▸ Hospital · AL · CCN 011300
Washington County Hospital
ST. STEPHENS AVENUE, CHATOM, AL, 36518
15 bedsCritical Access Hospitals9
Compliance grade
A
97/100
Procedures tracked
194
of 209 target codes
Payers
5
with negotiated rates
Rates published
1,673
last crawl 2026-05-22
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 5 | — | $850 | $950 | $1,288 | $2,160.69 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 5 | — | $54.17 | $57 | $80 | $838.62 |
| Psychiatric eval with medical services | CPT | 90792 | 5 | — | $54.17 | $57 | $80 | $838.62 |
| Psychotherapy 30 minutes | CPT | 90832 | 5 | — | $54.17 | $57 | $80 | $386.79 |
| Psychotherapy 45 minutes | CPT | 90834 | 5 | — | $54.17 | $57 | $80 | $466.51 |
| Psychotherapy 60 minutes | CPT | 90837 | 5 | — | $54.17 | $57 | $80 | $466.51 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 5 | — | $54.17 | $57 | $80 | $466.51 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 4 | $205.98 | $54.17 | $117.4 | $159.63 | $185.38 |
| ED visit level 2 | CPT | 99282 | 4 | $373.95 | $54.17 | $213.15 | $289.81 | $336.55 |
| ED visit level 3 | CPT | 99283 | 4 | $657.3 | $54.17 | $374.66 | $509.41 | $591.57 |
| ED visit level 4 | CPT | 99284 | 4 | $1,066.59 | $54.17 | $607.95 | $826.61 | $959.93 |
| ED visit level 5 | CPT | 99285 | 4 | $1,562.55 | $54.17 | $890.65 | $1,210.98 | $1,406.29 |
| Critical care, first hour | CPT | 99291 | 4 | $2,078.04 | $54.17 | $1,184.48 | $1,610.48 | $1,870.23 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 5 | $520.74 | $54.17 | $147.45 | $372.3 | $468.66 |
| CT head with contrast | CPT | 70460 | 5 | $891.45 | $54.17 | $207.05 | $508.12 | $802.3 |
| CT head with and without contrast | CPT | 70470 | 5 | $988.02 | $54.17 | $243.2 | $563.17 | $889.21 |
| CT neck with contrast | CPT | 70491 | 5 | $891.45 | $54.17 | $191.87 | $508.12 | $802.3 |
| MRI brain without contrast | CPT | 70551 | 5 | — | $54.17 | $57 | $90 | $7,955.52 |
| MRI brain with contrast | CPT | 70552 | 5 | — | $54.17 | $57 | $90 | $7,955.52 |
| MRI brain with and without contrast | CPT | 70553 | 5 | — | $54.17 | $57 | $90 | $7,955.52 |
| Chest X-ray single view | CPT | 71045 | 5 | $186.36 | $54.17 | $32.92 | $149.08 | $182.71 |
| Chest X-ray 2 views | CPT | 71046 | 5 | $186.36 | $54.17 | $22.8 | $74.45 | $182.71 |
| Chest X-ray 3 views | CPT | 71047 | 5 | $186.36 | $54.17 | $53.72 | $149.08 | $182.71 |
| CT chest without contrast | CPT | 71250 | 5 | $520.74 | $54.17 | $185.39 | $296.82 | $468.66 |
| CT chest with contrast | CPT | 71260 | 5 | $891.45 | $54.17 | $191.87 | $508.12 | $802.3 |
| CT chest with and without contrast | CPT | 71270 | 5 | $988.02 | $54.17 | $191.87 | $563.17 | $889.21 |
| MRI chest without contrast | CPT | 71550 | 5 | — | $54.17 | $57 | $90 | $1,424.14 |
| MRI chest with contrast | CPT | 71551 | 5 | — | $54.17 | $57 | $90 | $1,424.14 |
| MRI chest with and without contrast | CPT | 71552 | 5 | — | $54.17 | $57 | $90 | $1,424.14 |
| Lumbosacral spine X-ray | CPT | 72100 | 5 | $343.38 | $54.17 | $50.55 | $195.72 | $309.04 |
| CT cervical spine without contrast | CPT | 72125 | 4 | $520.74 | $54.17 | $181.46 | $356.71 | $468.66 |
| CT thoracic spine without contrast | CPT | 72128 | 4 | $520.74 | $54.17 | $181.02 | $356.71 | $468.66 |
| CT lumbar spine without contrast | CPT | 72131 | 4 | $520.74 | $54.17 | $180.59 | $356.71 | $468.66 |
| MRI cervical spine without contrast | CPT | 72141 | 4 | — | $54.17 | $57 | $85 | $288.69 |
| MRI thoracic spine without contrast | CPT | 72146 | 4 | — | $54.17 | $57 | $85 | $288.22 |
| MRI lumbar spine without contrast | CPT | 72148 | 4 | — | $54.17 | $57 | $85 | $289.15 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 4 | — | $54.17 | $57 | $85 | $408.65 |
| MRI cervical spine with and without contrast | CPT | 72156 | 4 | — | $54.17 | $57 | $85 | $484.09 |
