|
CHED Dislocation Repair Site Finger w/o Anesthesia BCE
|
Facility
|
IP
|
$395.94
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
8914582
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$348.43
|
|
|
CHED Dislocation Repair Site Hand BCE
|
Facility
|
IP
|
$811.25
|
|
|
Service Code
|
CPT 26670
|
| Hospital Charge Code |
8912588
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$713.90
|
|
|
CHED Dislocation Repair Site Hand BCE
|
Facility
|
OP
|
$811.25
|
|
|
Service Code
|
CPT 26670
|
| Hospital Charge Code |
8912588
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$527.31 |
| Rate for Payer: Aetna Commercial |
$446.19
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$73.01
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Amerigroup Medicare |
$215.67
|
| 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 |
$215.67
|
| Rate for Payer: BCBS of TX PPO |
$274.58
|
| Rate for Payer: Cash Price |
$713.90
|
| Rate for Payer: Cash Price |
$713.90
|
| Rate for Payer: Cash Price |
$713.90
|
| Rate for Payer: Cigna Commercial |
$488.55
|
| Rate for Payer: Cigna Medicaid |
$85.32
|
| Rate for Payer: Cigna Medicare |
$215.67
|
| Rate for Payer: Employer Direct Commercial |
$215.67
|
| Rate for Payer: Humana Medicare/TRICARE |
$215.67
|
| Rate for Payer: Molina CHIP/Medicaid |
$85.32
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Molina Medicare |
$215.67
|
| Rate for Payer: Multiplan Auto |
$527.31
|
| Rate for Payer: Multiplan Commercial |
$527.31
|
| Rate for Payer: Multiplan Workers Comp |
$527.31
|
| Rate for Payer: Parkland Medicaid |
$85.32
|
| Rate for Payer: Scott and White EPO/PPO |
$3.86
|
| Rate for Payer: Scott and White Medicare |
$215.67
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$85.32
|
| Rate for Payer: Superior Health Plan EPO |
$215.67
|
| Rate for Payer: Superior Health Plan Medicare |
$215.67
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Universal American Medicare |
$215.67
|
| Rate for Payer: Wellcare Medicare |
$215.67
|
| Rate for Payer: Wellmed Medicare |
$215.67
|
|
|
CHED Dislocation Repair Site Hip Post Arthroplasty BCE
|
Facility
|
OP
|
$1,329.63
|
|
|
Service Code
|
CPT 27265
|
| Hospital Charge Code |
8914583
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$864.26 |
| Rate for Payer: Aetna Commercial |
$731.30
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$119.67
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Amerigroup Medicare |
$215.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$360.12
|
| Rate for Payer: BCBS of TX Blue Essentials |
$431.28
|
| Rate for Payer: BCBS of TX Medicare |
$215.67
|
| Rate for Payer: BCBS of TX PPO |
$543.41
|
| Rate for Payer: Cash Price |
$1,170.07
|
| Rate for Payer: Cash Price |
$1,170.07
|
| Rate for Payer: Cash Price |
$1,170.07
|
| Rate for Payer: Cigna Commercial |
$488.55
|
| Rate for Payer: Cigna Medicaid |
$85.32
|
| Rate for Payer: Cigna Medicare |
$215.67
|
| Rate for Payer: Employer Direct Commercial |
$215.67
|
| Rate for Payer: Humana Medicare/TRICARE |
$215.67
|
| Rate for Payer: Molina CHIP/Medicaid |
$85.32
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Molina Medicare |
$215.67
|
| Rate for Payer: Multiplan Auto |
$864.26
|
| Rate for Payer: Multiplan Commercial |
$864.26
|
| Rate for Payer: Multiplan Workers Comp |
$864.26
|
| Rate for Payer: Parkland Medicaid |
$85.32
|
| Rate for Payer: Scott and White EPO/PPO |
$3.86
|
| Rate for Payer: Scott and White Medicare |
$215.67
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$85.32
|
| Rate for Payer: Superior Health Plan EPO |
$215.67
|
| Rate for Payer: Superior Health Plan Medicare |
$215.67
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Universal American Medicare |
$215.67
|
| Rate for Payer: Wellcare Medicare |
$215.67
|
| Rate for Payer: Wellmed Medicare |
$215.67
|
|
|
CHED Dislocation Repair Site Hip Post Arthroplasty BCE
|
Facility
|
IP
|
$1,329.63
|
|
|
Service Code
|
CPT 27265
|
| Hospital Charge Code |
8914583
