|
CHED Nail RepairProcedure Debridement of Nail 1-5 BCE
|
Facility
|
IP
|
$106.00
|
|
|
Service Code
|
CPT 11720
|
| Hospital Charge Code |
8910640
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$93.28
|
|
|
CHED Nail RepairProcedure Debridement of Nail 6+ BCE
|
Facility
|
IP
|
$309.00
|
|
|
Service Code
|
CPT 11721
|
| Hospital Charge Code |
8912641
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$271.92
|
|
|
CHED Nail RepairProcedure Debridement of Nail 6+ BCE
|
Facility
|
OP
|
$309.00
|
|
|
Service Code
|
CPT 11721
|
| Hospital Charge Code |
8912641
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$200.85 |
| Rate for Payer: Aetna Commercial |
$169.95
|
| Rate for Payer: Aetna Medicare |
$83.91
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$27.81
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$55.94
|
| Rate for Payer: Amerigroup Medicare |
$55.94
|
| Rate for Payer: BCBS of TX Blue Advantage |
$91.87
|
| Rate for Payer: BCBS of TX Blue Essentials |
$110.02
|
| Rate for Payer: BCBS of TX Medicare |
$55.94
|
| Rate for Payer: BCBS of TX PPO |
$138.63
|
| Rate for Payer: Cash Price |
$271.92
|
| Rate for Payer: Cash Price |
$271.92
|
| Rate for Payer: Cash Price |
$271.92
|
| Rate for Payer: Cigna Commercial |
$126.71
|
| Rate for Payer: Cigna Medicare |
$55.94
|
| Rate for Payer: Employer Direct Commercial |
$55.94
|
| Rate for Payer: Humana Medicare/TRICARE |
$55.94
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$55.94
|
| Rate for Payer: Molina Medicare |
$55.94
|
| Rate for Payer: Multiplan Auto |
$200.85
|
| Rate for Payer: Multiplan Commercial |
$200.85
|
| Rate for Payer: Multiplan Workers Comp |
$200.85
|
| Rate for Payer: Scott and White EPO/PPO |
$1.00
|
| Rate for Payer: Scott and White Medicare |
$55.94
|
| Rate for Payer: Superior Health Plan EPO |
$55.94
|
| Rate for Payer: Superior Health Plan Medicare |
$55.94
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$55.94
|
| Rate for Payer: Universal American Medicare |
$55.94
|
| Rate for Payer: Wellcare Medicare |
$55.94
|
| Rate for Payer: Wellmed Medicare |
$55.94
|
|
|
CHED Nail RepairProcedure Evacuation of subungual hematoma B
|
Facility
|
IP
|
$616.31
|
|
|
Service Code
|
CPT 11740
|
| Hospital Charge Code |
8914622
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$542.35
|
|
|
CHED Nail RepairProcedure Evacuation of subungual hematoma B
|
Facility
|
OP
|
$616.31
|
|
|
Service Code
|
CPT 11740
|
| Hospital Charge Code |
8914622
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$400.60 |
| Rate for Payer: Aetna Commercial |
$338.97
|
| Rate for Payer: Aetna Medicare |
$175.23
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$55.47
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Amerigroup Medicare |
$116.82
|
| Rate for Payer: BCBS of TX Blue Advantage |
$182.08
|
| Rate for Payer: BCBS of TX Blue Essentials |
$218.06
|
| Rate for Payer: BCBS of TX Medicare |
$116.82
|
| Rate for Payer: BCBS of TX PPO |
$274.76
|
| Rate for Payer: Cash Price |
$542.35
|
| Rate for Payer: Cash Price |
$542.35
|
| Rate for Payer: Cash Price |
$542.35
|
| Rate for Payer: Cigna Commercial |
$264.63
|
| Rate for Payer: Cigna Medicare |
$116.82
|
| Rate for Payer: Employer Direct Commercial |
$116.82
|
| Rate for Payer: Humana Medicare/TRICARE |
$116.82
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Molina Medicare |
$116.82
|
| Rate for Payer: Multiplan Auto |
$400.60
|
| Rate for Payer: Multiplan Commercial |
$400.60
|
| Rate for Payer: Multiplan Workers Comp |
$400.60
|
| Rate for Payer: Scott and White EPO/PPO |
$2.09
|
| Rate for Payer: Scott and White Medicare |
$116.82
|
| Rate for Payer: Superior Health Plan EPO |
$116.82
|
| Rate for Payer: Superior Health Plan Medicare |
$116.82
