|
CHED Foreign Body Removal Site Skin, Subcutaneous Complex FB
|
Facility
|
OP
|
$3,692.25
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
8914590
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$26.52 |
| Max. Negotiated Rate |
$3,458.95 |
| Rate for Payer: Aetna Commercial |
$2,200.00
|
| Rate for Payer: Aetna Medicare |
$2,224.11
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$332.30
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Amerigroup Medicare |
$1,482.74
|
| 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 |
$1,482.74
|
| Rate for Payer: BCBS of TX PPO |
$3,458.95
|
| Rate for Payer: Cash Price |
$3,249.18
|
| Rate for Payer: Cash Price |
$3,249.18
|
| Rate for Payer: Cash Price |
$3,249.18
|
| Rate for Payer: Cigna Commercial |
$3,358.84
|
| Rate for Payer: Cigna Medicaid |
$486.45
|
| Rate for Payer: Cigna Medicare |
$1,482.74
|
| Rate for Payer: Employer Direct Commercial |
$1,482.74
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,482.74
|
| Rate for Payer: Molina CHIP/Medicaid |
$486.45
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Molina Medicare |
$1,482.74
|
| Rate for Payer: Multiplan Auto |
$2,399.96
|
| Rate for Payer: Multiplan Commercial |
$2,399.96
|
| Rate for Payer: Multiplan Workers Comp |
$2,399.96
|
| Rate for Payer: Parkland Medicaid |
$486.45
|
| Rate for Payer: Scott and White EPO/PPO |
$26.52
|
| Rate for Payer: Scott and White Medicare |
$1,482.74
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$486.45
|
| Rate for Payer: Superior Health Plan EPO |
$1,482.74
|
| Rate for Payer: Superior Health Plan Medicare |
$1,482.74
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Universal American Medicare |
$1,482.74
|
| Rate for Payer: Wellcare Medicare |
$1,482.74
|
| Rate for Payer: Wellmed Medicare |
$1,482.74
|
|
|
CHED Foreign Body Removal Site Skin, Subcutaneous Simple FB
|
Facility
|
IP
|
$2,057.12
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
8914591
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,810.27
|
|
|
CHED Foreign Body Removal Site Skin, Subcutaneous Simple FB
|
Facility
|
OP
|
$2,057.12
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
8914591
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$1,337.13 |
| Rate for Payer: Aetna Commercial |
$1,131.42
|
| Rate for Payer: Aetna Medicare |
$547.00
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$185.14
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Amerigroup Medicare |
$364.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$178.41
|
| Rate for Payer: BCBS of TX Blue Essentials |
$213.66
|
| Rate for Payer: BCBS of TX Medicare |
$364.67
|
| Rate for Payer: BCBS of TX PPO |
$269.21
|
| Rate for Payer: Cash Price |
$1,810.27
|
| Rate for Payer: Cash Price |
$1,810.27
|
| Rate for Payer: Cash Price |
$1,810.27
|
| Rate for Payer: Cigna Commercial |
$826.08
|
| Rate for Payer: Cigna Medicaid |
$86.38
|
| Rate for Payer: Cigna Medicare |
$364.67
|
| Rate for Payer: Employer Direct Commercial |
$364.67
|
| Rate for Payer: Humana Medicare/TRICARE |
$364.67
|
| Rate for Payer: Molina CHIP/Medicaid |
$86.38
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Molina Medicare |
$364.67
|
| Rate for Payer: Multiplan Auto |
$1,337.13
|
| Rate for Payer: Multiplan Commercial |
$1,337.13
|
| Rate for Payer: Multiplan Workers Comp |
$1,337.13
|
| Rate for Payer: Parkland Medicaid |
$86.38
|
| Rate for Payer: Scott and White EPO/PPO |
$6.52
|
| Rate for Payer: Scott and White Medicare |
$364.67
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$86.38
|
| Rate for Payer: Superior Health Plan EPO |
$364.67
|
| Rate for Payer: Superior Health Plan Medicare |
$364.67
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Universal American Medicare |
$364.67
|
| Rate for Payer: Wellcare Medicare |
$364.67
|
| Rate for Payer: Wellmed Medicare |
$364.67
|
|
|
CHED Foreign Body Removal Site Upper Arm/Elbow BCE
|
Facility
|
IP
|
$2,440.57
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
8912599
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$2,147.70
|
|
|
CHED Foreign Body Removal Site Upper Arm/Elbow BCE
|
Facility
|
OP
|
$2,440.57
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
8912599
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$26.52 |
| Max. Negotiated Rate |
$3,358.84 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$2,224.11
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$219.65
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Amerigroup Medicare |
$1,482.74
|
| Rate for Payer: BCBS of TX Blue Advantage |
$245.91
|
| Rate for Payer: BCBS of TX Blue Essentials |
$294.50
|
| Rate for Payer: BCBS of TX Medicare |
$1,482.74
|
| Rate for Payer: BCBS of TX PPO |
$371.07
|
| Rate for Payer: Cash Price |
$2,147.70
|
| Rate for Payer: Cash Price |
$2,147.70
|
| Rate for Payer: Cash Price |
$2,147.70
|
| Rate for Payer: Cigna Commercial |
$3,358.84
|
| Rate for Payer: Cigna Medicaid |
$123.47
|
| Rate for Payer: Cigna Medicare |
$1,482.74
|
| Rate for Payer: Employer Direct Commercial |
$1,482.74
|
| Rate for Payer: Humana Medicare/TRICARE |
$1,482.74
|
| Rate for Payer: Molina CHIP/Medicaid |
$123.47
