|
Incision and drainage, forearm and/or wrist; deep abscess or hematoma
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 25028
|
| Hospital Charge Code |
36025028
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| 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 |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$6,080.78
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Incision and drainage, forearm and/or wrist; deep abscess or hematoma
|
Facility
|
IP
|
$16,982.40
|
|
|
Service Code
|
HCPCS 25028
|
| Hospital Charge Code |
9900264
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$11,548.03
|
|
|
Incision and drainage, leg or ankle; deep abscess or hematoma
|
Facility
|
OP
|
$7,264.65
|
|
|
Service Code
|
HCPCS 27603
|
| Hospital Charge Code |
9900417
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$815.20 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$815.20
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Amerigroup Medicare |
$2,917.95
|
| Rate for Payer: BCBS of TX Blue Advantage |
$3,872.55
|
| Rate for Payer: BCBS of TX Blue Essentials |
$4,637.78
|
| Rate for Payer: BCBS of TX Medicare |
$2,917.95
|
| Rate for Payer: BCBS of TX PPO |
$5,843.60
|
| Rate for Payer: Cash Price |
$4,939.96
|
| Rate for Payer: Cash Price |
$4,939.96
|
| Rate for Payer: Cash Price |
$4,939.96
|
| Rate for Payer: Cigna Commercial |
$6,168.03
|
| Rate for Payer: Cigna Medicaid |
$5,230.55
|
| Rate for Payer: Cigna Medicare |
$2,917.95
|
| Rate for Payer: Employer Direct Commercial |
$2,917.95
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,917.95
|
| Rate for Payer: Molina CHIP/Medicaid |
$5,230.55
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Molina Medicare |
$2,917.95
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Parkland Medicaid |
$5,230.55
|
| Rate for Payer: Scott and White EPO/PPO |
$5,398.21
|
| Rate for Payer: Scott and White Medicare |
$2,917.95
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$5,230.55
|
| Rate for Payer: Superior Health Plan EPO |
$2,917.95
|
| Rate for Payer: Superior Health Plan Medicare |
$2,917.95
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Universal American Medicare |
$2,917.95
|
| Rate for Payer: Wellcare Medicare |
$2,917.95
|
| Rate for Payer: Wellmed Medicare |
$2,917.95
|
|
|
Incision and drainage, leg or ankle; deep abscess or hematoma
|
Facility
|
IP
|
$7,264.65
|
|
|
Service Code
|
HCPCS 27603
|
| Hospital Charge Code |
9900417
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,939.96
|
|
|
Incision and drainage, leg or ankle; deep abscess or hematoma
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 27603
|
| Hospital Charge Code |
36027603
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$815.20 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$815.20
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Amerigroup Medicare |
$2,917.95
|
| Rate for Payer: BCBS of TX Blue Advantage |
$3,872.55
|
| Rate for Payer: BCBS of TX Blue Essentials |
$4,637.78
|
| Rate for Payer: BCBS of TX Medicare |
$2,917.95
|
| Rate for Payer: BCBS of TX PPO |
$5,843.60
|
| Rate for Payer: Cigna Commercial |
$6,168.03
|
| Rate for Payer: Cigna Medicare |
$2,917.95
|
| Rate for Payer: Employer Direct Commercial |
$2,917.95
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,917.95
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Molina Medicare |
$2,917.95
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$5,398.21
|
| Rate for Payer: Scott and White Medicare |
$2,917.95
|
| Rate for Payer: Superior Health Plan EPO |
$2,917.95
|
| Rate for Payer: Superior Health Plan Medicare |
$2,917.95
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Universal American Medicare |
$2,917.95
|
| Rate for Payer: Wellcare Medicare |
$2,917.95
|
| Rate for Payer: Wellmed Medicare |
$2,917.95
|
|
|
Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous
|
Facility
|
IP
|
$993.50
|
|
|
Service Code
|
HCPCS 10060
|
| Hospital Charge Code |
9900072
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$675.58
|
|
|
Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