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Universal American Medicare |
$116.82
|
| Rate for Payer: Wellcare Medicare |
$116.82
|
| Rate for Payer: Wellmed Medicare |
$116.82
|
|
|
CHED Nail RepairProcedure Nail and Nail Matrix, Excision BCE
|
Facility
|
IP
|
$8,017.06
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
8910641
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$7,055.01
|
|
|
CHED Nail RepairProcedure Nail and Nail Matrix, Excision BCE
|
Facility
|
OP
|
$8,017.06
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
8910641
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$5,211.09 |
| Rate for Payer: Aetna Commercial |
$4,409.38
|
| Rate for Payer: Aetna Medicare |
$547.00
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$721.54
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Amerigroup Medicare |
$364.67
|
| Rate for Payer: BCBS of TX Blue Advantage |
$165.75
|
| Rate for Payer: BCBS of TX Blue Essentials |
$198.50
|
| Rate for Payer: BCBS of TX Medicare |
$364.67
|
| Rate for Payer: BCBS of TX PPO |
$250.11
|
| Rate for Payer: Cash Price |
$7,055.01
|
| Rate for Payer: Cash Price |
$7,055.01
|
| Rate for Payer: Cash Price |
$7,055.01
|
| Rate for Payer: Cigna Commercial |
$826.08
|
| Rate for Payer: Cigna Medicaid |
$84.71
|
| 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 |
$84.71
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$364.67
|
| Rate for Payer: Molina Medicare |
$364.67
|
| Rate for Payer: Multiplan Auto |
$5,211.09
|
| Rate for Payer: Multiplan Commercial |
$5,211.09
|
| Rate for Payer: Multiplan Workers Comp |
$5,211.09
|
| Rate for Payer: Parkland Medicaid |
$84.71
|
| 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 |
$84.71
|
| 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 Nail RepairProcedure Nail Bed Repair BCE
|
Facility
|
IP
|
$2,124.70
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
8914623
|
|
Hospital Revenue Code
|
451
|
| Rate for Payer: Cash Price |
$1,869.74
|
|
|
CHED Nail RepairProcedure Nail Bed Repair BCE
|
Facility
|
OP
|
$2,124.70
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
8914623
|
|
Hospital Revenue Code
|
451
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$1,381.06 |
| Rate for Payer: Aetna Commercial |
$1,168.58
|
| Rate for Payer: Aetna Medicare |
$861.57
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$191.22
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$574.38
|
| Rate for Payer: Amerigroup Medicare |
$574.38
|
| Rate for Payer: BCBS of TX Blue Advantage |
$830.02
|
| Rate for Payer: BCBS of TX Blue Essentials |
$994.04
|
| Rate for Payer: BCBS of TX Medicare |
$574.38
|
| Rate for Payer: BCBS of TX PPO |
$1,252.49
|
| Rate for Payer: Cash Price |
$1,869.74
|
| Rate for Payer: Cash Price |
$1,869.74
|
| Rate for Payer: Cash Price |
$1,869.74
|
| Rate for Payer: Cigna Commercial |
$1,301.14
|
| Rate for Payer: Cigna Medicaid |
$105.20
|
| Rate for Payer: Cigna Medicare |
$574.38
|
| Rate for Payer: Employer Direct Commercial |
$574.38
|
| Rate for Payer: Humana Medicare/TRICARE |
$574.38
|
| Rate for Payer: Molina CHIP/Medicaid |
$105.20
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$574.38
|
| Rate for Payer: Molina Medicare |
$574.38
|
| Rate for Payer: Multiplan Auto |
$1,381.06
|
| Rate for Payer: Multiplan Commercial |
$1,381.06
|
| Rate for Payer: Multiplan Workers Comp |
$1,381.06
|
| Rate for Payer: Parkland Medicaid |
$105.20
|
| Rate for Payer: Scott and White EPO/PPO |
$10.27
|
| Rate for Payer: Scott and White Medicare |
$574.38
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$105.20
|
| Rate for Payer: Superior Health Plan EPO |
$574.38
|
| Rate for Payer: Superior Health Plan Medicare |
$574.38
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$574.38
|
