White Rock Medical Center

All Charges

Charge

Type

Setting

Price

CHED Laceration Simple - Face > 30.0 cm BCE

Facility

$1,570.00

Service Code	CPT 12018
Hospital Charge Code	8910633
Hospital Revenue Code	450
Rate for Payer: Cash Price	$1,381.60

CHED Laceration Simple - Face > 30.0 cm BCE

Facility

$1,570.00

Service Code	CPT 12018
Hospital Charge Code	8910633
Hospital Revenue Code	450
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$1,020.50
Rate for Payer: Aetna Commercial	$863.50
Rate for Payer: Aetna Medicare	$274.64
Rate for Payer: Amerigroup CHIP/Medicaid	$141.30
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$183.09
Rate for Payer: Amerigroup Medicare	$183.09
Rate for Payer: BCBS of TX Blue Advantage	$291.80
Rate for Payer: BCBS of TX Blue Essentials	$349.46
Rate for Payer: BCBS of TX Medicare	$183.09
Rate for Payer: BCBS of TX PPO	$440.32
Rate for Payer: Cash Price	$1,381.60
Rate for Payer: Cash Price	$1,381.60
Rate for Payer: Cash Price	$1,381.60
Rate for Payer: Cigna Commercial	$414.75
Rate for Payer: Cigna Medicaid	$74.34
Rate for Payer: Cigna Medicare	$183.09
Rate for Payer: Employer Direct Commercial	$183.09
Rate for Payer: Humana Medicare/TRICARE	$183.09
Rate for Payer: Molina CHIP/Medicaid	$74.34
Rate for Payer: Molina Dual Medicare/Medicaid	$183.09
Rate for Payer: Molina Medicare	$183.09
Rate for Payer: Multiplan Auto	$1,020.50
Rate for Payer: Multiplan Commercial	$1,020.50
Rate for Payer: Multiplan Workers Comp	$1,020.50
Rate for Payer: Parkland Medicaid	$74.34
Rate for Payer: Scott and White EPO/PPO	$3.27
Rate for Payer: Scott and White Medicare	$183.09
Rate for Payer: Superior Health Plan CHIP/Medicaid	$74.34
Rate for Payer: Superior Health Plan EPO	$183.09
Rate for Payer: Superior Health Plan Medicare	$183.09
Rate for Payer: Universal American Dual Medicare/Medicaid	$183.09
Rate for Payer: Universal American Medicare	$183.09
Rate for Payer: Wellcare Medicare	$183.09
Rate for Payer: Wellmed Medicare	$183.09

CHED Laceration Simple - Face 5.1 to 7.5 cm BCE

Facility

$664.14

Service Code	CPT 12014
Hospital Charge Code	8910636
Hospital Revenue Code	450
Rate for Payer: Cash Price	$584.44

CHED Laceration Simple - Face 5.1 to 7.5 cm BCE

Facility

$664.14

Service Code	CPT 12014
Hospital Charge Code	8910636
Hospital Revenue Code	450
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$440.32
Rate for Payer: Aetna Commercial	$365.28
Rate for Payer: Aetna Medicare	$274.64
Rate for Payer: Amerigroup CHIP/Medicaid	$59.77
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$183.09
Rate for Payer: Amerigroup Medicare	$183.09
Rate for Payer: BCBS of TX Blue Advantage	$291.80
Rate for Payer: BCBS of TX Blue Essentials	$349.46
Rate for Payer: BCBS of TX Medicare	$183.09
Rate for Payer: BCBS of TX PPO	$440.32
Rate for Payer: Cash Price	$584.44
Rate for Payer: Cash Price	$584.44
Rate for Payer: Cash Price	$584.44
Rate for Payer: Cigna Commercial	$414.75
Rate for Payer: Cigna Medicare	$183.09
Rate for Payer: Employer Direct Commercial	$183.09
Rate for Payer: Humana Medicare/TRICARE	$183.09
Rate for Payer: Molina Dual Medicare/Medicaid	$183.09
Rate for Payer: Molina Medicare	$183.09
Rate for Payer: Multiplan Auto	$431.69
Rate for Payer: Multiplan Commercial	$431.69
Rate for Payer: Multiplan Workers Comp	$431.69
Rate for Payer: Scott and White EPO/PPO	$3.27
Rate for Payer: Scott and White Medicare	$183.09
Rate for Payer: Superior Health Plan EPO	$183.09
Rate for Payer: Superior Health Plan Medicare	$183.09
Rate for Payer: Universal American Dual Medicare/Medicaid	$183.09
Rate for Payer: Universal American Medicare	$183.09
Rate for Payer: Wellcare Medicare	$183.09
Rate for Payer: Wellmed Medicare	$183.09

