|
Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation, when performed
|
Facility
|
OP
|
$51,467.28
|
|
|
Service Code
|
HCPCS 24575
|
| Hospital Charge Code |
994036
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,609.96 |
| Max. Negotiated Rate |
$37,056.44 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$6,609.96
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,897.19
|
| Rate for Payer: Amerigroup Medicare |
$12,897.19
|
| Rate for Payer: BCBS of TX Blue Advantage |
$19,874.19
|
| Rate for Payer: BCBS of TX Blue Essentials |
$23,801.42
|
| Rate for Payer: BCBS of TX Medicare |
$12,897.19
|
| Rate for Payer: BCBS of TX PPO |
$29,989.79
|
| Rate for Payer: Cash Price |
$34,997.75
|
| Rate for Payer: Cash Price |
$34,997.75
|
| Rate for Payer: Cash Price |
$34,997.75
|
| Rate for Payer: Cigna Commercial |
$27,262.32
|
| Rate for Payer: Cigna Medicaid |
$37,056.44
|
| Rate for Payer: Cigna Medicare |
$12,897.19
|
| Rate for Payer: Employer Direct Commercial |
$12,897.19
|
| Rate for Payer: Humana Medicare/TRICARE |
$12,897.19
|
| Rate for Payer: Molina CHIP/Medicaid |
$37,056.44
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$12,897.19
|
| Rate for Payer: Molina Medicare |
$12,897.19
|
| 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 |
$37,056.44
|
| Rate for Payer: Scott and White EPO/PPO |
$23,859.80
|
| Rate for Payer: Scott and White Medicare |
$12,897.19
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$37,056.44
|
| Rate for Payer: Superior Health Plan EPO |
$12,897.19
|
| Rate for Payer: Superior Health Plan Medicare |
$12,897.19
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$12,897.19
|
| Rate for Payer: Universal American Medicare |
$12,897.19
|
| Rate for Payer: Wellcare Medicare |
$12,897.19
|
| Rate for Payer: Wellmed Medicare |
$12,897.19
|
|
|
Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when
|
Facility
|
IP
|
$23,663.07
|
|
|
Service Code
|
HCPCS 24546
|
| Hospital Charge Code |
9900256
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$16,090.89
|
|
|
Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when
|
Facility
|
OP
|
$40,184.12
|
|
|
Service Code
|
CPT 24546
|
| Hospital Charge Code |
36024546
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$9,166.70 |
| Max. Negotiated Rate |
$40,184.12 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$9,166.70
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,897.19
|
| Rate for Payer: Amerigroup Medicare |
$12,897.19
|
| Rate for Payer: BCBS of TX Blue Advantage |
$26,629.95
|
| Rate for Payer: BCBS of TX Blue Essentials |
$31,892.16
|
| Rate for Payer: BCBS of TX Medicare |
$12,897.19
|
| Rate for Payer: BCBS of TX PPO |
$40,184.12
|
| Rate for Payer: Cigna Commercial |
$27,262.32
|
| Rate for Payer: Cigna Medicare |
$12,897.19
|
| Rate for Payer: Employer Direct Commercial |
$12,897.19
|
| Rate for Payer: Humana Medicare/TRICARE |
$12,897.19
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$12,897.19
|
| Rate for Payer: Molina Medicare |
$12,897.19
|
| 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 |
$23,859.80
|
| Rate for Payer: Scott and White Medicare |
$12,897.19
|
| Rate for Payer: Superior Health Plan EPO |
$12,897.19
|
| Rate for Payer: Superior Health Plan Medicare |
$12,897.19
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$12,897.19
|
| Rate for Payer: Universal American Medicare |
$12,897.19
|
| Rate for Payer: Wellcare Medicare |
$12,897.19
|
| Rate for Payer: Wellmed Medicare |
$12,897.19
|
|
|
Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when
|
Facility
|
OP
|
$23,663.07
|
|
|
Service Code
|
HCPCS 24546
|
| Hospital Charge Code |
9900256
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$9,166.70 |
| Max. Negotiated Rate |
$40,184.12 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$9,166.70
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,897.19
|
| Rate for Payer: Amerigroup Medicare |
$12,897.19
|
| Rate for Payer: BCBS of TX Blue Advantage |
$26,629.95
|
| Rate for Payer: BCBS of TX Blue Essentials |
$31,892.16
|
| Rate for Payer: BCBS of TX Medicare |
$12,897.19
|
| Rate for Payer: BCBS of TX PPO |
$40,184.12
|
| Rate for Payer: Cash Price |
$16,090.89
|
| Rate for Payer: Cash Price |
$16,090.89
|
| Rate for Payer: Cash Price |
$16,090.89
|
| Rate for Payer: Cigna Commercial |
$27,262.32
|
| Rate for Payer: Cigna Medicaid |
$17,037.41
|
| Rate for Payer: Cigna Medicare |
$12,897.19
|
| Rate for Payer: Employer Direct Commercial |
$12,897.19
|
| Rate for Payer: Humana Medicare/TRICARE |
$12,897.19
|
| Rate for Payer: Molina CHIP/Medicaid |
$17,037.41
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$12,897.19
|
| Rate for Payer: Molina Medicare |
$12,897.19
|
| 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 |
$17,037.41
|
| Rate for Payer: Scott and White EPO/PPO |
$23,859.80
|
| Rate for Payer: Scott and White Medicare |
$12,897.19
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$17,037.41
|
| Rate for Payer: Superior Health Plan EPO |