| Rate for Payer: Universal American Medicare |
$574.38
|
| Rate for Payer: Wellcare Medicare |
$574.38
|
| Rate for Payer: Wellmed Medicare |
$574.38
|
|
|
CHED Nail RepairProcedure Nail plate avulsion, single BCE
|
Facility
|
IP
|
$550.08
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
8914624
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$484.07
|
|
|
CHED Nail RepairProcedure Nail plate avulsion, single BCE
|
Facility
|
OP
|
$550.08
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
8914624
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$440.32 |
| Rate for Payer: Aetna Commercial |
$302.54
|
| Rate for Payer: Aetna Medicare |
$274.64
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$49.51
|
| 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 |
$484.07
|
| Rate for Payer: Cash Price |
$484.07
|
| Rate for Payer: Cash Price |
$484.07
|
| 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 |
$357.55
|
| Rate for Payer: Multiplan Commercial |
$357.55
|
| Rate for Payer: Multiplan Workers Comp |
$357.55
|
| 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 Nail RepairProcedure Trim Nondystrophic Nails BCE
|
Facility
|
OP
|
$219.25
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
8912642
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$142.51 |
| Rate for Payer: Aetna Commercial |
$120.59
|
| Rate for Payer: Aetna Medicare |
$83.91
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$19.73
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$55.94
|
| Rate for Payer: Amerigroup Medicare |
$55.94
|
| Rate for Payer: BCBS of TX Blue Advantage |
$91.87
|
| Rate for Payer: BCBS of TX Blue Essentials |
$110.02
|
| Rate for Payer: BCBS of TX Medicare |
$55.94
|
| Rate for Payer: BCBS of TX PPO |
$138.63
|
| Rate for Payer: Cash Price |
$192.94
|
| Rate for Payer: Cash Price |
$192.94
|
| Rate for Payer: Cash Price |
$192.94
|
| Rate for Payer: Cigna Commercial |
$126.71
|
| Rate for Payer: Cigna Medicare |
$55.94
|
| Rate for Payer: Employer Direct Commercial |
$55.94
|
| Rate for Payer: Humana Medicare/TRICARE |
$55.94
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$55.94
|
| Rate for Payer: Molina Medicare |
$55.94
|
| Rate for Payer: Multiplan Auto |
$142.51
|
| Rate for Payer: Multiplan Commercial |
$142.51
|
| Rate for Payer: Multiplan Workers Comp |
$142.51
|
| Rate for Payer: Scott and White EPO/PPO |
$1.00
|
| Rate for Payer: Scott and White Medicare |
$55.94
|
| Rate for Payer: Superior Health Plan EPO |
$55.94
|
| Rate for Payer: Superior Health Plan Medicare |
$55.94
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$55.94
|
| Rate for Payer: Universal American Medicare |
$55.94
|
| Rate for Payer: Wellcare Medicare |
$55.94
|
| Rate for Payer: Wellmed Medicare |
$55.94
|
|
|
CHED Nail RepairProcedure Trim Nondystrophic Nails BCE
|
Facility
|
IP
|
$219.25
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
8912642
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$192.94
|
|
|
CHED Nosebleed Complexity Anterior, Simple BCE
|
Facility
|
OP
|
$488.04
|
|
|
Service Code
|
CPT 30901
|
| Hospital Charge Code |
8914625
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$317.23 |
| Rate for Payer: Aetna Commercial |
$268.42
|
| Rate for Payer: Aetna Medicare |
$175.23
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$43.92
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Amerigroup Medicare |
$116.82
|
| Rate for Payer: BCBS of TX Blue Advantage |
$182.08
|
| Rate for Payer: BCBS of TX Blue Essentials |
$218.06
|
| Rate for Payer: BCBS of TX Medicare |
$116.82
|
| Rate for Payer: BCBS of TX PPO |
$274.76
|
| Rate for Payer: Cash Price |
$429.48
|
| Rate for Payer: Cash Price |
$429.48
|
| Rate for Payer: Cash Price |
$429.48
|
| Rate for Payer: Cigna Commercial |