36010060
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$65.06 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$65.06
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$201.55
|
| Rate for Payer: Amerigroup Medicare |
$201.55
|
| Rate for Payer: BCBS of TX Blue Advantage |
$125.97
|
| Rate for Payer: BCBS of TX Blue Essentials |
$150.86
|
| Rate for Payer: BCBS of TX Medicare |
$201.55
|
| Rate for Payer: BCBS of TX PPO |
$190.08
|
| Rate for Payer: Cigna Commercial |
$426.04
|
| Rate for Payer: Cigna Medicare |
$201.55
|
| Rate for Payer: Employer Direct Commercial |
$201.55
|
| Rate for Payer: Humana Medicare/TRICARE |
$201.55
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$201.55
|
| Rate for Payer: Molina Medicare |
$201.55
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$372.87
|
| Rate for Payer: Scott and White Medicare |
$201.55
|
| Rate for Payer: Superior Health Plan EPO |
$201.55
|
| Rate for Payer: Superior Health Plan Medicare |
$201.55
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$201.55
|
| Rate for Payer: Universal American Medicare |
$201.55
|
| Rate for Payer: Wellcare Medicare |
$201.55
|
| Rate for Payer: Wellmed Medicare |
$201.55
|
|
|
Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
36010061
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$98.28 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$98.28
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$408.37
|
| Rate for Payer: Amerigroup Medicare |
$408.37
|
| Rate for Payer: BCBS of TX Blue Advantage |
$192.87
|
| Rate for Payer: BCBS of TX Blue Essentials |
$230.98
|
| Rate for Payer: BCBS of TX Medicare |
$408.37
|
| Rate for Payer: BCBS of TX PPO |
$291.03
|
| Rate for Payer: Cigna Commercial |
$863.21
|
| Rate for Payer: Cigna Medicare |
$408.37
|
| Rate for Payer: Employer Direct Commercial |
$408.37
|
| Rate for Payer: Humana Medicare/TRICARE |
$408.37
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$408.37
|
| Rate for Payer: Molina Medicare |
$408.37
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$755.48
|
| Rate for Payer: Scott and White Medicare |
$408.37
|
| Rate for Payer: Superior Health Plan EPO |
$408.37
|
| Rate for Payer: Superior Health Plan Medicare |
$408.37
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$408.37
|
| Rate for Payer: Universal American Medicare |
$408.37
|
| Rate for Payer: Wellcare Medicare |
$408.37
|
| Rate for Payer: Wellmed Medicare |
$408.37
|
|
|
Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous
|
Facility
|
OP
|
$2,238.42
|
|
|
Service Code
|
HCPCS 10061
|
| Hospital Charge Code |
9900073
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$98.28 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$98.28
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$408.37
|
| Rate for Payer: Amerigroup Medicare |
$408.37
|
| Rate for Payer: BCBS of TX Blue Advantage |
$192.87
|
| Rate for Payer: BCBS of TX Blue Essentials |
$230.98
|
| Rate for Payer: BCBS of TX Medicare |
$408.37
|
| Rate for Payer: BCBS of TX PPO |
$291.03
|
| Rate for Payer: Cash Price |
$1,522.13
|
| Rate for Payer: Cash Price |
$1,522.13
|
| Rate for Payer: Cash Price |
$1,522.13
|
| Rate for Payer: Cigna Commercial |
$863.21
|
| Rate for Payer: Cigna Medicaid |
$1,611.66
|
| Rate for Payer: Cigna Medicare |
$408.37
|
| Rate for Payer: Employer Direct Commercial |
$408.37
|
| Rate for Payer: Humana Medicare/TRICARE |
$408.37
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,611.66
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$408.37
|
| Rate for Payer: Molina Medicare |
$408.37
|
| 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 |
$1,611.66
|
| Rate for Payer: Scott and White EPO/PPO |
$755.48
|
| Rate for Payer: Scott and White Medicare |
$408.37
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,611.66
|
| Rate for Payer: Superior Health Plan EPO |
$408.37
|
| Rate for Payer: Superior Health Plan Medicare |
$408.37
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$408.37
|
| Rate for Payer: Universal American Medicare |
$408.37
|
