|
PAD, TIP CLEANER ELECTRO SURGICAL LARGE STERILE -- DHF
|
Facility
|
OP
|
$183.92
|
|
| Hospital Charge Code |
80322159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.55 |
| Max. Negotiated Rate |
$119.55 |
| Rate for Payer: Aetna Commercial |
$101.16
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$16.55
|
| Rate for Payer: BCBS of TX Blue Advantage |
$55.18
|
| Rate for Payer: BCBS of TX Blue Essentials |
$66.21
|
| Rate for Payer: BCBS of TX PPO |
$73.57
|
| Rate for Payer: Cash Price |
$161.85
|
| Rate for Payer: Multiplan Auto |
$119.55
|
| Rate for Payer: Multiplan Commercial |
$119.55
|
| Rate for Payer: Multiplan Workers Comp |
$119.55
|
| Rate for Payer: Scott and White EPO/PPO |
$91.96
|
| Rate for Payer: Superior Health Plan EPO |
$25.01
|
|
|
PAD, TIP CLEANER ELECTRO SURGICAL LARGE STERILE -- DHF
|
Facility
|
IP
|
$183.92
|
|
| Hospital Charge Code |
80322159
|
|
Hospital Revenue Code
|
270
|
| Rate for Payer: Cash Price |
$161.85
|
|
|
Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)
|
Facility
|
OP
|
$12,223.34
|
|
|
Service Code
|
CPT 42145
|
| Hospital Charge Code |
36042145
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$118.13 |
| Max. Negotiated Rate |
$12,223.34 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$8,033.61
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,954.22
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$5,355.74
|
| Rate for Payer: Amerigroup Medicare |
$5,355.74
|
| Rate for Payer: BCBS of TX Blue Advantage |
$8,100.39
|
| Rate for Payer: BCBS of TX Blue Essentials |
$9,701.06
|
| Rate for Payer: BCBS of TX Medicare |
$5,355.74
|
| Rate for Payer: BCBS of TX PPO |
$12,223.34
|
| Rate for Payer: Cigna Commercial |
$12,132.30
|
| Rate for Payer: Cigna Medicaid |
$1,954.22
|
| Rate for Payer: Cigna Medicare |
$5,355.74
|
| Rate for Payer: Employer Direct Commercial |
$5,355.74
|
| Rate for Payer: Humana Medicare/TRICARE |
$5,355.74
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,954.22
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$5,355.74
|
| Rate for Payer: Molina Medicare |
$5,355.74
|
| 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 |
$1,954.22
|
| Rate for Payer: Scott and White EPO/PPO |
$118.13
|
| Rate for Payer: Scott and White Medicare |
$5,355.74
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,954.22
|
| Rate for Payer: Superior Health Plan EPO |
$5,355.74
|
| Rate for Payer: Superior Health Plan Medicare |
$5,355.74
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$5,355.74
|
| Rate for Payer: Universal American Medicare |
$5,355.74
|
| Rate for Payer: Wellcare Medicare |
$5,355.74
|
| Rate for Payer: Wellmed Medicare |
$5,355.74
|
|
|
Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 42156
|
| Hospital Charge Code |
36042156
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$10,000.00 |
| 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
|
|
|
PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC
|
Facility
|
IP
|
$54,860.60
|
|
|
Service Code
|
MSDRG 406
|
| Min. Negotiated Rate |
$23,459.43 |
| Max. Negotiated Rate |
$54,860.60 |
| Rate for Payer: Aetna Commercial |
$32,483.25
|
| Rate for Payer: Aetna Medicare |
$35,189.14
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$23,459.43
|
| Rate for Payer: Amerigroup Medicare |
$23,459.43
|
| Rate for Payer: BCBS of TX Blue Advantage |
$23,929.50
|
| Rate for Payer: BCBS of TX Blue Essentials |
$29,229.60
|
| Rate for Payer: BCBS of TX Medicare |
$23,459.43
|
| Rate for Payer: BCBS of TX PPO |
$32,478.59
|
| Rate for Payer: Cigna Commercial |
$37,189.71
|
| Rate for Payer: Cigna Medicare |
