|
Nasal/sinus endoscopy, surgical with ethmoidectomy total (anterior and posterior)
|
Facility
|
IP
|
$46,582.08
|
|
|
Service Code
|
HCPCS 31255
|
| Hospital Charge Code |
9900605
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$31,675.81
|
|
|
Nasal/sinus endoscopy, surgical with ethmoidectomy total (anterior and posterior)
|
Facility
|
OP
|
$14,986.17
|
|
|
Service Code
|
CPT 31255
|
| Hospital Charge Code |
36031255
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,630.12 |
| Max. Negotiated Rate |
$14,986.17 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,630.12
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Amerigroup Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,085.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,880.72
|
| Rate for Payer: BCBS of TX Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX PPO |
$13,709.71
|
| Rate for Payer: Cigna Commercial |
$14,986.17
|
| Rate for Payer: Cigna Medicare |
$7,089.62
|
| Rate for Payer: Employer Direct Commercial |
$7,089.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,089.62
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Molina Medicare |
$7,089.62
|
| 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 |
$11,579.95
|
| Rate for Payer: Scott and White Medicare |
$7,089.62
|
| Rate for Payer: Superior Health Plan EPO |
$7,089.62
|
| Rate for Payer: Superior Health Plan Medicare |
$7,089.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Universal American Medicare |
$7,089.62
|
| Rate for Payer: Wellcare Medicare |
$7,089.62
|
| Rate for Payer: Wellmed Medicare |
$7,089.62
|
|
|
Nasal/sinus endoscopy, surgical with ethmoidectomy total (anterior and posterior)
|
Facility
|
OP
|
$46,582.08
|
|
|
Service Code
|
HCPCS 31255
|
| Hospital Charge Code |
9900605
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,630.12 |
| Max. Negotiated Rate |
$33,539.10 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,630.12
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Amerigroup Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,085.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,880.72
|
| Rate for Payer: BCBS of TX Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX PPO |
$13,709.71
|
| Rate for Payer: Cash Price |
$31,675.81
|
| Rate for Payer: Cash Price |
$31,675.81
|
| Rate for Payer: Cash Price |
$31,675.81
|
| Rate for Payer: Cigna Commercial |
$14,986.17
|
| Rate for Payer: Cigna Medicaid |
$33,539.10
|
| Rate for Payer: Cigna Medicare |
$7,089.62
|
| Rate for Payer: Employer Direct Commercial |
$7,089.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,089.62
|
| Rate for Payer: Molina CHIP/Medicaid |
$33,539.10
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Molina Medicare |
$7,089.62
|
| 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 |
$33,539.10
|
| Rate for Payer: Scott and White EPO/PPO |
$11,579.95
|
| Rate for Payer: Scott and White Medicare |
$7,089.62
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$33,539.10
|
| Rate for Payer: Superior Health Plan EPO |
$7,089.62
|
| Rate for Payer: Superior Health Plan Medicare |
$7,089.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Universal American Medicare |
$7,089.62
|
| Rate for Payer: Wellcare Medicare |
$7,089.62
|
| Rate for Payer: Wellmed Medicare |
$7,089.62
|
|
|
Nasal/sinus endoscopy, surgical with ethmoidectomy total (anterior and posterior), including fronta
|
Facility
|
IP
|
$14,556.90
|
|
|
Service Code
|
HCPCS 31253
|
| Hospital Charge Code |
9900603
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$9,898.69
|
|
|
Nasal/sinus endoscopy, surgical with ethmoidectomy total (anterior and posterior), including fronta
|
Facility
|
OP
|
$14,986.17
|
|
|
Service Code
|
CPT 31253
|
| Hospital Charge Code |
36031253
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,630.12 |
| Max. Negotiated Rate |
$14,986.17 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,630.12
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Amerigroup Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,085.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,880.72
|
| Rate for Payer: BCBS of TX Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX PPO |
$13,709.71
|
| Rate for Payer: Cigna Commercial |
$14,986.17
|
| Rate for Payer: Cigna Medicare |
$7,089.62
|
| Rate for Payer: Employer Direct Commercial |
$7,089.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,089.62
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Molina Medicare |
$7,089.62
|
| 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 |
$11,579.95
