|
CHED Orthopedic Cast Application Hand BCE
|
Facility
|
OP
|
$682.00
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
8912648
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$443.30 |
| Rate for Payer: Aetna Commercial |
$375.10
|
| Rate for Payer: Aetna Medicare |
$216.15
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$61.38
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Amerigroup Medicare |
$144.10
|
| Rate for Payer: BCBS of TX Blue Advantage |
$100.05
|
| Rate for Payer: BCBS of TX Blue Essentials |
$119.82
|
| Rate for Payer: BCBS of TX Medicare |
$144.10
|
| Rate for Payer: BCBS of TX PPO |
$150.97
|
| Rate for Payer: Cash Price |
$600.16
|
| Rate for Payer: Cash Price |
$600.16
|
| Rate for Payer: Cash Price |
$600.16
|
| Rate for Payer: Cigna Commercial |
$326.44
|
| Rate for Payer: Cigna Medicaid |
$48.73
|
| Rate for Payer: Cigna Medicare |
$144.10
|
| Rate for Payer: Employer Direct Commercial |
$144.10
|
| Rate for Payer: Humana Medicare/TRICARE |
$144.10
|
| Rate for Payer: Molina CHIP/Medicaid |
$48.73
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Molina Medicare |
$144.10
|
| Rate for Payer: Multiplan Auto |
$443.30
|
| Rate for Payer: Multiplan Commercial |
$443.30
|
| Rate for Payer: Multiplan Workers Comp |
$443.30
|
| Rate for Payer: Parkland Medicaid |
$48.73
|
| Rate for Payer: Scott and White EPO/PPO |
$2.58
|
| Rate for Payer: Scott and White Medicare |
$144.10
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$48.73
|
| Rate for Payer: Superior Health Plan EPO |
$144.10
|
| Rate for Payer: Superior Health Plan Medicare |
$144.10
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Universal American Medicare |
$144.10
|
| Rate for Payer: Wellcare Medicare |
$144.10
|
| Rate for Payer: Wellmed Medicare |
$144.10
|
|
|
CHED Orthopedic Cast Application Hand BCE
|
Facility
|
IP
|
$682.00
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
8912648
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$600.16
|
|
|
CHED Orthopedic Cast Application Lower Extremity BCE
|
Facility
|
OP
|
$740.50
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
8912649
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$556.38 |
| Rate for Payer: Aetna Commercial |
$407.28
|
| Rate for Payer: Aetna Medicare |
$368.42
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$66.64
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Amerigroup Medicare |
$245.61
|
| Rate for Payer: BCBS of TX Blue Advantage |
$131.40
|
| Rate for Payer: BCBS of TX Blue Essentials |
$157.36
|
| Rate for Payer: BCBS of TX Medicare |
$245.61
|
| Rate for Payer: BCBS of TX PPO |
$198.27
|
| Rate for Payer: Cash Price |
$651.64
|
| Rate for Payer: Cash Price |
$651.64
|
| Rate for Payer: Cash Price |
$651.64
|
| Rate for Payer: Cigna Commercial |
$556.38
|
| Rate for Payer: Cigna Medicaid |
$63.67
|
| 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 |
$63.67
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Molina Medicare |
$245.61
|
| Rate for Payer: Multiplan Auto |
$481.32
|
| Rate for Payer: Multiplan Commercial |
$481.32
|
| Rate for Payer: Multiplan Workers Comp |
$481.32
|
| Rate for Payer: Parkland Medicaid |
$63.67
|
| 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 |
$63.67
|
| 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 Lower Extremity BCE
|
Facility
|
IP
|
$740.50
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
8912649
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$651.64
|
|
|
CHED Orthopedic Cast Application Upper Arm/Elbow BCE
|
Facility
|
IP
|
$544.34
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
