|
Under Excision Procedures on the Humerus (Upper Arm) and Elbow
|
Facility
|
OP
|
$18,930.45
|
|
|
Service Code
|
HCPCS 24077
|
| Hospital Charge Code |
9900239
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$815.20 |
| Max. Negotiated Rate |
$13,629.92 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$815.20
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Amerigroup Medicare |
$2,917.95
|
| Rate for Payer: BCBS of TX Blue Advantage |
$3,872.55
|
| Rate for Payer: BCBS of TX Blue Essentials |
$4,637.78
|
| Rate for Payer: BCBS of TX Medicare |
$2,917.95
|
| Rate for Payer: BCBS of TX PPO |
$5,843.60
|
| Rate for Payer: Cash Price |
$12,872.71
|
| Rate for Payer: Cash Price |
$12,872.71
|
| Rate for Payer: Cash Price |
$12,872.71
|
| Rate for Payer: Cigna Commercial |
$6,168.03
|
| Rate for Payer: Cigna Medicaid |
$13,629.92
|
| Rate for Payer: Cigna Medicare |
$2,917.95
|
| Rate for Payer: Employer Direct Commercial |
$2,917.95
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,917.95
|
| Rate for Payer: Molina CHIP/Medicaid |
$13,629.92
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Molina Medicare |
$2,917.95
|
| 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
|
| Rate for Payer: Parkland Medicaid |
$13,629.92
|
| Rate for Payer: Scott and White EPO/PPO |
$4,807.56
|
| Rate for Payer: Scott and White Medicare |
$2,917.95
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$13,629.92
|
| Rate for Payer: Superior Health Plan EPO |
$2,917.95
|
| Rate for Payer: Superior Health Plan Medicare |
$2,917.95
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,917.95
|
| Rate for Payer: Universal American Medicare |
$2,917.95
|
| Rate for Payer: Wellcare Medicare |
$2,917.95
|
| Rate for Payer: Wellmed Medicare |
$2,917.95
|
|
|
Under Excision Procedures on the Thyroid Gland
|
Facility
|
IP
|
$15,258.15
|
|
|
Service Code
|
HCPCS 60252
|
| Hospital Charge Code |
9900734
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$10,375.54
|
|
|
Under Excision Procedures on the Thyroid Gland
|
Facility
|
OP
|
$15,258.15
|
|
|
Service Code
|
HCPCS 60252
|
| Hospital Charge Code |
9900734
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,373.23 |
| Max. Negotiated Rate |
$12,570.48 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$1,373.23
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Amerigroup Medicare |
$5,946.81
|
| Rate for Payer: BCBS of TX Blue Advantage |
$8,100.39
|
| Rate for Payer: BCBS of TX Blue Essentials |
$9,701.06
|
| Rate for Payer: BCBS of TX Medicare |
$5,946.81
|
| Rate for Payer: BCBS of TX PPO |
$12,223.34
|
| Rate for Payer: Cash Price |
$10,375.54
|
| Rate for Payer: Cash Price |
$10,375.54
|
| Rate for Payer: Cash Price |
$10,375.54
|
| Rate for Payer: Cigna Commercial |
$12,570.48
|
| Rate for Payer: Cigna Medicaid |
$10,985.87
|
| Rate for Payer: Cigna Medicare |
$5,946.81
|
| Rate for Payer: Employer Direct Commercial |
$5,946.81
|
| Rate for Payer: Humana Medicare/TRICARE |
$5,946.81
|
| Rate for Payer: Molina CHIP/Medicaid |
$10,985.87
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Molina Medicare |
$5,946.81
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Parkland Medicaid |
$10,985.87
|
| Rate for Payer: Scott and White EPO/PPO |
$9,908.12
|
| Rate for Payer: Scott and White Medicare |
$5,946.81
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$10,985.87
|
| Rate for Payer: Superior Health Plan EPO |
$5,946.81
|
| Rate for Payer: Superior Health Plan Medicare |
$5,946.81
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Universal American Medicare |
$5,946.81
|
| Rate for Payer: Wellcare Medicare |
$5,946.81
|
| Rate for Payer: Wellmed Medicare |
$5,946.81
|
