White Rock Medical Center

All Charges

Charge

Type

Setting

Price

Laparoscopic Duodenal Switch

Facility

$20,242.00

Service Code	HCPCS 43659
Hospital Charge Code	99412
Hospital Revenue Code	360
Rate for Payer: Cash Price	$13,764.56

Laparoscopic Duodenal Switch

Facility

$20,242.00

Service Code	HCPCS 43659
Hospital Charge Code	99412
Hospital Revenue Code	360
Min. Negotiated Rate	$1,821.78
Max. Negotiated Rate	$14,574.24
Rate for Payer: Amerigroup CHIP/Medicaid	$1,821.78
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Amerigroup Medicare	$6,073.08
Rate for Payer: BCBS of TX Blue Advantage	$8,072.30
Rate for Payer: BCBS of TX Blue Essentials	$9,667.42
Rate for Payer: BCBS of TX Medicare	$6,073.08
Rate for Payer: BCBS of TX PPO	$12,180.95
Rate for Payer: Cash Price	$13,764.56
Rate for Payer: Cash Price	$13,764.56
Rate for Payer: Cash Price	$13,764.56
Rate for Payer: Cigna Commercial	$12,837.39
Rate for Payer: Cigna Medicaid	$14,574.24
Rate for Payer: Cigna Medicare	$6,073.08
Rate for Payer: Employer Direct Commercial	$6,073.08
Rate for Payer: Humana Medicare/TRICARE	$6,073.08
Rate for Payer: Molina CHIP/Medicaid	$14,574.24
Rate for Payer: Molina Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Molina Medicare	$6,073.08
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	$14,574.24
Rate for Payer: Scott and White EPO/PPO	$11,235.20
Rate for Payer: Scott and White Medicare	$6,073.08
Rate for Payer: Superior Health Plan CHIP/Medicaid	$14,574.24
Rate for Payer: Superior Health Plan EPO	$6,073.08
Rate for Payer: Superior Health Plan Medicare	$6,073.08
Rate for Payer: Universal American Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Universal American Medicare	$6,073.08
Rate for Payer: Wellcare Medicare	$6,073.08
Rate for Payer: Wellmed Medicare	$6,073.08

Laparoscopic Electrode

Facility

$53.36

Hospital Charge Code	993168
Hospital Revenue Code	270
Rate for Payer: Cash Price	$36.28

Laparoscopic Electrode

Facility

$53.36

Hospital Charge Code	993168
Hospital Revenue Code	270
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$38.42
Rate for Payer: Amerigroup CHIP/Medicaid	$4.80
Rate for Payer: BCBS of TX Blue Advantage	$16.01
Rate for Payer: BCBS of TX Blue Essentials	$19.21
Rate for Payer: BCBS of TX PPO	$21.34
Rate for Payer: Cash Price	$36.28
Rate for Payer: Cigna Medicaid	$38.42
Rate for Payer: Molina CHIP/Medicaid	$38.42
Rate for Payer: Multiplan Auto	$34.68
Rate for Payer: Multiplan Commercial	$34.68
Rate for Payer: Multiplan Workers Comp	$34.68
Rate for Payer: Parkland Medicaid	$38.42
Rate for Payer: Scott and White EPO/PPO	$26.68
Rate for Payer: Superior Health Plan CHIP/Medicaid	$38.42
Rate for Payer: Superior Health Plan EPO	$7.26

Laparoscopic Liver Biopsy

Facility

$12,837.39

Service Code	CPT 47379
Hospital Charge Code	36047379
Hospital Revenue Code	360
Min. Negotiated Rate	$6,073.08
Max. Negotiated Rate	$12,837.39
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Amerigroup Medicare	$6,073.08
Rate for Payer: BCBS of TX Blue Advantage	$8,072.30
Rate for Payer: BCBS of TX Blue Essentials	$9,667.42
Rate for Payer: BCBS of TX Medicare	$6,073.08
Rate for Payer: BCBS of TX PPO	$12,180.95
Rate for Payer: Cigna Commercial	$12,837.39
Rate for Payer: Cigna Medicare	$6,073.08
Rate for Payer: Employer Direct Commercial	$6,073.08
Rate for Payer: Humana Medicare/TRICARE	$6,073.08
Rate for Payer: Molina Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Molina Medicare	$6,073.08
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	$11,235.20
Rate for Payer: Scott and White Medicare	$6,073.08
Rate for Payer: Superior Health Plan EPO	$6,073.08
Rate for Payer: Superior Health Plan Medicare	$6,073.08
Rate for Payer: Universal American Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Universal American Medicare	$6,073.08
Rate for Payer: Wellcare Medicare	$6,073.08
Rate for Payer: Wellmed Medicare	$6,073.08

