|
Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 26756
|
| Hospital Charge Code |
36026756
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,571.54
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,474.90
|
| Rate for Payer: BCBS of TX Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each
|
Facility
|
OP
|
$11,906.64
|
|
|
Service Code
|
HCPCS 26756
|
| Hospital Charge Code |
9900368
|
|
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 |
$8,096.52
|
| Rate for Payer: Cash Price |
$8,096.52
|
| Rate for Payer: Cash Price |
$8,096.52
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$8,572.78
|
| 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 |
$8,572.78
|
| 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 |
$8,572.78
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$8,572.78
|
| 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
|
|
|
Percutaneous skeletal fixation of femoral fracture, proximal end, neck
|
Facility
|
OP
|
$28,574.92
|
|
|
Service Code
|
HCPCS 27235
|
| Hospital Charge Code |
994085
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,571.74 |
| Max. Negotiated Rate |
$20,573.94 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$2,571.74
|
| 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 |
$19,430.95
|
| Rate for Payer: Cash Price |
$19,430.95
|
| Rate for Payer: Cash Price |
$19,430.95
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| Rate for Payer: Cigna Medicaid |
$20,573.94
|
| 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 |
$20,573.94
|
| 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 |
$20,573.94
|
| Rate for Payer: Scott and White EPO/PPO |
$12,104.03
|
| Rate for Payer: Scott and White Medicare |
$7,289.28
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$20,573.94
|
| 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
|
|
|
Percutaneous skeletal fixation of femoral fracture, proximal end, neck
|
Facility
|
IP
|
$28,574.92
|
|
|
Service Code
|
HCPCS 27235
|
| Hospital Charge Code |
994085
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$19,430.95
|
|
|
Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with manipulation
|
Facility
|
IP
|
$9,906.40
|
|
|
Service Code
|
HCPCS 26776
|
| Hospital Charge Code |
9900370
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,736.35
|
|
|
Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with manipulation
|
Facility
|
OP
|
$9,906.40
|
|
|
Service Code
|
HCPCS 26776
|
| Hospital Charge Code |
9900370
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,571.54
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,474.90
|
| Rate for Payer: BCBS of TX Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cash Price |
$6,736.35
|
| Rate for Payer: Cash Price |
$6,736.35
|
| Rate for Payer: Cash Price |
$6,736.35
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$7,132.61
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina CHIP/Medicaid |
$7,132.61
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Parkland Medicaid |
$7,132.61
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$7,132.61
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with manipulation
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 26776
|
| Hospital Charge Code |
36026776
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,571.54
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,474.90
|
| Rate for Payer: BCBS of TX Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Percutaneous skeletal fixation of metacarpal fracture, each bone
|
Facility
|
OP
|
$9,906.40
|
|
|
Service Code
|
HCPCS 26608
|
| Hospital Charge Code |
9900360
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,571.54
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,474.90
|
| Rate for Payer: BCBS of TX Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cash Price |
$6,736.35
|
| Rate for Payer: Cash Price |
$6,736.35
|
| Rate for Payer: Cash Price |
$6,736.35
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$7,132.61
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina CHIP/Medicaid |
$7,132.61
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Parkland Medicaid |
$7,132.61
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$7,132.61
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Percutaneous skeletal fixation of metacarpal fracture, each bone
|
Facility
|
IP
|
$9,906.40
|
|
|
Service Code
|
HCPCS 26608
|
| Hospital Charge Code |
9900360
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,736.35
|
|
|
Percutaneous skeletal fixation of metacarpal fracture, each bone