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,170.07
|
|
|
CHED Dislocation Repair Site Jaw BCE
|
Facility
|
OP
|
$1,027.40
|
|
|
Service Code
|
CPT 21480
|
| Hospital Charge Code |
8912589
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$667.81 |
| Rate for Payer: Aetna Commercial |
$565.07
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$92.47
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Amerigroup Medicare |
$215.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$360.12
|
| Rate for Payer: BCBS of TX Blue Essentials |
$431.28
|
| Rate for Payer: BCBS of TX Medicare |
$215.67
|
| Rate for Payer: BCBS of TX PPO |
$543.41
|
| Rate for Payer: Cash Price |
$904.11
|
| Rate for Payer: Cash Price |
$904.11
|
| Rate for Payer: Cash Price |
$904.11
|
| Rate for Payer: Cigna Commercial |
$488.55
|
| Rate for Payer: Cigna Medicaid |
$85.32
|
| Rate for Payer: Cigna Medicare |
$215.67
|
| Rate for Payer: Employer Direct Commercial |
$215.67
|
| Rate for Payer: Humana Medicare/TRICARE |
$215.67
|
| Rate for Payer: Molina CHIP/Medicaid |
$85.32
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Molina Medicare |
$215.67
|
| Rate for Payer: Multiplan Auto |
$667.81
|
| Rate for Payer: Multiplan Commercial |
$667.81
|
| Rate for Payer: Multiplan Workers Comp |
$667.81
|
| Rate for Payer: Parkland Medicaid |
$85.32
|
| Rate for Payer: Scott and White EPO/PPO |
$3.86
|
| Rate for Payer: Scott and White Medicare |
$215.67
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$85.32
|
| Rate for Payer: Superior Health Plan EPO |
$215.67
|
| Rate for Payer: Superior Health Plan Medicare |
$215.67
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Universal American Medicare |
$215.67
|
| Rate for Payer: Wellcare Medicare |
$215.67
|
| Rate for Payer: Wellmed Medicare |
$215.67
|
|
|
CHED Dislocation Repair Site Jaw BCE
|
Facility
|
IP
|
$1,027.40
|
|
|
Service Code
|
CPT 21480
|
| Hospital Charge Code |
8912589
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$904.11
|
|
|
CHED Dislocation Repair Site Kneecap w/o Anesthesia BCE
|
Facility
|
OP
|
$550.22
|
|
|
Service Code
|
CPT 27560
|
| Hospital Charge Code |
8912590
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$543.41 |
| Rate for Payer: Aetna Commercial |
$302.62
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$49.52
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Amerigroup Medicare |
$215.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$360.12
|
| Rate for Payer: BCBS of TX Blue Essentials |
$431.28
|
| Rate for Payer: BCBS of TX Medicare |
$215.67
|
| Rate for Payer: BCBS of TX PPO |
$543.41
|
| Rate for Payer: Cash Price |
$484.19
|
| Rate for Payer: Cash Price |
$484.19
|
| Rate for Payer: Cash Price |
$484.19
|
| Rate for Payer: Cigna Commercial |
$488.55
|
| Rate for Payer: Cigna Medicaid |
$85.32
|
| Rate for Payer: Cigna Medicare |
$215.67
|
| Rate for Payer: Employer Direct Commercial |
$215.67
|
| Rate for Payer: Humana Medicare/TRICARE |
$215.67
|
| Rate for Payer: Molina CHIP/Medicaid |
$85.32
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Molina Medicare |
$215.67
|
| Rate for Payer: Multiplan Auto |
$357.64
|
| Rate for Payer: Multiplan Commercial |
$357.64
|
| Rate for Payer: Multiplan Workers Comp |
$357.64
|
| Rate for Payer: Parkland Medicaid |
$85.32
|
| Rate for Payer: Scott and White EPO/PPO |
$3.86
|
| Rate for Payer: Scott and White Medicare |
$215.67
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$85.32
|
| Rate for Payer: Superior Health Plan EPO |
$215.67
|
| Rate for Payer: Superior Health Plan Medicare |
$215.67
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Universal American Medicare |
$215.67
|
| Rate for Payer: Wellcare Medicare |
$215.67
|
| Rate for Payer: Wellmed Medicare |
$215.67
|
|
|
CHED Dislocation Repair Site Kneecap w/o Anesthesia BCE
|
Facility
|
IP
|
$550.22
|
|
|
Service Code
|
CPT 27560
|
| Hospital Charge Code |
8912590
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$484.19