|
|
Under Excision Procedures on the Thyroid Gland
|
Facility
|
OP
|
$12,570.48
|
|
|
Service Code
|
CPT 60252
|
| Hospital Charge Code |
36060252
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,946.81 |
| Max. Negotiated Rate |
$12,570.48 |
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Amerigroup Medicare |
$5,946.81
|
| Rate for Payer: BCBS of TX Blue Advantage |
$8,100.39
|
| Rate for Payer: BCBS of TX Blue Essentials |
$9,701.06
|
| Rate for Payer: BCBS of TX Medicare |
$5,946.81
|
| Rate for Payer: BCBS of TX PPO |
$12,223.34
|
| Rate for Payer: Cigna Commercial |
$12,570.48
|
| Rate for Payer: Cigna Medicare |
$5,946.81
|
| Rate for Payer: Employer Direct Commercial |
$5,946.81
|
| Rate for Payer: Humana Medicare/TRICARE |
$5,946.81
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Molina Medicare |
$5,946.81
|
| Rate for Payer: Multiplan Auto |
$10,000.00
|
| Rate for Payer: Multiplan Commercial |
$10,000.00
|
| Rate for Payer: Multiplan Workers Comp |
$10,000.00
|
| Rate for Payer: Scott and White EPO/PPO |
$9,908.12
|
| Rate for Payer: Scott and White Medicare |
$5,946.81
|
| Rate for Payer: Superior Health Plan EPO |
$5,946.81
|
| Rate for Payer: Superior Health Plan Medicare |
$5,946.81
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$5,946.81
|
| Rate for Payer: Universal American Medicare |
$5,946.81
|
| Rate for Payer: Wellcare Medicare |
$5,946.81
|
| Rate for Payer: Wellmed Medicare |
$5,946.81
|
|
|
Under Fracture and/or Dislocation Procedures on the Foot and Toes
|
Facility
|
OP
|
$12,336.12
|
|
|
Service Code
|
HCPCS 28505
|
| Hospital Charge Code |
9900521
|
|
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 |
$8,388.56
|
| Rate for Payer: Cash Price |
$8,388.56
|
| Rate for Payer: Cash Price |
$8,388.56
|
| Rate for Payer: Cigna Commercial |
$6,947.94
|
| Rate for Payer: Cigna Medicaid |
$8,882.01
|
| 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 |
$8,882.01
|
| 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 |
$8,882.01
|
| 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 |
$8,882.01
|
| 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
|
|
|
Under Fracture and/or Dislocation Procedures on the Foot and Toes
|
Facility
|
IP
|
$12,336.12
|
|
|
Service Code
|
HCPCS 28505
|
| Hospital Charge Code |
9900521
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$8,388.56
|
|
|
Under Fracture and/or Dislocation Procedures on the Foot and Toes
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 28505
|
| Hospital Charge Code |
36028505
|
|
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
|
|
|
Under Fracture and/or Dislocation Procedures on the Hand and Fingers
|
Facility
|
OP
|
$721.67
|
|
|
Service Code
|
HCPCS 26700
|
| Hospital Charge Code |
9900363
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$85.32 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$85.32
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$247.79
|
| Rate for Payer: Amerigroup Medicare |
$247.79
|
| Rate for Payer: BCBS of TX Blue Advantage |
$181.96
|
| Rate for Payer: BCBS of TX Blue Essentials |
$217.92
|
| Rate for Payer: BCBS of TX Medicare |
$247.79
|
| Rate for Payer: BCBS of TX PPO |
$274.58
|
| Rate for Payer: Cash Price |
$490.74
|
| Rate for Payer: Cash Price |
$490.74
|
| Rate for Payer: Cash Price |
$490.74
|
| Rate for Payer: Cigna Commercial |
$523.79
|
| Rate for Payer: Cigna Medicaid |
$519.60
|
| Rate for Payer: Cigna Medicare |
$247.79
|
| Rate for Payer: Employer Direct Commercial |
$247.79
|
| Rate for Payer: Humana Medicare/TRICARE |
$247.79
|
| Rate for Payer: Molina CHIP/Medicaid |
$519.60
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$247.79
|