CHED Laceration Simple - Scalp <= 2.5 cm BCE

Facility

$558.30

Service Code	CPT 12001
Hospital Charge Code	8914618
Hospital Revenue Code	450
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$440.32
Rate for Payer: Aetna Commercial	$307.06
Rate for Payer: Aetna Medicare	$274.64
Rate for Payer: Amerigroup CHIP/Medicaid	$50.25
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$183.09
Rate for Payer: Amerigroup Medicare	$183.09
Rate for Payer: BCBS of TX Blue Advantage	$291.80
Rate for Payer: BCBS of TX Blue Essentials	$349.46
Rate for Payer: BCBS of TX Medicare	$183.09
Rate for Payer: BCBS of TX PPO	$440.32
Rate for Payer: Cash Price	$491.30
Rate for Payer: Cash Price	$491.30
Rate for Payer: Cash Price	$491.30
Rate for Payer: Cigna Commercial	$414.75
Rate for Payer: Cigna Medicare	$183.09
Rate for Payer: Employer Direct Commercial	$183.09
Rate for Payer: Humana Medicare/TRICARE	$183.09
Rate for Payer: Molina Dual Medicare/Medicaid	$183.09
Rate for Payer: Molina Medicare	$183.09
Rate for Payer: Multiplan Auto	$362.90
Rate for Payer: Multiplan Commercial	$362.90
Rate for Payer: Multiplan Workers Comp	$362.90
Rate for Payer: Scott and White EPO/PPO	$3.27
Rate for Payer: Scott and White Medicare	$183.09
Rate for Payer: Superior Health Plan EPO	$183.09
Rate for Payer: Superior Health Plan Medicare	$183.09
Rate for Payer: Universal American Dual Medicare/Medicaid	$183.09
Rate for Payer: Universal American Medicare	$183.09
Rate for Payer: Wellcare Medicare	$183.09
Rate for Payer: Wellmed Medicare	$183.09

CHED Laceration Simple - Scalp <= 2.5 cm BCE

Facility

$558.30

Service Code	CPT 12001
Hospital Charge Code	8914618
Hospital Revenue Code	450
Rate for Payer: Cash Price	$491.30

CHED Laceration Simple - Scalp 2.6 to 7.5 cm BCE

Facility

$680.25

Service Code	CPT 12002
Hospital Charge Code	8912638
Hospital Revenue Code	450
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$442.16
Rate for Payer: Aetna Commercial	$374.14
Rate for Payer: Aetna Medicare	$274.64
Rate for Payer: Amerigroup CHIP/Medicaid	$61.22
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$183.09
Rate for Payer: Amerigroup Medicare	$183.09
Rate for Payer: BCBS of TX Blue Advantage	$291.80
Rate for Payer: BCBS of TX Blue Essentials	$349.46
Rate for Payer: BCBS of TX Medicare	$183.09
Rate for Payer: BCBS of TX PPO	$440.32
Rate for Payer: Cash Price	$598.62
Rate for Payer: Cash Price	$598.62
Rate for Payer: Cash Price	$598.62
Rate for Payer: Cigna Commercial	$414.75
Rate for Payer: Cigna Medicare	$183.09
Rate for Payer: Employer Direct Commercial	$183.09
Rate for Payer: Humana Medicare/TRICARE	$183.09
Rate for Payer: Molina Dual Medicare/Medicaid	$183.09
Rate for Payer: Molina Medicare	$183.09
Rate for Payer: Multiplan Auto	$442.16
Rate for Payer: Multiplan Commercial	$442.16
Rate for Payer: Multiplan Workers Comp	$442.16
Rate for Payer: Scott and White EPO/PPO	$3.27
Rate for Payer: Scott and White Medicare	$183.09
Rate for Payer: Superior Health Plan EPO	$183.09
Rate for Payer: Superior Health Plan Medicare	$183.09
Rate for Payer: Universal American Dual Medicare/Medicaid	$183.09
Rate for Payer: Universal American Medicare	$183.09
Rate for Payer: Wellcare Medicare	$183.09
Rate for Payer: Wellmed Medicare	$183.09