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 26608
|
| Hospital Charge Code |
36026608
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,571.54
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,474.90
|
| Rate for Payer: BCBS of TX Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Percutaneous skeletal fixation of ulnar styloid fracture
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 25651
|
| Hospital Charge Code |
36025651
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,571.54
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,474.90
|
| Rate for Payer: BCBS of TX Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
Percutaneous skeletal fixation of ulnar styloid fracture
|
Facility
|
OP
|
$10,900.00
|
|
|
Service Code
|
HCPCS 25651
|
| Hospital Charge Code |
9900307
|
|
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 |
$7,412.00
|
| Rate for Payer: Cash Price |
$7,412.00
|
| Rate for Payer: Cash Price |
$7,412.00
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$7,848.00
|
| 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 |
$7,848.00
|
| 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 |
$7,848.00
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$7,848.00
|
| 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
|
|
|
Percutaneous skeletal fixation of ulnar styloid fracture
|
Facility
|
IP
|
$10,900.00
|
|
|
Service Code
|
HCPCS 25651
|
| Hospital Charge Code |
9900307
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$7,412.00
|
|
|
Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle phalanx, fi
|
Facility
|
OP
|
$6,480.00
|
|
|
Service Code
|
HCPCS 26727
|
| Hospital Charge Code |
9900365
|
|
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 |
$4,406.40
|
| Rate for Payer: Cash Price |
$4,406.40
|
| Rate for Payer: Cash Price |
$4,406.40
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$4,665.60
|
| 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 |
$4,665.60
|
| 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 |
$4,665.60
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$4,665.60
|
| 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
|
|
|
Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle phalanx, fi
|
Facility
|
IP
|
$6,480.00
|
|
|
Service Code
|
HCPCS 26727
|
| Hospital Charge Code |
9900365
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,406.40
|
|
|
Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle phalanx, fi
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 26727
|
| Hospital Charge Code |
36026727
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Amerigroup Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,571.54
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,474.90
|
| Rate for Payer: BCBS of TX Medicare |
$3,286.91
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicare |
$3,286.91
|
| Rate for Payer: Employer Direct Commercial |
$3,286.91
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,286.91
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Molina Medicare |
$3,286.91
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$5,476.44
|
| Rate for Payer: Scott and White Medicare |
$3,286.91
|
| Rate for Payer: Superior Health Plan EPO |
$3,286.91
|
| Rate for Payer: Superior Health Plan Medicare |
$3,286.91
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,286.91
|
| Rate for Payer: Universal American Medicare |
$3,286.91
|
| Rate for Payer: Wellcare Medicare |
$3,286.91
|
| Rate for Payer: Wellmed Medicare |
$3,286.91
|
|
|
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES
|
Facility
|
IP
|
$20,250.15
|
|
|
Service Code
|
APR-DRG 1832
|
| Min. Negotiated Rate |
$19,092.55 |
| Max. Negotiated Rate |
$20,250.15 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$19,092.55
|
| Rate for Payer: Cigna Medicaid |
$19,092.55
|
| Rate for Payer: Molina CHIP/Medicaid |
$19,092.55
|
| Rate for Payer: Parkland Medicaid |
$19,092.55
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$20,250.15
|
|
|
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES
|
Facility
|
IP
|
$19,263.42
|
|
|
Service Code
|
APR-DRG 1831
|
| Min. Negotiated Rate |
$18,162.23 |
| Max. Negotiated Rate |
$19,263.42 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$18,162.23
|
| Rate for Payer: Cigna Medicaid |
$18,162.23
|
| Rate for Payer: Molina CHIP/Medicaid |
$18,162.23
|
| Rate for Payer: Parkland Medicaid |
$18,162.23
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$19,263.42
|
|
|
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES
|
Facility
|
IP
|