| Rate for Payer: Molina Medicare |
$247.79
|
| 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 |
$519.60
|
| Rate for Payer: Scott and White EPO/PPO |
$398.99
|
| Rate for Payer: Scott and White Medicare |
$247.79
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$519.60
|
| Rate for Payer: Superior Health Plan EPO |
$247.79
|
| Rate for Payer: Superior Health Plan Medicare |
$247.79
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$247.79
|
| Rate for Payer: Universal American Medicare |
$247.79
|
| Rate for Payer: Wellcare Medicare |
$247.79
|
| Rate for Payer: Wellmed Medicare |
$247.79
|
|
|
Under Fracture and/or Dislocation Procedures on the Hand and Fingers
|
Facility
|
IP
|
$721.67
|
|
|
Service Code
|
HCPCS 26700
|
| Hospital Charge Code |
9900363
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$490.74
|
|
|
Under Fracture and/or Dislocation Procedures on the Hand and Fingers
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
36026700
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$85.32 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$85.32
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$247.79
|
| Rate for Payer: Amerigroup Medicare |
$247.79
|
| Rate for Payer: BCBS of TX Blue Advantage |
$181.96
|
| Rate for Payer: BCBS of TX Blue Essentials |
$217.92
|
| Rate for Payer: BCBS of TX Medicare |
$247.79
|
| Rate for Payer: BCBS of TX PPO |
$274.58
|
| Rate for Payer: Cigna Commercial |
$523.79
|
| Rate for Payer: Cigna Medicare |
$247.79
|
| Rate for Payer: Employer Direct Commercial |
$247.79
|
| Rate for Payer: Humana Medicare/TRICARE |
$247.79
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$247.79
|
| Rate for Payer: Molina Medicare |
$247.79
|
| 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 |
$398.99
|
| Rate for Payer: Scott and White Medicare |
$247.79
|
| Rate for Payer: Superior Health Plan EPO |
$247.79
|
| Rate for Payer: Superior Health Plan Medicare |
$247.79
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$247.79
|
| Rate for Payer: Universal American Medicare |
$247.79
|
| Rate for Payer: Wellcare Medicare |
$247.79
|
| Rate for Payer: Wellmed Medicare |
$247.79
|
|
|
Under Fracture and/or Dislocation Procedures on the Humerus (Upper Arm) and Elbow
|
Facility
|
IP
|
$75,235.74
|
|
|
Service Code
|
HCPCS 24666
|
| Hospital Charge Code |
9900261
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$51,160.30
|
|
|
Under Fracture and/or Dislocation Procedures on the Humerus (Upper Arm) and Elbow
|
Facility
|
OP
|
$29,989.79
|
|
|
Service Code
|
CPT 24666
|
| Hospital Charge Code |
36024666
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,495.85 |
| Max. Negotiated Rate |
$29,989.79 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$7,495.85
|
| 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
|
|
|
Under Fracture and/or Dislocation Procedures on the Humerus (Upper Arm) and Elbow
|
Facility
|
OP
|
$73,888.56
|
|
|
Service Code
|
HCPCS 24515
|
| Hospital Charge Code |
9900255
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,576.70 |
| Max. Negotiated Rate |
$53,199.76 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$6,576.70
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,897.19
|
| Rate for Payer: Amerigroup Medicare |
$12,897.19
|
| Rate for Payer: BCBS of TX Blue Advantage |
$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 |
$50,244.22
|
| Rate for Payer: Cash Price |
$50,244.22
|
| Rate for Payer: Cash Price |
$50,244.22
|
| Rate for Payer: Cigna Commercial |
$27,262.32
|
| Rate for Payer: Cigna Medicaid |
$53,199.76
|
| 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 |
$53,199.76
|
| 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 |
