▸ Hospital · TX · CCN 451360
Chi St Lukes Health Memorial San Augustine
HOSPITAL DR, SAN AUGUSTINE, TX, 451360
10 beds1
Compliance grade
A
100/100
Procedures tracked
184
of 209 target codes
Payers
11
with negotiated rates
Rates published
4,779
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 2 | — | — | $8,412.28 | $9,598.26 | $10,784 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 9 | $478 | $167.3 | $4.08 | $34.15 | $430.2 |
| ED visit level 2 | CPT | 99282 | 9 | $696 | $243.6 | $80.95 | $428 | $626.4 |
| ED visit level 3 | CPT | 99283 | 9 | $1,615 | $565.25 | $30.82 | $236.81 | $1,485 |
| ED visit level 4 | CPT | 99284 | 8 | $2,833 | $991.55 | $1,160 | $2,180 | $3,276 |
| ED visit level 5 | CPT | 99285 | 8 | $3,449 | $1,207.15 | $2,231.51 | $2,880 | $4,368 |
| Critical care, first hour | CPT | 99291 | 8 | $4,680 | $1,638 | $2,880 | $3,276 | $4,368 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 9 | $3,735 | $1,307.25 | $109.6 | $2,285.74 | $3,361.5 |
| CT head with contrast | CPT | 70460 | 9 | $4,333 | $1,516.55 | $154.36 | $2,651.94 | $3,899.7 |
| CT head with and without contrast | CPT | 70470 | 9 | $5,110 | $1,788.5 | $181.1 | $3,230.97 | $4,599 |
| CT neck with contrast | CPT | 70491 | 9 | $4,580 | $1,603 | $192.13 | $2,803.31 | $4,122 |
| MRI brain without contrast | CPT | 70551 | 9 | $6,236 | $2,182.6 | $218.85 | $758.5 | $5,612.4 |
| MRI brain with contrast | CPT | 70552 | 9 | $7,027 | $2,459.45 | $252.74 | $825.2 | $6,324.3 |
| MRI brain with and without contrast | CPT | 70553 | 9 | $8,381.42 | $2,933.5 | $357.85 | $4,891.4 | $7,543.28 |
| Chest X-ray single view | CPT | 71045 | 9 | $612 | $214.2 | $20.71 | $395.97 | $550.8 |
| Chest X-ray 2 views | CPT | 71046 | 9 | $759 | $265.65 | $28.74 | $491.08 | $683.1 |
| Chest X-ray 3 views | CPT | 71047 | 9 | $760 | $266 | $36.75 | $475.2 | $684 |
| CT chest without contrast | CPT | 71250 | 9 | $3,403 | $1,191.05 | $114.46 | $2,181.77 | $3,062.7 |
| CT chest with contrast | CPT | 71260 | 9 | $4,528.44 | $1,584.96 | $185.78 | $825.2 | $4,075.6 |
| CT chest with and without contrast | CPT | 71270 | 9 | $5,572 | $1,950.2 | $222.54 | $825.2 | $5,014.8 |
| MRI chest without contrast | CPT | 71550 | 9 | $4,918 | $1,721.3 | $232.31 | $3,067.04 | $4,426.2 |
| MRI chest with contrast | CPT | 71551 | 9 | $5,312 | $1,859.2 | $432.7 | $2,102.18 | $4,780.8 |
| MRI chest with and without contrast | CPT | 71552 | 9 | $7,482.24 | $2,618.79 | $456.37 | $4,579.41 | $6,734.02 |
| Lumbosacral spine X-ray | CPT | 72100 | 9 | $1,004 | $351.4 | $33.08 | $644.74 | $903.6 |
| CT cervical spine without contrast | CPT | 72125 | 9 | $4,074 | $1,425.9 | $114.46 | $2,493.3 | $3,666.6 |
| CT thoracic spine without contrast | CPT | 72128 | 9 | $4,074 | $1,425.9 | $114.46 | $2,493.3 | $3,666.6 |
| CT lumbar spine without contrast | CPT | 72131 | 9 | $4,074 | $1,425.9 | $114.46 | $373.71 | $3,666.6 |
| MRI cervical spine without contrast | CPT | 72141 | 9 | $5,496 | $1,923.6 | $212.84 | $758.5 | $4,946.4 |
| MRI thoracic spine without contrast | CPT | 72146 | 9 | $5,496 | $1,923.6 | $213.18 | $758.5 | $4,946.4 |
| MRI lumbar spine without contrast | CPT | 72148 | 9 | $5,496 | $1,923.6 | $212.84 | $758.5 | $4,946.4 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 9 | $4,728 | $1,654.8 | $305.06 | $1,490.05 | $4,255.2 |
| MRI cervical spine with and without contrast | CPT | 72156 | 9 | $8,551 | $2,992.85 | $359.86 | $1,490.05 | $7,695.9 |
| MRI lumbar spine with contrast | CPT | 72158 | 9 | $7,828 | $2,739.8 | $359.19 | $1,490.05 | $7,045.2 |
| CT pelvis without contrast | CPT | 72192 | 9 | $4,000 | $1,400 | $114.46 | $373.71 | $3,600 |