$31,977.33
|
|
|
Service Code
|
APR-DRG 1834
|
| Min. Negotiated Rate |
$30,149.35 |
| Max. Negotiated Rate |
$31,977.33 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$30,149.35
|
| Rate for Payer: Cigna Medicaid |
$30,149.35
|
| Rate for Payer: Molina CHIP/Medicaid |
$30,149.35
|
| Rate for Payer: Parkland Medicaid |
$30,149.35
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$31,977.33
|
|
|
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES
|
Facility
|
IP
|
$31,192.02
|
|
|
Service Code
|
APR-DRG 1833
|
| Min. Negotiated Rate |
$29,408.93 |
| Max. Negotiated Rate |
$31,192.02 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$29,408.93
|
| Rate for Payer: Cigna Medicaid |
$29,408.93
|
| Rate for Payer: Molina CHIP/Medicaid |
$29,408.93
|
| Rate for Payer: Parkland Medicaid |
$29,408.93
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$31,192.02
|
|
|
Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery
|
Facility
|
IP
|
$41,927.24
|
|
|
Service Code
|
HCPCS C9601
|
| Hospital Charge Code |
990979
|
|
Hospital Revenue Code
|
480
|
| Rate for Payer: Cash Price |
$28,510.52
|
|
|
Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery
|
Facility
|
OP
|
$41,927.24
|
|
|
Service Code
|
HCPCS C9601
|
| Hospital Charge Code |
990979
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$3,773.45 |
| Max. Negotiated Rate |
$30,187.61 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,773.45
|
| Rate for Payer: BCBS of TX Blue Advantage |
$12,578.17
|
| Rate for Payer: BCBS of TX Blue Essentials |
$15,093.81
|
| Rate for Payer: BCBS of TX PPO |
$16,770.90
|
| Rate for Payer: Cash Price |
$28,510.52
|
| Rate for Payer: Cigna Medicaid |
$30,187.61
|
| Rate for Payer: Molina CHIP/Medicaid |
$30,187.61
|
| Rate for Payer: Multiplan Auto |
$27,252.71
|
| Rate for Payer: Multiplan Commercial |
$27,252.71
|
| Rate for Payer: Multiplan Workers Comp |
$27,252.71
|
| Rate for Payer: Parkland Medicaid |
$30,187.61
|
| Rate for Payer: Scott and White EPO/PPO |
$20,963.62
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$30,187.61
|
| Rate for Payer: Superior Health Plan EPO |
$5,702.10
|
|
|
Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch
|
Facility
|
OP
|
$41,927.24
|
|
|
Service Code
|
HCPCS C9600
|
| Hospital Charge Code |
990978
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$3,773.45 |
| Max. Negotiated Rate |
$30,187.61 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,773.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$11,596.79
|
| Rate for Payer: Amerigroup Medicare |
$11,596.79
|
| Rate for Payer: BCBS of TX Blue Advantage |
$16,547.16
|
| Rate for Payer: BCBS of TX Blue Essentials |
$19,816.96
|
| Rate for Payer: BCBS of TX Medicare |
$11,596.79
|
| Rate for Payer: BCBS of TX PPO |
$24,969.37
|
| Rate for Payer: Cash Price |
$28,510.52
|
| Rate for Payer: Cash Price |
$28,510.52
|
| Rate for Payer: Cash Price |
$28,510.52
|
| Rate for Payer: Cigna Commercial |
$24,513.51
|
| Rate for Payer: Cigna Medicaid |
$30,187.61
|
| Rate for Payer: Cigna Medicare |
$11,596.79
|
| Rate for Payer: Employer Direct Commercial |
$11,596.79
|
| Rate for Payer: Humana Medicare/TRICARE |
$11,596.79
|
| Rate for Payer: Molina CHIP/Medicaid |
$30,187.61
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$11,596.79
|
| Rate for Payer: Molina Medicare |
$11,596.79
|
| Rate for Payer: Multiplan Auto |
$27,252.71
|
| Rate for Payer: Multiplan Commercial |
$27,252.71
|
| Rate for Payer: Multiplan Workers Comp |
$27,252.71
|
| Rate for Payer: Parkland Medicaid |
$30,187.61
|
| Rate for Payer: Scott and White EPO/PPO |
$20,963.62
|
| Rate for Payer: Scott and White Medicare |
$11,596.79
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$30,187.61
|
| Rate for Payer: Superior Health Plan EPO |
$11,596.79
|
| Rate for Payer: Superior Health Plan Medicare |
$11,596.79
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$11,596.79
|
| Rate for Payer: Universal American Medicare |
$11,596.79
|
| Rate for Payer: Wellcare Medicare |
$11,596.79
|
| Rate for Payer: Wellmed Medicare |
$11,596.79
|
|
|
Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch
|
Facility
|
IP
|
$41,927.24
|
|
|
Service Code
|
HCPCS C9600
|
| Hospital Charge Code |
990978
|
|
Hospital Revenue Code
|
480
|
| Rate for Payer: Cash Price |
$28,510.52
|
|
|
Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; single major coronary artery or branch
|
Facility
|
IP
|
$45,362.28
|
|
|
Service Code
|
HCPCS 92924
|
| Hospital Charge Code |
994088
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$30,846.35
|
|