CHED Laceration Simple - Scalp 2.6 to 7.5 cm BCE

Facility

$680.25

Service Code	CPT 12002
Hospital Charge Code	8912638
Hospital Revenue Code	450
Rate for Payer: Cash Price	$598.62

CHED Laceration Simple - Scalp > 30 cm BCE

Facility

$393.64

Service Code	CPT 12007
Hospital Charge Code	8910637
Hospital Revenue Code	450
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$440.32
Rate for Payer: Aetna Commercial	$216.50
Rate for Payer: Aetna Medicare	$274.64
Rate for Payer: Amerigroup CHIP/Medicaid	$35.43
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$183.09
Rate for Payer: Amerigroup Medicare	$183.09
Rate for Payer: BCBS of TX Blue Advantage	$291.80
Rate for Payer: BCBS of TX Blue Essentials	$349.46
Rate for Payer: BCBS of TX Medicare	$183.09
Rate for Payer: BCBS of TX PPO	$440.32
Rate for Payer: Cash Price	$346.40
Rate for Payer: Cash Price	$346.40
Rate for Payer: Cash Price	$346.40
Rate for Payer: Cigna Commercial	$414.75
Rate for Payer: Cigna Medicaid	$74.34
Rate for Payer: Cigna Medicare	$183.09
Rate for Payer: Employer Direct Commercial	$183.09
Rate for Payer: Humana Medicare/TRICARE	$183.09
Rate for Payer: Molina CHIP/Medicaid	$74.34
Rate for Payer: Molina Dual Medicare/Medicaid	$183.09
Rate for Payer: Molina Medicare	$183.09
Rate for Payer: Multiplan Auto	$255.87
Rate for Payer: Multiplan Commercial	$255.87
Rate for Payer: Multiplan Workers Comp	$255.87
Rate for Payer: Parkland Medicaid	$74.34
Rate for Payer: Scott and White EPO/PPO	$3.27
Rate for Payer: Scott and White Medicare	$183.09
Rate for Payer: Superior Health Plan CHIP/Medicaid	$74.34
Rate for Payer: Superior Health Plan EPO	$183.09
Rate for Payer: Superior Health Plan Medicare	$183.09
Rate for Payer: Universal American Dual Medicare/Medicaid	$183.09
Rate for Payer: Universal American Medicare	$183.09
Rate for Payer: Wellcare Medicare	$183.09
Rate for Payer: Wellmed Medicare	$183.09

CHED Laceration Simple - Scalp > 30 cm BCE

Facility

$393.64

Service Code	CPT 12007
Hospital Charge Code	8910637
Hospital Revenue Code	450
Rate for Payer: Cash Price	$346.40

CHED Laceration Simple - Scalp 7.6 to 12.5 cm BCE

Facility

$691.09

Service Code	CPT 12004
Hospital Charge Code	8910638
Hospital Revenue Code	450
Rate for Payer: Cash Price	$608.16

