|
Arthroplasty, ankle; revision, total ankle
|
Facility
|
OP
|
$8,000.00
|
|
|
Service Code
|
HCPCS 27703
|
| Hospital Charge Code |
994010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$720.00 |
| Max. Negotiated Rate |
$37,232.21 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$720.00
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$17,613.72
|
| Rate for Payer: Amerigroup Medicare |
$17,613.72
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,924.73
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,305.06
|
| Rate for Payer: BCBS of TX Medicare |
$17,613.72
|
| Rate for Payer: BCBS of TX PPO |
$2,904.38
|
| Rate for Payer: Cash Price |
$5,440.00
|
| Rate for Payer: Cash Price |
$5,440.00
|
| Rate for Payer: Cash Price |
$5,440.00
|
| Rate for Payer: Cigna Commercial |
$37,232.21
|
| Rate for Payer: Cigna Medicaid |
$5,760.00
|
| Rate for Payer: Cigna Medicare |
$17,613.72
|
| Rate for Payer: Employer Direct Commercial |
$17,613.72
|
| Rate for Payer: Humana Medicare/TRICARE |
$17,613.72
|
| Rate for Payer: Molina CHIP/Medicaid |
$5,760.00
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$17,613.72
|
| Rate for Payer: Molina Medicare |
$17,613.72
|
| 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 |
$5,760.00
|
| Rate for Payer: Scott and White EPO/PPO |
$4,000.00
|
| Rate for Payer: Scott and White Medicare |
$17,613.72
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$5,760.00
|
| Rate for Payer: Superior Health Plan EPO |
$17,613.72
|
| Rate for Payer: Superior Health Plan Medicare |
$17,613.72
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$17,613.72
|
| Rate for Payer: Universal American Medicare |
$17,613.72
|
| Rate for Payer: Wellcare Medicare |
$17,613.72
|
| Rate for Payer: Wellmed Medicare |
$17,613.72
|
|
|
Arthroplasty, ankle; with implant (total ankle)
|
Facility
|
IP
|
$71,025.12
|
|
|
Service Code
|
HCPCS 27702
|
| Hospital Charge Code |
990950
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$48,297.08
|
|
|
Arthroplasty, ankle; with implant (total ankle)
|
Facility
|
OP
|
$71,025.12
|
|
|
Service Code
|
HCPCS 27702
|
| Hospital Charge Code |
990950
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,667.73 |
| Max. Negotiated Rate |
$57,617.77 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$6,392.26
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$27,257.67
|
| Rate for Payer: Amerigroup Medicare |
$27,257.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,667.73
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,997.28
|
| Rate for Payer: BCBS of TX Medicare |
$27,257.67
|
| Rate for Payer: BCBS of TX PPO |
$2,516.57
|
| Rate for Payer: Cash Price |
$48,297.08
|
| Rate for Payer: Cash Price |
$48,297.08
|
| Rate for Payer: Cash Price |
$48,297.08
|
| Rate for Payer: Cigna Commercial |
$57,617.77
|
| Rate for Payer: Cigna Medicaid |
$51,138.09
|
| Rate for Payer: Cigna Medicare |
$27,257.67
|
| Rate for Payer: Employer Direct Commercial |
$27,257.67
|
| Rate for Payer: Humana Medicare/TRICARE |
$27,257.67
|
| Rate for Payer: Molina CHIP/Medicaid |
$51,138.09
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$27,257.67
|
| Rate for Payer: Molina Medicare |
$27,257.67
|
| 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 |
$51,138.09
|
| Rate for Payer: Scott and White EPO/PPO |
$31,530.55
|
| Rate for Payer: Scott and White Medicare |
$27,257.67
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$51,138.09
|
| Rate for Payer: Superior Health Plan EPO |
$27,257.67
|
| Rate for Payer: Superior Health Plan Medicare |
$27,257.67
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$27,257.67
|
| Rate for Payer: Universal American Medicare |
$27,257.67
|
| Rate for Payer: Wellcare Medicare |
$27,257.67
|
| Rate for Payer: Wellmed Medicare |
$27,257.67
|
|
|
Arthroplasty, glenohumeral joint total shoulder (glenoid and proximal humeral replacement (eg, tota
|
Facility
|
OP
|
$98,518.08
|
|
|
Service Code
|
HCPCS 23472
|
| Hospital Charge Code |
9900226
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,523.57 |
| Max. Negotiated Rate |
$70,933.02 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$8,866.63
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$17,613.72
|
| Rate for Payer: Amerigroup Medicare |
$17,613.72
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,523.57
|
| Rate for Payer: BCBS of TX Blue Essentials |
$3,022.24
|
| Rate for Payer: BCBS of TX Medicare |
$17,613.72
|
| Rate for Payer: BCBS of TX PPO |
$3,808.02
|
| Rate for Payer: Cash Price |
$66,992.29
|
| Rate for Payer: Cash Price |
$66,992.29
|
| Rate for Payer: Cash Price |
$66,992.29
|
| Rate for Payer: Cigna Commercial |
$37,232.21
|
| Rate for Payer: Cigna Medicaid |
$70,933.02
|
| Rate for Payer: Cigna Medicare |
$17,613.72
|
| Rate for Payer: Employer Direct Commercial |
$17,613.72
|
| Rate for Payer: Humana Medicare/TRICARE |
$17,613.72