$264.63
|
| Rate for Payer: Cigna Medicare |
$116.82
|
| Rate for Payer: Employer Direct Commercial |
$116.82
|
| Rate for Payer: Humana Medicare/TRICARE |
$116.82
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Molina Medicare |
$116.82
|
| Rate for Payer: Multiplan Auto |
$317.23
|
| Rate for Payer: Multiplan Commercial |
$317.23
|
| Rate for Payer: Multiplan Workers Comp |
$317.23
|
| Rate for Payer: Scott and White EPO/PPO |
$2.09
|
| Rate for Payer: Scott and White Medicare |
$116.82
|
| Rate for Payer: Superior Health Plan EPO |
$116.82
|
| Rate for Payer: Superior Health Plan Medicare |
$116.82
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Universal American Medicare |
$116.82
|
| Rate for Payer: Wellcare Medicare |
$116.82
|
| Rate for Payer: Wellmed Medicare |
$116.82
|
|
|
CHED Nosebleed Complexity Anterior, Simple BCE
|
Facility
|
IP
|
$488.04
|
|
|
Service Code
|
CPT 30901
|
| Hospital Charge Code |
8914625
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$429.48
|
|
|
CHED OB/GYNProcedure Delivery, Vaginal BCE
|
Facility
|
IP
|
$6,736.83
|
|
|
Service Code
|
CPT 59409
|
| Hospital Charge Code |
8912643
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$5,928.41
|
|
|
CHED OB/GYNProcedure Delivery, Vaginal BCE
|
Facility
|
OP
|
$6,736.83
|
|
|
Service Code
|
CPT 59409
|
| Hospital Charge Code |
8912643
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$51.13 |
| Max. Negotiated Rate |
$6,476.93 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$4,288.80
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$606.31
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,859.20
|
| Rate for Payer: Amerigroup Medicare |
$2,859.20
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,171.83
|
| Rate for Payer: BCBS of TX Blue Essentials |
$4,996.20
|
| Rate for Payer: BCBS of TX Medicare |
$2,859.20
|
| Rate for Payer: BCBS of TX PPO |
$6,295.21
|
| Rate for Payer: Cash Price |
$5,928.41
|
| Rate for Payer: Cash Price |
$5,928.41
|
| Rate for Payer: Cash Price |
$5,928.41
|
| Rate for Payer: Cigna Commercial |
$6,476.93
|
| Rate for Payer: Cigna Medicare |
$2,859.20
|
| Rate for Payer: Employer Direct Commercial |
$2,859.20
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,859.20
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,859.20
|
| Rate for Payer: Molina Medicare |
$2,859.20
|
| Rate for Payer: Multiplan Auto |
$4,378.94
|
| Rate for Payer: Multiplan Commercial |
$4,378.94
|
| Rate for Payer: Multiplan Workers Comp |
$4,378.94
|
| Rate for Payer: Scott and White EPO/PPO |
$51.13
|
| Rate for Payer: Scott and White Medicare |
$2,859.20
|
| Rate for Payer: Superior Health Plan EPO |
$2,859.20
|
| Rate for Payer: Superior Health Plan Medicare |
$2,859.20
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,859.20
|
| Rate for Payer: Universal American Medicare |
$2,859.20
|
| Rate for Payer: Wellcare Medicare |
$2,859.20
|
| Rate for Payer: Wellmed Medicare |
$2,859.20
|
|
|
CHED OB/GYNProcedure Removal of Contraceptive Capsule BCE
|
Facility
|
IP
|
$1,718.00
|
|
|
Service Code
|
CPT 11976
|
| Hospital Charge Code |
8914626
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,511.84
|
|
|
CHED OB/GYNProcedure Removal of Contraceptive Capsule BCE
|
Facility
|
OP
|
$1,718.00
|
|
|
Service Code
|
CPT 11976
|
| Hospital Charge Code |
8914626
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$11.51 |
| Max. Negotiated Rate |
$1,457.60 |
| Rate for Payer: Aetna Commercial |
$1,400.00
|
| Rate for Payer: Aetna Medicare |
$965.18
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$154.62
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$643.45
|
| Rate for Payer: Amerigroup Medicare |
$643.45
|
| Rate for Payer: BCBS of TX Blue Advantage |
$125.97
|