CHED Laceration Simple - Scalp 7.6 to 12.5 cm BCE

Facility

$691.09

Service Code	CPT 12004
Hospital Charge Code	8910638
Hospital Revenue Code	450
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$449.21
Rate for Payer: Aetna Commercial	$380.10
Rate for Payer: Aetna Medicare	$274.64
Rate for Payer: Amerigroup CHIP/Medicaid	$62.20
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$183.09
Rate for Payer: Amerigroup Medicare	$183.09
Rate for Payer: BCBS of TX Blue Advantage	$291.80
Rate for Payer: BCBS of TX Blue Essentials	$349.46
Rate for Payer: BCBS of TX Medicare	$183.09
Rate for Payer: BCBS of TX PPO	$440.32
Rate for Payer: Cash Price	$608.16
Rate for Payer: Cash Price	$608.16
Rate for Payer: Cash Price	$608.16
Rate for Payer: Cigna Commercial	$414.75
Rate for Payer: Cigna Medicare	$183.09
Rate for Payer: Employer Direct Commercial	$183.09
Rate for Payer: Humana Medicare/TRICARE	$183.09
Rate for Payer: Molina Dual Medicare/Medicaid	$183.09
Rate for Payer: Molina Medicare	$183.09
Rate for Payer: Multiplan Auto	$449.21
Rate for Payer: Multiplan Commercial	$449.21
Rate for Payer: Multiplan Workers Comp	$449.21
Rate for Payer: Scott and White EPO/PPO	$3.27
Rate for Payer: Scott and White Medicare	$183.09
Rate for Payer: Superior Health Plan EPO	$183.09
Rate for Payer: Superior Health Plan Medicare	$183.09
Rate for Payer: Universal American Dual Medicare/Medicaid	$183.09
Rate for Payer: Universal American Medicare	$183.09
Rate for Payer: Wellcare Medicare	$183.09
Rate for Payer: Wellmed Medicare	$183.09

CHED LesionProcedure Incision of breast lesion BCE

Facility

$7,177.02

Service Code	CPT 19020
Hospital Charge Code	8914619
Hospital Revenue Code	450
Min. Negotiated Rate	$26.52
Max. Negotiated Rate	$4,665.06
Rate for Payer: Aetna Commercial	$3,090.00
Rate for Payer: Aetna Medicare	$2,224.11
Rate for Payer: Amerigroup CHIP/Medicaid	$645.93
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	$6,315.78
Rate for Payer: Cash Price	$6,315.78
Rate for Payer: Cash Price	$6,315.78
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	$4,665.06
Rate for Payer: Multiplan Commercial	$4,665.06
Rate for Payer: Multiplan Workers Comp	$4,665.06
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 LesionProcedure Incision of breast lesion BCE

Facility

$7,177.02

Service Code	CPT 19020
Hospital Charge Code	8914619
Hospital Revenue Code	450
Rate for Payer: Cash Price	$6,315.78

CHED LesionProcedure Removal of Skin Tags BCE

Facility

$2,466.72

Service Code	CPT 11200
Hospital Charge Code	8912639
Hospital Revenue Code	450
Rate for Payer: Cash Price	$2,170.71

CHED LesionProcedure Removal of Skin Tags BCE

Facility

$2,466.72

Service Code	CPT 11200
Hospital Charge Code	8912639
Hospital Revenue Code	450
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$1,603.37
Rate for Payer: Aetna Commercial	$1,356.70
Rate for Payer: Aetna Medicare	$274.64
Rate for Payer: Amerigroup CHIP/Medicaid	$222.00
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$183.09
Rate for Payer: Amerigroup Medicare	$183.09
Rate for Payer: BCBS of TX Blue Advantage	$291.80
Rate for Payer: BCBS of TX Blue Essentials	$349.46
Rate for Payer: BCBS of TX Medicare	$183.09
Rate for Payer: BCBS of TX PPO	$440.32
Rate for Payer: Cash Price	$2,170.71
Rate for Payer: Cash Price	$2,170.71
Rate for Payer: Cash Price	$2,170.71
Rate for Payer: Cigna Commercial	$414.75
Rate for Payer: Cigna Medicare	$183.09
Rate for Payer: Employer Direct Commercial	$183.09
Rate for Payer: Humana Medicare/TRICARE	$183.09
Rate for Payer: Molina Dual Medicare/Medicaid	$183.09
Rate for Payer: Molina Medicare	$183.09
Rate for Payer: Multiplan Auto	$1,603.37
Rate for Payer: Multiplan Commercial	$1,603.37
Rate for Payer: Multiplan Workers Comp	$1,603.37
Rate for Payer: Scott and White EPO/PPO	$3.27
Rate for Payer: Scott and White Medicare	$183.09
Rate for Payer: Superior Health Plan EPO	$183.09
Rate for Payer: Superior Health Plan Medicare	$183.09
Rate for Payer: Universal American Dual Medicare/Medicaid	$183.09
Rate for Payer: Universal American Medicare	$183.09
Rate for Payer: Wellcare Medicare	$183.09
Rate for Payer: Wellmed Medicare	$183.09

