health Plan Medicare |
$17,156.17
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$17,156.17
|
| Rate for Payer: Universal American Medicare |
$17,156.17
|
| Rate for Payer: Wellcare Medicare |
$17,156.17
|
| Rate for Payer: Wellmed Medicare |
$17,156.17
|
|