|
| Rate for Payer: Scott and White Medicare |
$7,089.62
|
| Rate for Payer: Superior Health Plan EPO |
$7,089.62
|
| Rate for Payer: Superior Health Plan Medicare |
$7,089.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Universal American Medicare |
$7,089.62
|
| Rate for Payer: Wellcare Medicare |
$7,089.62
|
| Rate for Payer: Wellmed Medicare |
$7,089.62
|
|
|
Nasal/sinus endoscopy, surgical with ethmoidectomy total (anterior and posterior), including fronta
|
Facility
|
OP
|
$14,556.90
|
|
|
Service Code
|
HCPCS 31253
|
| Hospital Charge Code |
9900603
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,630.12 |
| Max. Negotiated Rate |
$14,986.17 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,630.12
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Amerigroup Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,085.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,880.72
|
| Rate for Payer: BCBS of TX Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX PPO |
$13,709.71
|
| Rate for Payer: Cash Price |
$9,898.69
|
| Rate for Payer: Cash Price |
$9,898.69
|
| Rate for Payer: Cash Price |
$9,898.69
|
| Rate for Payer: Cigna Commercial |
$14,986.17
|
| Rate for Payer: Cigna Medicaid |
$10,480.97
|
| Rate for Payer: Cigna Medicare |
$7,089.62
|
| Rate for Payer: Employer Direct Commercial |
$7,089.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,089.62
|
| Rate for Payer: Molina CHIP/Medicaid |
$10,480.97
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Molina Medicare |
$7,089.62
|
| 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 |
$10,480.97
|
| Rate for Payer: Scott and White EPO/PPO |
$11,579.95
|
| Rate for Payer: Scott and White Medicare |
$7,089.62
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$10,480.97
|
| Rate for Payer: Superior Health Plan EPO |
$7,089.62
|
| Rate for Payer: Superior Health Plan Medicare |
$7,089.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Universal American Medicare |
$7,089.62
|
| Rate for Payer: Wellcare Medicare |
$7,089.62
|
| Rate for Payer: Wellmed Medicare |
$7,089.62
|
|
|
Nasal/sinus endoscopy, surgical with ethmoidectomy total (anterior and posterior), including spheno
|
Facility
|
IP
|
$23,291.04
|
|
|
Service Code
|
HCPCS 31259
|
| Hospital Charge Code |
9900608
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$15,837.91
|
|
|
Nasal/sinus endoscopy, surgical with ethmoidectomy total (anterior and posterior), including spheno
|
Facility
|
OP
|
$23,291.04
|
|
|
Service Code
|
HCPCS 31259
|
| Hospital Charge Code |
9900608
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,630.12 |
| Max. Negotiated Rate |
$16,769.55 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,630.12
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Amerigroup Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,085.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,880.72
|
| Rate for Payer: BCBS of TX Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX PPO |
$13,709.71
|
| Rate for Payer: Cash Price |
$15,837.91
|
| Rate for Payer: Cash Price |
$15,837.91
|
| Rate for Payer: Cash Price |
$15,837.91
|
| Rate for Payer: Cigna Commercial |
$14,986.17
|
| Rate for Payer: Cigna Medicaid |
$16,769.55
|
| Rate for Payer: Cigna Medicare |
$7,089.62
|
| Rate for Payer: Employer Direct Commercial |
$7,089.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,089.62
|
| Rate for Payer: Molina CHIP/Medicaid |
$16,769.55
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Molina Medicare |
$7,089.62
|
| 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 |
$16,769.55
|
| Rate for Payer: Scott and White EPO/PPO |
$11,579.95
|
| Rate for Payer: Scott and White Medicare |
$7,089.62
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$16,769.55
|
| Rate for Payer: Superior Health Plan EPO |
$7,089.62
|
| Rate for Payer: Superior Health Plan Medicare |
$7,089.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Universal American Medicare |
$7,089.62
|
| Rate for Payer: Wellcare Medicare |
$7,089.62
|
| Rate for Payer: Wellmed Medicare |
$7,089.62
|
|
|
Nasal/sinus endoscopy, surgical with ethmoidectomy total (anterior and posterior), including spheno
|
Facility
|
OP
|
$14,986.17
|
|
|
Service Code
|
CPT 31259
|
| Hospital Charge Code |
36031259
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,630.12 |
| Max. Negotiated Rate |
$14,986.17 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,630.12
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Amerigroup Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,085.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,880.72
