▸ Hospital · TX · CCN 451390
Dimmit Regional Hospital
704 HOSPITAL DRIVE, CARRIZO SPRINGS, TX, 451390
Compliance grade
A
93/100
Procedures tracked
97
of 209 target codes
Payers
3
with negotiated rates
Rates published
1,800
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 3 | $423 | $254 | $161 | $387 | $406 |
| ED visit level 2 | CPT | 99282 | 3 | $779 | $467 | $296 | $713 | $748 |
| ED visit level 3 | CPT | 99283 | 3 | $1,359 | $815 | $516 | $1,243.5 | $1,305 |
| ED visit level 4 | CPT | 99284 | 3 | $2,110 | $1,266 | $802 | $1,931 | $2,026 |
| ED visit level 5 | CPT | 99285 | 3 | $3,066 | $1,840 | $1,165 | $2,805 | $2,943 |
| Critical care, first hour | CPT | 99291 | 3 | $3,371 | $2,023 | $1,281 | $3,084.5 | $3,236 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 3 | $2,107 | $1,264 | $801 | $1,928 | $2,023 |
| CT head with contrast | CPT | 70460 | 3 | $2,903 | $1,742 | $1,103 | $2,656.5 | $2,787 |
| CT head with and without contrast | CPT | 70470 | 3 | $2,918 | $1,751 | $1,109 | $2,670 | $2,801 |
| CT neck with contrast | CPT | 70491 | 3 | $2,647 | $1,588 | $1,006 | $2,422 | $2,541 |
| MRI brain without contrast | CPT | 70551 | 3 | $1,029 | $617 | $391 | $941.5 | $988 |
| MRI brain with and without contrast | CPT | 70553 | 3 | $2,150 | $1,290 | $608 | $1,536 | $2,064 |
| Chest X-ray single view | CPT | 71045 | 3 | $350 | $210 | $133 | $320.5 | $336 |
| Chest X-ray 2 views | CPT | 71046 | 3 | $503 | $302 | $191 | $460.5 | $483 |
| Chest X-ray 3 views | CPT | 71047 | 3 | $582 | $349 | $221 | $532.5 | $559 |
| CT chest without contrast | CPT | 71250 | 3 | $1,970 | $1,182 | $749 | $1,802.5 | $1,891 |
| CT chest with contrast | CPT | 71260 | 3 | $1,245 | $747 | $473 | $1,139 | $1,195 |
| CT chest with and without contrast | CPT | 71270 | 3 | $3,059 | $1,835 | $1,162 | $2,799 | $2,937 |
| MRI chest without contrast | CPT | 71550 | 3 | $1,029 | $617 | $391 | $941.5 | $988 |
| MRI chest with and without contrast | CPT | 71552 | 3 | $1,600 | $960 | $608 | $1,464 | $1,536 |
| Lumbosacral spine X-ray | CPT | 72100 | 3 | $524 | $314 | $199 | $479.5 | $503 |
| CT cervical spine without contrast | CPT | 72125 | 3 | $2,345 | $1,407 | $891 | $2,145.5 | $2,251 |
| CT thoracic spine without contrast | CPT | 72128 | 3 | $3,098 | $1,859 | $1,177 | $2,834.5 | $2,974 |
| CT lumbar spine without contrast | CPT | 72131 | 3 | $3,030 | $1,818 | $1,151 | $2,772.5 | $2,909 |
| MRI cervical spine without contrast | CPT | 72141 | 3 | $1,029 | $617 | $391 | $941.5 | $988 |
| MRI thoracic spine without contrast | CPT | 72146 | 3 | $1,029 | $617 | $391 | $941.5 | $988 |
| MRI lumbar spine without contrast | CPT | 72148 | 3 | $1,029 | $617 | $391 | $941.5 | $988 |
| MRI cervical spine with and without contrast | CPT | 72156 | 3 | $1,600 | $960 | $608 | $1,464 | $1,536 |
| MRI lumbar spine with contrast | CPT | 72158 | 3 | $1,600 | $960 | $608 | $1,464 | $1,536 |
| CT pelvis without contrast | CPT | 72192 | 3 | $2,223 | $1,334 | $845 | $2,034 | $2,134 |
| CT pelvis with contrast | CPT | 72193 | 3 | $3,261 | $1,957 | $1,239 | $2,984 | $3,131 |
| Shoulder X-ray | CPT | 73030 | 3 | $528 | $317 | $171 | $433 | $507 |
| Humerus X-ray | CPT | 73060 | 3 | $456 | $274 | $173 | $417.5 | $438 |
| Hand X-ray 3 views | CPT | 73130 | 3 | $352 | $211 | $134 | $322 | $338 |
| MRI upper extremity joint without contrast | CPT | 73221 | 3 | $1,029 | $617 | $391 | $941.5 | $988 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 3 | $1,600 | $960 | $608 | $1,464 | $1,536 |
| Knee X-ray 1-2 views | CPT | 73560 | 3 | $437 | $262 | $166 | $400 | $420 |
| Ankle X-ray 3 views | CPT | 73610 | 3 | $528 | $317 | $181 | $457 | $507 |
| MRI lower extremity joint without contrast | CPT | 73721 | 3 | $1,029 | $617 | $391 | $941.5 | $988 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 3 | $1,600 | $960 | $608 | $1,464 | $1,536 |
| CT abdomen without contrast | CPT | 74150 | 3 | $2,155 | $1,293 | $819 | $1,972 | $2,069 |
| CT abdomen with contrast | CPT | 74160 | 3 | $2,651 | $1,591 | $1,007 | $2,425.5 | $2,545 |
| CT abdomen with and without contrast | CPT | 74170 | 3 | $2,777 | $1,666 | $1,055 | $2,541 | $2,666 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 3 | $3,971 | $2,383 | $1,509 | $3,633.5 | $3,812 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 3 | $4,025 | $2,415 | $1,530 | $3,683 | $3,864 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 3 | $5,167 | $3,100 | $1,963 | $4,727.5 | $4,960 |
| MRI abdomen without contrast | CPT | 74181 | 3 | $1,029 | $617 | $391 | $941.5 | $988 |