8926599
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$479.02
|
|
|
CHED Orthopedic Cast Application Upper Arm/Elbow BCE
|
Facility
|
OP
|
$544.34
|
|
|
Service Code
|
CPT 29065
|
| Hospital Charge Code |
8926599
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$556.38 |
| Rate for Payer: Aetna Commercial |
$299.39
|
| Rate for Payer: Aetna Medicare |
$368.42
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$48.99
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Amerigroup Medicare |
$245.61
|
| Rate for Payer: BCBS of TX Blue Advantage |
$100.65
|
| Rate for Payer: BCBS of TX Blue Essentials |
$120.54
|
| Rate for Payer: BCBS of TX Medicare |
$245.61
|
| Rate for Payer: BCBS of TX PPO |
$151.88
|
| Rate for Payer: Cash Price |
$479.02
|
| Rate for Payer: Cash Price |
$479.02
|
| Rate for Payer: Cash Price |
$479.02
|
| Rate for Payer: Cigna Commercial |
$556.38
|
| Rate for Payer: Cigna Medicaid |
$49.28
|
| 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 |
$49.28
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Molina Medicare |
$245.61
|
| Rate for Payer: Multiplan Auto |
$353.82
|
| Rate for Payer: Multiplan Commercial |
$353.82
|
| Rate for Payer: Multiplan Workers Comp |
$353.82
|
| Rate for Payer: Parkland Medicaid |
$49.28
|
| 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 |
$49.28
|
| 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 Removal Arm/Leg BCE
|
Facility
|
IP
|
$644.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
8912645
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$566.72
|
|
|
CHED Orthopedic Cast Removal Arm/Leg BCE
|
Facility
|
OP
|
$644.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
8912645
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$556.38 |
| Rate for Payer: Aetna Commercial |
$354.20
|
| Rate for Payer: Aetna Medicare |
$368.42
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$57.96
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Amerigroup Medicare |
$245.61
|
| Rate for Payer: BCBS of TX Blue Advantage |
$57.26
|
| Rate for Payer: BCBS of TX Blue Essentials |
$68.58
|
| Rate for Payer: BCBS of TX Medicare |
$245.61
|
| Rate for Payer: BCBS of TX PPO |
$86.41
|
| Rate for Payer: Cash Price |
$566.72
|
| Rate for Payer: Cash Price |
$566.72
|
| Rate for Payer: Cash Price |
$566.72
|
| Rate for Payer: Cigna Commercial |
$556.38
|
| Rate for Payer: Cigna Medicaid |
$27.13
|
| 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 |
$27.13
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$245.61
|
| Rate for Payer: Molina Medicare |
$245.61
|
| Rate for Payer: Multiplan Auto |
$418.60
|
| Rate for Payer: Multiplan Commercial |
$418.60
|
| Rate for Payer: Multiplan Workers Comp |
$418.60
|
| Rate for Payer: Parkland Medicaid |
$27.13
|
| 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 |
$27.13
|
| 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
|
|
|
CHED Orthopedic Splinting Site Finger Splint, static BCE
|
Facility
|
IP
|
$344.90
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
8912646
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$303.51
|
|
|
CHED Orthopedic Splinting Site Finger Splint, static BCE
|
Facility
|
OP
|
$344.90
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
8912646
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$264.63 |
| Rate for Payer: Aetna Commercial |
$189.70
|
| Rate for Payer: Aetna Medicare |
$175.23
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$31.04
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$116.82
|
| Rate for Payer: Amerigroup Medicare |
$116.82
|
| 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 |