|
| Rate for Payer: BCBS of TX Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX PPO |
$13,709.71
|
| Rate for Payer: Cigna Commercial |
$14,986.17
|
| Rate for Payer: Cigna Medicare |
$7,089.62
|
| Rate for Payer: Employer Direct Commercial |
$7,089.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,089.62
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Molina Medicare |
$7,089.62
|
| 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 |
$11,579.95
|
| Rate for Payer: Scott and White Medicare |
$7,089.62
|
| Rate for Payer: Superior Health Plan EPO |
$7,089.62
|
| Rate for Payer: Superior Health Plan Medicare |
$7,089.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Universal American Medicare |
$7,089.62
|
| Rate for Payer: Wellcare Medicare |
$7,089.62
|
| Rate for Payer: Wellmed Medicare |
$7,089.62
|
|
|
Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including spheno
|
Facility
|
IP
|
$4,864.17
|
|
|
Service Code
|
HCPCS 31257
|
| Hospital Charge Code |
9900607
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,307.64
|
|
|
Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including spheno
|
Facility
|
OP
|
$14,986.17
|
|
|
Service Code
|
CPT 31257
|
| Hospital Charge Code |
36031257
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,630.12 |
| Max. Negotiated Rate |
$14,986.17 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,630.12
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Amerigroup Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,085.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,880.72
|
| Rate for Payer: BCBS of TX Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX PPO |
$13,709.71
|
| Rate for Payer: Cigna Commercial |
$14,986.17
|
| Rate for Payer: Cigna Medicare |
$7,089.62
|
| Rate for Payer: Employer Direct Commercial |
$7,089.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,089.62
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Molina Medicare |
$7,089.62
|
| 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 |
$11,579.95
|
| Rate for Payer: Scott and White Medicare |
$7,089.62
|
| Rate for Payer: Superior Health Plan EPO |
$7,089.62
|
| Rate for Payer: Superior Health Plan Medicare |
$7,089.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Universal American Medicare |
$7,089.62
|
| Rate for Payer: Wellcare Medicare |
$7,089.62
|
| Rate for Payer: Wellmed Medicare |
$7,089.62
|
|
|
Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including spheno
|
Facility
|
OP
|
$4,864.17
|
|
|
Service Code
|
HCPCS 31257
|
| Hospital Charge Code |
9900607
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,630.12 |
| Max. Negotiated Rate |
$14,986.17 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,630.12
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Amerigroup Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,085.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,880.72
|
| Rate for Payer: BCBS of TX Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX PPO |
$13,709.71
|
| Rate for Payer: Cash Price |
$3,307.64
|
| Rate for Payer: Cash Price |
$3,307.64
|
| Rate for Payer: Cash Price |
$3,307.64
|
| Rate for Payer: Cigna Commercial |
$14,986.17
|
| Rate for Payer: Cigna Medicaid |
$3,502.20
|
| Rate for Payer: Cigna Medicare |
$7,089.62
|
| Rate for Payer: Employer Direct Commercial |
$7,089.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,089.62
|
| Rate for Payer: Molina CHIP/Medicaid |
$3,502.20
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Molina Medicare |
$7,089.62
|
| 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 |
$3,502.20
|
| Rate for Payer: Scott and White EPO/PPO |
$11,579.95
|
| Rate for Payer: Scott and White Medicare |
$7,089.62
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$3,502.20
|
| Rate for Payer: Superior Health Plan EPO |
$7,089.62
|
| Rate for Payer: Superior Health Plan Medicare |
$7,089.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Universal American Medicare |
$7,089.62
|
| Rate for Payer: Wellcare Medicare |
$7,089.62
|
| Rate for Payer: Wellmed Medicare |
$7,089.62
|
|
|
Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from fr
|
Facility
|
OP
|
$14,986.17
|
|
|
Service Code
|
CPT 31276
|
| Hospital Charge Code |
36031276
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,630.12 |
| Max. Negotiated Rate |
$14,986.17 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,630.12
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Amerigroup Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,085.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,880.72