| CT pelvis with contrast | CPT | 72193 | 9 | $4,331 | $1,515.85 | $213.51 | $825.2 | $3,897.9 |
| Shoulder X-ray | CPT | 73030 | 9 | $848 | $296.8 | $27.74 | $544.46 | $763.2 |
| Humerus X-ray | CPT | 73060 | 9 | $818 | $286.3 | $27.4 | $154.37 | $736.2 |
| Hand X-ray 3 views | CPT | 73130 | 9 | $794 | $277.9 | $30.08 | $154.37 | $714.6 |
| MRI upper extremity joint without contrast | CPT | 73221 | 9 | $5,506 | $1,927.1 | $224.88 | $3,369.78 | $4,955.4 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 9 | $7,953 | $2,783.55 | $445.4 | $4,866.95 | $7,157.7 |
| Knee X-ray 1-2 views | CPT | 73560 | 9 | $704 | $246.4 | $29.4 | $404.78 | $633.6 |
| Ankle X-ray 3 views | CPT | 73610 | 9 | $869 | $304.15 | $29.74 | $154.37 | $782.1 |
| MRI lower extremity joint without contrast | CPT | 73721 | 9 | $5,739 | $2,008.65 | $224.88 | $3,512.56 | $5,165.1 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 9 | $7,949 | $2,782.15 | $444.73 | $1,490.05 | $7,154.1 |
| CT abdomen without contrast | CPT | 74150 | 9 | $3,568 | $1,248.8 | $114.46 | $373.71 | $3,211.2 |
| CT abdomen with contrast | CPT | 74160 | 9 | $5,013 | $1,754.55 | $218.19 | $825.2 | $4,511.7 |
| CT abdomen with and without contrast | CPT | 74170 | 9 | $5,875 | $2,056.25 | $248.26 | $825.2 | $5,287.5 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 9 | $6,938 | $2,428.3 | $189.79 | $3,390 | $6,244.2 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 9 | $7,204 | $2,521.4 | $252.74 | $825.2 | $6,483.6 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 9 | $8,393 | $2,937.55 | $252.74 | $5,137.3 | $7,553.7 |
| MRI abdomen without contrast | CPT | 74181 | 9 | $6,073 | $2,125.55 | $232.31 | $758.5 | $5,465.7 |
| MRI abdomen with and without contrast | CPT | 74183 | 9 | $7,304 | $2,556.4 | $404.3 | $1,490.05 | $6,573.6 |
| Abdominal ultrasound complete | CPT | 76700 | 9 | $1,797 | $628.95 | $114.46 | $309.05 | $1,617.3 |
| Abdominal ultrasound limited | CPT | 76705 | 9 | $1,541 | $539.35 | $87.21 | $294.75 | $1,386.9 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 9 | $1,816 | $635.6 | $107.93 | $309.05 | $1,634.4 |
| Obstetric ultrasound first trimester | CPT | 76801 | 9 | $1,379.16 | $482.71 | $114.46 | $203.5 | $1,241.25 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 9 | $1,247.4 | $436.59 | $114.46 | $253.89 | $1,122.66 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 9 | $1,984 | $694.4 | $114.46 | $1,259.07 | $1,785.6 |
| Transvaginal ultrasound | CPT | 76830 | 9 | $1,429 | $500.15 | $114.46 | $906.78 | $1,286.1 |
| Pelvic ultrasound complete | CPT | 76856 | 9 | $1,586 | $555.1 | $96.28 | $309.05 | $1,427.4 |
| Scrotal ultrasound | CPT | 76870 | 9 | $1,567 | $548.45 | $64.49 | $309.05 | $1,410.3 |
| Diagnostic mammography unilateral | CPT | 77065 | 9 | $532 | $186.2 | $82.82 | $278.95 | $478.8 |
| Diagnostic mammography bilateral | CPT | 77066 | 9 | $658 | $230.3 | $105.92 | $376.6 | $592.2 |
| Screening mammography bilateral | CPT | 77067 | 9 | $458 | $160.3 | $87.57 | $271.43 | $412.2 |
| EKG tracing only | CPT | 93005 | 7 | $693 | $242.55 | $110.8 | $449.4 | $623.7 |
| Transthoracic echocardiogram complete | CPT | 93306 | 7 | $4,833 | $1,691.55 | $274.29 | $3,132.5 | $4,349.7 |
| Transthoracic echocardiogram | CPT | 93307 | 9 | $1,795 | $628.25 | $132.65 | $228.81 | $1,615.5 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 2 | — | — | $12,548 | $14,664 | $16,781 |
| COPD w MCC | MS-DRG | 190 | 2 | — | — | $7,642.52 | $8,896.62 | $10,151 |
| COPD w CC | MS-DRG | 191 | 2 | — | — | $6,005.08 | $6,963.45 | $7,921.81 |
| COPD w/o CC/MCC | MS-DRG | 192 | 2 | — | — | $4,725.32 | $5,509.03 | $6,292.73 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 2 | — | — | $5,868.4 | $6,876.48 | $7,884.55 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 2 | — | — | $4,522 | $5,287.14 | $6,052.27 |