$23,459.43
|
| Rate for Payer: Employer Direct Commercial |
$23,459.43
|
| Rate for Payer: Humana Medicare/TRICARE |
$23,459.43
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$23,459.43
|
| Rate for Payer: Molina Medicare |
$23,459.43
|
| Rate for Payer: Multiplan Auto |
$54,860.60
|
| Rate for Payer: Multiplan Commercial |
$54,860.60
|
| Rate for Payer: Multiplan Workers Comp |
$54,860.60
|
| Rate for Payer: Scott and White EPO/PPO |
$25,264.75
|
| Rate for Payer: Scott and White Medicare |
$23,459.43
|
| Rate for Payer: Superior Health Plan EPO |
$23,459.43
|
| Rate for Payer: Superior Health Plan Medicare |
$23,459.43
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$23,459.43
|
| Rate for Payer: Universal American Medicare |
$23,459.43
|
| Rate for Payer: Wellcare Medicare |
$23,459.43
|
| Rate for Payer: Wellmed Medicare |
$23,459.43
|
|
|
PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC
|
Facility
|
IP
|
$104,598.80
|
|
|
Service Code
|
MSDRG 405
|
| Min. Negotiated Rate |
$42,140.21 |
| Max. Negotiated Rate |
$104,598.80 |
| Rate for Payer: Aetna Commercial |
$61,933.50
|
| Rate for Payer: Aetna Medicare |
$63,210.32
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$42,140.21
|
| Rate for Payer: Amerigroup Medicare |
$42,140.21
|
| Rate for Payer: BCBS of TX Blue Advantage |
$46,839.04
|
| Rate for Payer: BCBS of TX Blue Essentials |
$55,506.93
|
| Rate for Payer: BCBS of TX Medicare |
$42,140.21
|
| Rate for Payer: BCBS of TX PPO |
$61,676.76
|
| Rate for Payer: Cigna Commercial |
$70,906.98
|
| Rate for Payer: Cigna Medicare |
$42,140.21
|
| Rate for Payer: Employer Direct Commercial |
$42,140.21
|
| Rate for Payer: Humana Medicare/TRICARE |
$42,140.21
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$42,140.21
|
| Rate for Payer: Molina Medicare |
$42,140.21
|
| Rate for Payer: Multiplan Auto |
$104,598.80
|
| Rate for Payer: Multiplan Commercial |
$104,598.80
|
| Rate for Payer: Multiplan Workers Comp |
$104,598.80
|
| Rate for Payer: Scott and White EPO/PPO |
$48,170.50
|
| Rate for Payer: Scott and White Medicare |
$42,140.21
|
| Rate for Payer: Superior Health Plan EPO |
$42,140.21
|
| Rate for Payer: Superior Health Plan Medicare |
$42,140.21
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$42,140.21
|
| Rate for Payer: Universal American Medicare |
$42,140.21
|
| Rate for Payer: Wellcare Medicare |
$42,140.21
|
| Rate for Payer: Wellmed Medicare |
$42,140.21
|
|
|
PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$40,869.00
|
|
|
Service Code
|
MSDRG 407
|
| Min. Negotiated Rate |
$17,301.48 |
| Max. Negotiated Rate |
$40,869.00 |
| Rate for Payer: Aetna Commercial |
$24,198.75
|
| Rate for Payer: Aetna Medicare |
$27,306.69
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$18,204.46
|
| Rate for Payer: Amerigroup Medicare |
$18,204.46
|
| Rate for Payer: BCBS of TX Blue Advantage |
$17,301.48
|
| Rate for Payer: BCBS of TX Blue Essentials |
$20,708.17
|
| Rate for Payer: BCBS of TX Medicare |
$18,204.46
|
| Rate for Payer: BCBS of TX PPO |
$23,009.97
|
| Rate for Payer: Cigna Commercial |
$27,704.88
|
| Rate for Payer: Cigna Medicare |
$18,204.46
|
| Rate for Payer: Employer Direct Commercial |
$18,204.46
|
| Rate for Payer: Humana Medicare/TRICARE |
$18,204.46
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$18,204.46
|
| Rate for Payer: Molina Medicare |
$18,204.46
|
| Rate for Payer: Multiplan Auto |
$40,869.00
|
| Rate for Payer: Multiplan Commercial |
$40,869.00
|
| Rate for Payer: Multiplan Workers Comp |
$40,869.00
|
| Rate for Payer: Scott and White EPO/PPO |
$18,821.25
|
| Rate for Payer: Scott and White Medicare |
