▸ Hospital · TX · CCN 452040
SAN ANTONIO-AMG SPECIALTY HOSPITAL
718 LEXINGTON AVE., SAN ANTONIO, TX, 78212
4
Compliance grade
A
100/100
Procedures tracked
196
of 209 target codes
Payers
30
with negotiated rates
Rates published
19,996
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychiatric diagnostic evaluation | CPT | 90791 | 1 | — | — | $180 | $180 | $180 |
| Psychiatric eval with medical services | CPT | 90792 | 1 | — | — | $180 | $180 | $180 |
| Psychotherapy 30 minutes | CPT | 90832 | 1 | — | — | $75 | $75 | $75 |
| Psychotherapy 45 minutes | CPT | 90834 | 1 | — | — | $106.46 | $106.46 | $106.46 |
| Psychotherapy 60 minutes | CPT | 90837 | 1 | — | — | $150 | $150 | $150 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 1 | — | — | $177.44 | $177.44 | $177.44 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 1 | — | — | $17.01 | $17.01 | $17.01 |
| ED visit level 2 | CPT | 99282 | 1 | — | — | $32.92 | $32.92 | $32.92 |
| ED visit level 3 | CPT | 99283 | 1 | — | — | $55.93 | $55.93 | $55.93 |
| ED visit level 4 | CPT | 99284 | 1 | — | — | $94.66 | $94.66 | $94.66 |
| ED visit level 5 | CPT | 99285 | 1 | — | — | $137.36 | $137.36 | $137.36 |
| Critical care, first hour | CPT | 99291 | 11 | $4,466.63 | $4,466.63 | $168.75 | $3,349.97 | $4,019.97 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 13 | $4,224.96 | $4,224.96 | $91.94 | $3,168.72 | $3,802.46 |
| CT head with contrast | CPT | 70460 | 13 | $4,458.24 | $4,458.24 | $133.13 | $3,343.68 | $4,012.42 |
| CT head with and without contrast | CPT | 70470 | 13 | $6,791.04 | $6,791.04 | $159.7 | $5,093.28 | $6,111.94 |
| CT neck with contrast | CPT | 70491 | 13 | $6,485.4 | $6,485.4 | $168.11 | $4,864.05 | $5,836.86 |
| MRI brain without contrast | CPT | 70551 | 13 | $1,720.44 | $1,720.44 | $202.56 | $1,290.33 | $1,548.4 |
| MRI brain with contrast | CPT | 70552 | 13 | $4,673.35 | $4,673.35 | $299.51 | $3,505.01 | $4,206.02 |
| MRI brain with and without contrast | CPT | 70553 | 13 | $8,538.48 | $8,538.48 | $340.31 | $6,403.86 | $7,684.63 |
| Chest X-ray single view | CPT | 71045 | 11 | $730.08 | $730.08 | $14.05 | $547.56 | $657.07 |
| Chest X-ray 2 views | CPT | 71046 | 11 | $818.64 | $818.64 | $19.05 | $613.98 | $736.78 |
| Chest X-ray 3 views | CPT | 71047 | 11 | $929.88 | $929.88 | $24.32 | $697.41 | $836.89 |
| CT chest without contrast | CPT | 71250 | 13 | $6,723 | $6,723 | $114.53 | $5,042.25 | $6,050.7 |
| CT chest with contrast | CPT | 71260 | 13 | $5,968.08 | $5,968.08 | $156.6 | $4,476.06 | $5,371.27 |
| CT chest with and without contrast | CPT | 71270 | 13 | $7,055.64 | $7,055.64 | $193.63 | $5,291.73 | $6,350.08 |
| MRI chest without contrast | CPT | 71550 | 1 | — | — | $340.51 | $340.51 | $340.51 |
| MRI chest with contrast | CPT | 71551 | 1 | — | — | $475.44 | $475.44 | $475.44 |
| MRI chest with and without contrast | CPT | 71552 | 1 | — | — | $545.27 | $545.27 | $545.27 |
| Lumbosacral spine X-ray | CPT | 72100 | 11 | $1,114.56 | $1,114.56 | $24.04 | $835.92 | $1,003.1 |
| CT cervical spine without contrast | CPT | 72125 | 13 | $4,721.76 | $4,721.76 | $115.86 | $3,541.32 | $4,249.58 |
| CT thoracic spine without contrast | CPT | 72128 | 13 | $6,498.36 | $6,498.36 | $115.41 | $4,873.77 | $5,848.52 |
| CT lumbar spine without contrast | CPT | 72131 | 13 | $6,022.08 | $6,022.08 | $114.97 | $4,516.56 | $5,419.87 |
| MRI cervical spine without contrast | CPT | 72141 | 13 | $7,324 | $7,324 | $195.02 | $5,493 | $6,591.6 |
| MRI thoracic spine without contrast | CPT | 72146 | 13 | $7,175.52 | $7,175.52 | $195.02 | $5,381.64 | $6,457.97 |
| MRI lumbar spine without contrast | CPT | 72148 | 13 | $7,175.52 | $7,175.52 | $195.52 | $5,381.64 | $6,457.97 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 13 | $7,324 | $7,324 | $301.52 | $5,493 | $6,591.6 |
| MRI cervical spine with and without contrast | CPT | 72156 | 13 | $4,014.36 | $4,014.36 | $343.72 | $3,010.77 | $3,612.92 |
| MRI lumbar spine with contrast | CPT | 72158 | 13 | $9,448.92 | $9,448.92 | $342.21 | $7,086.69 | $8,504.03 |
| CT pelvis without contrast | CPT | 72192 | 13 | $3,805.92 | $3,805.92 | $114.53 | $2,854.44 | $3,425.33 |
| CT pelvis with contrast | CPT | 72193 | 13 | $4,577.04 | $4,577.04 | $233.21 | $3,432.78 | $4,119.34 |
| Shoulder X-ray | CPT | 73030 | 11 | $760.12 | $760.12 | $20.99 | $331.45 | $684.11 |