| MRI lumbar spine with contrast | CPT | 72158 | 4 | — | $54.17 | $57 | $85 | $482.69 |
| CT pelvis without contrast | CPT | 72192 | 5 | $520.74 | $54.17 | $185.88 | $416.59 | $1,008.55 |
| CT pelvis with contrast | CPT | 72193 | 5 | $891.45 | $54.17 | $307.58 | $713.16 | $1,008.55 |
| Shoulder X-ray | CPT | 73030 | 5 | — | $54.17 | $43.7 | $80 | $182.71 |
| Humerus X-ray | CPT | 73060 | 5 | — | $54.17 | $40.28 | $80 | $182.71 |
| Hand X-ray 3 views | CPT | 73130 | 5 | — | $54.17 | $46.14 | $80 | $182.71 |
| MRI upper extremity joint without contrast | CPT | 73221 | 5 | — | $54.17 | $57 | $90 | $812.68 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 5 | — | $54.17 | $57 | $90 | $812.68 |
| Knee X-ray 1-2 views | CPT | 73560 | 5 | — | $54.17 | $43.18 | $80 | $182.71 |
| Ankle X-ray 3 views | CPT | 73610 | 5 | — | $54.17 | $46.55 | $80 | $182.71 |
| MRI lower extremity joint without contrast | CPT | 73721 | 5 | — | $54.17 | $57 | $90 | $812.68 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 5 | — | $54.17 | $57 | $90 | $812.68 |
| CT abdomen without contrast | CPT | 74150 | 5 | $520.74 | $54.17 | $192.14 | $416.59 | $1,008.55 |
| CT abdomen with contrast | CPT | 74160 | 5 | $891.45 | $54.17 | $315.63 | $713.16 | $1,008.55 |
| CT abdomen with and without contrast | CPT | 74170 | 5 | $988.02 | $54.17 | $324.24 | $790.41 | $1,008.55 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 5 | $918.15 | $54.17 | $256.72 | $734.52 | $1,008.55 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 5 | $1,447.74 | $54.17 | $430.42 | $1,008.55 | $1,302.96 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 5 | $1,447.74 | $54.17 | $481.65 | $1,008.55 | $1,302.96 |
| MRI abdomen without contrast | CPT | 74181 | 4 | — | $54.17 | $57 | $85 | $296.02 |
| MRI abdomen with and without contrast | CPT | 74183 | 4 | — | $54.17 | $57 | $85 | $513 |
| Abdominal ultrasound complete | CPT | 76700 | 5 | $555.63 | $54.17 | $150.76 | $353.03 | $500.06 |
| Abdominal ultrasound limited | CPT | 76705 | 5 | $343.38 | $54.17 | $112.69 | $274.7 | $353.03 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 5 | — | $54.17 | $57 | $90 | $353.03 |
| Obstetric ultrasound first trimester | CPT | 76801 | 5 | $404 | $54.17 | $151.29 | $323.2 | $363.6 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 5 | $404 | $54.17 | $173.28 | $323.2 | $363.6 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 5 | — | $54.17 | $57 | $90 | $324.42 |
| Transvaginal ultrasound | CPT | 76830 | 5 | $343.08 | $54.17 | $153.45 | $274.46 | $353.03 |
| Pelvic ultrasound complete | CPT | 76856 | 5 | $343.38 | $54.17 | $136.03 | $274.7 | $353.03 |
| Scrotal ultrasound | CPT | 76870 | 5 | $343.38 | $54.17 | $129.54 | $274.7 | $353.03 |
| Diagnostic mammography unilateral | CPT | 77065 | 5 | $404.91 | $54.17 | $160.3 | $230.79 | $364.41 |
| Diagnostic mammography bilateral | CPT | 77066 | 5 | $477.45 | $54.17 | $161.54 | $315.27 | $429.7 |
| Screening mammography bilateral | CPT | 77067 | 5 | $400.92 | $54.17 | $71.25 | $162.24 | $360.82 |
| EKG complete | CPT | 93000 | 5 | — | $54.17 | $57 | $80 | $90 |
| EKG tracing only | CPT | 93005 | 5 | $167.88 | $54.17 | $84.11 | $125.91 | $151.09 |
| EKG interpretation only | CPT | 93010 | 5 | — | $54.17 | $57 | $80 | $90 |
| Transthoracic echocardiogram complete | CPT | 93306 | 5 | $1,460.07 | $54.17 | $832.23 | $1,168.05 | $1,480.98 |
| Transthoracic echocardiogram | CPT | 93307 | 5 | — | $54.17 | $57 | $80 | $1,480.98 |