CHED LesionProcedure Shaving, corn or callus BCE

Facility

$432.95

Service Code	CPT 11055
Hospital Charge Code	8912640
Hospital Revenue Code	450
Rate for Payer: Cash Price	$381.00

CHED LesionProcedure Shaving, corn or callus BCE

Facility

$432.95

Service Code	CPT 11055
Hospital Charge Code	8912640
Hospital Revenue Code	450
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$440.32
Rate for Payer: Aetna Commercial	$238.12
Rate for Payer: Aetna Medicare	$274.64
Rate for Payer: Amerigroup CHIP/Medicaid	$38.97
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$183.09
Rate for Payer: Amerigroup Medicare	$183.09
Rate for Payer: BCBS of TX Blue Advantage	$291.80
Rate for Payer: BCBS of TX Blue Essentials	$349.46
Rate for Payer: BCBS of TX Medicare	$183.09
Rate for Payer: BCBS of TX PPO	$440.32
Rate for Payer: Cash Price	$381.00
Rate for Payer: Cash Price	$381.00
Rate for Payer: Cash Price	$381.00
Rate for Payer: Cigna Commercial	$414.75
Rate for Payer: Cigna Medicare	$183.09
Rate for Payer: Employer Direct Commercial	$183.09
Rate for Payer: Humana Medicare/TRICARE	$183.09
Rate for Payer: Molina Dual Medicare/Medicaid	$183.09
Rate for Payer: Molina Medicare	$183.09
Rate for Payer: Multiplan Auto	$281.42
Rate for Payer: Multiplan Commercial	$281.42
Rate for Payer: Multiplan Workers Comp	$281.42
Rate for Payer: Scott and White EPO/PPO	$3.27
Rate for Payer: Scott and White Medicare	$183.09
Rate for Payer: Superior Health Plan EPO	$183.09
Rate for Payer: Superior Health Plan Medicare	$183.09
Rate for Payer: Universal American Dual Medicare/Medicaid	$183.09
Rate for Payer: Universal American Medicare	$183.09
Rate for Payer: Wellcare Medicare	$183.09
Rate for Payer: Wellmed Medicare	$183.09

CHED LineProcedure Arterial Catheterization BCE

Facility

$1,751.63

Service Code	CPT 36620
Hospital Charge Code	8910639
Hospital Revenue Code	450
Rate for Payer: Cash Price	$1,541.43

CHED LineProcedure Arterial Catheterization BCE

Facility

$1,751.63

Service Code	CPT 36620
Hospital Charge Code	8910639
Hospital Revenue Code	450
Min. Negotiated Rate	$157.65
Max. Negotiated Rate	$1,138.56
Rate for Payer: Aetna Commercial	$963.40
Rate for Payer: Amerigroup CHIP/Medicaid	$157.65
Rate for Payer: Cash Price	$1,541.43
Rate for Payer: Multiplan Auto	$1,138.56
Rate for Payer: Multiplan Commercial	$1,138.56
Rate for Payer: Multiplan Workers Comp	$1,138.56
Rate for Payer: Scott and White EPO/PPO	$875.82
Rate for Payer: Superior Health Plan EPO	$238.22

CHED LineProcedure Central Line >= 5 y/o BCE

Facility

$3,105.84

Service Code	CPT 36556
Hospital Charge Code	8914620
Hospital Revenue Code	450
Rate for Payer: Cash Price	$2,733.14