| Rate for Payer: Wellcare Medicare |
$408.37
|
| Rate for Payer: Wellmed Medicare |
$408.37
|
|
|
Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous
|
Facility
|
OP
|
$993.50
|
|
|
Service Code
|
HCPCS 10060
|
| Hospital Charge Code |
9900072
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$65.06 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$65.06
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$201.55
|
| Rate for Payer: Amerigroup Medicare |
$201.55
|
| Rate for Payer: BCBS of TX Blue Advantage |
$125.97
|
| Rate for Payer: BCBS of TX Blue Essentials |
$150.86
|
| Rate for Payer: BCBS of TX Medicare |
$201.55
|
| Rate for Payer: BCBS of TX PPO |
$190.08
|
| Rate for Payer: Cash Price |
$675.58
|
| Rate for Payer: Cash Price |
$675.58
|
| Rate for Payer: Cash Price |
$675.58
|
| Rate for Payer: Cigna Commercial |
$426.04
|
| Rate for Payer: Cigna Medicaid |
$715.32
|
| Rate for Payer: Cigna Medicare |
$201.55
|
| Rate for Payer: Employer Direct Commercial |
$201.55
|
| Rate for Payer: Humana Medicare/TRICARE |
$201.55
|
| Rate for Payer: Molina CHIP/Medicaid |
$715.32
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$201.55
|
| Rate for Payer: Molina Medicare |
$201.55
|
| 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 |
$715.32
|
| Rate for Payer: Scott and White EPO/PPO |
$372.87
|
| Rate for Payer: Scott and White Medicare |
$201.55
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$715.32
|
| Rate for Payer: Superior Health Plan EPO |
$201.55
|
| Rate for Payer: Superior Health Plan Medicare |
$201.55
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$201.55
|
| Rate for Payer: Universal American Medicare |
$201.55
|
| Rate for Payer: Wellcare Medicare |
$201.55
|
| Rate for Payer: Wellmed Medicare |
$201.55
|
|
|
Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous
|
Facility
|
IP
|
$2,238.42
|
|
|
Service Code
|
HCPCS 10061
|
| Hospital Charge Code |
9900073
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,522.13
|
|
|
Incision and drainage of hematoma, seroma or fluid collection
|
Facility
|
IP
|
$6,773.30
|
|
|
Service Code
|
HCPCS 10140
|
| Hospital Charge Code |
8912619
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,605.84
|
|
|
Incision and drainage of hematoma, seroma or fluid collection
|
Facility
|
OP
|
$6,773.30
|
|
|
Service Code
|
HCPCS 10140
|
| Hospital Charge Code |
8912619
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$90.81 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$90.81
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$183.82
|
| Rate for Payer: BCBS of TX Blue Essentials |
$220.14
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$277.38
|
| Rate for Payer: Cash Price |
$4,605.84
|
| Rate for Payer: Cash Price |
$4,605.84
|
| Rate for Payer: Cash Price |
$4,605.84
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$4,876.78
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina CHIP/Medicaid |
$4,876.78
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Parkland Medicaid |
$4,876.78
|
| Rate for Payer: Scott and White EPO/PPO |
$3,069.37
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$4,876.78
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
Incision and drainage of hematoma, seroma or fluid collection
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36010140
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$90.81 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$90.81
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$183.82
|
| Rate for Payer: BCBS of TX Blue Essentials |
$220.14
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$277.38
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$3,069.37
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia
|
Facility
|
OP
|
$10,969.56
|
|
|
Service Code
|
HCPCS 46045
|
| Hospital Charge Code |
991312
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$939.93 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$939.93
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,788.31
|
| Rate for Payer: Amerigroup Medicare |
$2,788.31
|
| Rate for Payer: BCBS of TX Blue Advantage |