$18,204.46
|
| Rate for Payer: Superior Health Plan EPO |
$18,204.46
|
| Rate for Payer: Superior Health Plan Medicare |
$18,204.46
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$18,204.46
|
| Rate for Payer: Universal American Medicare |
$18,204.46
|
| Rate for Payer: Wellcare Medicare |
$18,204.46
|
| Rate for Payer: Wellmed Medicare |
$18,204.46
|
|
|
PANCREAS TRANSPLANT
|
Facility
|
IP
|
$91,458.40
|
|
|
Service Code
|
MSDRG 010
|
| Min. Negotiated Rate |
$33,026.58 |
| Max. Negotiated Rate |
$91,458.40 |
| Rate for Payer: Aetna Commercial |
$54,153.00
|
| Rate for Payer: Aetna Medicare |
$55,807.38
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$37,204.92
|
| Rate for Payer: Amerigroup Medicare |
$37,204.92
|
| Rate for Payer: BCBS of TX Blue Advantage |
$33,026.58
|
| Rate for Payer: BCBS of TX Blue Essentials |
$46,578.93
|
| Rate for Payer: BCBS of TX Medicare |
$37,204.92
|
| Rate for Payer: BCBS of TX PPO |
$51,756.38
|
| Rate for Payer: Cigna Commercial |
$61,999.17
|
| Rate for Payer: Cigna Medicare |
$37,204.92
|
| Rate for Payer: Employer Direct Commercial |
$37,204.92
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$37,204.92
|
| Rate for Payer: Molina Medicare |
$37,204.92
|
| Rate for Payer: Multiplan Auto |
$91,458.40
|
| Rate for Payer: Multiplan Commercial |
$91,458.40
|
| Rate for Payer: Multiplan Workers Comp |
$91,458.40
|
| Rate for Payer: Scott and White EPO/PPO |
$42,119.00
|
| Rate for Payer: Scott and White Medicare |
$37,204.92
|
| Rate for Payer: Superior Health Plan EPO |
$37,204.92
|
| Rate for Payer: Superior Health Plan Medicare |
$37,204.92
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$37,204.92
|
| Rate for Payer: Universal American Medicare |
$37,204.92
|
| Rate for Payer: Wellcare Medicare |
$37,204.92
|
| Rate for Payer: Wellmed Medicare |
$37,204.92
|
|
|
Pancreatic Elastase, Fecal SO
|
Facility
|
OP
|
$415.00
|
|
|
Service Code
|
CPT 82656
|
| Hospital Charge Code |
1720077
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$269.75 |
| Rate for Payer: Aetna Commercial |
$12.11
|
| Rate for Payer: Aetna Medicare |
$17.30
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$4.50
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$11.53
|
| Rate for Payer: Amerigroup Medicare |
$11.53
|
| Rate for Payer: BCBS of TX Blue Advantage |
$19.02
|
| Rate for Payer: BCBS of TX Blue Essentials |
$22.83
|
| Rate for Payer: BCBS of TX Medicare |
$11.53
|
| Rate for Payer: BCBS of TX PPO |
$25.48
|
| Rate for Payer: Cash Price |
$365.20
|
| Rate for Payer: Cash Price |
$365.20
|
| Rate for Payer: Cigna Medicaid |
$11.53
|
| Rate for Payer: Cigna Medicare |
$11.53
|
| Rate for Payer: Employer Direct Commercial |
$11.53
|
| Rate for Payer: Humana Medicare/TRICARE |
$11.53
|
| Rate for Payer: Molina CHIP/Medicaid |
$11.53
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$11.53
|
| Rate for Payer: Molina Medicare |
$11.53
|
| Rate for Payer: Multiplan Auto |
$269.75
|
| Rate for Payer: Multiplan Commercial |
$269.75
|
| Rate for Payer: Multiplan Workers Comp |
$269.75
|
| Rate for Payer: Parkland Medicaid |
$11.53
|
| Rate for Payer: Scott and White EPO/PPO |
$14.41
|
| Rate for Payer: Scott and White Medicare |
$11.53
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$11.53
|
| Rate for Payer: Superior Health Plan EPO |
$11.53
|
| Rate for Payer: Superior Health Plan Medicare |
$11.53
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$11.53
|
| Rate for Payer: Universal American Medicare |
$11.53
|
| Rate for Payer: Wellcare Medicare |
$11.53
|
| Rate for Payer: Wellmed Medicare |
$11.53
|
|
|
