|
Repair, primary, disrupted ligament, ankle; collateral
|
Facility
|
OP
|
$15,408.22
|
|
|
Service Code
|
CPT 27695
|
| Hospital Charge Code |
36027695
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,138.19 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,138.19
|
| 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 |
$12,104.03
|
| 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
|
|
|
Repair, primary, disrupted ligament, ankle; collateral
|
Facility
|
OP
|
$18,453.00
|
|
|
Service Code
|
HCPCS 27695
|
| Hospital Charge Code |
9900439
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,138.19 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,138.19
|
| 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 |
$12,548.04
|
| Rate for Payer: Cash Price |
$12,548.04
|
| Rate for Payer: Cash Price |
$12,548.04
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| Rate for Payer: Cigna Medicaid |
$13,286.16
|
| 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 |
$13,286.16
|
| 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 |
$13,286.16
|
| 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 |
$13,286.16
|
| 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
|
|
|
Repair, primary, disrupted ligament, ankle; collateral
|
Facility
|
IP
|
$18,453.00
|
|
|
Service Code
|
HCPCS 27695
|
| Hospital Charge Code |
9900439
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$12,548.04
|
|
|
Repair, primary, open or percutaneous, ruptured Achilles tendon
|
Facility
|
OP
|
$15,408.22
|
|
|
Service Code
|
CPT 27650
|
| Hospital Charge Code |
36027650
|
|
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 |
$12,104.03
|
| 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
|
|
|
Repair, primary, open or percutaneous, ruptured Achilles tendon
|
Facility
|
OP
|
$39,687.78
|
|
|
Service Code
|
HCPCS 27650
|
| Hospital Charge Code |
9900428
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,398.52 |
| Max. Negotiated Rate |
$28,575.20 |
| 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 |
$26,987.69
|
| Rate for Payer: Cash Price |
$26,987.69
|
| Rate for Payer: Cash Price |
$26,987.69
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| Rate for Payer: Cigna Medicaid |
$28,575.20
|
| 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 |
$28,575.20
|
| 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 |
$28,575.20
|
| 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 |
$28,575.20
|
| 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
|
|
|
Repair, primary, open or percutaneous, ruptured Achilles tendon
|
Facility
|
IP
|
$39,687.78
|
|
|
Service Code
|
HCPCS 27650
|
| Hospital Charge Code |
9900428
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$26,987.69
|
|
|
Repair, primary, open or percutaneous, ruptured Achilles tendon; with graft (includes obtaining graf
|
Facility
|
IP
|
$18,794.85
|
|
|
Service Code
|
HCPCS 27652
|
| Hospital Charge Code |
9900429
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$12,780.50
|
|
|
Repair, primary, open or percutaneous, ruptured Achilles tendon; with graft (includes obtaining graf
|
Facility
|
OP
|
$18,794.85
|
|
|
Service Code
|
HCPCS 27652
|
| Hospital Charge Code |
9900429
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,382.49 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,382.49
|
| 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 |
$12,780.50
|
| Rate for Payer: Cash Price |
$12,780.50
|
| Rate for Payer: Cash Price |
$12,780.50
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| Rate for Payer: Cigna Medicaid |
$13,532.29
|
| 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 |
$13,532.29
|
| 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 |
$13,532.29
|
| 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 |
$13,532.29
|
| 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
|
|
|
Repair, primary, open or percutaneous, ruptured Achilles tendon; with graft (includes obtaining graf
|
Facility
|
OP
|
$15,408.22
|
|
|
Service Code
|
CPT 27652
|
| Hospital Charge Code |
36027652
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,382.49 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,382.49
|
| 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 |
$12,104.03
|
| 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
|
|
|
Repair recurrent incisional or ventral hernia incarcerated or strangulated
|
Facility
|
IP
|
$22,771.98
|
|
|
Service Code
|
HCPCS 49566
|
| Hospital Charge Code |
9900718
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$15,484.95
|
|
|
Repair recurrent incisional or ventral hernia incarcerated or strangulated