|
|
|
CHED Dislocation Repair Site Knee w/ Anesthesia BCE
|
Facility
|
IP
|
$5,236.25
|
|
|
Service Code
|
CPT 27552
|
| Hospital Charge Code |
8914584
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$4,607.90
|
|
|
CHED Dislocation Repair Site Knee w/ Anesthesia BCE
|
Facility
|
OP
|
$5,236.25
|
|
|
Service Code
|
CPT 27552
|
| Hospital Charge Code |
8914584
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$26.29 |
| Max. Negotiated Rate |
$3,415.58 |
| Rate for Payer: Aetna Commercial |
$2,200.00
|
| Rate for Payer: Aetna Medicare |
$2,204.79
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$471.26
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,469.86
|
| Rate for Payer: Amerigroup Medicare |
$1,469.86
|
| 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 |
$1,469.86
|
| Rate for Payer: BCBS of TX PPO |
$3,415.58
|
| Rate for Payer: Cash Price |
$4,607.90
|
| Rate for Payer: Cash Price |
$4,607.90
|
| Rate for Payer: Cash Price |
$4,607.90
|
| Rate for Payer: Cigna Commercial |
$3,329.66
|
| Rate for Payer: Cigna Medicaid |
$593.04
|
| Rate for Payer: Cigna Medicare |
$1,469.86
|
| Rate for Payer: Employer Direct Commercial |
$1,469.86
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,469.86
|
| Rate for Payer: Molina CHIP/Medicaid |
$593.04
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,469.86
|
| Rate for Payer: Molina Medicare |
$1,469.86
|
| Rate for Payer: Multiplan Auto |
$3,403.56
|
| Rate for Payer: Multiplan Commercial |
$3,403.56
|
| Rate for Payer: Multiplan Workers Comp |
$3,403.56
|
| Rate for Payer: Parkland Medicaid |
$593.04
|
| Rate for Payer: Scott and White EPO/PPO |
$26.29
|
| Rate for Payer: Scott and White Medicare |
$1,469.86
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$593.04
|
| Rate for Payer: Superior Health Plan EPO |
$1,469.86
|
| Rate for Payer: Superior Health Plan Medicare |
$1,469.86
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,469.86
|
| Rate for Payer: Universal American Medicare |
$1,469.86
|
| Rate for Payer: Wellcare Medicare |
$1,469.86
|
| Rate for Payer: Wellmed Medicare |
$1,469.86
|
|
|
CHED Dislocation Repair Site Knuckle BCE
|
Facility
|
OP
|
$983.81
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
8914585
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$639.48 |
| Rate for Payer: Aetna Commercial |
$541.10
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$88.54
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Amerigroup Medicare |
$215.67
|
| 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 |
$215.67
|
| Rate for Payer: BCBS of TX PPO |
$274.58
|
| Rate for Payer: Cash Price |
$865.75
|
| Rate for Payer: Cash Price |
$865.75
|
| Rate for Payer: Cash Price |
$865.75
|
| Rate for Payer: Cigna Commercial |
$488.55
|
| Rate for Payer: Cigna Medicaid |
$85.32
|
| Rate for Payer: Cigna Medicare |
$215.67
|
| Rate for Payer: Employer Direct Commercial |
$215.67
|
| Rate for Payer: Humana Medicare/TRICARE |
$215.67
|
| Rate for Payer: Molina CHIP/Medicaid |
$85.32
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Molina Medicare |
$215.67
|
| Rate for Payer: Multiplan Auto |
$639.48
|
| Rate for Payer: Multiplan Commercial |
$639.48
|
| Rate for Payer: Multiplan Workers Comp |
$639.48
|
| Rate for Payer: Parkland Medicaid |
$85.32
|
| Rate for Payer: Scott and White EPO/PPO |
$3.86
|
| Rate for Payer: Scott and White Medicare |
$215.67
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$85.32
|
| Rate for Payer: Superior Health Plan EPO |
$215.67
|
| Rate for Payer: Superior Health Plan Medicare |
$215.67
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Universal American Medicare |
$215.67
|
| Rate for Payer: Wellcare Medicare |
$215.67
|
| Rate for Payer: Wellmed Medicare |
$215.67
|
|
|
CHED Dislocation Repair Site Knuckle BCE
|
Facility
|
IP
|
$983.81
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
8914585
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$865.75
|
|
|