Pancreatic Elastase, Fecal SO
|
Facility
|
IP
|
$415.00
|
|
|
Service Code
|
CPT 82656
|
| Hospital Charge Code |
1720077
|
|
Hospital Revenue Code
|
301
|
| Rate for Payer: Cash Price |
$365.20
|
|
|
pantoprazole 40 mg DR Tab
|
Facility
|
IP
|
$20.05
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
77747563
|
|
Hospital Revenue Code
|
250
|
| Rate for Payer: Cash Price |
$13.63
|
|
|
pantoprazole 40 mg DR Tab
|
Facility
|
OP
|
$20.05
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
77747563
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.80 |
| Max. Negotiated Rate |
$13.03 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1.80
|
| Rate for Payer: BCBS of TX Blue Advantage |
$6.02
|
| Rate for Payer: BCBS of TX Blue Essentials |
$7.22
|
| Rate for Payer: BCBS of TX PPO |
$8.02
|
| Rate for Payer: Cash Price |
$13.63
|
| Rate for Payer: Multiplan Auto |
$13.03
|
| Rate for Payer: Multiplan Commercial |
$13.03
|
| Rate for Payer: Multiplan Workers Comp |
$13.03
|
| Rate for Payer: Scott and White EPO/PPO |
$10.02
|
| Rate for Payer: Superior Health Plan EPO |
$2.73
|
|
|
pantoprazole 40 mg iv
|
Facility
|
IP
|
$128.17
|
|
|
Service Code
|
HCPCS J2470
|
| Hospital Charge Code |
78414989
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$32.04 |
| Max. Negotiated Rate |
$64.08 |
| Rate for Payer: Cash Price |
$87.16
|
| Rate for Payer: Cigna Commercial |
$32.04
|
| Rate for Payer: Scott and White EPO/PPO |
$64.08
|
|
|
pantoprazole 40 mg iv
|
Facility
|
OP
|
$128.17
|
|
|
Service Code
|
HCPCS J2470
|
| Hospital Charge Code |
78414989
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.54 |
| Max. Negotiated Rate |
$83.31 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$11.54
|
| Rate for Payer: BCBS of TX Blue Advantage |
$38.45
|
| Rate for Payer: BCBS of TX Blue Essentials |
$46.14
|
| Rate for Payer: BCBS of TX PPO |
$51.27
|
| Rate for Payer: Cash Price |
$87.16
|
| Rate for Payer: Multiplan Auto |
$83.31
|
| Rate for Payer: Multiplan Commercial |
$83.31
|
| Rate for Payer: Multiplan Workers Comp |
$83.31
|
| Rate for Payer: Scott and White EPO/PPO |
$64.08
|
| Rate for Payer: Superior Health Plan EPO |
$17.43
|
|
|
pantoprazole 40 mg IV Inj
|
Facility
|
IP
|
$128.17
|
|
|
Service Code
|
HCPCS J2470
|
| Hospital Charge Code |
8037080
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$32.04 |
| Max. Negotiated Rate |
$64.08 |
| Rate for Payer: Cash Price |
$87.16
|
| Rate for Payer: Cigna Commercial |
$32.04
|
| Rate for Payer: Scott and White EPO/PPO |
$64.08
|
|
|
pantoprazole 40 mg IV Inj
|
Facility
|
OP
|
$128.17
|
|
|
Service Code
|
HCPCS J2470
|
| Hospital Charge Code |
8037080
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.54 |
| Max. Negotiated Rate |
$83.31 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$11.54
|
| Rate for Payer: BCBS of TX Blue Advantage |
$38.45
|
| Rate for Payer: BCBS of TX Blue Essentials |
$46.14
|
| Rate for Payer: BCBS of TX PPO |
$51.27
|
| Rate for Payer: Cash Price |
$87.16
|
| Rate for Payer: Multiplan Auto |
$83.31
|
| Rate for Payer: Multiplan Commercial |
$83.31
|
| Rate for Payer: Multiplan Workers Comp |
$83.31
|
| Rate for Payer: Scott and White EPO/PPO |
$64.08
|
| Rate for Payer: Superior Health Plan EPO |
$17.43
|
|
|
Pap IG (Image Guided) SO
|
Facility
|
OP
|
$169.00
|
|
|
Service Code
|
CPT 88175
|
| Hospital Charge Code |
8662511
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$10.38 |
| Max. Negotiated Rate |
$109.85 |
| Rate for Payer: Aetna Commercial |
$27.95
|
| Rate for Payer: Aetna Medicare |
$39.92
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$10.38