|
| Rate for Payer: Molina CHIP/Medicaid |
$70,933.02
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$17,613.72
|
| Rate for Payer: Molina Medicare |
$17,613.72
|
| 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 |
$70,933.02
|
| Rate for Payer: Scott and White EPO/PPO |
$31,530.55
|
| Rate for Payer: Scott and White Medicare |
$17,613.72
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$70,933.02
|
| Rate for Payer: Superior Health Plan EPO |
$17,613.72
|
| Rate for Payer: Superior Health Plan Medicare |
$17,613.72
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$17,613.72
|
| Rate for Payer: Universal American Medicare |
$17,613.72
|
| Rate for Payer: Wellcare Medicare |
$17,613.72
|
| Rate for Payer: Wellmed Medicare |
$17,613.72
|
|
|
Arthroplasty, glenohumeral joint total shoulder (glenoid and proximal humeral replacement (eg, tota
|
Facility
|
IP
|
$98,518.08
|
|
|
Service Code
|
HCPCS 23472
|
| Hospital Charge Code |
9900226
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$66,992.29
|
|
|
Arthroplasty, glenohumeral joint total shoulder (glenoid and proximal humeral replacement (eg, tota
|
Facility
|
OP
|
$37,232.21
|
|
|
Service Code
|
CPT 23472
|
| Hospital Charge Code |
36023472
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,523.57 |
| Max. Negotiated Rate |
$37,232.21 |
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$17,613.72
|
| Rate for Payer: Amerigroup Medicare |
$17,613.72
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,523.57
|
| Rate for Payer: BCBS of TX Blue Essentials |
$3,022.24
|
| Rate for Payer: BCBS of TX Medicare |
$17,613.72
|
| Rate for Payer: BCBS of TX PPO |
$3,808.02
|
| Rate for Payer: Cigna Commercial |
$37,232.21
|
| Rate for Payer: Cigna Medicare |
$17,613.72
|
| Rate for Payer: Employer Direct Commercial |
$17,613.72
|
| Rate for Payer: Humana Medicare/TRICARE |
$17,613.72
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$17,613.72
|
| Rate for Payer: Molina Medicare |
$17,613.72
|
| 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 |
$31,530.55
|
| Rate for Payer: Scott and White Medicare |
$17,613.72
|
| Rate for Payer: Superior Health Plan EPO |
$17,613.72
|
| Rate for Payer: Superior Health Plan Medicare |
$17,613.72
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$17,613.72
|
| Rate for Payer: Universal American Medicare |
$17,613.72
|
| Rate for Payer: Wellcare Medicare |
$17,613.72
|
| Rate for Payer: Wellmed Medicare |
$17,613.72
|
|
|
Arthroplasty, interphalangeal joint; each joint
|
Facility
|
IP
|
$11,906.64
|
|
|
Service Code
|
HCPCS 26535
|
| Hospital Charge Code |
9900352
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$8,096.52
|
|
|
Arthroplasty, interphalangeal joint; each joint
|
Facility
|
OP
|
$11,906.64
|
|
|
Service Code
|
HCPCS 26535
|
| Hospital Charge Code |
9900352
|
|
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
|
|
|
Arthroplasty, interphalangeal joint; each joint
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 26535
|
| Hospital Charge Code |
36026535
|
|
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
|
|
|
Arthroplasty, interphalangeal joint; with prosthetic implant, each joint
|
Facility
|
OP
|
$15,408.22
|
|
|
Service Code
|
CPT 26536
|
| Hospital Charge Code |
36026536
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,290.94 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,290.94
|
| 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
|
|
|
Arthroplasty, interphalangeal joint; with prosthetic implant, each joint
|
Facility
|
IP
|
$31,985.25
|
|
|
Service Code
|
HCPCS 26536
|
| Hospital Charge Code |
9900353
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$21,749.97
|
|
|
Arthroplasty, interphalangeal joint; with prosthetic implant, each joint
|
Facility
|
OP
|
$31,985.25
|
|
|
Service Code
|
HCPCS 26536
|
| Hospital Charge Code |
9900353
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,290.94 |
| Max. Negotiated Rate |
$23,029.38 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,290.94
|
| 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 |
$21,749.97
|
| Rate for Payer: Cash Price |
$21,749.97
|
| Rate for Payer: Cash Price |
$21,749.97
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| Rate for Payer: Cigna Medicaid |
$23,029.38
|
| 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 |
$23,029.38
|
| 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 |
$23,029.38
|
| 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 |
$23,029.38
|
| 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
|
|
|
Arthroplasty, interposition, intercarpal or carpometacarpal joints
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 25447
|
| Hospital Charge Code |
36025447
|
|
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
|
|
|
Arthroplasty, interposition, intercarpal or carpometacarpal joints
|
Facility
|
IP
|
$7,783.60
|