Laparoscopic Liver Biopsy

Facility

$11,221.70

Service Code	HCPCS 47379
Hospital Charge Code	9900705
Hospital Revenue Code	360
Min. Negotiated Rate	$6,073.08
Max. Negotiated Rate	$12,837.39
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Amerigroup Medicare	$6,073.08
Rate for Payer: BCBS of TX Blue Advantage	$8,072.30
Rate for Payer: BCBS of TX Blue Essentials	$9,667.42
Rate for Payer: BCBS of TX Medicare	$6,073.08
Rate for Payer: BCBS of TX PPO	$12,180.95
Rate for Payer: Cash Price	$7,630.76
Rate for Payer: Cash Price	$7,630.76
Rate for Payer: Cash Price	$7,630.76
Rate for Payer: Cigna Commercial	$12,837.39
Rate for Payer: Cigna Medicaid	$8,079.62
Rate for Payer: Cigna Medicare	$6,073.08
Rate for Payer: Employer Direct Commercial	$6,073.08
Rate for Payer: Humana Medicare/TRICARE	$6,073.08
Rate for Payer: Molina CHIP/Medicaid	$8,079.62
Rate for Payer: Molina Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Molina Medicare	$6,073.08
Rate for Payer: Multiplan Auto	$10,000.00
Rate for Payer: Multiplan Commercial	$10,000.00
Rate for Payer: Multiplan Workers Comp	$10,000.00
Rate for Payer: Parkland Medicaid	$8,079.62
Rate for Payer: Scott and White EPO/PPO	$11,235.20
Rate for Payer: Scott and White Medicare	$6,073.08
Rate for Payer: Superior Health Plan CHIP/Medicaid	$8,079.62
Rate for Payer: Superior Health Plan EPO	$6,073.08
Rate for Payer: Superior Health Plan Medicare	$6,073.08
Rate for Payer: Universal American Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Universal American Medicare	$6,073.08
Rate for Payer: Wellcare Medicare	$6,073.08
Rate for Payer: Wellmed Medicare	$6,073.08

Laparoscopic Liver Biopsy

Facility

$11,221.70

Service Code	HCPCS 47379
Hospital Charge Code	9900705
Hospital Revenue Code	360
Rate for Payer: Cash Price	$7,630.76

Laparoscopic Revision Band- removal gastric bypass

Facility

$20,242.00

Service Code	HCPCS 43659
Hospital Charge Code	994119
Hospital Revenue Code	360
Rate for Payer: Cash Price	$13,764.56

Laparoscopic Revision Band- removal gastric bypass

Facility

$20,242.00

Service Code	HCPCS 43659
Hospital Charge Code	994119
Hospital Revenue Code	360
Min. Negotiated Rate	$1,821.78
Max. Negotiated Rate	$14,574.24
Rate for Payer: Amerigroup CHIP/Medicaid	$1,821.78
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Amerigroup Medicare	$6,073.08
Rate for Payer: BCBS of TX Blue Advantage	$8,072.30
Rate for Payer: BCBS of TX Blue Essentials	$9,667.42
Rate for Payer: BCBS of TX Medicare	$6,073.08
Rate for Payer: BCBS of TX PPO	$12,180.95
Rate for Payer: Cash Price	$13,764.56
Rate for Payer: Cash Price	$13,764.56
Rate for Payer: Cash Price	$13,764.56
Rate for Payer: Cigna Commercial	$12,837.39
Rate for Payer: Cigna Medicaid	$14,574.24
Rate for Payer: Cigna Medicare	$6,073.08
Rate for Payer: Employer Direct Commercial	$6,073.08
Rate for Payer: Humana Medicare/TRICARE	$6,073.08
Rate for Payer: Molina CHIP/Medicaid	$14,574.24
Rate for Payer: Molina Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Molina Medicare	$6,073.08
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	$14,574.24
Rate for Payer: Scott and White EPO/PPO	$11,235.20
Rate for Payer: Scott and White Medicare	$6,073.08
Rate for Payer: Superior Health Plan CHIP/Medicaid	$14,574.24
Rate for Payer: Superior Health Plan EPO	$6,073.08
Rate for Payer: Superior Health Plan Medicare	$6,073.08
Rate for Payer: Universal American Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Universal American Medicare	$6,073.08
Rate for Payer: Wellcare Medicare	$6,073.08
Rate for Payer: Wellmed Medicare	$6,073.08

Laparoscopic Roux-en-Y Gastric Bypass (Must Include DRG 620/621 and CPT 43644)