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$26.61
|
| Rate for Payer: Amerigroup Medicare |
$26.61
|
| Rate for Payer: BCBS of TX Blue Advantage |
$43.91
|
| Rate for Payer: BCBS of TX Blue Essentials |
$52.69
|
| Rate for Payer: BCBS of TX Medicare |
$26.61
|
| Rate for Payer: BCBS of TX PPO |
$58.81
|
| Rate for Payer: Cash Price |
$148.72
|
| Rate for Payer: Cash Price |
$148.72
|
| Rate for Payer: Cigna Medicaid |
$26.61
|
| Rate for Payer: Cigna Medicare |
$26.61
|
| Rate for Payer: Employer Direct Commercial |
$26.61
|
| Rate for Payer: Humana Medicare/TRICARE |
$26.61
|
| Rate for Payer: Molina CHIP/Medicaid |
$26.61
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$26.61
|
| Rate for Payer: Molina Medicare |
$26.61
|
| Rate for Payer: Multiplan Auto |
$109.85
|
| Rate for Payer: Multiplan Commercial |
$109.85
|
| Rate for Payer: Multiplan Workers Comp |
$109.85
|
| Rate for Payer: Parkland Medicaid |
$26.61
|
| Rate for Payer: Scott and White EPO/PPO |
$33.26
|
| Rate for Payer: Scott and White Medicare |
$26.61
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$26.61
|
| Rate for Payer: Superior Health Plan EPO |
$26.61
|
| Rate for Payer: Superior Health Plan Medicare |
$26.61
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$26.61
|
| Rate for Payer: Universal American Medicare |
$26.61
|
| Rate for Payer: Wellcare Medicare |
$26.61
|
| Rate for Payer: Wellmed Medicare |
$26.61
|
|
|
Pap IG (Image Guided) SO
|
Facility
|
IP
|
$169.00
|
|
|
Service Code
|
CPT 88175
|
| Hospital Charge Code |
8662511
|
|
Hospital Revenue Code
|
311
|
| Rate for Payer: Cash Price |
$148.72
|
|
|
PARATHORMONE (PARATHYROID HORMONE)
|
Facility
|
OP
|
$302.00
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
1707926
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.10 |
| Max. Negotiated Rate |
$196.30 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$61.92
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$16.10
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$41.28
|
| Rate for Payer: Amerigroup Medicare |
$41.28
|
| Rate for Payer: BCBS of TX Blue Advantage |
$68.11
|
| Rate for Payer: BCBS of TX Blue Essentials |
$81.73
|
| Rate for Payer: BCBS of TX Medicare |
$41.28
|
| Rate for Payer: BCBS of TX PPO |
$91.23
|
| Rate for Payer: Cash Price |
$265.76
|
| Rate for Payer: Cash Price |
$265.76
|
| Rate for Payer: Cigna Medicaid |
$41.28
|
| Rate for Payer: Cigna Medicare |
$41.28
|
| Rate for Payer: Employer Direct Commercial |
$41.28
|
| Rate for Payer: Humana Medicare/TRICARE |
$41.28
|
| Rate for Payer: Molina CHIP/Medicaid |
$41.28
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$41.28
|
| Rate for Payer: Molina Medicare |
$41.28
|
| Rate for Payer: Multiplan Auto |
$196.30
|
| Rate for Payer: Multiplan Commercial |
$196.30
|
| Rate for Payer: Multiplan Workers Comp |
$196.30
|
| Rate for Payer: Parkland Medicaid |
$41.28
|
| Rate for Payer: Scott and White EPO/PPO |
$51.60
|
| Rate for Payer: Scott and White Medicare |
$41.28
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$41.28
|
| Rate for Payer: Superior Health Plan EPO |
$41.28
|
| Rate for Payer: Superior Health Plan Medicare |
$41.28
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$41.28
|
| Rate for Payer: Universal American Medicare |
$41.28
|
| Rate for Payer: Wellcare Medicare |
$41.28
|
| Rate for Payer: Wellmed Medicare |
$41.28
|
|
|
Parathyroid Hormone Intact Intraoperative/Post Operative
|
Facility
|
IP
|
$302.00
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
1707926
|
|
Hospital Revenue Code
|
301
|
| Rate for Payer: Cash Price |
$265.76
|
|
|
Parathyroid Hormone Intact Intraoperative/Post Operative