|
|
Service Code
|
HCPCS 25447
|
| Hospital Charge Code |
9900297
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$5,292.85
|
|
|
Arthroplasty, interposition, intercarpal or carpometacarpal joints
|
Facility
|
OP
|
$7,783.60
|
|
|
Service Code
|
HCPCS 25447
|
| Hospital Charge Code |
9900297
|
|
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
|
|
|
Arthroplasty, knee, condyle and plateau medial AND lateral compartments with or without patella res
|
Facility
|
OP
|
$29,989.79
|
|
|
Service Code
|
CPT 27447
|
| Hospital Charge Code |
36027447
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$29,989.79 |
| 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: 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 |
$22,267.47
|
| 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
|
|
|
Arthroplasty, knee, condyle and plateau medial AND lateral compartments with or without patella res
|
Facility
|
OP
|
$55,416.42
|
|
|
Service Code
|
HCPCS 27447
|
| Hospital Charge Code |
9900409
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,987.48 |
| Max. Negotiated Rate |
$39,899.82 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$4,987.48
|
| 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 |
$37,683.17
|
| Rate for Payer: Cash Price |
$37,683.17
|
| Rate for Payer: Cash Price |
$37,683.17
|
| Rate for Payer: Cigna Commercial |
$27,262.32
|
| Rate for Payer: Cigna Medicaid |
$39,899.82
|
| 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 |
$39,899.82
|
| 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 |
$39,899.82
|
| Rate for Payer: Scott and White EPO/PPO |
$22,267.47
|
| Rate for Payer: Scott and White Medicare |
$12,897.19
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$39,899.82
|
| 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
|
|
|
Arthroplasty, knee, condyle and plateau medial AND lateral compartments with or without patella res
|
Facility
|
IP
|
$55,416.42
|
|
|
Service Code
|
HCPCS 27447
|
| Hospital Charge Code |
9900409
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$37,683.17
|
|
|
Arthroplasty, metacarpophalangeal joint; each joint
|
Facility
|
IP
|
$39,687.78
|
|
|
Service Code
|
HCPCS 26530
|
| Hospital Charge Code |
9900350
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$26,987.69
|
|
|
Arthroplasty, metacarpophalangeal joint; each joint
|
Facility
|
OP
|
$15,408.22
|
|
|
Service Code
|
CPT 26530
|
| Hospital Charge Code |
36026530
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,157.11 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,157.11
|
| 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
|
|
|
Arthroplasty, metacarpophalangeal joint; each joint
|
Facility
|
OP
|
$39,687.78
|
|
|
Service Code
|
HCPCS 26530
|
| Hospital Charge Code |
9900350
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,157.11 |
| Max. Negotiated Rate |
$28,575.20 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,157.11
|
| 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
|
|
|
Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint
|
Facility
|
IP
|
$38,382.30
|
|
|
Service Code
|
HCPCS 26531
|
| Hospital Charge Code |
9900351
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$26,099.96
|
|
|
Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint
|
Facility
|
OP
|
$38,382.30
|
|
|
Service Code
|
HCPCS 26531
|
| Hospital Charge Code |
9900351
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,500.43 |
| Max. Negotiated Rate |
$27,635.26 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,500.43
|
| 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 |
$26,099.96
|
| Rate for Payer: Cash Price |
$26,099.96
|
| Rate for Payer: Cash Price |
$26,099.96
|
| Rate for Payer: Cigna Commercial |
$15,408.22
|
| Rate for Payer: Cigna Medicaid |
$27,635.26
|
| 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 |
$27,635.26
|
| 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 |
$27,635.26
|
| 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 |
$27,635.26
|
| 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
|
|
|
Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint
|
Facility
|
OP
|
$15,408.22
|
|
|
Service Code
|
CPT 26531
|
| Hospital Charge Code |
36026531
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,500.43 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,500.43
|
| 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
|
|
|
Arthroplasty, radial head; with implant
|
Facility
|
OP
|
$29,989.79
|
|
|
Service Code
|
CPT 24366
|
| Hospital Charge Code |
36024366
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,448.53 |
| Max. Negotiated Rate |
$29,989.79 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$7,448.53
|
| 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: 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 |
$22,267.47
|
| 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
|
|