Facility

$16,500.00

Service Code	MSDRG 620
Hospital Charge Code	2
Min. Negotiated Rate	$16,500.00
Max. Negotiated Rate	$16,500.00
Rate for Payer: BARInet Commercial	$16,500.00

Laparoscopic Roux-en-Y Gastric Bypass (Must Include DRG 620/621 and CPT 43644)

Facility

$16,500.00

Service Code	MSDRG 621
Hospital Charge Code	2
Min. Negotiated Rate	$16,500.00
Max. Negotiated Rate	$16,500.00
Rate for Payer: BARInet Commercial	$16,500.00

Laparoscopic Roux-en-Y Gastric Bypass (Must Include DRG 620/621 and CPT 43644)

Facility

$16,500.00

Service Code	MSDRG 621
Hospital Charge Code	1
Min. Negotiated Rate	$16,500.00
Max. Negotiated Rate	$16,500.00
Rate for Payer: BARInet Commercial	$16,500.00

Laparoscopic Roux-en-Y Gastric Bypass (Must Include DRG 620/621 and CPT 43644)

Facility

$16,500.00

Service Code	MSDRG 620
Hospital Charge Code	1
Min. Negotiated Rate	$16,500.00
Max. Negotiated Rate	$16,500.00
Rate for Payer: BARInet Commercial	$16,500.00

laparoscopic shears

Facility

$2,224.60

Hospital Charge Code	993972
Hospital Revenue Code	272
Min. Negotiated Rate	$200.21
Max. Negotiated Rate	$1,601.71
Rate for Payer: Amerigroup CHIP/Medicaid	$200.21
Rate for Payer: BCBS of TX Blue Advantage	$667.38
Rate for Payer: BCBS of TX Blue Essentials	$800.86
Rate for Payer: BCBS of TX PPO	$889.84
Rate for Payer: Cash Price	$1,512.73
Rate for Payer: Cigna Medicaid	$1,601.71
Rate for Payer: Molina CHIP/Medicaid	$1,601.71
Rate for Payer: Multiplan Auto	$1,445.99
Rate for Payer: Multiplan Commercial	$1,445.99
Rate for Payer: Multiplan Workers Comp	$1,445.99
Rate for Payer: Parkland Medicaid	$1,601.71
Rate for Payer: Scott and White EPO/PPO	$1,112.30
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1,601.71
Rate for Payer: Superior Health Plan EPO	$302.55

laparoscopic shears

Facility

$2,224.60

Hospital Charge Code	993972
Hospital Revenue Code	272
Rate for Payer: Cash Price	$1,512.73

Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s)

Facility

$22,771.98

Service Code	HCPCS 49320
Hospital Charge Code	9900709
Hospital Revenue Code	360
Min. Negotiated Rate	$1,888.85
Max. Negotiated Rate	$16,395.83
Rate for Payer: Amerigroup CHIP/Medicaid	$1,888.85
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Amerigroup Medicare	$6,073.08
Rate for Payer: BCBS of TX Blue Advantage	$8,072.30
Rate for Payer: BCBS of TX Blue Essentials	$9,667.42
Rate for Payer: BCBS of TX Medicare	$6,073.08
Rate for Payer: BCBS of TX PPO	$12,180.95
Rate for Payer: Cash Price	$15,484.95
Rate for Payer: Cash Price	$15,484.95
Rate for Payer: Cash Price	$15,484.95
Rate for Payer: Cigna Commercial	$12,837.39
Rate for Payer: Cigna Medicaid	$16,395.83
Rate for Payer: Cigna Medicare	$6,073.08
Rate for Payer: Employer Direct Commercial	$6,073.08
Rate for Payer: Humana Medicare/TRICARE	$6,073.08
Rate for Payer: Molina CHIP/Medicaid	$16,395.83
Rate for Payer: Molina Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Molina Medicare	$6,073.08
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	$16,395.83
Rate for Payer: Scott and White EPO/PPO	$11,235.20
Rate for Payer: Scott and White Medicare	$6,073.08
Rate for Payer: Superior Health Plan CHIP/Medicaid	$16,395.83
Rate for Payer: Superior Health Plan EPO	$6,073.08
Rate for Payer: Superior Health Plan Medicare	$6,073.08
Rate for Payer: Universal American Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Universal American Medicare	$6,073.08
Rate for Payer: Wellcare Medicare	$6,073.08
Rate for Payer: Wellmed Medicare	$6,073.08

Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s)