|
Facility
|
OP
|
$22,771.98
|
|
|
Service Code
|
HCPCS 49566
|
| Hospital Charge Code |
9900718
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,049.48 |
| Max. Negotiated Rate |
$16,395.83 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$2,049.48
|
| 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 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 Medicaid |
$16,395.83
|
| Rate for Payer: Molina CHIP/Medicaid |
$16,395.83
|
| 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 |
$11,385.99
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$16,395.83
|
| Rate for Payer: Superior Health Plan EPO |
$3,096.99
|
|
|
Repair recurrent incisional or ventral hernia incarcerated or strangulated
|
Facility
|
OP
|
$12,180.95
|
|
|
Service Code
|
CPT 49566
|
| Hospital Charge Code |
36049566
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$8,072.30 |
| Max. Negotiated Rate |
$12,180.95 |
| 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 PPO |
$12,180.95
|
| 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
|
|
|
Repair recurrent incisional or ventral hernia reducible
|
Facility
|
OP
|
$53,422.00
|
|
|
Service Code
|
HCPCS 49565
|
| Hospital Charge Code |
9900717
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,807.98 |
| Max. Negotiated Rate |
$38,463.84 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$4,807.98
|
| 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 PPO |
$12,180.95
|
| Rate for Payer: Cash Price |
$36,326.96
|
| Rate for Payer: Cash Price |
$36,326.96
|
| Rate for Payer: Cash Price |
$36,326.96
|
| Rate for Payer: Cigna Medicaid |
$38,463.84
|
| Rate for Payer: Molina CHIP/Medicaid |
$38,463.84
|
| 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 |
$38,463.84
|
| Rate for Payer: Scott and White EPO/PPO |
$26,711.00
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$38,463.84
|
| Rate for Payer: Superior Health Plan EPO |
$7,265.39
|
|
|
Repair recurrent incisional or ventral hernia reducible
|
Facility
|
OP
|
$12,180.95
|
|
|
Service Code
|
CPT 49565
|
| Hospital Charge Code |
36049565
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$8,072.30 |
| Max. Negotiated Rate |
$12,180.95 |
| 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 PPO |
$12,180.95
|
| 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
|
|
|
Repair recurrent incisional or ventral hernia reducible
|
Facility
|
IP
|
$53,422.00
|
|
|
Service Code
|
HCPCS 49565
|
| Hospital Charge Code |
9900717
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$36,326.96
|
|
|
Repair recurrent inguinal hernia, any age; reducible
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 49520
|
| Hospital Charge Code |
36049520
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,151.54 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,151.54
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,596.72
|
| Rate for Payer: Amerigroup Medicare |
$3,596.72
|
| Rate for Payer: BCBS of TX Blue Advantage |
$5,192.60
|
| Rate for Payer: BCBS of TX Blue Essentials |
$6,218.68
|
| Rate for Payer: BCBS of TX Medicare |
$3,596.72
|
| Rate for Payer: BCBS of TX PPO |
$7,835.54
|
| Rate for Payer: Cigna Commercial |
$7,602.81
|
| Rate for Payer: Cigna Medicare |
$3,596.72
|
| Rate for Payer: Employer Direct Commercial |
$3,596.72
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,596.72
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,596.72
|
| Rate for Payer: Molina Medicare |
$3,596.72
|
| 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 |
$5,853.44
|
| Rate for Payer: Scott and White Medicare |
$3,596.72
|
| Rate for Payer: Superior Health Plan EPO |
$3,596.72
|
| Rate for Payer: Superior Health Plan Medicare |
$3,596.72
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,596.72
|
| Rate for Payer: Universal American Medicare |
$3,596.72
|
| Rate for Payer: Wellcare Medicare |
$3,596.72
|
| Rate for Payer: Wellmed Medicare |
$3,596.72
|
|
|
Repair recurrent inguinal hernia, any age; reducible
|
Facility
|
OP
|
$14,167.72
|
|
|
Service Code
|
HCPCS 49520
|
| Hospital Charge Code |
9900714
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,151.54 |
| Max. Negotiated Rate |
$10,200.76 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,151.54
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$3,596.72
|
| Rate for Payer: Amerigroup Medicare |
$3,596.72
|
| Rate for Payer: BCBS of TX Blue Advantage |
$5,192.60
|
| Rate for Payer: BCBS of TX Blue Essentials |
$6,218.68
|
| Rate for Payer: BCBS of TX Medicare |
$3,596.72
|
| Rate for Payer: BCBS of TX PPO |
$7,835.54
|