| Stress echocardiogram | CPT | 93350 | 5 | — | $54.17 | $57 | $80 | $1,480.98 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| COPD w MCC | MS-DRG | 190 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| COPD w CC | MS-DRG | 191 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| COPD w/o CC/MCC | MS-DRG | 192 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| AMI discharged alive w MCC | MS-DRG | 280 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| AMI discharged alive w CC | MS-DRG | 281 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Heart failure & shock w MCC | MS-DRG | 291 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Heart failure & shock w CC | MS-DRG | 292 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| GI hemorrhage w CC | MS-DRG | 378 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Kidney/UTI w MCC | MS-DRG | 689 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Initial hospital care, low complexity | CPT | 99221 | 4 | $283.59 | $54.17 | $146.39 | $209.08 | $255.23 |
| Initial hospital care, moderate complexity | CPT | 99222 | 4 | $386.88 | $54.17 | $220.52 | $299.83 | $348.19 |
| Initial hospital care, high complexity | CPT | 99223 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Hospital discharge, <30 min | CPT | 99238 | 4 | $188.79 | $54.17 | $107.61 | $146.31 | $169.91 |
| Hospital discharge, >30 min | CPT | 99239 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 5 | $80 | $54.17 | $9.73 | $42.59 | $72 |
| General health panel | CPT | 80050 | 5 | — | $54.17 | $26.51 | $57 | $90 |
| Electrolyte panel | CPT | 80051 | 5 | $41.52 | $54.17 | $8.06 | $26.51 | $37.36 |
| Comprehensive metabolic panel | CPT | 80053 | 5 | $62.58 | $54.17 | $12.14 | $35.67 | $56.32 |
| Lipid panel | CPT | 80061 | 5 | $49.8 | $54.17 | $15.4 | $28.38 | $44.82 |
| Renal function panel | CPT | 80069 | 5 | $51.39 | $54.17 | $9.98 | $29.29 | $46.25 |
| Hepatic function panel | CPT | 80076 | 5 | $80 | $54.17 | $9.4 | $41.1 | $72 |
| Urinalysis non-automated | CPT | 81002 | 4 | — | $54.17 | $4 | $68.5 | $90 |
| Urinalysis automated | CPT | 81003 | 4 | — | $54.17 | $2.59 | $68.5 | $90 |
| Glucose quantitative | CPT | 82947 | 5 | $23.22 | $54.17 | $4.52 | $15.64 | $20.89 |
| Hemoglobin A1c | CPT | 83036 | 5 | $54.45 | $54.17 | $11.17 | $38.72 | $49 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 5 | $99.45 | $54.17 | $19.32 | $56.68 | $89.5 |
| Complete blood count with automated differential | CPT | 85025 | 5 | $45 | $54.17 | $8.94 | $25.65 | $40.5 |
| Complete blood count without differential | CPT | 85027 | 5 | $36 | $54.17 | $7.44 | $20.52 | $32.4 |
| Urine culture bacterial | CPT | 87086 | 5 | $47.79 | $54.17 | $9.28 | $27.24 | $43.01 |
| Urine culture identification | CPT | 87088 | 5 | — | $54.17 | $9.3 | $57 | $90 |
| Tissue exam by pathologist level IV | CPT | 88305 | 5 | $144 | $54.17 | $30.71 | $82.08 | $129.6 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 5 | — | $54.17 | $57 | $80 | $588.01 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Vaginal delivery only | CPT | 59409 | 5 | — | $54.17 | $57 | $80 | $6,928.28 |
| Vaginal delivery with postpartum | CPT | 59410 | 5 | — | $54.17 | $57 | $80 | $6,928.28 |
| Routine obstetric care with C-section | CPT | 59510 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| C-section delivery only | CPT | 59514 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| C-section with postpartum | CPT | 59515 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 4 | $221.04 | $54.17 | $125.99 | $171.31 | $198.93 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 4 | $290.88 | $54.17 | $165.8 | $225.43 | $261.79 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Office visit, established patient, 5 min | CPT | 99211 | 4 | $170.31 | $54.17 | $14.97 | $48.61 | $153.27 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 4 | $221.04 | $54.17 | $125.99 | $171.31 | $198.93 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 4 | $221.04 | $54.17 | $125.99 | $171.31 | $198.93 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 5 | — | $54.17 | $57 | $80 | $3,052.74 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 5 | — | $54.17 | $57 | $80 | $3,052.74 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Colonoscopy diagnostic | CPT | 45378 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Colonoscopy with biopsy | CPT | 45380 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Colonoscopy with polyp removal | CPT | 45385 | 5 | — | $54.17 | $57 | $80 | $6,531.95 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 5 | — | $54.17 | $57 | $80 | $29,754 |