| AMI discharged alive w MCC | MS-DRG | 280 | 2 | — | — | $11,058 | $12,765 | $14,471 |
| AMI discharged alive w CC | MS-DRG | 281 | 2 | — | — | $6,338.28 | $7,466.78 | $8,595.28 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 2 | — | — | $4,933.4 | $5,740.4 | $6,547.39 |
| Heart failure & shock w MCC | MS-DRG | 291 | 2 | — | — | $9,118.12 | $10,530 | $11,941 |
| Heart failure & shock w CC | MS-DRG | 292 | 2 | — | — | $6,086.68 | $7,060.59 | $8,034.5 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 2 | — | — | $4,437.68 | $5,126.08 | $5,814.48 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 2 | — | — | $8,155.24 | $9,346.85 | $10,538 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 2 | — | — | $5,095.92 | $5,903.29 | $6,710.65 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 2 | — | — | $3,797.12 | $4,379.9 | $4,962.67 |
| GI hemorrhage w CC | MS-DRG | 378 | 2 | — | — | $6,753.76 | $7,760.59 | $8,767.41 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 2 | — | — | $4,332.28 | $5,030.79 | $5,729.3 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 2 | — | — | $5,197.92 | $5,977.36 | $6,756.79 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 2 | — | — | $9,605.68 | $11,277 | $12,949 |
| Kidney/UTI w MCC | MS-DRG | 689 | 2 | — | — | $7,556.84 | $8,741.09 | $9,925.34 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 2 | — | — | $5,386.96 | $6,201.87 | $7,016.77 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 2 | — | — | $12,704 | $14,632 | $16,560 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 2 | — | — | $6,946.88 | $8,084.3 | $9,221.71 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 11 | $542 | $189.7 | $7.11 | $23.2 | $487.8 |
| Electrolyte panel | CPT | 80051 | 11 | $525 | $183.75 | $5.89 | $13.47 | $472.5 |
| Comprehensive metabolic panel | CPT | 80053 | 11 | $886 | $310.1 | $7.77 | $20.65 | $797.4 |
| Lipid panel | CPT | 80061 | 11 | $482 | $168.7 | $11 | $20.3 | $433.8 |
| Renal function panel | CPT | 80069 | 11 | $542 | $189.7 | $7.29 | $24.07 | $487.8 |
| Hepatic function panel | CPT | 80076 | 11 | $512 | $179.2 | $6.86 | $29.49 | $460.8 |
| Urinalysis automated | CPT | 81003 | 11 | $96 | $33.6 | $1.89 | $9 | $86.4 |
| Glucose quantitative | CPT | 82947 | 11 | $163 | $57.05 | $3.3 | $11.48 | $146.7 |
| Hemoglobin A1c | CPT | 83036 | 11 | $297 | $103.95 | $7.77 | $15.4 | $267.3 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 11 | $376 | $131.6 | $7.77 | $22.33 | $338.4 |
| Complete blood count with automated differential | CPT | 85025 | 11 | $332 | $116.2 | $6.53 | $19.55 | $298.8 |
| Complete blood count without differential | CPT | 85027 | 11 | $261 | $91.35 | $5.43 | $12.16 | $234.9 |
| Urine culture bacterial | CPT | 87086 | 11 | $351 | $122.85 | $6.78 | $31.48 | $315.9 |
| Tissue exam by pathologist level IV | CPT | 88305 | 9 | $777 | $271.95 | $52.12 | $153.33 | $699.3 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 9 | $628 | $219.8 | $13.62 | $43.29 | $565.2 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 1 | — | — | $1,354.78 | $3,010.63 | $3,440.72 |
| Vaginal delivery only | CPT | 59409 | 2 | — | — | $1,431.85 | $3,090.97 | $3,636.43 |
| Vaginal delivery with postpartum | CPT | 59410 | 1 | — | — | $676.94 | $1,504.31 | $1,719.22 |
| Routine obstetric care with C-section | CPT | 59510 | 1 | — | — | $1,502.65 | $3,339.23 | $3,816.26 |
| C-section delivery only | CPT | 59514 | 2 | — | — | $596.67 | $1,363.82 | $2,826 |