| MRI abdomen with and without contrast | CPT | 74183 | 3 | $1,600 | $960 | $608 | $1,464 | $1,536 |
| Abdominal ultrasound complete | CPT | 76700 | 3 | $890 | $534 | $338 | $814 | $854 |
| Abdominal ultrasound limited | CPT | 76705 | 3 | $890 | $534 | $338 | $814 | $854 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 3 | $890 | $534 | $338 | $814 | $854 |
| Obstetric ultrasound first trimester | CPT | 76801 | 3 | $890 | $534 | $181 | $456 | $854 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 3 | $890 | $534 | $209 | $528 | $854 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 3 | $955 | $573 | $258 | $653 | $917 |
| Transvaginal ultrasound | CPT | 76830 | 3 | $890 | $534 | $338 | $814 | $854 |
| Pelvic ultrasound complete | CPT | 76856 | 3 | $890 | $534 | $338 | $814 | $854 |
| Scrotal ultrasound | CPT | 76870 | 3 | $890 | $534 | $338 | $814 | $854 |
| Diagnostic mammography unilateral | CPT | 77065 | 3 | $499 | $299 | $190 | $456.5 | $479 |
| Diagnostic mammography bilateral | CPT | 77066 | 3 | $631 | $379 | $240 | $577.5 | $606 |
| Screening mammography bilateral | CPT | 77067 | 3 | $510 | $306 | $194 | $467 | $490 |
| EKG complete | CPT | 93000 | 3 | $50 | $30 | $19 | $46 | $48 |
| EKG tracing only | CPT | 93005 | 3 | $285 | $171 | $108 | $261 | $274 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 3 | $92 | $55 | $35 | $84 | $88 |
| Electrolyte panel | CPT | 80051 | 3 | $77 | $46 | $29 | $70.5 | $74 |
| Comprehensive metabolic panel | CPT | 80053 | 3 | $225 | $135 | $86 | $206 | $216 |
| Lipid panel | CPT | 80061 | 3 | $179 | $107 | $6 | $42 | $172 |
| Renal function panel | CPT | 80069 | 3 | $104 | $62 | $40 | $95 | $100 |
| Hepatic function panel | CPT | 80076 | 3 | $98 | $59 | $4 | $23.5 | $94 |
| Urinalysis non-automated | CPT | 81002 | 3 | $40 | $24 | $15 | $36.5 | $38 |
| Urinalysis automated | CPT | 81003 | 3 | $45 | $27 | $6 | $16.5 | $43 |
| Glucose quantitative | CPT | 82947 | 3 | $75 | $45 | $6 | $56 | $72 |
| Hemoglobin A1c | CPT | 83036 | 3 | $106 | $64 | $11 | $34.5 | $102 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 3 | $202 | $121 | $9 | $50 | $194 |
| Complete blood count with automated differential | CPT | 85025 | 3 | $93 | $56 | $6 | $73 | $89 |
| Complete blood count without differential | CPT | 85027 | 3 | $10 | $6 | $4 | $9.5 | $10 |
| Urine culture identification | CPT | 87088 | 3 | $97 | $58 | $37 | $88.5 | $93 |
| Tissue exam by pathologist level IV | CPT | 88305 | 3 | $144 | $86 | $55 | $131.5 | $138 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 3 | $950 | $570 | $361 | $869.5 | $912 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 3 | $9,153 | $5,492 | $3,478 | $8,375 | $8,787 |
| Vaginal delivery only | CPT | 59409 | 3 | $12,718 | $7,631 | $760 | $3,376.5 | $12,209 |
| C-section delivery only | CPT | 59514 | 3 | $2,000 | $1,200 | $760 | $1,830 | $1,920 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 3 | $271 | $163 | $78 | $197 | $260 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 3 | $423 | $254 | $114 | $337 | $406 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 3 | $640 | $384 | $171 | $432 | $614 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 3 | $840 | $504 | $217 | $547 | $806 |
| Office visit, established patient, 5 min | CPT | 99211 | 3 | $150 | $90 | $23 | $58 | $144 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 3 | $215 | $129 | $46 | $115 | $206 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 3 | $345 | $207 | $131 | $315.5 | $331 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 3 | $490 | $294 | $114 | $288 | $470 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 3 | $684 | $410 | $152 | $384 | $657 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 3 | $1,059 | $635 | $175 | $443 | $1,017 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 3 | $8,222 | $4,933 | $519 | $2,218 | $7,893 |
| Colonoscopy diagnostic | CPT | 45378 | 3 | $5,269 | $3,161 | $198 | $1,250.5 | $5,058 |
| Colonoscopy with biopsy | CPT | 45380 | 3 | $1,592 | $955 | $605 | $1,456.5 | $1,528 |
| Colonoscopy with polyp removal | CPT | 45385 | 3 | $774 | $464 | $294 | $708 | $743 |
| surgery | ||||||||
| Shoulder arthroscopy with decompression | CPT | 29826 | 3 | $488 | $293 | $185 | $446.5 | $468 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 3 | $1,562 | $937 | $594 | $1,429.5 | $1,500 |
Payer mix (top 3)
| Payer | Codes covered | Median rate |
|---|---|---|
| Aetna | 97 | $561 |
| Blue Cross Blue Shield | 97 | $614 |
| UnitedHealthcare | 97 | $250.5 |