$12,897.19
|
| Rate for Payer: Superior Health Plan Medicare |
$12,897.19
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$12,897.19
|
| Rate for Payer: Universal American Medicare |
$12,897.19
|
| Rate for Payer: Wellcare Medicare |
$12,897.19
|
| Rate for Payer: Wellmed Medicare |
$12,897.19
|
|
|
Open treatment of interphalangeal joint dislocation includes internal fixation, when performed, sing
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 26785
|
| Hospital Charge Code |
36026785
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,571.54
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,474.90
|
| Rate for Payer: BCBS of TX Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$6,080.78
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Open treatment of interphalangeal joint dislocation includes internal fixation, when performed, sing
|
Facility
|
OP
|
$11,400.00
|
|
|
Service Code
|
HCPCS 26785
|
| Hospital Charge Code |
9900371
|
|
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 |
$7,752.00
|
| Rate for Payer: Cash Price |
$7,752.00
|
| Rate for Payer: Cash Price |
$7,752.00
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$8,208.00
|
| 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 |
$8,208.00
|
| 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 |
$8,208.00
|
| Rate for Payer: Scott and White EPO/PPO |
$6,080.78
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$8,208.00
|
| 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
|
|
|
Open treatment of interphalangeal joint dislocation includes internal fixation, when performed, sing
|
Facility
|
IP
|
$11,400.00
|
|
|
Service Code
|
HCPCS 26785
|
| Hospital Charge Code |
9900371
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$7,752.00
|
|
|
Open treatment of lunate dislocation
|
Facility
|
OP
|
$11,981.00
|
|
|
Service Code
|
HCPCS 25695
|
| Hospital Charge Code |
9900309
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,398.52 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$2,398.52
|
| 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 |
$9,989.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,963.90
|
| Rate for Payer: BCBS of TX Medicare |
$7,289.28
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cash Price |
$8,147.08
|
| Rate for Payer: Cash Price |
$8,147.08
|
| Rate for Payer: Cash Price |
$8,147.08
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| Rate for Payer: Cigna Medicaid |
$8,626.32
|
| 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 |
$8,626.32
|
| 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 |
$8,626.32
|
| Rate for Payer: Scott and White EPO/PPO |
$13,485.17
|
| Rate for Payer: Scott and White Medicare |
$7,289.28
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$8,626.32
|
| 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
|
|
|
Open treatment of lunate dislocation
|
Facility
|
IP
|
$11,981.00
|
|
|
Service Code
|
HCPCS 25695
|
| Hospital Charge Code |
9900309
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$8,147.08
|
|
|
Open treatment of lunate dislocation
|
Facility
|
OP
|
$15,408.22
|
|
|
Service Code
|
CPT 25695
|
| Hospital Charge Code |
36025695
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,398.52 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$2,398.52
|
| 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 |
$9,989.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,963.90
|
| Rate for Payer: BCBS of TX Medicare |
$7,289.28
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| 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 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: Scott and White EPO/PPO |
$13,485.17
|
| Rate for Payer: Scott and White Medicare |
$7,289.28
|
| 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
|
|
|
Open treatment of medial malleolus fracture, includes internal fixation, when performed
|
Facility
|
OP
|
$15,408.22
|
|
|
Service Code
|
CPT 27766
|
| Hospital Charge Code |
36027766
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,398.52 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$2,398.52
|
| 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 |
$9,989.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,963.90
|
| Rate for Payer: BCBS of TX Medicare |
$7,289.28
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| 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 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: Scott and White EPO/PPO |
$13,485.17
|
| Rate for Payer: Scott and White Medicare |
$7,289.28
|
| 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
|
|
|
Open treatment of medial malleolus fracture, includes internal fixation, when performed
|
Facility
|
IP
|
$37,589.70
|
|
|
Service Code
|
HCPCS 27766
|
| Hospital Charge Code |
9900443
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$25,561.00
|
|
|
Open treatment of medial malleolus fracture, includes internal fixation, when performed
|
Facility
|
OP
|
$37,589.70
|
|
|
Service Code