| C-section with postpartum | CPT | 59515 | 1 | — | — | $822.32 | $1,827.38 | $2,088.43 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 7 | $410 | $143.5 | $47 | $234.54 | $369 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 7 | $477 | $166.95 | $81.53 | $273.69 | $429.3 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 7 | $631 | $220.85 | $47 | $407.48 | $567.9 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 7 | $1,646 | $576.1 | $47 | $617.75 | $1,481.4 |
| Office visit, established patient, 5 min | CPT | 99211 | 7 | $265 | $92.75 | $18.47 | $171.8 | $238.5 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 7 | $355 | $124.25 | $47 | $224.75 | $319.5 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 7 | $437 | $152.95 | $53.06 | $250.39 | $393.3 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 7 | $514 | $179.9 | $47 | $325.53 | $462.6 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 7 | $1,563 | $547.05 | $47 | $523.5 | $1,406.7 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 9 | $3,238.4 | $1,133.44 | $275.42 | $1,130.11 | $2,914.56 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 4 | — | — | $275.42 | $378.8 | $2,007 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 4 | — | — | $87.32 | $275.42 | $1,392 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 4 | — | — | $275.42 | $368.24 | $1,392 |
| Colonoscopy diagnostic | CPT | 45378 | 4 | — | — | $275.42 | $368.24 | $2,007 |
| Colonoscopy with biopsy | CPT | 45380 | 4 | — | — | $368.78 | $488.58 | $2,007 |
| Colonoscopy with polyp removal | CPT | 45385 | 4 | — | — | $368.78 | $488.58 | $2,007 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 2 | — | — | $949.84 | $2,171.06 | $2,826 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 2 | — | — | $21,255 | $24,704 | $28,152 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 2 | — | — | $13,520 | $15,787 | $18,054 |
| Hip hemiarthroplasty | CPT | 27125 | 2 | — | — | $739.57 | $1,690.44 | $2,826 |
| Total hip replacement | CPT | 27130 | 2 | — | — | $885.4 | $2,023.78 | $2,826 |
| Total knee replacement | CPT | 27447 | 2 | — | — | $2,826 | $13,767 | $16,197 |
| Knee revision arthroplasty single component | CPT | 27486 | 2 | — | — | $917.96 | $2,098.2 | $2,826 |
| Knee revision arthroplasty all components | CPT | 27487 | 2 | — | — | $1,148.13 | $2,624.3 | $2,915.89 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 1 | — | — | $2,293 | $2,293 | $2,293 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 4 | — | — | $1,073.68 | $2,329.7 | $8,970.27 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 4 | — | — | $877.23 | $1,293.79 | $4,232.37 |
| ACL reconstruction | CPT | 29888 | 4 | — | — | $1,073.68 | $1,710.18 | $8,970.27 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 2 | — | — | $32,982 | $38,262 | $43,542 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 2 | — | — | $17,265 | $19,843 | $22,420 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 2 | — | — | $11,629 | $13,308 | $14,988 |
| CABG single arterial graft | CPT | 33533 | 2 | — | — | $1,222.29 | $2,793.8 | $3,104.22 |
| CABG 2 arterial grafts | CPT | 33534 | 2 | — | — | $1,437.99 | $3,104.23 | $3,652.03 |
| CABG 3 arterial grafts | CPT | 33535 | 2 | — | — | $1,602.13 | $3,458.58 | $4,068.91 |
| CABG 4+ arterial grafts | CPT | 33536 | 2 | — | — | $1,720.84 | $3,714.83 | $4,370.38 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 2 | — | — | $11,479 | $13,144 | $14,808 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 2 | — | — | $8,943.36 | $10,269 | $11,595 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 2 | — | — | $23,896 | $27,186 | $30,477 |
| Open appendectomy | CPT | 44950 | 2 | — | — | $1,834.03 | $3,959.18 | $4,657.86 |