|
Facility
|
OP
|
$302.00
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
1707926
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.10 |
| Max. Negotiated Rate |
$196.30 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$61.92
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$16.10
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$41.28
|
| Rate for Payer: Amerigroup Medicare |
$41.28
|
| Rate for Payer: BCBS of TX Blue Advantage |
$68.11
|
| Rate for Payer: BCBS of TX Blue Essentials |
$81.73
|
| Rate for Payer: BCBS of TX Medicare |
$41.28
|
| Rate for Payer: BCBS of TX PPO |
$91.23
|
| Rate for Payer: Cash Price |
$265.76
|
| Rate for Payer: Cash Price |
$265.76
|
| Rate for Payer: Cigna Medicaid |
$41.28
|
| Rate for Payer: Cigna Medicare |
$41.28
|
| Rate for Payer: Employer Direct Commercial |
$41.28
|
| Rate for Payer: Humana Medicare/TRICARE |
$41.28
|
| Rate for Payer: Molina CHIP/Medicaid |
$41.28
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$41.28
|
| Rate for Payer: Molina Medicare |
$41.28
|
| Rate for Payer: Multiplan Auto |
$196.30
|
| Rate for Payer: Multiplan Commercial |
$196.30
|
| Rate for Payer: Multiplan Workers Comp |
$196.30
|
| Rate for Payer: Parkland Medicaid |
$41.28
|
| Rate for Payer: Scott and White EPO/PPO |
$51.60
|
| Rate for Payer: Scott and White Medicare |
$41.28
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$41.28
|
| Rate for Payer: Superior Health Plan EPO |
$41.28
|
| Rate for Payer: Superior Health Plan Medicare |
$41.28
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$41.28
|
| Rate for Payer: Universal American Medicare |
$41.28
|
| Rate for Payer: Wellcare Medicare |
$41.28
|
| Rate for Payer: Wellmed Medicare |
$41.28
|
|
|
Paravertebral block (PVB) (paraspinous block), thoracic; second and any additional injection site(s)
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 64462
|
| Hospital Charge Code |
36064462
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$10,000.00 |
| 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
|
|
|
Paravertebral block (PVB) (paraspinous block), thoracic; single injection site (includes imaging gui
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 64461
|
| Hospital Charge Code |
36064461
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$13.95 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$948.68
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$262.86
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Amerigroup Medicare |
$632.45
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,043.83
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,250.10
|
| Rate for Payer: BCBS of TX Medicare |
$632.45
|
| Rate for Payer: BCBS of TX PPO |
$1,575.13
|
| Rate for Payer: Cigna Commercial |
$1,432.68
|
| Rate for Payer: Cigna Medicaid |
$262.86
|
| Rate for Payer: Cigna Medicare |
$632.45
|
| Rate for Payer: Employer Direct Commercial |
$632.45
|
| Rate for Payer: Humana Medicare/TRICARE |
$632.45
|
| Rate for Payer: Molina CHIP/Medicaid |
$262.86
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Molina Medicare |
$632.45
|
| 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 |
$262.86
|
| Rate for Payer: Scott and White EPO/PPO |
$13.95
|
| Rate for Payer: Scott and White Medicare |
$632.45
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$262.86
|
| Rate for Payer: Superior Health Plan EPO |
$632.45
|
| Rate for Payer: Superior Health Plan Medicare |
$632.45
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$632.45
|
| Rate for Payer: Universal American Medicare |
$632.45
|