|
HCPCS 27766
|
| Hospital Charge Code |
9900443
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,398.52 |
| Max. Negotiated Rate |
$27,064.58 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$2,398.52
|
| 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 |
$9,989.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,963.90
|
| Rate for Payer: BCBS of TX Medicare |
$7,289.28
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cash Price |
$25,561.00
|
| Rate for Payer: Cash Price |
$25,561.00
|
| Rate for Payer: Cash Price |
$25,561.00
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| Rate for Payer: Cigna Medicaid |
$27,064.58
|
| 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 |
$27,064.58
|
| 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 |
$27,064.58
|
| Rate for Payer: Scott and White EPO/PPO |
$13,485.17
|
| Rate for Payer: Scott and White Medicare |
$7,289.28
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$27,064.58
|
| 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
|
|
|
Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone
|
Facility
|
OP
|
$7,076.00
|
|
|
Service Code
|
HCPCS 26615
|
| Hospital Charge Code |
9900361
|
|
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 |
$4,811.68
|
| Rate for Payer: Cash Price |
$4,811.68
|
| Rate for Payer: Cash Price |
$4,811.68
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$5,094.72
|
| 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 |
$5,094.72
|
| 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 |
$5,094.72
|
| Rate for Payer: Scott and White EPO/PPO |
$6,080.78
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$5,094.72
|
| 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
|
|
|
Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone
|
Facility
|
IP
|
$7,076.00
|
|
|
Service Code
|
HCPCS 26615
|
| Hospital Charge Code |
9900361
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,811.68
|
|
|
Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 26615
|
| Hospital Charge Code |
36026615
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,571.54
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,474.90
|
| Rate for Payer: BCBS of TX Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$6,080.78
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Open treatment of metatarsal fracture, includes internal fixation, when performed, each
|
Facility
|
OP
|
$14,352.00
|
|
|
Service Code
|
HCPCS 28485
|
| Hospital Charge Code |
9900520
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,227.18 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,227.18
|
| 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 |
$9,989.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,963.90
|
| Rate for Payer: BCBS of TX Medicare |
$7,289.28
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cash Price |
$9,759.36
|
| Rate for Payer: Cash Price |
$9,759.36
|
| Rate for Payer: Cash Price |
$9,759.36
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| Rate for Payer: Cigna Medicaid |
$10,333.44
|
| 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 |
$10,333.44
|
| 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 |
$10,333.44
|
| Rate for Payer: Scott and White EPO/PPO |
$13,485.17
|
| Rate for Payer: Scott and White Medicare |
$7,289.28
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$10,333.44
|
| 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
|
|
|
Open treatment of metatarsal fracture, includes internal fixation, when performed, each
|
Facility
|
IP
|
$14,352.00
|
|
|
Service Code
|
HCPCS 28485
|
| Hospital Charge Code |
9900520
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$9,759.36
|
|
|
Open treatment of metatarsal fracture, includes internal fixation, when performed, each
|
Facility
|
OP
|
$15,408.22
|
|
|
Service Code
|
CPT 28485
|
| Hospital Charge Code |
36028485
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,227.18 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,227.18
|
| 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 |
$9,989.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$11,963.90
|
| Rate for Payer: BCBS of TX Medicare |
$7,289.28
|
| Rate for Payer: BCBS of TX PPO |
$15,074.51
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| 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 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: Scott and White EPO/PPO |
$13,485.17
|
| Rate for Payer: Scott and White Medicare |
$7,289.28
|
| 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
|
|
|
Open treatment of nasal fracture; complicated, with internal and/or external skeletal fixation
|
Facility
|
OP
|
$22,318.84
|
|
|
Service Code
|
HCPCS 21330
|
| Hospital Charge Code |
9900194
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,954.22 |
| Max. Negotiated Rate |
$16,069.56 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,954.22
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Amerigroup Medicare |
$5,946.81
|