| Laparoscopic appendectomy | CPT | 44970 | 2 | — | — | $2,826 | $6,104.6 | $7,181.89 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 2 | — | — | $45,776 | $53,287 | $60,798 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 2 | — | — | $26,742 | $30,941 | $35,141 |
| Major joint replacement w MCC | MS-DRG | 469 | 2 | — | — | $20,974 | $24,417 | $27,860 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 2 | — | — | $12,919 | $15,192 | $17,466 |
| Laparoscopic cholecystectomy | CPT | 47562 | 4 | — | — | $1,073.68 | $1,977.62 | $7,181.89 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 4 | — | — | $1,073.68 | $1,977.62 | $7,181.89 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 2 | — | — | $20,567 | $23,675 | $26,783 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 2 | — | — | $14,249 | $16,387 | $18,525 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 2 | — | — | $11,198 | $12,898 | $14,599 |
| Open umbilical hernia repair | CPT | 49560 | 4 | — | — | $877.23 | $1,377.56 | $4,657.86 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 4 | — | — | $877.23 | $1,377.56 | $4,657.86 |
| Lap inguinal hernia repair | CPT | 49650 | 4 | — | — | $1,073.68 | $1,976.68 | $7,181.89 |
| Lap incisional hernia repair | CPT | 49652 | 4 | — | — | $1,073.68 | $1,977.62 | $7,181.89 |
| Total abdominal hysterectomy | CPT | 58150 | 2 | — | — | $654.56 | $1,496.13 | $2,826 |
| Vaginal hysterectomy | CPT | 58260 | 4 | — | — | $1,073.68 | $1,858.9 | $7,043 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 4 | — | — | $1,073.68 | $1,977.62 | $7,181.89 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 4 | — | — | $1,073.68 | $2,333.18 | $12,153 |
| Lap salpingo-oophorectomy | CPT | 58661 | 4 | — | — | $1,073.68 | $1,977.62 | $7,181.89 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 2 | — | — | $20,815 | $24,066 | $27,316 |
| OR procedure for obesity w CC | MS-DRG | 620 | 2 | — | — | $11,975 | $13,949 | $15,923 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 2 | — | — | $10,856 | $12,402 | $13,948 |
| Complex cataract surgery | CPT | 66982 | 4 | — | — | $755.85 | $1,001.97 | $6,798 |
| Cataract surgery with lens implant | CPT | 66984 | 4 | — | — | $755.85 | $1,001.97 | $6,798 |
| Intravitreal injection | CPT | 67028 | 4 | — | — | $30.62 | $275.42 | $1,392 |
| Vitrectomy mechanical | CPT | 67042 | 4 | — | — | $1,073.68 | $1,701.07 | $7,043 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 2 | — | — | $7,699.64 | $8,945.14 | $10,191 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 2 | — | — | $12,199 | $13,821 | $15,443 |
| PCI single major coronary artery | CPT | 92920 | 7 | $18,211 | $6,373.85 | $5,237.55 | $13,658 | $17,899 |
| PCI with drug-eluting stent | CPT | 92928 | 7 | $23,378 | $8,182.3 | $10,826 | $17,534 | $36,997 |
| PCI bypass graft | CPT | 92937 | 7 | $22,005 | $7,701.75 | $10,826 | $16,504 | $36,997 |
| Left heart catheterization | CPT | 93452 | 7 | $40,417 | $14,146 | $2,898.01 | $26,716 | $36,375 |
| Coronary angiography with cath | CPT | 93455 | 7 | $31,246 | $10,936 | $2,898.01 | $20,654 | $28,121 |
| Coronary angiography with bypass cath | CPT | 93458 | 7 | $51,699 | $18,095 | $2,898.01 | $34,173 | $46,529 |
Payer mix (top 11)
| Payer | Codes covered | Median rate |
|---|---|---|
| UnitedHealthcare | 164 | $368.78 |
| Cigna | 163 | $663.07 |
| Blue Cross Blue Shield | 139 | $325.07 |
| Humana | 97 | $552.8 |
| Medicaid | 97 | $186.16 |
| commercial | phcs | all plans | 97 | $513 |
| commercial | galaxy | all plans | 97 | $684 |
| Aetna | 97 | $483.7 |
| Multiplan | 97 | $532 |
| Medicare | 16 | $8.83 |
| commercial | angelina county | all plans | 13 | $15.69 |