$116.82
|
| Rate for Payer: BCBS of TX PPO |
$138.63
|
| Rate for Payer: Cash Price |
$303.51
|
| Rate for Payer: Cash Price |
$303.51
|
| Rate for Payer: Cash Price |
$303.51
|
| 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 |
$224.18
|
| Rate for Payer: Multiplan Commercial |
$224.18
|
| Rate for Payer: Multiplan Workers Comp |
$224.18
|
| 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 Orthopedic Splinting Site Posterior Long Arm Splint BC
|
Facility
|
OP
|
$510.32
|
|
|
Service Code
|
CPT 29105
|
| Hospital Charge Code |
8910642
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$331.71 |
| Rate for Payer: Aetna Commercial |
$280.68
|
| Rate for Payer: Aetna Medicare |
$216.15
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$45.93
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Amerigroup Medicare |
$144.10
|
| Rate for Payer: BCBS of TX Blue Advantage |
$83.17
|
| Rate for Payer: BCBS of TX Blue Essentials |
$99.60
|
| Rate for Payer: BCBS of TX Medicare |
$144.10
|
| Rate for Payer: BCBS of TX PPO |
$125.50
|
| Rate for Payer: Cash Price |
$449.08
|
| Rate for Payer: Cash Price |
$449.08
|
| Rate for Payer: Cash Price |
$449.08
|
| Rate for Payer: Cigna Commercial |
$326.44
|
| Rate for Payer: Cigna Medicaid |
$40.14
|
| Rate for Payer: Cigna Medicare |
$144.10
|
| Rate for Payer: Employer Direct Commercial |
$144.10
|
| Rate for Payer: Humana Medicare/TRICARE |
$144.10
|
| Rate for Payer: Molina CHIP/Medicaid |
$40.14
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Molina Medicare |
$144.10
|
| Rate for Payer: Multiplan Auto |
$331.71
|
| Rate for Payer: Multiplan Commercial |
$331.71
|
| Rate for Payer: Multiplan Workers Comp |
$331.71
|
| Rate for Payer: Parkland Medicaid |
$40.14
|
| Rate for Payer: Scott and White EPO/PPO |
$2.58
|
| Rate for Payer: Scott and White Medicare |
$144.10
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$40.14
|
| Rate for Payer: Superior Health Plan EPO |
$144.10
|
| Rate for Payer: Superior Health Plan Medicare |
$144.10
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Universal American Medicare |
$144.10
|
| Rate for Payer: Wellcare Medicare |
$144.10
|
| Rate for Payer: Wellmed Medicare |
$144.10
|
|
|
CHED Orthopedic Splinting Site Posterior Long Arm Splint BC
|
Facility
|
IP
|
$510.32
|
|
|
Service Code
|
CPT 29105
|
| Hospital Charge Code |
8910642
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$449.08
|
|
|
CHED Orthopedic Splinting Site Posterior Long Leg Splint BC
|
Facility
|
IP
|
$591.52
|
|
|
Service Code
|
CPT 29505
|
| Hospital Charge Code |
8914627
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$520.54
|
|
|
CHED Orthopedic Splinting Site Posterior Long Leg Splint BC
|
Facility
|
OP
|
$591.52
|
|
|
Service Code
|
CPT 29505
|
| Hospital Charge Code |
8914627
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$384.49 |
| Rate for Payer: Aetna Commercial |
$325.34
|
| Rate for Payer: Aetna Medicare |
$216.15
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$53.24
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Amerigroup Medicare |
$144.10
|
| Rate for Payer: BCBS of TX Blue Advantage |
$97.03
|
| Rate for Payer: BCBS of TX Blue Essentials |
$116.20
|
| Rate for Payer: BCBS of TX Medicare |
$144.10
|
| Rate for Payer: BCBS of TX PPO |
$146.41
|
| Rate for Payer: Cash Price |
$520.54
|
| Rate for Payer: Cash Price |
$520.54
|
| Rate for Payer: Cash Price |
$520.54
|
| Rate for Payer: Cigna Commercial |
$326.44
|
| Rate for Payer: Cigna Medicaid |
$48.45
|
| Rate for Payer: Cigna Medicare |
$144.10
|
| Rate for Payer: Employer Direct Commercial |