|
| Rate for Payer: BCBS of TX Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX PPO |
$13,709.71
|
| Rate for Payer: Cigna Commercial |
$14,986.17
|
| Rate for Payer: Cigna Medicare |
$7,089.62
|
| Rate for Payer: Employer Direct Commercial |
$7,089.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,089.62
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Molina Medicare |
$7,089.62
|
| 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 |
$11,579.95
|
| Rate for Payer: Scott and White Medicare |
$7,089.62
|
| Rate for Payer: Superior Health Plan EPO |
$7,089.62
|
| Rate for Payer: Superior Health Plan Medicare |
$7,089.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Universal American Medicare |
$7,089.62
|
| Rate for Payer: Wellcare Medicare |
$7,089.62
|
| Rate for Payer: Wellmed Medicare |
$7,089.62
|
|
|
Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from fr
|
Facility
|
IP
|
$23,291.04
|
|
|
Service Code
|
HCPCS 31276
|
| Hospital Charge Code |
9900610
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$15,837.91
|
|
|
Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from fr
|
Facility
|
OP
|
$23,291.04
|
|
|
Service Code
|
HCPCS 31276
|
| Hospital Charge Code |
9900610
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,630.12 |
| Max. Negotiated Rate |
$16,769.55 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,630.12
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Amerigroup Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,085.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,880.72
|
| Rate for Payer: BCBS of TX Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX PPO |
$13,709.71
|
| Rate for Payer: Cash Price |
$15,837.91
|
| Rate for Payer: Cash Price |
$15,837.91
|
| Rate for Payer: Cash Price |
$15,837.91
|
| Rate for Payer: Cigna Commercial |
$14,986.17
|
| Rate for Payer: Cigna Medicaid |
$16,769.55
|
| Rate for Payer: Cigna Medicare |
$7,089.62
|
| Rate for Payer: Employer Direct Commercial |
$7,089.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,089.62
|
| Rate for Payer: Molina CHIP/Medicaid |
$16,769.55
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Molina Medicare |
$7,089.62
|
| 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 |
$16,769.55
|
| Rate for Payer: Scott and White EPO/PPO |
$11,579.95
|
| Rate for Payer: Scott and White Medicare |
$7,089.62
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$16,769.55
|
| Rate for Payer: Superior Health Plan EPO |
$7,089.62
|
| Rate for Payer: Superior Health Plan Medicare |
$7,089.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Universal American Medicare |
$7,089.62
|
| Rate for Payer: Wellcare Medicare |
$7,089.62
|
| Rate for Payer: Wellmed Medicare |
$7,089.62
|
|
|
Nasal/sinus endoscopy, surgical, with maxillary antrostomy
|
Facility
|
IP
|
$18,588.12
|
|
|
Service Code
|
HCPCS 31256
|
| Hospital Charge Code |
9900606
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$12,639.92
|
|
|
Nasal/sinus endoscopy, surgical, with maxillary antrostomy
|
Facility
|
OP
|
$18,588.12
|
|
|
Service Code
|
HCPCS 31256
|
| Hospital Charge Code |
9900606
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,062.24 |
| Max. Negotiated Rate |
$13,383.45 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,062.24
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,745.34
|
| Rate for Payer: Amerigroup Medicare |
$3,745.34
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,904.64
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,873.82
|
| Rate for Payer: BCBS of TX Medicare |
$3,745.34
|
| Rate for Payer: BCBS of TX PPO |
$7,401.01
|
| Rate for Payer: Cash Price |
$12,639.92
|
| Rate for Payer: Cash Price |
$12,639.92
|
| Rate for Payer: Cash Price |
$12,639.92
|
| Rate for Payer: Cigna Commercial |
$7,916.96
|
| Rate for Payer: Cigna Medicaid |
$13,383.45
|
| Rate for Payer: Cigna Medicare |
$3,745.34
|
| Rate for Payer: Employer Direct Commercial |
$3,745.34
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,745.34
|
| Rate for Payer: Molina CHIP/Medicaid |
$13,383.45
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,745.34
|
| Rate for Payer: Molina Medicare |
$3,745.34
|
| 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 |
$13,383.45
|
| Rate for Payer: Scott and White EPO/PPO |
$6,335.94
|
| Rate for Payer: Scott and White Medicare |
$3,745.34
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$13,383.45
|
| Rate for Payer: Superior Health Plan EPO |
$3,745.34
|