| Hip hemiarthroplasty | CPT | 27125 | 5 | — | $54.17 | $57 | $80 | $29,754 |
| Total hip replacement | CPT | 27130 | 5 | — | $54.17 | $57 | $80 | $29,754 |
| Total knee replacement | CPT | 27447 | 5 | — | $54.17 | $57 | $80 | $29,754 |
| Knee revision arthroplasty single component | CPT | 27486 | 5 | — | $54.17 | $57 | $80 | $29,754 |
| Knee revision arthroplasty all components | CPT | 27487 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 5 | — | $54.17 | $57 | $80 | $7,134.64 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 5 | — | $54.17 | $57 | $80 | $17,847 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 5 | — | $54.17 | $57 | $80 | $7,134.64 |
| ACL reconstruction | CPT | 29888 | 5 | — | $54.17 | $57 | $80 | $17,847 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| CABG single arterial graft | CPT | 33533 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| CABG 2 arterial grafts | CPT | 33534 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| CABG 3 arterial grafts | CPT | 33535 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| CABG 4+ arterial grafts | CPT | 33536 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Open appendectomy | CPT | 44950 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Laparoscopic appendectomy | CPT | 44970 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Major joint replacement w MCC | MS-DRG | 469 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Laparoscopic cholecystectomy | CPT | 47562 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Lap inguinal hernia repair | CPT | 49650 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Total abdominal hysterectomy | CPT | 58150 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Vaginal hysterectomy | CPT | 58260 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| Lap salpingo-oophorectomy | CPT | 58661 | 4 | — | $54.17 | $57 | $77.5 | $90 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| OR procedure for obesity w CC | MS-DRG | 620 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Complex cataract surgery | CPT | 66982 | 5 | — | $54.17 | $57 | $80 | $5,502.03 |
| Cataract surgery with lens implant | CPT | 66984 | 5 | — | $54.17 | $57 | $80 | $5,502.03 |
| Intravitreal injection | CPT | 67028 | 5 | — | $54.17 | $57 | $80 | $1,005.88 |
| Vitrectomy mechanical | CPT | 67042 | 5 | — | $54.17 | $57 | $80 | $10,287 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 5 | — | $850 | $975 | $2,160.69 | $3,129 |
| PCI single major coronary artery | CPT | 92920 | 5 | — | $54.17 | $57 | $80 | $27,447 |
| PCI with drug-eluting stent | CPT | 92928 | 5 | — | $54.17 | $57 | $80 | $27,447 |
| PCI bypass graft | CPT | 92937 | 5 | — | $54.17 | $57 | $80 | $27,447 |
| Left heart catheterization | CPT | 93452 | 5 | — | $54.17 | $57 | $80 | $7,513.23 |
| Coronary angiography with cath | CPT | 93455 | 5 | — | $54.17 | $57 | $80 | $7,513.23 |
| Coronary angiography with bypass cath | CPT | 93458 | 5 | — | $54.17 | $57 | $80 | $7,513.23 |
Payer mix (top 5)
| Payer | Codes covered | Median rate |
|---|---|---|
| Aetna | 194 | $140.6 |
| blue advantage | 194 | $80 |
| Humana | 194 | $90 |
| UnitedHealthcare | 194 | $57 |
| Blue Cross Blue Shield | 138 | $1,424.14 |