Facility

$12,837.39

Service Code	CPT 49320
Hospital Charge Code	36049320
Hospital Revenue Code	360
Min. Negotiated Rate	$1,888.85
Max. Negotiated Rate	$12,837.39
Rate for Payer: Amerigroup CHIP/Medicaid	$1,888.85
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Amerigroup Medicare	$6,073.08
Rate for Payer: BCBS of TX Blue Advantage	$8,072.30
Rate for Payer: BCBS of TX Blue Essentials	$9,667.42
Rate for Payer: BCBS of TX Medicare	$6,073.08
Rate for Payer: BCBS of TX PPO	$12,180.95
Rate for Payer: Cigna Commercial	$12,837.39
Rate for Payer: Cigna Medicare	$6,073.08
Rate for Payer: Employer Direct Commercial	$6,073.08
Rate for Payer: Humana Medicare/TRICARE	$6,073.08
Rate for Payer: Molina Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Molina Medicare	$6,073.08
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	$11,235.20
Rate for Payer: Scott and White Medicare	$6,073.08
Rate for Payer: Superior Health Plan EPO	$6,073.08
Rate for Payer: Superior Health Plan Medicare	$6,073.08
Rate for Payer: Universal American Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Universal American Medicare	$6,073.08
Rate for Payer: Wellcare Medicare	$6,073.08
Rate for Payer: Wellmed Medicare	$6,073.08

Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s)

Facility

$22,771.98

Service Code	HCPCS 49320
Hospital Charge Code	9900709
Hospital Revenue Code	360
Rate for Payer: Cash Price	$15,484.95

Laparoscopy, Duodenal Switch

Facility

$20,242.00

Service Code	HCPCS 43659
Hospital Charge Code	994215
Hospital Revenue Code	360
Rate for Payer: Cash Price	$13,764.56

Laparoscopy, Duodenal Switch

Facility

$20,242.00

Service Code	HCPCS 43659
Hospital Charge Code	994215
Hospital Revenue Code	360
Min. Negotiated Rate	$1,821.78
Max. Negotiated Rate	$14,574.24
Rate for Payer: Amerigroup CHIP/Medicaid	$1,821.78
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Amerigroup Medicare	$6,073.08
Rate for Payer: BCBS of TX Blue Advantage	$8,072.30
Rate for Payer: BCBS of TX Blue Essentials	$9,667.42
Rate for Payer: BCBS of TX Medicare	$6,073.08
Rate for Payer: BCBS of TX PPO	$12,180.95
Rate for Payer: Cash Price	$13,764.56
Rate for Payer: Cash Price	$13,764.56
Rate for Payer: Cash Price	$13,764.56
Rate for Payer: Cigna Commercial	$12,837.39
Rate for Payer: Cigna Medicaid	$14,574.24
Rate for Payer: Cigna Medicare	$6,073.08
Rate for Payer: Employer Direct Commercial	$6,073.08
Rate for Payer: Humana Medicare/TRICARE	$6,073.08
Rate for Payer: Molina CHIP/Medicaid	$14,574.24
Rate for Payer: Molina Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Molina Medicare	$6,073.08
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	$14,574.24
Rate for Payer: Scott and White EPO/PPO	$11,235.20
Rate for Payer: Scott and White Medicare	$6,073.08
Rate for Payer: Superior Health Plan CHIP/Medicaid	$14,574.24
Rate for Payer: Superior Health Plan EPO	$6,073.08
Rate for Payer: Superior Health Plan Medicare	$6,073.08
Rate for Payer: Universal American Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Universal American Medicare	$6,073.08
Rate for Payer: Wellcare Medicare	$6,073.08
Rate for Payer: Wellmed Medicare	$6,073.08

Laparoscopy, surgical, appendectomy

Facility

$21,990.36

Service Code	HCPCS 44970
Hospital Charge Code	990980
Hospital Revenue Code	360
Rate for Payer: Cash Price	$14,953.44