$53,199.76
|
| 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 |
$53,199.76
|
| 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
|
|
|
Under Fracture and/or Dislocation Procedures on the Humerus (Upper Arm) and Elbow
|
Facility
|
IP
|
$73,888.56
|
|
|
Service Code
|
HCPCS 24515
|
| Hospital Charge Code |
9900255
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$50,244.22
|
|
|
Under Fracture and/or Dislocation Procedures on the Humerus (Upper Arm) and Elbow
|
Facility
|
OP
|
$75,235.74
|
|
|
Service Code
|
HCPCS 24666
|
| Hospital Charge Code |
9900261
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,495.85 |
| Max. Negotiated Rate |
$54,169.73 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$7,495.85
|
| 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 |
$51,160.30
|
| Rate for Payer: Cash Price |
$51,160.30
|
| Rate for Payer: Cash Price |
$51,160.30
|
| Rate for Payer: Cigna Commercial |
$27,262.32
|
| Rate for Payer: Cigna Medicaid |
$54,169.73
|
| 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 |
$54,169.73
|
| 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 |
$54,169.73
|
| 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 |
$54,169.73
|
| 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
|
|
|
Under Fracture and/or Dislocation Procedures on the Humerus (Upper Arm) and Elbow
|
Facility
|
IP
|
$38,382.30
|
|
|
Service Code
|
HCPCS 24615
|
| Hospital Charge Code |
9900259
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$26,099.96
|
|
|
Under Fracture and/or Dislocation Procedures on the Humerus (Upper Arm) and Elbow
|
Facility
|
OP
|
$29,989.79
|
|
|
Service Code
|
CPT 24515
|
| Hospital Charge Code |
36024515
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,576.70 |
| Max. Negotiated Rate |
$29,989.79 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$6,576.70
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$12,897.19
|
| Rate for Payer: Amerigroup Medicare |
$12,897.19
|
| Rate for Payer: BCBS of TX Blue Advantage |
$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
|
|
|
Under Fracture and/or Dislocation Procedures on the Humerus (Upper Arm) and Elbow
|
Facility
|
OP
|
$38,382.30
|
|
|
Service Code
|
HCPCS 24615
|
| Hospital Charge Code |
9900259
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,347.69 |
| Max. Negotiated Rate |
$27,635.26 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,347.69
|
| 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
|
|
|
Under Fracture and/or Dislocation Procedures on the Humerus (Upper Arm) and Elbow
|
Facility
|
OP
|
$15,408.22
|
|
|
Service Code
|
CPT 24615
|
| Hospital Charge Code |
36024615
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,347.69 |
| Max. Negotiated Rate |
$15,408.22 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$3,347.69
|
| 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
|
|
|
Under Fracture and/or Dislocation Procedures on the Pelvis and Hip Joint
|
Facility
|
OP
|
$34,525.45
|
|
|
Service Code
|
HCPCS 27266
|
| Hospital Charge Code |
9900385
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$593.04 |
| Max. Negotiated Rate |
$24,858.32 |
| 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 |
$23,477.31
|
| Rate for Payer: Cash Price |
$23,477.31
|
| Rate for Payer: Cash Price |
$23,477.31
|
| Rate for Payer: Cigna Commercial |
$3,414.49
|
| Rate for Payer: Cigna Medicaid |
$24,858.32
|
| 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 |
$24,858.32
|
| 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: Parkland Medicaid |
$24,858.32
|
| 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 |
$24,858.32
|
| 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
