|
US Art/Vein Abd/Pelvis/Scrotal Complete
|
Facility
|
OP
|
$2,433.00
|
|
|
Service Code
|
HCPCS 93975
|
| Hospital Charge Code |
5032015
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$218.97 |
| Max. Negotiated Rate |
$1,751.76 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$218.97
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$239.69
|
| Rate for Payer: Amerigroup Medicare |
$239.69
|
| Rate for Payer: BCBS of TX Blue Advantage |
$729.90
|
| Rate for Payer: BCBS of TX Blue Essentials |
$875.88
|
| Rate for Payer: BCBS of TX Medicare |
$239.69
|
| Rate for Payer: BCBS of TX PPO |
$973.20
|
| Rate for Payer: Cash Price |
$1,654.44
|
| Rate for Payer: Cash Price |
$1,654.44
|
| Rate for Payer: Cash Price |
$1,654.44
|
| Rate for Payer: Cigna Commercial |
$506.65
|
| Rate for Payer: Cigna Medicaid |
$1,751.76
|
| Rate for Payer: Cigna Medicare |
$239.69
|
| Rate for Payer: Employer Direct Commercial |
$239.69
|
| Rate for Payer: Humana Medicare/TRICARE |
$239.69
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,751.76
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$239.69
|
| Rate for Payer: Molina Medicare |
$239.69
|
| Rate for Payer: Multiplan Auto |
$1,581.45
|
| Rate for Payer: Multiplan Commercial |
$1,581.45
|
| Rate for Payer: Multiplan Workers Comp |
$1,581.45
|
| Rate for Payer: Parkland Medicaid |
$1,751.76
|
| Rate for Payer: Scott and White EPO/PPO |
$1,216.50
|
| Rate for Payer: Scott and White Medicare |
$239.69
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,751.76
|
| Rate for Payer: Superior Health Plan EPO |
$239.69
|
| Rate for Payer: Superior Health Plan Medicare |
$239.69
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$239.69
|
| Rate for Payer: Universal American Medicare |
$239.69
|
| Rate for Payer: Wellcare Medicare |
$239.69
|
| Rate for Payer: Wellmed Medicare |
$239.69
|
|
|
US Art/Vein Abd/Pelvis/Scrotal Complete
|
Facility
|
IP
|
$2,433.00
|
|
|
Service Code
|
HCPCS 93975
|
| Hospital Charge Code |
5032015
|
|
Hospital Revenue Code
|
921
|
| Rate for Payer: Cash Price |
$1,654.44
|
|
|
US Art/Vein Abd/Pelvis/Scrotal Limited
|
Facility
|
OP
|
$1,868.00
|
|
|
Service Code
|
HCPCS 93976
|
| Hospital Charge Code |
3500345
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$105.02 |
| Max. Negotiated Rate |
$1,344.96 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$168.12
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$105.02
|
| Rate for Payer: Amerigroup Medicare |
$105.02
|
| Rate for Payer: BCBS of TX Blue Advantage |
$560.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$672.48
|
| Rate for Payer: BCBS of TX Medicare |
$105.02
|
| Rate for Payer: BCBS of TX PPO |
$747.20
|
| Rate for Payer: Cash Price |
$1,270.24
|
| Rate for Payer: Cash Price |
$1,270.24
|
| Rate for Payer: Cash Price |
$1,270.24
|
| Rate for Payer: Cigna Commercial |
$222.00
|
| Rate for Payer: Cigna Medicaid |
$1,344.96
|
| Rate for Payer: Cigna Medicare |
$105.02
|
| Rate for Payer: Employer Direct Commercial |
$105.02
|
| Rate for Payer: Humana Medicare/TRICARE |
$105.02
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,344.96
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$105.02
|
| Rate for Payer: Molina Medicare |
$105.02
|
| Rate for Payer: Multiplan Auto |
$1,214.20
|
| Rate for Payer: Multiplan Commercial |
$1,214.20
|
| Rate for Payer: Multiplan Workers Comp |
$1,214.20
|
| Rate for Payer: Parkland Medicaid |
$1,344.96
|
| Rate for Payer: Scott and White EPO/PPO |
$934.00
|
| Rate for Payer: Scott and White Medicare |
$105.02
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,344.96
|
| Rate for Payer: Superior Health Plan EPO |
$105.02
|
| Rate for Payer: Superior Health Plan Medicare |
$105.02
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$105.02
|
| Rate for Payer: Universal American Medicare |
$105.02
|
| Rate for Payer: Wellcare Medicare |
$105.02
|
| Rate for Payer: Wellmed Medicare |
$105.02
|
|
|
US Art/Vein Abd/Pelvis/Scrotal Limited
|
Facility
|
IP
|
$1,868.00
|
|
|
Service Code
|
HCPCS 93976
|