$3,914.78
|
| Rate for Payer: BCBS of TX Blue Essentials |
$4,688.36
|
| Rate for Payer: BCBS of TX Medicare |
$2,788.31
|
| Rate for Payer: BCBS of TX PPO |
$5,907.33
|
| Rate for Payer: Cash Price |
$7,459.30
|
| Rate for Payer: Cash Price |
$7,459.30
|
| Rate for Payer: Cash Price |
$7,459.30
|
| Rate for Payer: Cigna Commercial |
$5,893.97
|
| Rate for Payer: Cigna Medicaid |
$7,898.08
|
| Rate for Payer: Cigna Medicare |
$2,788.31
|
| Rate for Payer: Employer Direct Commercial |
$2,788.31
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,788.31
|
| Rate for Payer: Molina CHIP/Medicaid |
$7,898.08
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,788.31
|
| Rate for Payer: Molina Medicare |
$2,788.31
|
| 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 |
$7,898.08
|
| Rate for Payer: Scott and White EPO/PPO |
$5,158.37
|
| Rate for Payer: Scott and White Medicare |
$2,788.31
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$7,898.08
|
| Rate for Payer: Superior Health Plan EPO |
$2,788.31
|
| Rate for Payer: Superior Health Plan Medicare |
$2,788.31
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,788.31
|
| Rate for Payer: Universal American Medicare |
$2,788.31
|
| Rate for Payer: Wellcare Medicare |
$2,788.31
|
| Rate for Payer: Wellmed Medicare |
$2,788.31
|
|
|
Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia
|
Facility
|
IP
|
$10,969.56
|
|
|
Service Code
|
HCPCS 46045
|
| Hospital Charge Code |
991312
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$7,459.30
|
|
|
Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure)
|
Facility
|
IP
|
$4,716.32
|
|
|
Service Code
|
HCPCS 46040
|
| Hospital Charge Code |
994037
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,207.10
|
|
|
Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure)
|
Facility
|
OP
|
$4,716.32
|
|
|
Service Code
|
HCPCS 46040
|
| Hospital Charge Code |
994037
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$429.26 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$429.26
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,202.09
|
| Rate for Payer: Amerigroup Medicare |
$1,202.09
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,677.05
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,008.44
|
| Rate for Payer: BCBS of TX Medicare |
$1,202.09
|
| Rate for Payer: BCBS of TX PPO |
$2,530.63
|
| Rate for Payer: Cash Price |
$3,207.10
|
| Rate for Payer: Cash Price |
$3,207.10
|
| Rate for Payer: Cash Price |
$3,207.10
|
| Rate for Payer: Cigna Commercial |
$2,541.00
|
| Rate for Payer: Cigna Medicaid |
$3,395.75
|
| Rate for Payer: Cigna Medicare |
$1,202.09
|
| Rate for Payer: Employer Direct Commercial |
$1,202.09
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,202.09
|
| Rate for Payer: Molina CHIP/Medicaid |
$3,395.75
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,202.09
|
| Rate for Payer: Molina Medicare |
$1,202.09
|
| 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 |
$3,395.75
|
| Rate for Payer: Scott and White EPO/PPO |
$2,223.87
|
| Rate for Payer: Scott and White Medicare |
$1,202.09
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$3,395.75
|
| Rate for Payer: Superior Health Plan EPO |
$1,202.09
|
| Rate for Payer: Superior Health Plan Medicare |
$1,202.09
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,202.09
|
| Rate for Payer: Universal American Medicare |
$1,202.09
|
| Rate for Payer: Wellcare Medicare |
$1,202.09
|
| Rate for Payer: Wellmed Medicare |
$1,202.09
|
|
|
Incision and drainage, open, of deep abscess posterior spine; cervical, thoracic, or cervicothoracic
|
Facility
|
IP
|
$9,354.01
|
|
|
Service Code
|
HCPCS 22010
|
| Hospital Charge Code |
994104
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,360.73
|
|
|
Incision and drainage, open, of deep abscess posterior spine; cervical, thoracic, or cervicothoracic
|
Facility
|
OP
|
$9,354.01
|
|
|
Service Code
|
HCPCS 22010
|
| Hospital Charge Code |
994104
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$841.86 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$841.86