$144.10
|
| Rate for Payer: Humana Medicare/TRICARE |
$144.10
|
| Rate for Payer: Molina CHIP/Medicaid |
$48.45
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Molina Medicare |
$144.10
|
| Rate for Payer: Multiplan Auto |
$384.49
|
| Rate for Payer: Multiplan Commercial |
$384.49
|
| Rate for Payer: Multiplan Workers Comp |
$384.49
|
| Rate for Payer: Parkland Medicaid |
$48.45
|
| Rate for Payer: Scott and White EPO/PPO |
$2.58
|
| Rate for Payer: Scott and White Medicare |
$144.10
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$48.45
|
| Rate for Payer: Superior Health Plan EPO |
$144.10
|
| Rate for Payer: Superior Health Plan Medicare |
$144.10
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Universal American Medicare |
$144.10
|
| Rate for Payer: Wellcare Medicare |
$144.10
|
| Rate for Payer: Wellmed Medicare |
$144.10
|
|
|
CHED Orthopedic Splinting Site Posterior Short Arm Splint B
|
Facility
|
IP
|
$618.22
|
|
|
Service Code
|
CPT 29125
|
| Hospital Charge Code |
8910643
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$544.03
|
|
|
CHED Orthopedic Splinting Site Posterior Short Arm Splint B
|
Facility
|
OP
|
$618.22
|
|
|
Service Code
|
CPT 29125
|
| Hospital Charge Code |
8910643
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$401.84 |
| Rate for Payer: Aetna Commercial |
$340.02
|
| Rate for Payer: Aetna Medicare |
$175.23
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$55.64
|
| 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 |
$544.03
|
| Rate for Payer: Cash Price |
$544.03
|
| Rate for Payer: Cash Price |
$544.03
|
| 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 |
$401.84
|
| Rate for Payer: Multiplan Commercial |
$401.84
|
| Rate for Payer: Multiplan Workers Comp |
$401.84
|
| 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 Orthopedic Splinting Site Posterior Short Leg Splint B
|
Facility
|
IP
|
$553.30
|
|
|
Service Code
|
CPT 29515
|
| Hospital Charge Code |
8910644
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$486.90
|
|
|
CHED Orthopedic Splinting Site Posterior Short Leg Splint B
|
Facility
|
OP
|
$553.30
|
|
|
Service Code
|
CPT 29515
|
| Hospital Charge Code |
8910644
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$359.64 |
| Rate for Payer: Aetna Commercial |
$304.32
|
| Rate for Payer: Aetna Medicare |
$216.15
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$49.80
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Amerigroup Medicare |
$144.10
|
| Rate for Payer: BCBS of TX Blue Advantage |
$70.51
|
| Rate for Payer: BCBS of TX Blue Essentials |
$84.44
|
| Rate for Payer: BCBS of TX Medicare |
$144.10
|
| Rate for Payer: BCBS of TX PPO |
$106.39
|
| Rate for Payer: Cash Price |
$486.90
|
| Rate for Payer: Cash Price |
$486.90
|
| Rate for Payer: Cash Price |
$486.90
|
| Rate for Payer: Cigna Commercial |
$326.44
|
| Rate for Payer: Cigna Medicaid |
$34.33
|
| Rate for Payer: Cigna Medicare |
$144.10
|
| Rate for Payer: Employer Direct Commercial |
$144.10
|
| Rate for Payer: Humana Medicare/TRICARE |
$144.10
|
| Rate for Payer: Molina CHIP/Medicaid |
$34.33
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Molina Medicare |
$144.10
|
| Rate for Payer: Multiplan Auto |
$359.64
|
| Rate for Payer: Multiplan Commercial |
$359.64
|
| Rate for Payer: Multiplan Workers Comp |
$359.64
|
| Rate for Payer: Parkland Medicaid |
$34.33
|
| Rate for Payer: Scott and White EPO/PPO |
$2.58
|
| Rate for Payer: Scott and White Medicare |
$144.10
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$34.33
|
| Rate for Payer: Superior Health Plan EPO |
$144.10
|
