|
Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfer's elbow); percutaneous
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
36024357
|
|
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
|
|
|
Tenotomy, open, extensor, foot or toe, each tendon
|
Facility
|
IP
|
$8,201.00
|
|
|
Service Code
|
HCPCS 28234
|
| Hospital Charge Code |
9900493
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$5,576.68
|
|
|
Tenotomy, open, extensor, foot or toe, each tendon
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 28234
|
| Hospital Charge Code |
36028234
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$593.04 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$593.04
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Amerigroup Medicare |
$1,615.32
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,263.50
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,710.78
|
| Rate for Payer: BCBS of TX Medicare |
$1,615.32
|
| Rate for Payer: BCBS of TX PPO |
$3,415.58
|
| Rate for Payer: Cigna Commercial |
$3,414.49
|
| Rate for Payer: Cigna Medicare |
$1,615.32
|
| Rate for Payer: Employer Direct Commercial |
$1,615.32
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,615.32
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Molina Medicare |
$1,615.32
|
| 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 |
$2,719.24
|
| Rate for Payer: Scott and White Medicare |
$1,615.32
|
| Rate for Payer: Superior Health Plan EPO |
$1,615.32
|
| Rate for Payer: Superior Health Plan Medicare |
$1,615.32
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Universal American Medicare |
$1,615.32
|
| Rate for Payer: Wellcare Medicare |
$1,615.32
|
| Rate for Payer: Wellmed Medicare |
$1,615.32
|
|
|
Tenotomy, open, extensor, foot or toe, each tendon
|
Facility
|
OP
|
$8,201.00
|
|
|
Service Code
|
HCPCS 28234
|
| Hospital Charge Code |
9900493
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$593.04 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$593.04
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Amerigroup Medicare |
$1,615.32
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,263.50
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,710.78
|
| Rate for Payer: BCBS of TX Medicare |
$1,615.32
|
| Rate for Payer: BCBS of TX PPO |
$3,415.58
|
| Rate for Payer: Cash Price |
$5,576.68
|
| Rate for Payer: Cash Price |
$5,576.68
|
| Rate for Payer: Cash Price |
$5,576.68
|
| Rate for Payer: Cigna Commercial |
$3,414.49
|
| Rate for Payer: Cigna Medicaid |
$5,904.72
|
| Rate for Payer: Cigna Medicare |
$1,615.32
|
| Rate for Payer: Employer Direct Commercial |
$1,615.32
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,615.32
|
| Rate for Payer: Molina CHIP/Medicaid |
$5,904.72
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Molina Medicare |
$1,615.32
|
| 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 |
$5,904.72
|
| Rate for Payer: Scott and White EPO/PPO |
$2,719.24
|
| Rate for Payer: Scott and White Medicare |
$1,615.32
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$5,904.72
|
| Rate for Payer: Superior Health Plan EPO |
$1,615.32
|
| Rate for Payer: Superior Health Plan Medicare |
$1,615.32
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Universal American Medicare |
$1,615.32
|
| Rate for Payer: Wellcare Medicare |
$1,615.32
|
| Rate for Payer: Wellmed Medicare |
$1,615.32
|
|
|
Tenotomy, open, tendon flexor; foot, single or multiple tendon(s) (separate procedure)
|
Facility
|
IP
|
$6,125.30
|
|
|
Service Code
|
HCPCS 28230
|
| Hospital Charge Code |
991013
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,165.20
|
|
|
Tenotomy, open, tendon flexor; foot, single or multiple tendon(s) (separate procedure)
|
Facility
|
OP
|
$6,125.30
|
|
|
Service Code
|
HCPCS 28230
|
| Hospital Charge Code |
991013
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$221.76 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$221.76
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Amerigroup Medicare |
$1,615.32
|
| Rate for Payer: BCBS of TX Blue Advantage |
$469.50
|
| Rate for Payer: BCBS of TX Blue Essentials |
$562.28
|
| Rate for Payer: BCBS of TX Medicare |
$1,615.32
|
| Rate for Payer: BCBS of TX PPO |
$708.47
|
| Rate for Payer: Cash Price |
$4,165.20
|
| Rate for Payer: Cash Price |