| Hospital Charge Code |
3500345
|
|
Hospital Revenue Code
|
921
|
| Rate for Payer: Cash Price |
$1,270.24
|
|
|
US Biopsy Liver
|
Facility
|
IP
|
$3,191.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
3500782
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$2,169.88
|
|
|
US Biopsy Liver
|
Facility
|
OP
|
$3,191.00
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
3500782
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$486.45 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$486.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cash Price |
$2,169.88
|
| Rate for Payer: Cash Price |
$2,169.88
|
| Rate for Payer: Cash Price |
$2,169.88
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$2,297.52
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina CHIP/Medicaid |
$2,297.52
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| 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 |
$2,297.52
|
| Rate for Payer: Scott and White EPO/PPO |
$3,069.37
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$2,297.52
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
US Biopsy Lymph Node
|
Facility
|
IP
|
$2,714.00
|
|
|
Service Code
|
HCPCS 38505
|
| Hospital Charge Code |
3521017
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$1,845.52
|
|
|
US Biopsy Lymph Node
|
Facility
|
OP
|
$2,714.00
|
|
|
Service Code
|
HCPCS 38505
|
| Hospital Charge Code |
3521017
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$486.45 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$486.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cash Price |
$1,845.52
|
| Rate for Payer: Cash Price |
$1,845.52
|
| Rate for Payer: Cash Price |
$1,845.52
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$1,954.08
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,954.08
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| 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 |
$1,954.08
|
| Rate for Payer: Scott and White EPO/PPO |
$3,069.37
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,954.08
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
US Biopsy Muscle
|
Facility
|
OP
|
$3,321.00
|
|
|
Service Code
|
HCPCS 20206
|
| Hospital Charge Code |
3802220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$486.45 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$486.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cash Price |
$2,258.28
|
| Rate for Payer: Cash Price |
$2,258.28
|
| Rate for Payer: Cash Price |
$2,258.28
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$2,391.12
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina CHIP/Medicaid |
$2,391.12
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| 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 |
$2,391.12
|
| Rate for Payer: Scott and White EPO/PPO |
$3,069.37
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$2,391.12
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
US Biopsy Muscle
|
Facility
|
IP
|
$3,321.00
|
|
|
Service Code
|
HCPCS 20206
|
| Hospital Charge Code |
3802220
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$2,258.28
|
|
|
US Biopsy Pancreas
|
Facility
|
IP
|
$2,714.00
|
|
|
Service Code
|
HCPCS 48102
|
| Hospital Charge Code |
2117570
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$1,845.52
|
|
|
US Biopsy Pancreas
|
Facility
|
OP
|
$2,714.00
|
|
|
Service Code
|
HCPCS 48102
|
| Hospital Charge Code |
2117570
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$486.45 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$486.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cash Price |
$1,845.52
|
| Rate for Payer: Cash Price |
$1,845.52
|
| Rate for Payer: Cash Price |
$1,845.52
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$1,954.08
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,954.08
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| 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 |
$1,954.08
|
| Rate for Payer: Scott and White EPO/PPO |
$3,069.37
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,954.08