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Molina Medicare |
$1,482.74
|
| Rate for Payer: Multiplan Auto |
$1,586.37
|
| Rate for Payer: Multiplan Commercial |
$1,586.37
|
| Rate for Payer: Multiplan Workers Comp |
$1,586.37
|
| Rate for Payer: Parkland Medicaid |
$123.47
|
| Rate for Payer: Scott and White EPO/PPO |
$26.52
|
| Rate for Payer: Scott and White Medicare |
$1,482.74
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$123.47
|
| Rate for Payer: Superior Health Plan EPO |
$1,482.74
|
| Rate for Payer: Superior Health Plan Medicare |
$1,482.74
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$1,482.74
|
| Rate for Payer: Universal American Medicare |
$1,482.74
|
| Rate for Payer: Wellcare Medicare |
$1,482.74
|
| Rate for Payer: Wellmed Medicare |
$1,482.74
|
|
|
CHED Fracture Site Bimalleolar Fx, w/o Manipulation BCE
|
Facility
|
IP
|
$1,058.75
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
8910615
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$931.70
|
|
|
CHED Fracture Site Bimalleolar Fx, w/o Manipulation BCE
|
Facility
|
OP
|
$1,058.75
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
8910615
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$688.19 |
| Rate for Payer: Aetna Commercial |
$582.31
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$95.29
|
| 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 |
$931.70
|
| Rate for Payer: Cash Price |
$931.70
|
| Rate for Payer: Cash Price |
$931.70
|
| 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 |
$688.19
|
| Rate for Payer: Multiplan Commercial |
$688.19
|
| Rate for Payer: Multiplan Workers Comp |
$688.19
|
| 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 Fracture Site Elbow/ Monteggia w/ manipulation BCE
|
Facility
|
OP
|
$3,361.17
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
8912600
|
|
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 |
$302.51
|
| 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 |
$2,957.83
|
| Rate for Payer: Cash Price |
$2,957.83
|
| Rate for Payer: Cash Price |
$2,957.83
|
| 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 |
$2,184.76
|
| Rate for Payer: Multiplan Commercial |
$2,184.76
|
| Rate for Payer: Multiplan Workers Comp |
$2,184.76
|
| 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 Fracture Site Elbow/ Monteggia w/ manipulation BCE
|
Facility
|
IP
|
$3,361.17
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
8912600
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$2,957.83
|
|
|
CHED Fracture Site Fibula Fx, Distal, w/ manipulation BCE
|
Facility
|
IP
|
$215.64
|
|
|
Service Code
|
CPT 27788
|
| Hospital Charge Code |
8914592
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$189.76
|
|
|
CHED Fracture Site Fibula Fx, Distal, w/ manipulation BCE
|
Facility
|
OP
|
$215.64
|
|
|
Service Code
|
CPT 27788
|
| Hospital Charge Code |
8914592
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$543.41 |
| Rate for Payer: Aetna Commercial |
$118.60
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$19.41
|
| 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 |
$189.76
|
| Rate for Payer: Cash Price |
$189.76
|
| Rate for Payer: Cash Price |
$189.76
|
| 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 |
$140.17
|
| Rate for Payer: Multiplan Commercial |
$140.17
|
| Rate for Payer: Multiplan Workers Comp |
$140.17
|
| 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 Fracture Site Fibula Fx, Distal, w/o manipulation BCE
|
Facility
|
IP
|
$753.08
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
8914593
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$662.71
|
|
|
CHED Fracture Site Fibula Fx, Distal, w/o manipulation BCE
|
Facility
|
OP
|
$753.08
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
8914593
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$543.41 |
| Rate for Payer: Aetna Commercial |
$414.19
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$67.78
|
| 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 |
$662.71
|
| Rate for Payer: Cash Price |
$662.71
|
| Rate for Payer: Cash Price |
$662.71
|
| 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 |
$489.50
|
| Rate for Payer: Multiplan Commercial |
$489.50
|
| Rate for Payer: Multiplan Workers Comp |
$489.50
|
| 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 Fracture Site Great Toe w/ manipulation BCE
|
Facility
|
OP
|
$1,117.44
|
|
|
Service Code
|
CPT 28495
|
| Hospital Charge Code |
8912601
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$726.34 |
| Rate for Payer: Aetna Commercial |
$614.59
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$100.57
|
| 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 |
$983.35
|
| Rate for Payer: Cash Price |
$983.35
|
| Rate for Payer: Cash Price |
$983.35
|
| 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 |
$726.34
|
| Rate for Payer: Multiplan Commercial |
$726.34
|
| Rate for Payer: Multiplan Workers Comp |
$726.34
|
| 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 Fracture Site Great Toe w/ manipulation BCE
|
Facility
|
IP
|
$1,117.44
|
|
|
Service Code
|
CPT 28495
|
| Hospital Charge Code |
8912601
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$983.35
|
|
|