CHED LineProcedure Central Line >= 5 y/o BCE

Facility

$3,105.84

Service Code	CPT 36556
Hospital Charge Code	8914620
Hospital Revenue Code	450
Min. Negotiated Rate	$52.13
Max. Negotiated Rate	$6,603.56
Rate for Payer: Aetna Commercial	$1,400.00
Rate for Payer: Aetna Medicare	$4,372.65
Rate for Payer: Amerigroup CHIP/Medicaid	$279.53
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$2,915.10
Rate for Payer: Amerigroup Medicare	$2,915.10
Rate for Payer: BCBS of TX Blue Advantage	$2,723.99
Rate for Payer: BCBS of TX Blue Essentials	$3,262.26
Rate for Payer: BCBS of TX Medicare	$2,915.10
Rate for Payer: BCBS of TX PPO	$4,110.45
Rate for Payer: Cash Price	$2,733.14
Rate for Payer: Cash Price	$2,733.14
Rate for Payer: Cash Price	$2,733.14
Rate for Payer: Cigna Commercial	$6,603.56
Rate for Payer: Cigna Medicaid	$1,118.22
Rate for Payer: Cigna Medicare	$2,915.10
Rate for Payer: Employer Direct Commercial	$2,915.10
Rate for Payer: Humana Medicare/TRICARE	$2,915.10
Rate for Payer: Molina CHIP/Medicaid	$1,118.22
Rate for Payer: Molina Dual Medicare/Medicaid	$2,915.10
Rate for Payer: Molina Medicare	$2,915.10
Rate for Payer: Multiplan Auto	$2,018.80
Rate for Payer: Multiplan Commercial	$2,018.80
Rate for Payer: Multiplan Workers Comp	$2,018.80
Rate for Payer: Parkland Medicaid	$1,118.22
Rate for Payer: Scott and White EPO/PPO	$52.13
Rate for Payer: Scott and White Medicare	$2,915.10
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1,118.22
Rate for Payer: Superior Health Plan EPO	$2,915.10
Rate for Payer: Superior Health Plan Medicare	$2,915.10
Rate for Payer: Universal American Dual Medicare/Medicaid	$2,915.10
Rate for Payer: Universal American Medicare	$2,915.10
Rate for Payer: Wellcare Medicare	$2,915.10
Rate for Payer: Wellmed Medicare	$2,915.10

CHED LineProcedure Intraosseous Infusion BCE

Facility

$420.53

Service Code	CPT 36680
Hospital Charge Code	8914621
Hospital Revenue Code	450
Min. Negotiated Rate	$6.52
Max. Negotiated Rate	$916.25
Rate for Payer: Aetna Commercial	$231.29
Rate for Payer: Aetna Medicare	$546.58
Rate for Payer: Amerigroup CHIP/Medicaid	$37.85
Rate for Payer: Amerigroup Dual Medicare/Medicaid	$364.39
Rate for Payer: Amerigroup Medicare	$364.39
Rate for Payer: BCBS of TX Blue Advantage	$607.20
Rate for Payer: BCBS of TX Blue Essentials	$727.18
Rate for Payer: BCBS of TX Medicare	$364.39
Rate for Payer: BCBS of TX PPO	$916.25
Rate for Payer: Cash Price	$370.07
Rate for Payer: Cash Price	$370.07
Rate for Payer: Cash Price	$370.07
Rate for Payer: Cigna Commercial	$825.46
Rate for Payer: Cigna Medicare	$364.39
Rate for Payer: Employer Direct Commercial	$364.39
Rate for Payer: Humana Medicare/TRICARE	$364.39
Rate for Payer: Molina Dual Medicare/Medicaid	$364.39
Rate for Payer: Molina Medicare	$364.39
Rate for Payer: Multiplan Auto	$273.34
Rate for Payer: Multiplan Commercial	$273.34
Rate for Payer: Multiplan Workers Comp	$273.34
Rate for Payer: Scott and White EPO/PPO	$6.52
Rate for Payer: Scott and White Medicare	$364.39
Rate for Payer: Superior Health Plan EPO	$364.39
Rate for Payer: Superior Health Plan Medicare	$364.39
Rate for Payer: Universal American Dual Medicare/Medicaid	$364.39
Rate for Payer: Universal American Medicare	$364.39
Rate for Payer: Wellcare Medicare	$364.39
Rate for Payer: Wellmed Medicare	$364.39

CHED LineProcedure Intraosseous Infusion BCE

Facility

$420.53

Service Code	CPT 36680
Hospital Charge Code	8914621
Hospital Revenue Code	450
Rate for Payer: Cash Price	$370.07

CHED Nail RepairProcedure Debridement of Nail 1-5 BCE

Facility

$106.00

Service Code	CPT 11720
Hospital Charge Code	8910640
Hospital Revenue Code	450
Rate for Payer: Cash Price	$93.28

Know your out-of-pocket cost for care.

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