|
|
|
Under Fracture and/or Dislocation Procedures on the Pelvis and Hip Joint
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 27266
|
| Hospital Charge Code |
36027266
|
|
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
|
|
|
Under Fracture and/or Dislocation Procedures on the Pelvis and Hip Joint
|
Facility
|
IP
|
$34,525.45
|
|
|
Service Code
|
HCPCS 27266
|
| Hospital Charge Code |
9900385
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$23,477.31
|
|
|
Under Lower Extremity Application of Casts
|
Facility
|
OP
|
$739.14
|
|
|
Service Code
|
HCPCS 29445
|
| Hospital Charge Code |
9900540
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$49.94 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$49.94
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$280.97
|
| Rate for Payer: Amerigroup Medicare |
$280.97
|
| Rate for Payer: BCBS of TX Blue Advantage |
$103.66
|
| Rate for Payer: BCBS of TX Blue Essentials |
$124.14
|
| Rate for Payer: BCBS of TX Medicare |
$280.97
|
| Rate for Payer: BCBS of TX PPO |
$156.42
|
| Rate for Payer: Cash Price |
$502.62
|
| Rate for Payer: Cash Price |
$502.62
|
| Rate for Payer: Cash Price |
$502.62
|
| Rate for Payer: Cigna Commercial |
$593.92
|
| Rate for Payer: Cigna Medicaid |
$532.18
|
| Rate for Payer: Cigna Medicare |
$280.97
|
| Rate for Payer: Employer Direct Commercial |
$280.97
|
| Rate for Payer: Humana Medicare/TRICARE |
$280.97
|
| Rate for Payer: Molina CHIP/Medicaid |
$532.18
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$280.97
|
| Rate for Payer: Molina Medicare |
$280.97
|
| 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 |
$532.18
|
| Rate for Payer: Scott and White EPO/PPO |
$454.38
|
| Rate for Payer: Scott and White Medicare |
$280.97
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$532.18
|
| Rate for Payer: Superior Health Plan EPO |
$280.97
|
| Rate for Payer: Superior Health Plan Medicare |
$280.97
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$280.97
|
| Rate for Payer: Universal American Medicare |
$280.97
|
| Rate for Payer: Wellcare Medicare |
$280.97
|
| Rate for Payer: Wellmed Medicare |
$280.97
|
|
|
Under Lower Extremity Application of Casts
|
Facility
|
OP
|
$10,000.00
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
36029445
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$49.94 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$49.94
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$280.97
|
| Rate for Payer: Amerigroup Medicare |
$280.97
|
| Rate for Payer: BCBS of TX Blue Advantage |
$103.66
|
| Rate for Payer: BCBS of TX Blue Essentials |
$124.14
|
| Rate for Payer: BCBS of TX Medicare |
$280.97
|
| Rate for Payer: BCBS of TX PPO |
$156.42
|
| Rate for Payer: Cigna Commercial |
$593.92
|
| Rate for Payer: Cigna Medicare |
$280.97
|
| Rate for Payer: Employer Direct Commercial |
$280.97
|
| Rate for Payer: Humana Medicare/TRICARE |
$280.97
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$280.97
|
| Rate for Payer: Molina Medicare |
$280.97
|
| 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 |
$454.38
|
| Rate for Payer: Scott and White Medicare |
$280.97
|
| Rate for Payer: Superior Health Plan EPO |
$280.97
|
| Rate for Payer: Superior Health Plan Medicare |
$280.97
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$280.97
|
| Rate for Payer: Universal American Medicare |
$280.97
|
| Rate for Payer: Wellcare Medicare |
$280.97
|
| Rate for Payer: Wellmed Medicare |
$280.97
|
|
|
Under Lower Extremity Application of Casts
|
Facility
|
IP
|
$739.14
|
|
|
Service Code
|
HCPCS 29445
|
| Hospital Charge Code |
9900540
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$502.62
|
|