CHED DISLOCATION REPAIR SITE NURSEMAID ELBOW W/MAINIPLATION
|
Facility
|
OP
|
$1,554.75
|
|
|
Service Code
|
CPT 24640
|
| Hospital Charge Code |
8912586
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$1,010.59 |
| Rate for Payer: Aetna Commercial |
$855.11
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$139.93
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Amerigroup Medicare |
$215.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$93.42
|
| Rate for Payer: BCBS of TX Blue Essentials |
$111.88
|
| Rate for Payer: BCBS of TX Medicare |
$215.67
|
| Rate for Payer: BCBS of TX PPO |
$140.97
|
| Rate for Payer: Cash Price |
$1,368.18
|
| Rate for Payer: Cash Price |
$1,368.18
|
| Rate for Payer: Cash Price |
$1,368.18
|
| Rate for Payer: Cigna Commercial |
$488.55
|
| Rate for Payer: Cigna Medicaid |
$49.00
|
| Rate for Payer: Cigna Medicare |
$215.67
|
| Rate for Payer: Employer Direct Commercial |
$215.67
|
| Rate for Payer: Humana Medicare/TRICARE |
$215.67
|
| Rate for Payer: Molina CHIP/Medicaid |
$49.00
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Molina Medicare |
$215.67
|
| Rate for Payer: Multiplan Auto |
$1,010.59
|
| Rate for Payer: Multiplan Commercial |
$1,010.59
|
| Rate for Payer: Multiplan Workers Comp |
$1,010.59
|
| Rate for Payer: Parkland Medicaid |
$49.00
|
| Rate for Payer: Scott and White EPO/PPO |
$3.86
|
| Rate for Payer: Scott and White Medicare |
$215.67
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$49.00
|
| Rate for Payer: Superior Health Plan EPO |
$215.67
|
| Rate for Payer: Superior Health Plan Medicare |
$215.67
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Universal American Medicare |
$215.67
|
| Rate for Payer: Wellcare Medicare |
$215.67
|
| Rate for Payer: Wellmed Medicare |
$215.67
|
|
|
CHED DISLOCATION REPAIR SITE NURSEMAID ELBOW W/MAINIPLATION
|
Facility
|
IP
|
$1,554.75
|
|
|
Service Code
|
CPT 24640
|
| Hospital Charge Code |
8912586
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,368.18
|
|
|
CHED Dislocation Repair Site Shoulder w/ Anesthesia BCE
|
Facility
|
IP
|
$3,086.72
|
|
|
Service Code
|
CPT 23655
|
| Hospital Charge Code |
8914586
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$2,716.31
|
|
|
CHED Dislocation Repair Site Shoulder w/ Anesthesia BCE
|
Facility
|
OP
|
$3,086.72
|
|
|
Service Code
|
CPT 23655
|
| Hospital Charge Code |
8914586
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$26.29 |
| Max. Negotiated Rate |
$3,415.58 |
| Rate for Payer: Aetna Commercial |
$2,200.00
|
| Rate for Payer: Aetna Medicare |
$2,204.79
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$277.80
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,469.86
|
| Rate for Payer: Amerigroup Medicare |
$1,469.86
|
| 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 |
$1,469.86
|
| Rate for Payer: BCBS of TX PPO |
$3,415.58
|
| Rate for Payer: Cash Price |
$2,716.31
|
| Rate for Payer: Cash Price |
$2,716.31
|
| Rate for Payer: Cash Price |
$2,716.31
|
| Rate for Payer: Cigna Commercial |
$3,329.66
|
| Rate for Payer: Cigna Medicaid |
$593.04
|
| Rate for Payer: Cigna Medicare |
$1,469.86
|
| Rate for Payer: Employer Direct Commercial |
$1,469.86
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,469.86
|
| Rate for Payer: Molina CHIP/Medicaid |
$593.04
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,469.86
|
| Rate for Payer: Molina Medicare |
$1,469.86
|
| Rate for Payer: Multiplan Auto |
$2,006.37
|
| Rate for Payer: Multiplan Commercial |
$2,006.37
|
| Rate for Payer: Multiplan Workers Comp |
$2,006.37
|
| Rate for Payer: Parkland Medicaid |
$593.04
|
| Rate for Payer: Scott and White EPO/PPO |
$26.29
|
| Rate for Payer: Scott and White Medicare |
$1,469.86
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$593.04
|
| Rate for Payer: Superior Health Plan EPO |
$1,469.86
|
| Rate for Payer: Superior Health Plan Medicare |
$1,469.86
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,469.86
|
| Rate for Payer: Universal American Medicare |