| Rate for Payer: Superior Health Plan Medicare |
$144.10
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Universal American Medicare |
$144.10
|
| Rate for Payer: Wellcare Medicare |
$144.10
|
| Rate for Payer: Wellmed Medicare |
$144.10
|
|
|
CHED Orthopedic Strapping Site Toes BCE
|
Facility
|
OP
|
$329.19
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
8912647
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$213.97 |
| Rate for Payer: Aetna Commercial |
$181.05
|
| Rate for Payer: Aetna Medicare |
$83.91
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$29.63
|
| 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 |
$289.69
|
| Rate for Payer: Cash Price |
$289.69
|
| Rate for Payer: Cash Price |
$289.69
|
| 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 |
$213.97
|
| Rate for Payer: Multiplan Commercial |
$213.97
|
| Rate for Payer: Multiplan Workers Comp |
$213.97
|
| 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 Orthopedic Strapping Site Toes BCE
|
Facility
|
IP
|
$329.19
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
8912647
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$289.69
|
|
|
CHED Orthopedic Strapping Site Unna boot BCE
|
Facility
|
OP
|
$476.78
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
8914628
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$326.44 |
| Rate for Payer: Aetna Commercial |
$262.23
|
| Rate for Payer: Aetna Medicare |
$216.15
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$42.91
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Amerigroup Medicare |
$144.10
|
| Rate for Payer: BCBS of TX Blue Advantage |
$70.51
|
| Rate for Payer: BCBS of TX Blue Essentials |
$84.44
|
| Rate for Payer: BCBS of TX Medicare |
$144.10
|
| Rate for Payer: BCBS of TX PPO |
$106.39
|
| Rate for Payer: Cash Price |
$419.57
|
| Rate for Payer: Cash Price |
$419.57
|
| Rate for Payer: Cash Price |
$419.57
|
| Rate for Payer: Cigna Commercial |
$326.44
|
| Rate for Payer: Cigna Medicaid |
$35.16
|
| Rate for Payer: Cigna Medicare |
$144.10
|
| Rate for Payer: Employer Direct Commercial |
$144.10
|
| Rate for Payer: Humana Medicare/TRICARE |
$144.10
|
| Rate for Payer: Molina CHIP/Medicaid |
$35.16
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Molina Medicare |
$144.10
|
| Rate for Payer: Multiplan Auto |
$309.91
|
| Rate for Payer: Multiplan Commercial |
$309.91
|
| Rate for Payer: Multiplan Workers Comp |
$309.91
|
| Rate for Payer: Parkland Medicaid |
$35.16
|
| Rate for Payer: Scott and White EPO/PPO |
$2.58
|
| Rate for Payer: Scott and White Medicare |
$144.10
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$35.16
|
| Rate for Payer: Superior Health Plan EPO |
$144.10
|
| Rate for Payer: Superior Health Plan Medicare |
$144.10
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$144.10
|
| Rate for Payer: Universal American Medicare |
$144.10
|
| Rate for Payer: Wellcare Medicare |
$144.10
|
| Rate for Payer: Wellmed Medicare |
$144.10
|
|
|
CHED Orthopedic Strapping Site Unna boot BCE
|
Facility
|
IP
|
$476.78
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
8914628
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$419.57
|
|
|
CHED Paracentesis with imaging BCE
|
Facility
|
IP
|
$2,613.56
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
8910646
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$2,299.93
|
|
|
CHED Paracentesis with imaging BCE
|
Facility
|
OP
|
$2,613.56
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
8910646
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$14.83 |
| Max. Negotiated Rate |
$2,200.00 |
| Rate for Payer: Aetna Commercial |
$2,200.00
|