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
US Biopsy Prostate
|
Facility
|
OP
|
$1,833.00
|
|
|
Service Code
|
HCPCS 55700
|
| Hospital Charge Code |
3500741
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$164.97 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$164.97
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,958.49
|
| Rate for Payer: BCBS of TX Blue Essentials |
$3,543.10
|
| Rate for Payer: BCBS of TX PPO |
$4,464.31
|
| Rate for Payer: Cash Price |
$1,246.44
|
| Rate for Payer: Cash Price |
$1,246.44
|
| Rate for Payer: Cash Price |
$1,246.44
|
| Rate for Payer: Cigna Medicaid |
$1,319.76
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,319.76
|
| 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 |
$1,319.76
|
| Rate for Payer: Scott and White EPO/PPO |
$916.50
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,319.76
|
| Rate for Payer: Superior Health Plan EPO |
$249.29
|
|
|
US Biopsy Prostate
|
Facility
|
IP
|
$1,833.00
|
|
|
Service Code
|
HCPCS 55700
|
| Hospital Charge Code |
3500741
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$1,246.44
|
|
|
US Biopsy Renal Right
|
Facility
|
OP
|
$1,821.00
|
|
|
Service Code
|
HCPCS 50200 RT
|
| Hospital Charge Code |
3520020
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$247.66 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$486.45
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cash Price |
$1,238.28
|
| Rate for Payer: Cash Price |
$1,238.28
|
| Rate for Payer: Cash Price |
$1,238.28
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$1,311.12
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,311.12
|
| 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 |
$1,311.12
|
| Rate for Payer: Scott and White EPO/PPO |
$910.50
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,311.12
|
| Rate for Payer: Superior Health Plan EPO |
$247.66
|
|
|
US Biopsy Renal Right
|
Facility
|
IP
|
$1,821.00
|
|
|
Service Code
|
HCPCS 50200 RT
|
| Hospital Charge Code |
3520020
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$1,238.28
|
|
|
US Biopsy Soft Tissue Neck
|
Facility
|
IP
|
$4,329.00
|
|
|
Service Code
|
HCPCS 21550
|
| Hospital Charge Code |
5037507
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$2,943.72
|
|
|
US Biopsy Soft Tissue Neck
|
Facility
|
OP
|
$4,329.00
|
|
|
Service Code
|
HCPCS 21550
|
| Hospital Charge Code |
5037507
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$486.45 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$486.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cash Price |
$2,943.72
|
| Rate for Payer: Cash Price |
$2,943.72
|
| Rate for Payer: Cash Price |
$2,943.72
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$3,116.88
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina CHIP/Medicaid |
$3,116.88
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| 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 |
$3,116.88
|
| Rate for Payer: Scott and White EPO/PPO |
$3,069.37
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$3,116.88
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
US Biopsy Thyroid Perc Core Needle
|
Facility
|
OP
|
$1,175.00
|
|
|
Service Code
|
HCPCS 60100
|
| Hospital Charge Code |
2117729
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$42.63 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$42.63
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$711.36
|
| Rate for Payer: Amerigroup Medicare |
$711.36
|
| Rate for Payer: BCBS of TX Blue Advantage |
$89.80
|
| Rate for Payer: BCBS of TX Blue Essentials |
$107.54
|
| Rate for Payer: BCBS of TX Medicare |
$711.36
|
| Rate for Payer: BCBS of TX PPO |
$135.50
|
| Rate for Payer: Cash Price |
$799.00
|
| Rate for Payer: Cash Price |
$799.00
|
| Rate for Payer: Cash Price |
$799.00
|
| Rate for Payer: Cigna Commercial |
$1,503.68
|
| Rate for Payer: Cigna Medicaid |
$846.00
|
| Rate for Payer: Cigna Medicare |
$711.36
|
| Rate for Payer: Employer Direct Commercial |
$711.36
|
| Rate for Payer: Humana Medicare/TRICARE |
$711.36