$1,469.86
|
| Rate for Payer: Wellcare Medicare |
$1,469.86
|
| Rate for Payer: Wellmed Medicare |
$1,469.86
|
|
|
CHED Dislocation Repair Site Shoulder w/o Anesthesia BCE
|
Facility
|
OP
|
$1,758.83
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
8912591
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$1,143.24 |
| Rate for Payer: Aetna Commercial |
$967.36
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$158.29
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Amerigroup Medicare |
$215.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$360.12
|
| Rate for Payer: BCBS of TX Blue Essentials |
$431.28
|
| Rate for Payer: BCBS of TX Medicare |
$215.67
|
| Rate for Payer: BCBS of TX PPO |
$543.41
|
| Rate for Payer: Cash Price |
$1,547.77
|
| Rate for Payer: Cash Price |
$1,547.77
|
| Rate for Payer: Cash Price |
$1,547.77
|
| Rate for Payer: Cigna Commercial |
$488.55
|
| Rate for Payer: Cigna Medicaid |
$85.32
|
| Rate for Payer: Cigna Medicare |
$215.67
|
| Rate for Payer: Employer Direct Commercial |
$215.67
|
| Rate for Payer: Humana Medicare/TRICARE |
$215.67
|
| Rate for Payer: Molina CHIP/Medicaid |
$85.32
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Molina Medicare |
$215.67
|
| Rate for Payer: Multiplan Auto |
$1,143.24
|
| Rate for Payer: Multiplan Commercial |
$1,143.24
|
| Rate for Payer: Multiplan Workers Comp |
$1,143.24
|
| Rate for Payer: Parkland Medicaid |
$85.32
|
| Rate for Payer: Scott and White EPO/PPO |
$3.86
|
| Rate for Payer: Scott and White Medicare |
$215.67
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$85.32
|
| Rate for Payer: Superior Health Plan EPO |
$215.67
|
| Rate for Payer: Superior Health Plan Medicare |
$215.67
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Universal American Medicare |
$215.67
|
| Rate for Payer: Wellcare Medicare |
$215.67
|
| Rate for Payer: Wellmed Medicare |
$215.67
|
|
|
CHED Dislocation Repair Site Shoulder w/o Anesthesia BCE
|
Facility
|
IP
|
$1,758.83
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
8912591
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,547.77
|
|
|
CHED Dislocation Repair Site Thumb BCE
|
Facility
|
IP
|
$675.00
|
|
|
Service Code
|
CPT 26641
|
| Hospital Charge Code |
8912592
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$594.00
|
|
|
CHED Dislocation Repair Site Thumb BCE
|
Facility
|
OP
|
$675.00
|
|
|
Service Code
|
CPT 26641
|
| Hospital Charge Code |
8912592
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$488.55 |
| Rate for Payer: Aetna Commercial |
$371.25
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$60.75
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Amerigroup Medicare |
$215.67
|
| 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 |
$215.67
|
| Rate for Payer: BCBS of TX PPO |
$274.58
|
| Rate for Payer: Cash Price |
$594.00
|
| Rate for Payer: Cash Price |
$594.00
|
| Rate for Payer: Cash Price |
$594.00
|
| Rate for Payer: Cigna Commercial |
$488.55
|
| Rate for Payer: Cigna Medicaid |
$85.32
|
| Rate for Payer: Cigna Medicare |
$215.67
|
| Rate for Payer: Employer Direct Commercial |
$215.67
|
| Rate for Payer: Humana Medicare/TRICARE |
$215.67
|
| Rate for Payer: Molina CHIP/Medicaid |
$85.32
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Molina Medicare |
$215.67
|
| Rate for Payer: Multiplan Auto |
$438.75
|
| Rate for Payer: Multiplan Commercial |
$438.75
|
| Rate for Payer: Multiplan Workers Comp |
$438.75
|
| Rate for Payer: Parkland Medicaid |
$85.32
|
| Rate for Payer: Scott and White EPO/PPO |
$3.86
|
| Rate for Payer: Scott and White Medicare |
$215.67
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$85.32
|
| Rate for Payer: Superior Health Plan EPO |
$215.67
|
| Rate for Payer: Superior Health Plan Medicare |
$215.67
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Universal American Medicare |
$215.67
|
| Rate for Payer: Wellcare Medicare |
$215.67
|
| Rate for Payer: Wellmed Medicare |
$215.67
|
|
|