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,289.28
|
| Rate for Payer: Amerigroup Medicare |
$7,289.28
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,668.93
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,998.72
|
| Rate for Payer: BCBS of TX Medicare |
$7,289.28
|
| Rate for Payer: BCBS of TX PPO |
$2,518.39
|
| Rate for Payer: Cash Price |
$6,360.73
|
| Rate for Payer: Cash Price |
$6,360.73
|
| Rate for Payer: Cash Price |
$6,360.73
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| Rate for Payer: Cigna Medicaid |
$6,734.89
|
| Rate for Payer: Cigna Medicare |
$7,289.28
|
| Rate for Payer: Employer Direct Commercial |
$7,289.28
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,289.28
|
| Rate for Payer: Molina CHIP/Medicaid |
$6,734.89
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,289.28
|
| Rate for Payer: Molina Medicare |
$7,289.28
|
| 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 |
$6,734.89
|
| Rate for Payer: Scott and White EPO/PPO |
$13,485.17
|
| Rate for Payer: Scott and White Medicare |
$7,289.28
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$6,734.89
|
| Rate for Payer: Superior Health Plan EPO |
$7,289.28
|
| Rate for Payer: Superior Health Plan Medicare |
$7,289.28
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,289.28
|
| Rate for Payer: Universal American Medicare |
$7,289.28
|
| Rate for Payer: Wellcare Medicare |
$7,289.28
|
| Rate for Payer: Wellmed Medicare |
$7,289.28
|
|
|
Incision and drainage, pelvis or hip joint area; deep abscess or hematoma
|
Facility
|
IP
|
$3,084.03
|
|
|
Service Code
|
HCPCS 26990
|
| Hospital Charge Code |
5052200
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$2,097.14
|
|
|
Incision and drainage, pelvis or hip joint area; deep abscess or hematoma
|
Facility
|
OP
|
$3,084.03
|
|
|
Service Code
|
HCPCS 26990
|
| Hospital Charge Code |
9900378
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| 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 |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cash Price |
$2,097.14
|
| Rate for Payer: Cash Price |
$2,097.14
|
| Rate for Payer: Cash Price |
$2,097.14
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$2,220.50
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina CHIP/Medicaid |
$2,220.50
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| 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 |
$2,220.50
|
| Rate for Payer: Scott and White EPO/PPO |
$6,080.78
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$2,220.50
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Incision and drainage, pelvis or hip joint area; deep abscess or hematoma
|
Facility
|
OP
|
$3,084.03
|
|
|
Service Code
|
HCPCS 26990
|
| Hospital Charge Code |
5052200
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| 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 |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cash Price |
$2,097.14
|
| Rate for Payer: Cash Price |
$2,097.14
|
| Rate for Payer: Cash Price |
$2,097.14
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$2,220.50
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina CHIP/Medicaid |
$2,220.50
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| 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 |
$2,220.50
|
| Rate for Payer: Scott and White EPO/PPO |
$6,080.78
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$2,220.50
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Incision and drainage, pelvis or hip joint area; deep abscess or hematoma
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 26990
|
| Hospital Charge Code |
36026990
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| 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 |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$6,080.78
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Incision and drainage, pelvis or hip joint area; deep abscess or hematoma
|
Facility
|
IP
|
$3,084.03
|
|
|
Service Code
|
HCPCS 26990
|
| Hospital Charge Code |
9900378
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$2,097.14
|
|