| Rate for Payer: BCBS of TX Blue Essentials |
$150.86
|
| Rate for Payer: BCBS of TX Medicare |
$643.45
|
| Rate for Payer: BCBS of TX PPO |
$190.08
|
| Rate for Payer: Cash Price |
$1,511.84
|
| Rate for Payer: Cash Price |
$1,511.84
|
| Rate for Payer: Cash Price |
$1,511.84
|
| Rate for Payer: Cigna Commercial |
$1,457.60
|
| Rate for Payer: Cigna Medicaid |
$61.74
|
| Rate for Payer: Cigna Medicare |
$643.45
|
| Rate for Payer: Employer Direct Commercial |
$643.45
|
| Rate for Payer: Humana Medicare/TRICARE |
$643.45
|
| Rate for Payer: Molina CHIP/Medicaid |
$61.74
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$643.45
|
| Rate for Payer: Molina Medicare |
$643.45
|
| Rate for Payer: Multiplan Auto |
$1,116.70
|
| Rate for Payer: Multiplan Commercial |
$1,116.70
|
| Rate for Payer: Multiplan Workers Comp |
$1,116.70
|
| Rate for Payer: Parkland Medicaid |
$61.74
|
| Rate for Payer: Scott and White EPO/PPO |
$11.51
|
| Rate for Payer: Scott and White Medicare |
$643.45
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$61.74
|
| Rate for Payer: Superior Health Plan EPO |
$643.45
|
| Rate for Payer: Superior Health Plan Medicare |
$643.45
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$643.45
|
| Rate for Payer: Universal American Medicare |
$643.45
|
| Rate for Payer: Wellcare Medicare |
$643.45
|
| Rate for Payer: Wellmed Medicare |
$643.45
|
|
|
CHED OPEN TX PHLNGL SHFT FX PRXML/MDL PHLNX EA W/INT FX WHEN
|
Facility
|
IP
|
$11,099.03
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
8912644
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$9,767.15
|
|
|
CHED OPEN TX PHLNGL SHFT FX PRXML/MDL PHLNX EA W/INT FX WHEN
|
Facility
|
OP
|
$11,099.03
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
8912644
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$52.94 |
| Max. Negotiated Rate |
$7,214.37 |
| Rate for Payer: Aetna Commercial |
$3,090.00
|
| Rate for Payer: Aetna Medicare |
$4,440.36
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$998.91
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Amerigroup Medicare |
$2,960.24
|
| Rate for Payer: BCBS of TX Blue Advantage |
$4,571.54
|
| Rate for Payer: BCBS of TX Blue Essentials |
$5,474.90
|
| Rate for Payer: BCBS of TX Medicare |
$2,960.24
|
| Rate for Payer: BCBS of TX PPO |
$6,898.37
|
| Rate for Payer: Cash Price |
$9,767.15
|
| Rate for Payer: Cash Price |
$9,767.15
|
| Rate for Payer: Cash Price |
$9,767.15
|
| Rate for Payer: Cigna Commercial |
$6,705.80
|
| Rate for Payer: Cigna Medicaid |
$1,088.27
|
| Rate for Payer: Cigna Medicare |
$2,960.24
|
| Rate for Payer: Employer Direct Commercial |
$2,960.24
|
| Rate for Payer: Humana Medicare/TRICARE |
$2,960.24
|
| Rate for Payer: Molina CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Molina Medicare |
$2,960.24
|
| Rate for Payer: Multiplan Auto |
$7,214.37
|
| Rate for Payer: Multiplan Commercial |
$7,214.37
|
| Rate for Payer: Multiplan Workers Comp |
$7,214.37
|
| Rate for Payer: Parkland Medicaid |
$1,088.27
|
| Rate for Payer: Scott and White EPO/PPO |
$52.94
|
| Rate for Payer: Scott and White Medicare |
$2,960.24
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$1,088.27
|
| Rate for Payer: Superior Health Plan EPO |
$2,960.24
|
| Rate for Payer: Superior Health Plan Medicare |
$2,960.24
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$2,960.24
|
| Rate for Payer: Universal American Medicare |
$2,960.24
|
| Rate for Payer: Wellcare Medicare |
$2,960.24
|
| Rate for Payer: Wellmed Medicare |
$2,960.24
|
|
|
CHED Orthopedic Cast Application Foot/Ankle BCE
|
Facility
|
OP
|
$579.92
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
8914630
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$556.38 |
| Rate for Payer: Aetna Commercial |
$318.96