CHED Dislocation Repair Site Toe, Interphalangeal w/o Anes B
|
Facility
|
IP
|
$218.35
|
|
|
Service Code
|
CPT 28660
|
| Hospital Charge Code |
8912593
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$192.15
|
|
|
CHED Dislocation Repair Site Toe, Interphalangeal w/o Anes B
|
Facility
|
OP
|
$218.35
|
|
|
Service Code
|
CPT 28660
|
| Hospital Charge Code |
8912593
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$488.55 |
| Rate for Payer: Aetna Commercial |
$120.09
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$19.65
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Amerigroup Medicare |
$215.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$115.11
|
| Rate for Payer: BCBS of TX Blue Essentials |
$137.86
|
| Rate for Payer: BCBS of TX Medicare |
$215.67
|
| Rate for Payer: BCBS of TX PPO |
$173.70
|
| Rate for Payer: Cash Price |
$192.15
|
| Rate for Payer: Cash Price |
$192.15
|
| Rate for Payer: Cash Price |
$192.15
|
| Rate for Payer: Cigna Commercial |
$488.55
|
| Rate for Payer: Cigna Medicaid |
$59.25
|
| Rate for Payer: Cigna Medicare |
$215.67
|
| Rate for Payer: Employer Direct Commercial |
$215.67
|
| Rate for Payer: Humana Medicare/TRICARE |
$215.67
|
| Rate for Payer: Molina CHIP/Medicaid |
$59.25
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Molina Medicare |
$215.67
|
| Rate for Payer: Multiplan Auto |
$141.93
|
| Rate for Payer: Multiplan Commercial |
$141.93
|
| Rate for Payer: Multiplan Workers Comp |
$141.93
|
| Rate for Payer: Parkland Medicaid |
$59.25
|
| Rate for Payer: Scott and White EPO/PPO |
$3.86
|
| Rate for Payer: Scott and White Medicare |
$215.67
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$59.25
|
| Rate for Payer: Superior Health Plan EPO |
$215.67
|
| Rate for Payer: Superior Health Plan Medicare |
$215.67
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Universal American Medicare |
$215.67
|
| Rate for Payer: Wellcare Medicare |
$215.67
|
| Rate for Payer: Wellmed Medicare |
$215.67
|
|
|
CHED Dislocation Repair Site Toe, Metatarsophalangeal w/o An
|
Facility
|
IP
|
$960.50
|
|
|
Service Code
|
CPT 28630
|
| Hospital Charge Code |
8912594
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$845.24
|
|
|
CHED Dislocation Repair Site Toe, Metatarsophalangeal w/o An
|
Facility
|
OP
|
$960.50
|
|
|
Service Code
|
CPT 28630
|
| Hospital Charge Code |
8912594
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$624.32 |
| Rate for Payer: Aetna Commercial |
$528.28
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$86.44
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Amerigroup Medicare |
$215.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$148.86
|
| Rate for Payer: BCBS of TX Blue Essentials |
$178.28
|
| Rate for Payer: BCBS of TX Medicare |
$215.67
|
| Rate for Payer: BCBS of TX PPO |
$224.63
|
| Rate for Payer: Cash Price |
$845.24
|
| Rate for Payer: Cash Price |
$845.24
|
| Rate for Payer: Cash Price |
$845.24
|
| Rate for Payer: Cigna Commercial |
$488.55
|
| Rate for Payer: Cigna Medicaid |
$70.60
|
| Rate for Payer: Cigna Medicare |
$215.67
|
| Rate for Payer: Employer Direct Commercial |
$215.67
|
| Rate for Payer: Humana Medicare/TRICARE |
$215.67
|
| Rate for Payer: Molina CHIP/Medicaid |
$70.60
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Molina Medicare |
$215.67
|
| Rate for Payer: Multiplan Auto |
$624.32
|
| Rate for Payer: Multiplan Commercial |
$624.32
|
| Rate for Payer: Multiplan Workers Comp |
$624.32
|
| Rate for Payer: Parkland Medicaid |
$70.60
|
| Rate for Payer: Scott and White EPO/PPO |
$3.86
|
| Rate for Payer: Scott and White Medicare |
$215.67
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$70.60
|
| Rate for Payer: Superior Health Plan EPO |
$215.67
|
| Rate for Payer: Superior Health Plan Medicare |
$215.67
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$215.67
|
| Rate for Payer: Universal American Medicare |
$215.67
|
| Rate for Payer: Wellcare Medicare |
$215.67
|
| Rate for Payer: Wellmed Medicare |
$215.67
|
|