$4,165.20
|
| Rate for Payer: Cash Price |
$4,165.20
|
| Rate for Payer: Cigna Commercial |
$3,414.49
|
| Rate for Payer: Cigna Medicaid |
$4,410.22
|
| Rate for Payer: Cigna Medicare |
$1,615.32
|
| Rate for Payer: Employer Direct Commercial |
$1,615.32
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,615.32
|
| Rate for Payer: Molina CHIP/Medicaid |
$4,410.22
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Molina Medicare |
$1,615.32
|
| 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 |
$4,410.22
|
| Rate for Payer: Scott and White EPO/PPO |
$2,719.24
|
| Rate for Payer: Scott and White Medicare |
$1,615.32
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$4,410.22
|
| Rate for Payer: Superior Health Plan EPO |
$1,615.32
|
| Rate for Payer: Superior Health Plan Medicare |
$1,615.32
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Universal American Medicare |
$1,615.32
|
| Rate for Payer: Wellcare Medicare |
$1,615.32
|
| Rate for Payer: Wellmed Medicare |
$1,615.32
|
|
|
Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)
|
Facility
|
OP
|
$4,873.23
|
|
|
Service Code
|
HCPCS 28232
|
| Hospital Charge Code |
9900492
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$203.76 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$203.76
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Amerigroup Medicare |
$1,615.32
|
| Rate for Payer: BCBS of TX Blue Advantage |
$438.16
|
| Rate for Payer: BCBS of TX Blue Essentials |
$524.74
|
| Rate for Payer: BCBS of TX Medicare |
$1,615.32
|
| Rate for Payer: BCBS of TX PPO |
$661.17
|
| Rate for Payer: Cash Price |
$3,313.80
|
| Rate for Payer: Cash Price |
$3,313.80
|
| Rate for Payer: Cash Price |
$3,313.80
|
| Rate for Payer: Cigna Commercial |
$3,414.49
|
| Rate for Payer: Cigna Medicaid |
$3,508.73
|
| Rate for Payer: Cigna Medicare |
$1,615.32
|
| Rate for Payer: Employer Direct Commercial |
$1,615.32
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,615.32
|
| Rate for Payer: Molina CHIP/Medicaid |
$3,508.73
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Molina Medicare |
$1,615.32
|
| 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 |
$3,508.73
|
| Rate for Payer: Scott and White EPO/PPO |
$2,719.24
|
| Rate for Payer: Scott and White Medicare |
$1,615.32
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$3,508.73
|
| Rate for Payer: Superior Health Plan EPO |
$1,615.32
|
| Rate for Payer: Superior Health Plan Medicare |
$1,615.32
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Universal American Medicare |
$1,615.32
|
| Rate for Payer: Wellcare Medicare |
$1,615.32
|
| Rate for Payer: Wellmed Medicare |
$1,615.32
|
|
|
Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)
|
Facility
|
IP
|
$4,873.23
|
|
|
Service Code
|
HCPCS 28232
|
| Hospital Charge Code |
9900492
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,313.80
|
|
|
Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 28232
|
| Hospital Charge Code |
36028232
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$203.76 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$203.76
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Amerigroup Medicare |
$1,615.32
|
| Rate for Payer: BCBS of TX Blue Advantage |
$438.16
|
| Rate for Payer: BCBS of TX Blue Essentials |
$524.74
|
| Rate for Payer: BCBS of TX Medicare |
$1,615.32
|
| Rate for Payer: BCBS of TX PPO |
$661.17
|
| Rate for Payer: Cigna Commercial |
$3,414.49
|
| Rate for Payer: Cigna Medicare |
$1,615.32
|
| Rate for Payer: Employer Direct Commercial |
$1,615.32
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,615.32
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Molina Medicare |
$1,615.32
|
| 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 |
$2,719.24
|
| Rate for Payer: Scott and White Medicare |
$1,615.32
|
| Rate for Payer: Superior Health Plan EPO |
$1,615.32
|
| Rate for Payer: Superior Health Plan Medicare |
$1,615.32
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,615.32
|
| Rate for Payer: Universal American Medicare |
$1,615.32
|
| Rate for Payer: Wellcare Medicare |
$1,615.32
|
| Rate for Payer: Wellmed Medicare |
$1,615.32
|
|
|
Tenotomy, percutaneous, Achilles tendon (separate procedure); general anesthesia
|
Facility
|
OP
|
$7,783.60
|
|
|
Service Code
|
HCPCS 27606