| Rate for Payer: Wellcare Medicare |
$632.45
|
| Rate for Payer: Wellmed Medicare |
$632.45
|
|
|
Paring/Cutting Benign Lesion 2-4
|
Facility
|
OP
|
$403.00
|
|
|
Service Code
|
CPT 11056
|
| Hospital Charge Code |
7150779
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$440.32 |
| Rate for Payer: Aetna Commercial |
$221.65
|
| Rate for Payer: Aetna Medicare |
$274.64
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$36.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$183.09
|
| Rate for Payer: Amerigroup Medicare |
$183.09
|
| Rate for Payer: BCBS of TX Blue Advantage |
$291.80
|
| Rate for Payer: BCBS of TX Blue Essentials |
$349.46
|
| Rate for Payer: BCBS of TX Medicare |
$183.09
|
| Rate for Payer: BCBS of TX PPO |
$440.32
|
| Rate for Payer: Cash Price |
$354.64
|
| Rate for Payer: Cash Price |
$354.64
|
| Rate for Payer: Cash Price |
$354.64
|
| Rate for Payer: Cigna Commercial |
$414.75
|
| Rate for Payer: Cigna Medicare |
$183.09
|
| Rate for Payer: Employer Direct Commercial |
$183.09
|
| Rate for Payer: Humana Medicare/TRICARE |
$183.09
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$183.09
|
| Rate for Payer: Molina Medicare |
$183.09
|
| Rate for Payer: Multiplan Auto |
$261.95
|
| Rate for Payer: Multiplan Commercial |
$261.95
|
| Rate for Payer: Multiplan Workers Comp |
$261.95
|
| Rate for Payer: Scott and White EPO/PPO |
$3.27
|
| Rate for Payer: Scott and White Medicare |
$183.09
|
| Rate for Payer: Superior Health Plan EPO |
$183.09
|
| Rate for Payer: Superior Health Plan Medicare |
$183.09
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$183.09
|
| Rate for Payer: Universal American Medicare |
$183.09
|
| Rate for Payer: Wellcare Medicare |
$183.09
|
| Rate for Payer: Wellmed Medicare |
$183.09
|
|
|
Paring/Cutting Benign Lesion Over 4
|
Facility
|
OP
|
$521.00
|
|
|
Service Code
|
CPT 11057
|
| Hospital Charge Code |
7150780
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$414.75 |
| Rate for Payer: Aetna Commercial |
$286.55
|
| Rate for Payer: Aetna Medicare |
$274.64
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$46.89
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$183.09
|
| Rate for Payer: Amerigroup Medicare |
$183.09
|
| Rate for Payer: BCBS of TX Blue Advantage |
$97.03
|
| Rate for Payer: BCBS of TX Blue Essentials |
$116.20
|
| Rate for Payer: BCBS of TX Medicare |
$183.09
|
| Rate for Payer: BCBS of TX PPO |
$146.41
|
| Rate for Payer: Cash Price |
$458.48
|
| Rate for Payer: Cash Price |
$458.48
|
| Rate for Payer: Cash Price |
$458.48
|
| Rate for Payer: Cigna Commercial |
$414.75
|
| Rate for Payer: Cigna Medicaid |
$55.65
|
| Rate for Payer: Cigna Medicare |
$183.09
|
| Rate for Payer: Employer Direct Commercial |
$183.09
|
| Rate for Payer: Humana Medicare/TRICARE |
$183.09
|
| Rate for Payer: Molina CHIP/Medicaid |
$55.65
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$183.09
|
| Rate for Payer: Molina Medicare |
$183.09
|
| Rate for Payer: Multiplan Auto |
$338.65
|
| Rate for Payer: Multiplan Commercial |
$338.65
|
| Rate for Payer: Multiplan Workers Comp |
$338.65
|
| Rate for Payer: Parkland Medicaid |
$55.65
|
| Rate for Payer: Scott and White EPO/PPO |
$3.27
|
| Rate for Payer: Scott and White Medicare |
$183.09
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$55.65
|
| Rate for Payer: Superior Health Plan EPO |
$183.09
|
| Rate for Payer: Superior Health Plan Medicare |
$183.09
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$183.09
|
| Rate for Payer: Universal American Medicare |
$183.09
|
| Rate for Payer: Wellcare Medicare |
$183.09
|
| Rate for Payer: Wellmed Medicare |
$183.09
|
|