Laparoscopy, surgical, appendectomy

Facility

$21,990.36

Service Code	HCPCS 44970
Hospital Charge Code	990980
Hospital Revenue Code	360
Min. Negotiated Rate	$1,979.13
Max. Negotiated Rate	$15,833.06
Rate for Payer: Amerigroup CHIP/Medicaid	$1,979.13
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Amerigroup Medicare	$6,073.08
Rate for Payer: BCBS of TX Blue Advantage	$8,072.30
Rate for Payer: BCBS of TX Blue Essentials	$9,667.42
Rate for Payer: BCBS of TX Medicare	$6,073.08
Rate for Payer: BCBS of TX PPO	$12,180.95
Rate for Payer: Cash Price	$14,953.44
Rate for Payer: Cash Price	$14,953.44
Rate for Payer: Cash Price	$14,953.44
Rate for Payer: Cigna Commercial	$12,837.39
Rate for Payer: Cigna Medicaid	$15,833.06
Rate for Payer: Cigna Medicare	$6,073.08
Rate for Payer: Employer Direct Commercial	$6,073.08
Rate for Payer: Humana Medicare/TRICARE	$6,073.08
Rate for Payer: Molina CHIP/Medicaid	$15,833.06
Rate for Payer: Molina Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Molina Medicare	$6,073.08
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	$15,833.06
Rate for Payer: Scott and White EPO/PPO	$11,235.20
Rate for Payer: Scott and White Medicare	$6,073.08
Rate for Payer: Superior Health Plan CHIP/Medicaid	$15,833.06
Rate for Payer: Superior Health Plan EPO	$6,073.08
Rate for Payer: Superior Health Plan Medicare	$6,073.08
Rate for Payer: Universal American Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Universal American Medicare	$6,073.08
Rate for Payer: Wellcare Medicare	$6,073.08
Rate for Payer: Wellmed Medicare	$6,073.08

Laparoscopy, surgical cholecystectomy

Facility

$15,181.32

Service Code	HCPCS 47562
Hospital Charge Code	9900706
Hospital Revenue Code	360
Rate for Payer: Cash Price	$10,323.30

Laparoscopy, surgical cholecystectomy

Facility

$15,181.32

Service Code	HCPCS 47562
Hospital Charge Code	9900706
Hospital Revenue Code	360
Min. Negotiated Rate	$1,888.85
Max. Negotiated Rate	$12,837.39
Rate for Payer: Amerigroup CHIP/Medicaid	$1,888.85
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Amerigroup Medicare	$6,073.08
Rate for Payer: BCBS of TX Blue Advantage	$8,072.30
Rate for Payer: BCBS of TX Blue Essentials	$9,667.42
Rate for Payer: BCBS of TX Medicare	$6,073.08
Rate for Payer: BCBS of TX PPO	$12,180.95
Rate for Payer: Cash Price	$10,323.30
Rate for Payer: Cash Price	$10,323.30
Rate for Payer: Cash Price	$10,323.30
Rate for Payer: Cigna Commercial	$12,837.39
Rate for Payer: Cigna Medicaid	$10,930.55
Rate for Payer: Cigna Medicare	$6,073.08
Rate for Payer: Employer Direct Commercial	$6,073.08
Rate for Payer: Humana Medicare/TRICARE	$6,073.08
Rate for Payer: Molina CHIP/Medicaid	$10,930.55
Rate for Payer: Molina Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Molina Medicare	$6,073.08
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	$10,930.55
Rate for Payer: Scott and White EPO/PPO	$11,235.20
Rate for Payer: Scott and White Medicare	$6,073.08
Rate for Payer: Superior Health Plan CHIP/Medicaid	$10,930.55
Rate for Payer: Superior Health Plan EPO	$6,073.08
Rate for Payer: Superior Health Plan Medicare	$6,073.08
Rate for Payer: Universal American Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Universal American Medicare	$6,073.08
Rate for Payer: Wellcare Medicare	$6,073.08
Rate for Payer: Wellmed Medicare	$6,073.08

Laparoscopy, surgical cholecystectomy

Facility

$12,837.39

Service Code	CPT 47562
Hospital Charge Code	36047562
Hospital Revenue Code	360
Min. Negotiated Rate	$1,888.85
Max. Negotiated Rate	$12,837.39
Rate for Payer: Amerigroup CHIP/Medicaid	$1,888.85
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Amerigroup Medicare	$6,073.08
Rate for Payer: BCBS of TX Blue Advantage	$8,072.30
Rate for Payer: BCBS of TX Blue Essentials	$9,667.42
Rate for Payer: BCBS of TX Medicare	$6,073.08
Rate for Payer: BCBS of TX PPO	$12,180.95
Rate for Payer: Cigna Commercial	$12,837.39
Rate for Payer: Cigna Medicare	$6,073.08
Rate for Payer: Employer Direct Commercial	$6,073.08
Rate for Payer: Humana Medicare/TRICARE	$6,073.08
Rate for Payer: Molina Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Molina Medicare	$6,073.08
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	$11,235.20
Rate for Payer: Scott and White Medicare	$6,073.08
Rate for Payer: Superior Health Plan EPO	$6,073.08
Rate for Payer: Superior Health Plan Medicare	$6,073.08
Rate for Payer: Universal American Dual Medicare/Medicaid	$6,073.08
Rate for Payer: Universal American Medicare	$6,073.08
Rate for Payer: Wellcare Medicare	$6,073.08
Rate for Payer: Wellmed Medicare	$6,073.08

Know your out-of-pocket cost for care.

All Charges