| Rate for Payer: Cash Price |
$9,634.05
|
| Rate for Payer: Cash Price |
$9,634.05
|
| Rate for Payer: Cash Price |
$9,634.05
|
| Rate for Payer: Cigna Commercial |
$7,602.81
|
| Rate for Payer: Cigna Medicaid |
$10,200.76
|
| Rate for Payer: Cigna Medicare |
$3,596.72
|
| Rate for Payer: Employer Direct Commercial |
$3,596.72
|
| Rate for Payer: Humana Medicare/TRICARE |
$3,596.72
|
| Rate for Payer: Molina CHIP/Medicaid |
$10,200.76
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$3,596.72
|
| Rate for Payer: Molina Medicare |
$3,596.72
|
| 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 |
$10,200.76
|
| Rate for Payer: Scott and White EPO/PPO |
$5,853.44
|
| Rate for Payer: Scott and White Medicare |
$3,596.72
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$10,200.76
|
| Rate for Payer: Superior Health Plan EPO |
$3,596.72
|
| Rate for Payer: Superior Health Plan Medicare |
$3,596.72
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$3,596.72
|
| Rate for Payer: Universal American Medicare |
$3,596.72
|
| Rate for Payer: Wellcare Medicare |
$3,596.72
|
| Rate for Payer: Wellmed Medicare |
$3,596.72
|
|
|
Repair recurrent inguinal hernia, any age; reducible
|
Facility
|
IP
|
$14,167.72
|
|
|
Service Code
|
HCPCS 49520
|
| Hospital Charge Code |
9900714
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$9,634.05
|
|
|
Repair, secondary, Achilles tendon, with or without graft
|
Facility
|
OP
|
$15,408.22
|
|
|
Service Code
|
CPT 27654
|
| Hospital Charge Code |
36027654
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,122.54 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,122.54
|
| 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 |
$12,104.03
|
| 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
|
|
|
Repair, secondary, Achilles tendon, with or without graft
|
Facility
|
IP
|
$20,504.00
|
|
|
Service Code
|
HCPCS 27654
|
| Hospital Charge Code |
9900430
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$13,942.72
|
|
|
Repair, secondary, Achilles tendon, with or without graft
|
Facility
|
OP
|
$20,504.00
|
|
|
Service Code
|
HCPCS 27654
|
| Hospital Charge Code |
9900430
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,122.54 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,122.54
|
| 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 |
$13,942.72
|
| Rate for Payer: Cash Price |
$13,942.72
|
| Rate for Payer: Cash Price |
$13,942.72
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| Rate for Payer: Cigna Medicaid |
$14,762.88
|
| 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 |
$14,762.88
|
| 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 |
$14,762.88
|
| 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 |
$14,762.88
|
| 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
|
|
|
Repair, secondary, disrupted ligament, ankle, collateral (eg, Watson-Jones procedure)
|
Facility
|
OP
|
$15,662.38
|
|
|
Service Code
|
HCPCS 27696
|
| Hospital Charge Code |
9900440
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,122.54 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,122.54
|
| 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 |
$10,650.42
|
| Rate for Payer: Cash Price |
$10,650.42
|
| Rate for Payer: Cash Price |
$10,650.42
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| Rate for Payer: Cigna Medicaid |
$11,276.91
|
| 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 |
$11,276.91
|
| 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 |
$11,276.91
|
| 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 |
$11,276.91
|
| 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
|
|
|
Repair, secondary, disrupted ligament, ankle, collateral (eg, Watson-Jones procedure)
|
Facility
|
IP
|
$37,589.70
|
|
|
Service Code
|
HCPCS 27698
|
| Hospital Charge Code |
9900441
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$25,561.00
|
|
|
Repair, secondary, disrupted ligament, ankle, collateral (eg, Watson-Jones procedure)
|
Facility
|
OP
|
$37,589.70
|
|
|
Service Code
|
HCPCS 27698
|
| Hospital Charge Code |
9900441
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,121.84 |
| Max. Negotiated Rate |
$27,064.58 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,121.84
|
| 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 |
$12,104.03
|
| 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
|
|
|
Repair, secondary, disrupted ligament, ankle, collateral (eg, Watson-Jones procedure)
|
Facility
|
IP
|
$15,662.38
|
|
|
Service Code
|
HCPCS 27696
|
| Hospital Charge Code |
9900440
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$10,650.42
|
|