|
| Rate for Payer: Aetna Medicare |
$368.42
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$52.19
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Amerigroup Medicare |
$245.61
|
| Rate for Payer: BCBS of TX Blue Advantage |
$80.76
|
| Rate for Payer: BCBS of TX Blue Essentials |
$96.72
|
| Rate for Payer: BCBS of TX Medicare |
$245.61
|
| Rate for Payer: BCBS of TX PPO |
$121.87
|
| Rate for Payer: Cash Price |
$510.33
|
| Rate for Payer: Cash Price |
$510.33
|
| Rate for Payer: Cash Price |
$510.33
|
| Rate for Payer: Cigna Commercial |
$556.38
|
| Rate for Payer: Cigna Medicaid |
$39.03
|
| Rate for Payer: Cigna Medicare |
$245.61
|
| Rate for Payer: Employer Direct Commercial |
$245.61
|
| Rate for Payer: Humana Medicare/TRICARE |
$245.61
|
| Rate for Payer: Molina CHIP/Medicaid |
$39.03
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Molina Medicare |
$245.61
|
| Rate for Payer: Multiplan Auto |
$376.95
|
| Rate for Payer: Multiplan Commercial |
$376.95
|
| Rate for Payer: Multiplan Workers Comp |
$376.95
|
| Rate for Payer: Parkland Medicaid |
$39.03
|
| Rate for Payer: Scott and White EPO/PPO |
$4.39
|
| Rate for Payer: Scott and White Medicare |
$245.61
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$39.03
|
| Rate for Payer: Superior Health Plan EPO |
$245.61
|
| Rate for Payer: Superior Health Plan Medicare |
$245.61
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Universal American Medicare |
$245.61
|
| Rate for Payer: Wellcare Medicare |
$245.61
|
| Rate for Payer: Wellmed Medicare |
$245.61
|
|
|
CHED Orthopedic Cast Application Foot/Ankle BCE
|
Facility
|
IP
|
$579.92
|
|
|
Service Code
|
CPT 29405
|
| Hospital Charge Code |
8914630
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$510.33
|
|
|
CHED Orthopedic Cast Application Forearm BCE
|
Facility
|
IP
|
$520.00
|
|
|
Service Code
|
CPT 29075
|
| Hospital Charge Code |
8914629
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$457.60
|
|
|
CHED Orthopedic Cast Application Forearm BCE
|
Facility
|
OP
|
$520.00
|
|
|
Service Code
|
CPT 29075
|
| Hospital Charge Code |
8914629
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$556.38 |
| Rate for Payer: Aetna Commercial |
$286.00
|
| Rate for Payer: Aetna Medicare |
$368.42
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$46.80
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Amerigroup Medicare |
$245.61
|
| Rate for Payer: BCBS of TX Blue Advantage |
$92.22
|
| Rate for Payer: BCBS of TX Blue Essentials |
$110.44
|
| Rate for Payer: BCBS of TX Medicare |
$245.61
|
| Rate for Payer: BCBS of TX PPO |
$139.15
|
| Rate for Payer: Cash Price |
$457.60
|
| Rate for Payer: Cash Price |
$457.60
|
| Rate for Payer: Cash Price |
$457.60
|
| Rate for Payer: Cigna Commercial |
$556.38
|
| Rate for Payer: Cigna Medicaid |
$45.13
|
| Rate for Payer: Cigna Medicare |
$245.61
|
| Rate for Payer: Employer Direct Commercial |
$245.61
|
| Rate for Payer: Humana Medicare/TRICARE |
$245.61
|
| Rate for Payer: Molina CHIP/Medicaid |
$45.13
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Molina Medicare |
$245.61
|
| Rate for Payer: Multiplan Auto |
$338.00
|
| Rate for Payer: Multiplan Commercial |
$338.00
|
| Rate for Payer: Multiplan Workers Comp |
$338.00
|
| Rate for Payer: Parkland Medicaid |
$45.13
|
| Rate for Payer: Scott and White EPO/PPO |
$4.39
|
| Rate for Payer: Scott and White Medicare |
$245.61
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$45.13
|
| Rate for Payer: Superior Health Plan EPO |
$245.61
|
| Rate for Payer: Superior Health Plan Medicare |
$245.61
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Universal American Medicare |
$245.61
|
| Rate for Payer: Wellcare Medicare |
$245.61
|
| Rate for Payer: Wellmed Medicare |
$245.61
|
|