| Rate for Payer: Superior Health Plan Medicare |
$3,745.34
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,745.34
|
| Rate for Payer: Universal American Medicare |
$3,745.34
|
| Rate for Payer: Wellcare Medicare |
$3,745.34
|
| Rate for Payer: Wellmed Medicare |
$3,745.34
|
|
|
Nasal/sinus endoscopy, surgical, with maxillary antrostomy
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 31256
|
| Hospital Charge Code |
36031256
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,062.24 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,062.24
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,745.34
|
| Rate for Payer: Amerigroup Medicare |
$3,745.34
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,904.64
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,873.82
|
| Rate for Payer: BCBS of TX Medicare |
$3,745.34
|
| Rate for Payer: BCBS of TX PPO |
$7,401.01
|
| Rate for Payer: Cigna Commercial |
$7,916.96
|
| Rate for Payer: Cigna Medicare |
$3,745.34
|
| Rate for Payer: Employer Direct Commercial |
$3,745.34
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,745.34
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,745.34
|
| Rate for Payer: Molina Medicare |
$3,745.34
|
| 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 |
$6,335.94
|
| Rate for Payer: Scott and White Medicare |
$3,745.34
|
| Rate for Payer: Superior Health Plan EPO |
$3,745.34
|
| Rate for Payer: Superior Health Plan Medicare |
$3,745.34
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,745.34
|
| Rate for Payer: Universal American Medicare |
$3,745.34
|
| Rate for Payer: Wellcare Medicare |
$3,745.34
|
| Rate for Payer: Wellmed Medicare |
$3,745.34
|
|
|
Nasal/sinus endoscopy, surgical, with maxillary antrostomy with removal of tissue from maxillary si
|
Facility
|
OP
|
$14,453.00
|
|
|
Service Code
|
HCPCS 31267
|
| Hospital Charge Code |
9900609
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,630.12 |
| Max. Negotiated Rate |
$14,986.17 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,630.12
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Amerigroup Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,085.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,880.72
|
| Rate for Payer: BCBS of TX Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX PPO |
$13,709.71
|
| Rate for Payer: Cash Price |
$9,828.04
|
| Rate for Payer: Cash Price |
$9,828.04
|
| Rate for Payer: Cash Price |
$9,828.04
|
| Rate for Payer: Cigna Commercial |
$14,986.17
|
| Rate for Payer: Cigna Medicaid |
$10,406.16
|
| Rate for Payer: Cigna Medicare |
$7,089.62
|
| Rate for Payer: Employer Direct Commercial |
$7,089.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,089.62
|
| Rate for Payer: Molina CHIP/Medicaid |
$10,406.16
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Molina Medicare |
$7,089.62
|
| 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 |
$10,406.16
|
| Rate for Payer: Scott and White EPO/PPO |
$11,579.95
|
| Rate for Payer: Scott and White Medicare |
$7,089.62
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$10,406.16
|
| Rate for Payer: Superior Health Plan EPO |
$7,089.62
|
| Rate for Payer: Superior Health Plan Medicare |
$7,089.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Universal American Medicare |
$7,089.62
|
| Rate for Payer: Wellcare Medicare |
$7,089.62
|
| Rate for Payer: Wellmed Medicare |
$7,089.62
|
|
|
Nasal/sinus endoscopy, surgical, with maxillary antrostomy with removal of tissue from maxillary si
|
Facility
|
IP
|
$14,453.00
|
|
|
Service Code
|
HCPCS 31267
|
| Hospital Charge Code |
9900609
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$9,828.04
|
|
|
Nasal/sinus endoscopy, surgical, with maxillary antrostomy with removal of tissue from maxillary si
|
Facility
|
OP
|
$14,986.17
|
|
|
Service Code
|
CPT 31267
|
| Hospital Charge Code |
36031267
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,630.12 |
| Max. Negotiated Rate |
$14,986.17 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,630.12
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Amerigroup Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,085.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,880.72
|
| Rate for Payer: BCBS of TX Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX PPO |
$13,709.71
|
| Rate for Payer: Cigna Commercial |
$14,986.17
|
| Rate for Payer: Cigna Medicare |
$7,089.62
|
| Rate for Payer: Employer Direct Commercial |
$7,089.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,089.62
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Molina Medicare |