|
| Hospital Charge Code |
9900418
|
|
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 |
$5,292.85
|
| Rate for Payer: Cash Price |
$5,292.85
|
| Rate for Payer: Cash Price |
$5,292.85
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$5,604.19
|
| 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 |
$5,604.19
|
| 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 |
$5,604.19
|
| 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 |
$5,604.19
|
| 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
|
|
|
Tenotomy, percutaneous, Achilles tendon (separate procedure); general anesthesia
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 27606
|
| Hospital Charge Code |
36027606
|
|
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
|
|
|
Tenotomy, percutaneous, Achilles tendon (separate procedure); general anesthesia
|
Facility
|
IP
|
$7,783.60
|
|
|
Service Code
|
HCPCS 27606
|
| Hospital Charge Code |
9900418
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$5,292.85
|
|
|
Tenotomy, percutaneous, adductor or hamstring; single tendon (separate procedure)
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 27306
|
| Hospital Charge Code |
36027306
|
|
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
|
|
|
Tenotomy, percutaneous, adductor or hamstring; single tendon (separate procedure)
|
Facility
|
OP
|
$17,353.68
|
|
|
Service Code
|
HCPCS 27306
|
| Hospital Charge Code |
9900390
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.27 |
| Max. Negotiated Rate |
$12,494.65 |
| 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 |
$11,800.50
|
| Rate for Payer: Cash Price |
$11,800.50
|
| Rate for Payer: Cash Price |
$11,800.50
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$12,494.65
|
| 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 |
$12,494.65
|
| 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 |
$12,494.65
|
| 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 |
$12,494.65
|
| 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
|
|
|
Tenotomy, percutaneous, adductor or hamstring; single tendon (separate procedure)
|
Facility
|
IP
|
$17,353.68
|
|
|
Service Code
|
HCPCS 27306
|
| Hospital Charge Code |
9900390
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$11,800.50
|
|
|
Tenotomy, shoulder area single tendon
|
Facility
|
OP
|
$24,076.97
|
|
|
Service Code
|
HCPCS 23405
|
| Hospital Charge Code |
9900221
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,398.52 |
| Max. Negotiated Rate |
$17,335.42 |
| 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 |
$16,372.34
|
| Rate for Payer: Cash Price |
$16,372.34
|
| Rate for Payer: Cash Price |
$16,372.34
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| Rate for Payer: Cigna Medicaid |
$17,335.42
|
| 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 |
$17,335.42
|
| 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 |
$17,335.42
|
| 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 |
$17,335.42
|
| 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
|
|
|
Tenotomy, shoulder area single tendon
|
Facility
|
OP
|
$15,408.22
|
|
|
Service Code
|
CPT 23405
|
| Hospital Charge Code |
36023405
|
|
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
|
|
|
Tenotomy, shoulder area single tendon
|
Facility
|
IP
|
$24,076.97
|
|
|
Service Code
|
HCPCS 23405
|
| Hospital Charge Code |
9900221
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$16,372.34
|
|
|
TENSIONER CERCLAGE DISP
|
Facility
|
OP
|
$2,083.86
|
|
| Hospital Charge Code |
146432
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$1,500.38 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$187.55
|
| Rate for Payer: BCBS of TX Blue Advantage |
$625.16
|
| Rate for Payer: BCBS of TX Blue Essentials |
$750.19
|
| Rate for Payer: BCBS of TX PPO |
$833.54
|
| Rate for Payer: Cash Price |
$1,417.02
|
| Rate for Payer: Cigna Medicaid |
$1,500.38
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,500.38
|
| Rate for Payer: Multiplan Auto |
$1,354.51
|
| Rate for Payer: Multiplan Commercial |
$1,354.51
|
| Rate for Payer: Multiplan Workers Comp |
$1,354.51
|
| Rate for Payer: Parkland Medicaid |
$1,500.38
|
| Rate for Payer: Scott and White EPO/PPO |
$1,041.93
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,500.38
|