|
| Rate for Payer: Molina CHIP/Medicaid |
$846.00
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$711.36
|
| Rate for Payer: Molina Medicare |
$711.36
|
| 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 |
$846.00
|
| Rate for Payer: Scott and White EPO/PPO |
$1,316.02
|
| Rate for Payer: Scott and White Medicare |
$711.36
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$846.00
|
| Rate for Payer: Superior Health Plan EPO |
$711.36
|
| Rate for Payer: Superior Health Plan Medicare |
$711.36
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$711.36
|
| Rate for Payer: Universal American Medicare |
$711.36
|
| Rate for Payer: Wellcare Medicare |
$711.36
|
| Rate for Payer: Wellmed Medicare |
$711.36
|
|
|
US Biopsy Thyroid Perc Core Needle
|
Facility
|
IP
|
$1,175.00
|
|
|
Service Code
|
HCPCS 60100
|
| Hospital Charge Code |
2117729
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$799.00
|
|
|
US Breast Biopsy w/ US Guide Left
|
Facility
|
OP
|
$5,178.00
|
|
|
Service Code
|
HCPCS 19083
|
| Hospital Charge Code |
3530037
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$486.45 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$486.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cash Price |
$3,521.04
|
| Rate for Payer: Cash Price |
$3,521.04
|
| Rate for Payer: Cash Price |
$3,521.04
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$3,728.16
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina CHIP/Medicaid |
$3,728.16
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| 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 |
$3,728.16
|
| Rate for Payer: Scott and White EPO/PPO |
$3,069.37
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$3,728.16
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
US Breast Biopsy w/ US Guide Left
|
Facility
|
IP
|
$5,178.00
|
|
|
Service Code
|
HCPCS 19083
|
| Hospital Charge Code |
3530037
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$3,521.04
|
|
|
US Breast Biopsy w/ US Guide Right
|
Facility
|
OP
|
$5,178.00
|
|
|
Service Code
|
HCPCS 19083
|
| Hospital Charge Code |
3530035
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$486.45 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Amerigroup CHIP/Medicaid |
$486.45
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Amerigroup Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX Blue Advantage |
$2,292.24
|
| Rate for Payer: BCBS of TX Blue Essentials |
$2,745.20
|
| Rate for Payer: BCBS of TX Medicare |
$1,659.12
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cash Price |
$3,521.04
|
| Rate for Payer: Cash Price |
$3,521.04
|
| Rate for Payer: Cash Price |
$3,521.04
|
| Rate for Payer: Cigna Commercial |
$3,507.10
|
| Rate for Payer: Cigna Medicaid |
$3,728.16
|
| Rate for Payer: Cigna Medicare |
$1,659.12
|
| Rate for Payer: Employer Direct Commercial |
$1,659.12
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,659.12
|
| Rate for Payer: Molina CHIP/Medicaid |
$3,728.16
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Molina Medicare |
$1,659.12
|
| 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 |
$3,728.16
|
| Rate for Payer: Scott and White EPO/PPO |
$3,069.37
|
| Rate for Payer: Scott and White Medicare |
$1,659.12
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$3,728.16
|
| Rate for Payer: Superior Health Plan EPO |
$1,659.12
|
| Rate for Payer: Superior Health Plan Medicare |
$1,659.12
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,659.12
|
| Rate for Payer: Universal American Medicare |
$1,659.12
|
| Rate for Payer: Wellcare Medicare |
$1,659.12
|
| Rate for Payer: Wellmed Medicare |
$1,659.12
|
|
|
US Breast Biopsy w/ US Guide Right
|
Facility
|
IP
|
$5,178.00
|
|
|
Service Code
|
HCPCS 19083
|
| Hospital Charge Code |
3530035
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$3,521.04
|
|
|
US Breast Complete Left
|
Facility
|
IP
|
$589.00
|
|
|
Service Code
|
HCPCS 76641 LT
|
| Hospital Charge Code |
3530061
|
|
Hospital Revenue Code
|
402
|
| Rate for Payer: Cash Price |
$400.52
|
|