| 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 |
$5,946.81
|
| Rate for Payer: BCBS of TX PPO |
$12,223.34
|
| Rate for Payer: Cash Price |
$15,176.81
|
| Rate for Payer: Cash Price |
$15,176.81
|
| Rate for Payer: Cash Price |
$15,176.81
|
| Rate for Payer: Cigna Commercial |
$12,570.48
|
| Rate for Payer: Cigna Medicaid |
$16,069.56
|
| Rate for Payer: Cigna Medicare |
$5,946.81
|
| Rate for Payer: Employer Direct Commercial |
$5,946.81
|
| Rate for Payer: Humana Medicare/TRICARE |
$5,946.81
|
| Rate for Payer: Molina CHIP/Medicaid |
$16,069.56
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Molina Medicare |
$5,946.81
|
| 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 |
$16,069.56
|
| Rate for Payer: Scott and White EPO/PPO |
$11,001.60
|
| Rate for Payer: Scott and White Medicare |
$5,946.81
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$16,069.56
|
| Rate for Payer: Superior Health Plan EPO |
$5,946.81
|
| Rate for Payer: Superior Health Plan Medicare |
$5,946.81
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Universal American Medicare |
$5,946.81
|
| Rate for Payer: Wellcare Medicare |
$5,946.81
|
| Rate for Payer: Wellmed Medicare |
$5,946.81
|
|
|
Open treatment of nasal fracture; complicated, with internal and/or external skeletal fixation
|
Facility
|
IP
|
$22,318.84
|
|
|
Service Code
|
HCPCS 21330
|
| Hospital Charge Code |
9900194
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$15,176.81
|
|
|
Open treatment of nasal fracture; complicated, with internal and/or external skeletal fixation
|
Facility
|
OP
|
$12,570.48
|
|
|
Service Code
|
CPT 21330
|
| Hospital Charge Code |
36021330
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,954.22 |
| Max. Negotiated Rate |
$12,570.48 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,954.22
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Amerigroup Medicare |
$5,946.81
|
| 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 |
$5,946.81
|
| Rate for Payer: BCBS of TX PPO |
$12,223.34
|
| Rate for Payer: Cigna Commercial |
$12,570.48
|
| Rate for Payer: Cigna Medicare |
$5,946.81
|
| Rate for Payer: Employer Direct Commercial |
$5,946.81
|
| Rate for Payer: Humana Medicare/TRICARE |
$5,946.81
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Molina Medicare |
$5,946.81
|
| 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 |
$11,001.60
|
| Rate for Payer: Scott and White Medicare |
$5,946.81
|
| Rate for Payer: Superior Health Plan EPO |
$5,946.81
|
| Rate for Payer: Superior Health Plan Medicare |
$5,946.81
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Universal American Medicare |
$5,946.81
|
| Rate for Payer: Wellcare Medicare |
$5,946.81
|
| Rate for Payer: Wellmed Medicare |
$5,946.81
|
|
|
Open treatment of nasal fracture with concomitant open treatment of fractured septum
|
Facility
|
IP
|
$16,059.00
|
|
|
Service Code
|
HCPCS 31288
|
| Hospital Charge Code |
9900612
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$10,920.12
|
|
|
Open treatment of nasal fracture with concomitant open treatment of fractured septum
|
Facility
|
IP
|
$12,313.76
|
|
|
Service Code
|
HCPCS 21335
|
| Hospital Charge Code |
9900195
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$8,373.36
|
|
|
Open treatment of nasal fracture with concomitant open treatment of fractured septum
|
Facility
|
OP
|
$12,313.76
|
|
|
Service Code
|
HCPCS 21335
|
| Hospital Charge Code |
9900195
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$886.62 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$886.62
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,330.57
|
| Rate for Payer: Amerigroup Medicare |
$3,330.57
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,374.21
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,238.58
|
| Rate for Payer: BCBS of TX Medicare |
$3,330.57
|
| Rate for Payer: BCBS of TX PPO |
$6,600.61
|
| Rate for Payer: Cash Price |
$8,373.36
|
| Rate for Payer: Cash Price |
$8,373.36
|
| Rate for Payer: Cash Price |
$8,373.36
|
| Rate for Payer: Cigna Commercial |
$7,040.22
|
| Rate for Payer: Cigna Medicaid |
$8,865.91
|
| Rate for Payer: Cigna Medicare |
$3,330.57
|
| Rate for Payer: Employer Direct Commercial |
$3,330.57
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,330.57
|
| Rate for Payer: Molina CHIP/Medicaid |
$8,865.91
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,330.57
|
| Rate for Payer: Molina Medicare |
$3,330.57
|
| 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 |
$8,865.91
|
| Rate for Payer: Scott and White EPO/PPO |
$6,161.55
|
| Rate for Payer: Scott and White Medicare |
$3,330.57
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$8,865.91
|
| Rate for Payer: Superior Health Plan EPO |
$3,330.57
|
| Rate for Payer: Superior Health Plan Medicare |
$3,330.57
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,330.57
|
| Rate for Payer: Universal American Medicare |
$3,330.57
|
| Rate for Payer: Wellcare Medicare |
$3,330.57
|
| Rate for Payer: Wellmed Medicare |
$3,330.57
|
|
