|
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 |
$4,750.54
|
| 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 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 |
$1,996.58
|
| 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 |
$4,677.01
|
| 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
|
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 |
$5,476.44
|
| 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 |
$5,476.44
|
| 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
|
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
|
IP
|
$3,084.03
|
|
|
Service Code
|
HCPCS 26990
|
| Hospital Charge Code |
9900378
|
|
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
|
$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 |
$5,476.44
|
| 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, upper arm or elbow area bursa
|
Facility
|
IP
|
$4,924.50
|
|
|
Service Code
|
HCPCS 23931
|
| Hospital Charge Code |
9900235
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,348.66
|
|
|
Incision and drainage, upper arm or elbow area bursa
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
36023931
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$486.45 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$486.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$2,743.07
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
Incision and drainage, upper arm or elbow area bursa
|
Facility
|
OP
|
$4,924.50
|
|
|
Service Code
|
HCPCS 23931
|
| Hospital Charge Code |
9900235
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$486.45 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$486.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cash Price |
$3,348.66
|
| Rate for Payer: Cash Price |
$3,348.66
|
| Rate for Payer: Cash Price |
$3,348.66
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$3,545.64
|
| 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 |
$3,545.64
|
| 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 |
$3,545.64
|
| Rate for Payer: Scott and White EPO/PPO |
$2,743.07
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$3,545.64
|
| 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, upper arm or elbow area; deep abscess or hematoma
|
Facility
|
OP
|
$10,829.40
|
|
|
Service Code
|
HCPCS 23930
|
| Hospital Charge Code |
991113
|
|
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 |
$7,363.99
|
| Rate for Payer: Cash Price |
$7,363.99
|
| Rate for Payer: Cash Price |
$7,363.99
|
| Rate for Payer: Cigna Commercial |
$6,168.03
|
| Rate for Payer: Cigna Medicaid |
$7,797.17
|
| 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 |
$7,797.17
|
| 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 |
$7,797.17
|
| Rate for Payer: Scott and White EPO/PPO |
$4,807.56
|
| Rate for Payer: Scott and White Medicare |
$2,917.95
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$7,797.17
|
| 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, upper arm or elbow area; deep abscess or hematoma
|
Facility
|
IP
|
$10,829.40
|
|
|
Service Code
|
HCPCS 23930
|
| Hospital Charge Code |
991113
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$7,363.99
|
|
|
Incision and removal of foreign body, subcutaneous tissues; complicated
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
36010121
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$486.45 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$486.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$2,743.07
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
Incision and removal of foreign body, subcutaneous tissues; complicated
|
Facility
|
OP
|
$5,998.20
|
|
|
Service Code
|
HCPCS 10121
|
| Hospital Charge Code |
5202519
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$486.45 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$486.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cash Price |
$4,078.78
|
| Rate for Payer: Cash Price |
$4,078.78
|
| Rate for Payer: Cash Price |
$4,078.78
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$4,318.70
|
| 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 |
$4,318.70
|
| 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 |
$4,318.70
|
| Rate for Payer: Scott and White EPO/PPO |
$2,743.07
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$4,318.70
|
| 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 removal of foreign body, subcutaneous tissues; complicated
|
Facility
|
IP
|
$5,998.20
|
|
|
Service Code
|
HCPCS 10121
|
| Hospital Charge Code |
5202519
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,078.78
|
|
|
Incision and removal of foreign body, subcutaneous tissues; complicated
|
Facility
|
IP
|
$5,998.20
|
|
|
Service Code
|
HCPCS 10121
|
| Hospital Charge Code |
9900075
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,078.78
|
|
|
Incision and removal of foreign body, subcutaneous tissues; complicated
|
Facility
|
OP
|
$5,998.20
|
|
|
Service Code
|
HCPCS 10121
|
| Hospital Charge Code |
9900075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$486.45 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$486.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cash Price |
$4,078.78
|
| Rate for Payer: Cash Price |
$4,078.78
|
| Rate for Payer: Cash Price |
$4,078.78
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$4,318.70
|
| 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 |
$4,318.70
|
| 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 |
$4,318.70
|
| Rate for Payer: Scott and White EPO/PPO |
$2,743.07
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$4,318.70
|
| 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 removal of foreign body, subcutaneous tissues simple
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
36010120
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$86.38 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$86.38
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$408.37
|
| Rate for Payer: Amerigroup Medicare |
$408.37
|
| Rate for Payer: BCBS of TX Blue Advantage |
$178.41
|
| Rate for Payer: BCBS of TX Blue Essentials |
$213.66
|
| Rate for Payer: BCBS of TX Medicare |
$408.37
|
| Rate for Payer: BCBS of TX PPO |
$269.21
|
| 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 |
$674.64
|
| 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 removal of foreign body, subcutaneous tissues simple
|
Facility
|
OP
|
$2,057.12
|
|
|
Service Code
|
HCPCS 10120
|
| Hospital Charge Code |
9900074
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$86.38 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$86.38
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$408.37
|
| Rate for Payer: Amerigroup Medicare |
$408.37
|
| Rate for Payer: BCBS of TX Blue Advantage |
$178.41
|
| Rate for Payer: BCBS of TX Blue Essentials |
$213.66
|
| Rate for Payer: BCBS of TX Medicare |
$408.37
|
| Rate for Payer: BCBS of TX PPO |
$269.21
|
| Rate for Payer: Cash Price |
$1,398.84
|
| Rate for Payer: Cash Price |
$1,398.84
|
| Rate for Payer: Cash Price |
$1,398.84
|
| Rate for Payer: Cigna Commercial |
$863.21
|
| Rate for Payer: Cigna Medicaid |
$1,481.13
|
| 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 |
$1,481.13
|
| 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 |
$1,481.13
|
| Rate for Payer: Scott and White EPO/PPO |
$674.64
|
| Rate for Payer: Scott and White Medicare |
$408.37
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,481.13
|
| 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 removal of foreign body, subcutaneous tissues simple
|
Facility
|
IP
|
$2,057.12
|
|
|
Service Code
|
HCPCS 10120
|
| Hospital Charge Code |
9900074
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,398.84
|
|
|
Incision, bone cortex (eg, osteomyelitis or bone abscess), foot
|
Facility
|
OP
|
$9,906.40
|
|
|
Service Code
|
HCPCS 28005
|
| Hospital Charge Code |
9900456
|
|
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 |
$6,736.35
|
| Rate for Payer: Cash Price |
$6,736.35
|
| Rate for Payer: Cash Price |
$6,736.35
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$7,132.61
|
| 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 |
$7,132.61
|
| 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 |
$7,132.61
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$7,132.61
|
| 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, bone cortex (eg, osteomyelitis or bone abscess), foot
|
Facility
|
IP
|
$9,906.40
|
|
|
Service Code
|
HCPCS 28005
|
| Hospital Charge Code |
9900456
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,736.35
|
|