$7,089.62
|
| 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 |
$11,579.95
|
| Rate for Payer: Scott and White Medicare |
$7,089.62
|
| Rate for Payer: Superior Health Plan EPO |
$7,089.62
|
| Rate for Payer: Superior Health Plan Medicare |
$7,089.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Universal American Medicare |
$7,089.62
|
| Rate for Payer: Wellcare Medicare |
$7,089.62
|
| Rate for Payer: Wellmed Medicare |
$7,089.62
|
|
|
Nasal/sinus endoscopy, surgical, with sphenoidotomy
|
Facility
|
IP
|
$14,556.90
|
|
|
Service Code
|
HCPCS 31287
|
| Hospital Charge Code |
9900611
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$9,898.69
|
|
|
Nasal/sinus endoscopy, surgical, with sphenoidotomy
|
Facility
|
OP
|
$14,556.90
|
|
|
Service Code
|
HCPCS 31287
|
| Hospital Charge Code |
9900611
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,630.12 |
| Max. Negotiated Rate |
$14,986.17 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,630.12
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Amerigroup Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,085.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,880.72
|
| Rate for Payer: BCBS of TX Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX PPO |
$13,709.71
|
| Rate for Payer: Cash Price |
$9,898.69
|
| Rate for Payer: Cash Price |
$9,898.69
|
| Rate for Payer: Cash Price |
$9,898.69
|
| Rate for Payer: Cigna Commercial |
$14,986.17
|
| Rate for Payer: Cigna Medicaid |
$10,480.97
|
| Rate for Payer: Cigna Medicare |
$7,089.62
|
| Rate for Payer: Employer Direct Commercial |
$7,089.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,089.62
|
| Rate for Payer: Molina CHIP/Medicaid |
$10,480.97
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Molina Medicare |
$7,089.62
|
| 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 |
$10,480.97
|
| Rate for Payer: Scott and White EPO/PPO |
$11,579.95
|
| Rate for Payer: Scott and White Medicare |
$7,089.62
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$10,480.97
|
| Rate for Payer: Superior Health Plan EPO |
$7,089.62
|
| Rate for Payer: Superior Health Plan Medicare |
$7,089.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Universal American Medicare |
$7,089.62
|
| Rate for Payer: Wellcare Medicare |
$7,089.62
|
| Rate for Payer: Wellmed Medicare |
$7,089.62
|
|
|
Nasal/sinus endoscopy, surgical, with sphenoidotomy
|
Facility
|
OP
|
$14,986.17
|
|
|
Service Code
|
CPT 31287
|
| Hospital Charge Code |
36031287
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,630.12 |
| Max. Negotiated Rate |
$14,986.17 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,630.12
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Amerigroup Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX Blue Advantage |
$9,085.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$10,880.72
|
| Rate for Payer: BCBS of TX Medicare |
$7,089.62
|
| Rate for Payer: BCBS of TX PPO |
$13,709.71
|
| Rate for Payer: Cigna Commercial |
$14,986.17
|
| Rate for Payer: Cigna Medicare |
$7,089.62
|
| Rate for Payer: Employer Direct Commercial |
$7,089.62
|
| Rate for Payer: Humana Medicare/TRICARE |
$7,089.62
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Molina Medicare |
$7,089.62
|
| 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 |
$11,579.95
|
| Rate for Payer: Scott and White Medicare |
$7,089.62
|
| Rate for Payer: Superior Health Plan EPO |
$7,089.62
|
| Rate for Payer: Superior Health Plan Medicare |
$7,089.62
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$7,089.62
|
| Rate for Payer: Universal American Medicare |
$7,089.62
|
| Rate for Payer: Wellcare Medicare |
$7,089.62
|
| Rate for Payer: Wellmed Medicare |
$7,089.62
|
|
|
NDL,18GX1.5(1.2MMX40MM) BLUNT,FILL
|
Facility
|
OP
|
$1.73
|
|
| Hospital Charge Code |
993108
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$1.25 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$0.16
|
| Rate for Payer: BCBS of TX Blue Advantage |
$0.52
|
| Rate for Payer: BCBS of TX Blue Essentials |
$0.62
|
| Rate for Payer: BCBS of TX PPO |
$0.69
|
| Rate for Payer: Cash Price |
$1.18
|
| Rate for Payer: Cigna Medicaid |
$1.25
|
| Rate for Payer: Molina CHIP/Medicaid |
$1.25
|
| Rate for Payer: Multiplan Auto |
$1.12
|
| Rate for Payer: Multiplan Commercial |
$1.12
|
| Rate for Payer: Multiplan Workers Comp |
$1.12
|
| Rate for Payer: Parkland Medicaid |
$1.25
|
| Rate for Payer: Scott and White EPO/PPO |
$0.87
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1.25
|
| Rate for Payer: Superior Health Plan EPO |
$0.24
|
|