CHED Fracture Site Humerus, proximal, w/ manipulation BCE
|
Facility
|
IP
|
$2,090.25
|
|
|
Service Code
|
CPT 23605
|
| Hospital Charge Code |
8912602
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,839.42
|
|
|
CHED Fracture Site Humerus, proximal, w/ manipulation BCE
|
Facility
|
OP
|
$2,090.25
|
|
|
Service Code
|
CPT 23605
|
| Hospital Charge Code |
8912602
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$26.29 |
| Max. Negotiated Rate |
$3,415.58 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$2,204.79
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$188.12
|
| 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 |
$1,839.42
|
| Rate for Payer: Cash Price |
$1,839.42
|
| Rate for Payer: Cash Price |
$1,839.42
|
| 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 |
$1,358.66
|
| Rate for Payer: Multiplan Commercial |
$1,358.66
|
| Rate for Payer: Multiplan Workers Comp |
$1,358.66
|
| 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 Fracture Site Malleolus, Posterior, w/ manipulation BC
|
Facility
|
IP
|
$4,420.75
|
|
|
Service Code
|
CPT 27768
|
| Hospital Charge Code |
8910616
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$3,890.26
|
|
|
CHED Fracture Site Malleolus, Posterior, w/ manipulation BC
|
Facility
|
OP
|
$4,420.75
|
|
|
Service Code
|
CPT 27768
|
| Hospital Charge Code |
8910616
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$26.29 |
| Max. Negotiated Rate |
$3,415.58 |
| Rate for Payer: Aetna Commercial |
$2,431.41
|
| Rate for Payer: Aetna Medicare |
$2,204.79
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$397.87
|
| 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 |
$3,890.26
|
| Rate for Payer: Cash Price |
$3,890.26
|
| Rate for Payer: Cash Price |
$3,890.26
|
| Rate for Payer: Cigna Commercial |
$3,329.66
|
| Rate for Payer: Cigna Medicaid |
$850.02
|
| 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 |
$850.02
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$1,469.86
|
| Rate for Payer: Molina Medicare |
$1,469.86
|
| Rate for Payer: Multiplan Auto |
$2,873.49
|
| Rate for Payer: Multiplan Commercial |
$2,873.49
|
| Rate for Payer: Multiplan Workers Comp |
$2,873.49
|
| Rate for Payer: Parkland Medicaid |
$850.02
|
| 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 |
$850.02
|
| 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 Fracture Site Metacarpal fx, w/ manipulation BCE
|
Facility
|
IP
|
$1,317.75
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
8912603
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,159.62
|
|
|
CHED Fracture Site Metacarpal fx, w/ manipulation BCE
|
Facility
|
OP
|
$1,317.75
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
8912603
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$856.54 |
| Rate for Payer: Aetna Commercial |
$724.76
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$118.60
|
| 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 |
$1,159.62
|
| Rate for Payer: Cash Price |
$1,159.62
|
| Rate for Payer: Cash Price |
$1,159.62
|
| 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 |
$856.54
|
| Rate for Payer: Multiplan Commercial |
$856.54
|
| Rate for Payer: Multiplan Workers Comp |
$856.54
|
| 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 Fracture Site MP/Interphalangeal Joint, w/ manipulation
|
Facility
|
OP
|
$2,607.25
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
8914594
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$26.29 |
| Max. Negotiated Rate |
$3,415.58 |
| Rate for Payer: Aetna Commercial |
$1,433.99
|
| Rate for Payer: Aetna Medicare |
$2,204.79
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$234.65
|
| 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 |
$2,294.38
|
| Rate for Payer: Cash Price |
$2,294.38
|
| Rate for Payer: Cash Price |
$2,294.38
|
| 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 |
$1,694.71
|
| Rate for Payer: Multiplan Commercial |
$1,694.71
|
| Rate for Payer: Multiplan Workers Comp |
$1,694.71
|
| 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 Fracture Site MP/Interphalangeal Joint, w/ manipulation
|
Facility
|
IP
|
$2,607.25
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
8914594
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$2,294.38
|
|
|
CHED Fracture Site Phalangeal, Distal w/ manipulation BCE
|
Facility
|
OP
|
$1,056.25
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
8910617
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$686.56 |
| Rate for Payer: Aetna Commercial |
$580.94
|
| Rate for Payer: Aetna Medicare |
$323.50
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$95.06
|
| 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 |
$929.50
|
| Rate for Payer: Cash Price |
$929.50
|
| Rate for Payer: Cash Price |
$929.50
|
| 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 |
$686.56
|
| Rate for Payer: Multiplan Commercial |
$686.56
|
| Rate for Payer: Multiplan Workers Comp |
$686.56
|
| 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 Fracture Site Phalangeal, Distal w/ manipulation BCE
|
Facility
|
IP
|
$1,056.25
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
8910617
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$929.50
|
|