| Rate for Payer: Superior Health Plan EPO |
$283.40
|
|
|
TENSIONER CERCLAGE DISP
|
Facility
|
IP
|
$2,083.86
|
|
| Hospital Charge Code |
146432
|
|
Hospital Revenue Code
|
272
|
| Rate for Payer: Cash Price |
$1,417.02
|
|
|
TENSIX DBM CRUSH MIX 2.5 CC PREHYDATED PUTTY W/CHIPS
|
Facility
|
OP
|
$8,714.70
|
|
|
Service Code
|
HCPCS C9359
|
| Hospital Charge Code |
992411
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$784.32 |
| Max. Negotiated Rate |
$6,274.58 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$784.32
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,614.41
|
| Rate for Payer: BCBS of TX Blue Essentials |
$3,137.29
|
| Rate for Payer: BCBS of TX PPO |
$3,485.88
|
| Rate for Payer: Cash Price |
$5,926.00
|
| Rate for Payer: Cigna Medicaid |
$6,274.58
|
| Rate for Payer: Molina CHIP/Medicaid |
$6,274.58
|
| Rate for Payer: Multiplan Auto |
$4,357.35
|
| Rate for Payer: Multiplan Commercial |
$4,357.35
|
| Rate for Payer: Multiplan Workers Comp |
$4,357.35
|
| Rate for Payer: Parkland Medicaid |
$6,274.58
|
| Rate for Payer: Scott and White EPO/PPO |
$4,357.35
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$6,274.58
|
| Rate for Payer: Superior Health Plan EPO |
$1,185.20
|
|
|
TENSIX DBM CRUSH MIX 2.5 CC PREHYDATED PUTTY W/CHIPS
|
Facility
|
OP
|
$8,714.70
|
|
|
Service Code
|
HCPCS C9359
|
| Hospital Charge Code |
993152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$784.32 |
| Max. Negotiated Rate |
$6,274.58 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$784.32
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,614.41
|
| Rate for Payer: BCBS of TX Blue Essentials |
$3,137.29
|
| Rate for Payer: BCBS of TX PPO |
$3,485.88
|
| Rate for Payer: Cash Price |
$5,926.00
|
| Rate for Payer: Cigna Medicaid |
$6,274.58
|
| Rate for Payer: Molina CHIP/Medicaid |
$6,274.58
|
| Rate for Payer: Multiplan Auto |
$4,357.35
|
| Rate for Payer: Multiplan Commercial |
$4,357.35
|
| Rate for Payer: Multiplan Workers Comp |
$4,357.35
|
| Rate for Payer: Parkland Medicaid |
$6,274.58
|
| Rate for Payer: Scott and White EPO/PPO |
$4,357.35
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$6,274.58
|
| Rate for Payer: Superior Health Plan EPO |
$1,185.20
|
|
|
TENSIX DBM CRUSH MIX 2.5 CC PREHYDATED PUTTY W/CHIPS
|
Facility
|
IP
|
$8,714.70
|
|
|
Service Code
|
HCPCS C9359
|
| Hospital Charge Code |
992411
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,178.68 |
| Max. Negotiated Rate |
$4,357.35 |
| Rate for Payer: Cash Price |
$5,926.00
|
| Rate for Payer: Cigna Commercial |
$2,178.68
|
| Rate for Payer: Multiplan Auto |
$4,357.35
|
| Rate for Payer: Multiplan Commercial |
$4,357.35
|
| Rate for Payer: Multiplan Workers Comp |
$4,357.35
|
| Rate for Payer: Scott and White EPO/PPO |
$4,357.35
|
|
|
TENSIX DBM CRUSH MIX 2.5 CC PREHYDATED PUTTY W/CHIPS
|
Facility
|
IP
|
$8,714.70
|
|
|
Service Code
|
HCPCS C9359
|
| Hospital Charge Code |
993152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,178.68 |
| Max. Negotiated Rate |
$4,357.35 |
| Rate for Payer: Cash Price |
$5,926.00
|
| Rate for Payer: Cigna Commercial |
$2,178.68
|
| Rate for Payer: Multiplan Auto |
$4,357.35
|
| Rate for Payer: Multiplan Commercial |
$4,357.35
|
| Rate for Payer: Multiplan Workers Comp |
$4,357.35
|
| Rate for Payer: Scott and White EPO/PPO |
$4,357.35
|
|
|
Tensix dbm putty 10 cc prehydrated putty
|
Facility
|
OP
|
$16,276.20
|
|
|
Service Code
|
HCPCS C9359
|
| Hospital Charge Code |
992204
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,464.86 |
| Max. Negotiated Rate |
$11,718.86 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,464.86
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,882.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,859.43
|
| Rate for Payer: BCBS of TX PPO |
$6,510.48
|
| Rate for Payer: Cash Price |
$11,067.82
|
| Rate for Payer: Cigna Medicaid |
$11,718.86
|
| Rate for Payer: Molina CHIP/Medicaid |
$11,718.86
|
| Rate for Payer: Multiplan Auto |
$8,138.10
|
| Rate for Payer: Multiplan Commercial |
$8,138.10
|
| Rate for Payer: Multiplan Workers Comp |
$8,138.10
|
| Rate for Payer: Parkland Medicaid |
$11,718.86
|
| Rate for Payer: Scott and White EPO/PPO |
$8,138.10
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$11,718.86
|
| Rate for Payer: Superior Health Plan EPO |
$2,213.56
|
|