| Rate for Payer: Aetna Medicare |
$1,243.53
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$235.22
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$829.02
|
| Rate for Payer: Amerigroup Medicare |
$829.02
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,312.49
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,571.84
|
| Rate for Payer: BCBS of TX Medicare |
$829.02
|
| Rate for Payer: BCBS of TX PPO |
$1,980.52
|
| Rate for Payer: Cash Price |
$2,299.93
|
| Rate for Payer: Cash Price |
$2,299.93
|
| Rate for Payer: Cash Price |
$2,299.93
|
| Rate for Payer: Cigna Commercial |
$1,877.98
|
| Rate for Payer: Cigna Medicaid |
$334.95
|
| Rate for Payer: Cigna Medicare |
$829.02
|
| Rate for Payer: Employer Direct Commercial |
$829.02
|
| Rate for Payer: Humana Medicare/TRICARE |
$829.02
|
| Rate for Payer: Molina CHIP/Medicaid |
$334.95
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$829.02
|
| Rate for Payer: Molina Medicare |
$829.02
|
| Rate for Payer: Multiplan Auto |
$1,698.81
|
| Rate for Payer: Multiplan Commercial |
$1,698.81
|
| Rate for Payer: Multiplan Workers Comp |
$1,698.81
|
| Rate for Payer: Parkland Medicaid |
$334.95
|
| Rate for Payer: Scott and White EPO/PPO |
$14.83
|
| Rate for Payer: Scott and White Medicare |
$829.02
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$334.95
|
| Rate for Payer: Superior Health Plan EPO |
$829.02
|
| Rate for Payer: Superior Health Plan Medicare |
$829.02
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$829.02
|
| Rate for Payer: Universal American Medicare |
$829.02
|
| Rate for Payer: Wellcare Medicare |
$829.02
|
| Rate for Payer: Wellmed Medicare |
$829.02
|
|
|
CHED Paracentesis without imaging BCE
|
Facility
|
OP
|
$2,308.91
|
|
|
Service Code
|
CPT 49082
|
| Hospital Charge Code |
8910647
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$14.83 |
| Max. Negotiated Rate |
$2,200.00 |
| Rate for Payer: Aetna Commercial |
$2,200.00
|
| Rate for Payer: Aetna Medicare |
$1,243.53
|
| Rate for Payer: Amerigroup CHIP/Medicaid |
$207.80
|
| Rate for Payer: Amerigroup Dual Medicare/Medicaid |
$829.02
|
| Rate for Payer: Amerigroup Medicare |
$829.02
|
| Rate for Payer: BCBS of TX Blue Advantage |
$1,312.49
|
| Rate for Payer: BCBS of TX Blue Essentials |
$1,571.84
|
| Rate for Payer: BCBS of TX Medicare |
$829.02
|
| Rate for Payer: BCBS of TX PPO |
$1,980.52
|
| Rate for Payer: Cash Price |
$2,031.84
|
| Rate for Payer: Cash Price |
$2,031.84
|
| Rate for Payer: Cash Price |
$2,031.84
|
| Rate for Payer: Cigna Commercial |
$1,877.98
|
| Rate for Payer: Cigna Medicaid |
$334.95
|
| Rate for Payer: Cigna Medicare |
$829.02
|
| Rate for Payer: Employer Direct Commercial |
$829.02
|
| Rate for Payer: Humana Medicare/TRICARE |
$829.02
|
| Rate for Payer: Molina CHIP/Medicaid |
$334.95
|
| Rate for Payer: Molina Dual Medicare/Medicaid |
$829.02
|
| Rate for Payer: Molina Medicare |
$829.02
|
| Rate for Payer: Multiplan Auto |
$1,500.79
|
| Rate for Payer: Multiplan Commercial |
$1,500.79
|
| Rate for Payer: Multiplan Workers Comp |
$1,500.79
|
| Rate for Payer: Parkland Medicaid |
$334.95
|
| Rate for Payer: Scott and White EPO/PPO |
$14.83
|
| Rate for Payer: Scott and White Medicare |
$829.02
|
| Rate for Payer: Superior Health Plan CHIP/Medicaid |
$334.95
|
| Rate for Payer: Superior Health Plan EPO |
$829.02
|
| Rate for Payer: Superior Health Plan Medicare |
$829.02
|
| Rate for Payer: Universal American Dual Medicare/Medicaid |
$829.02
|
| Rate for Payer: Universal American Medicare |
$829.02
|
| Rate for Payer: Wellcare Medicare |
$829.02
|
| Rate for Payer: Wellmed Medicare |
$829.02
|
|