| Humerus X-ray | CPT | 73060 | 11 | $333.72 | $333.72 | $19.88 | $250.29 | $300.35 |
| Hand X-ray 3 views | CPT | 73130 | 11 | $787.32 | $787.32 | $23.21 | $590.49 | $708.59 |
| MRI upper extremity joint without contrast | CPT | 73221 | 1 | — | — | $221.14 | $221.14 | $221.14 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 1 | — | — | $466.9 | $466.9 | $466.9 |
| Knee X-ray 1-2 views | CPT | 73560 | 11 | $920.16 | $920.16 | $21.55 | $577.42 | $828.14 |
| Ankle X-ray 3 views | CPT | 73610 | 11 | $775.44 | $775.44 | $23.49 | $581.58 | $697.9 |
| MRI lower extremity joint without contrast | CPT | 73721 | 1 | — | — | $220.64 | $220.64 | $220.64 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 13 | $1,746.94 | $1,746.94 | $400 | $1,310.21 | $1,572.25 |
| CT abdomen without contrast | CPT | 74150 | 13 | $6,739.2 | $6,739.2 | $113.2 | $5,054.4 | $6,065.28 |
| CT abdomen with contrast | CPT | 74160 | 13 | $6,238.08 | $6,238.08 | $233.21 | $4,678.56 | $5,614.27 |
| CT abdomen with and without contrast | CPT | 74170 | 13 | $4,227.12 | $4,227.12 | $233.04 | $3,170.34 | $3,804.41 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 13 | $9,735.12 | $9,735.12 | $141.98 | $7,301.34 | $8,761.61 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 13 | $14,531 | $14,531 | $300 | $10,899 | $13,078 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 13 | $14,531 | $14,531 | $300 | $10,899 | $13,078 |
| MRI abdomen without contrast | CPT | 74181 | 13 | $7,324 | $7,324 | $205.26 | $5,493 | $6,591.6 |
| MRI abdomen with and without contrast | CPT | 74183 | 1 | — | — | $382.01 | $382.01 | $382.01 |
| Abdominal ultrasound complete | CPT | 76700 | 11 | $2,016.36 | $2,016.36 | $66.24 | $1,512.27 | $1,814.72 |
| Abdominal ultrasound limited | CPT | 76705 | 11 | $1,137.05 | $1,137.05 | $49.86 | $820.69 | $1,023.35 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 11 | $1,664.28 | $1,664.28 | $61.8 | $1,203.18 | $1,497.85 |
| Obstetric ultrasound first trimester | CPT | 76801 | 1 | — | — | $59.02 | $59.02 | $59.02 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 1 | — | — | $73.46 | $73.46 | $73.46 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 1 | — | — | $68.97 | $68.97 | $68.97 |
| Transvaginal ultrasound | CPT | 76830 | 1 | — | — | $72.9 | $72.9 | $72.9 |
| Pelvic ultrasound complete | CPT | 76856 | 11 | $1,758.24 | $1,758.24 | $61.24 | $1,318.68 | $1,582.42 |
| Scrotal ultrasound | CPT | 76870 | 11 | $1,058.4 | $1,058.4 | $59.02 | $793.8 | $952.56 |
| Diagnostic mammography unilateral | CPT | 77065 | 1 | — | — | $72.63 | $72.63 | $72.63 |
| Diagnostic mammography bilateral | CPT | 77066 | 1 | — | — | $92.61 | $92.61 | $92.61 |
| Screening mammography bilateral | CPT | 77067 | 1 | — | — | $76.51 | $76.51 | $76.51 |
| EKG complete | CPT | 93000 | 1 | — | — | $12.22 | $12.22 | $12.22 |
| EKG tracing only | CPT | 93005 | 11 | $513 | $513 | $5.12 | $384.75 | $461.7 |
| EKG interpretation only | CPT | 93010 | 1 | — | — | $7.1 | $7.1 | $7.1 |
| Transthoracic echocardiogram complete | CPT | 93306 | 11 | $3,128.76 | $3,128.76 | $112.91 | $2,346.57 | $2,815.88 |
| Transthoracic echocardiogram | CPT | 93307 | 11 | $2,000.16 | $2,000.16 | $82.95 | $1,500.12 | $1,800.14 |
| Stress echocardiogram | CPT | 93350 | 11 | $2,639.52 | $2,639.52 | $104.18 | $1,979.64 | $2,375.57 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 20 | — | — | $57,373 | $57,373 | $86,059 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 20 | — | — | $30,058 | $30,058 | $45,087 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 20 | — | — | $21,083 | $21,083 | $31,624 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 20 | — | — | $35,752 | $35,752 | $53,628 |
| COPD w MCC | MS-DRG | 190 | 20 | — | — | $28,823 | $28,823 | $43,235 |
| COPD w CC | MS-DRG | 191 | 20 | — | — | $28,823 | $28,823 | $43,235 |
| COPD w/o CC/MCC | MS-DRG | 192 | 20 | — | — | $28,823 | $28,823 | $43,235 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 20 | — | — | $23,526 | $23,526 | $35,289 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 20 | — | — | $21,083 | $21,083 | $31,624 |
| AMI discharged alive w MCC | MS-DRG | 280 | 20 | — | — | $36,162 | $36,162 | $54,243 |
| AMI discharged alive w CC | MS-DRG | 281 | 20 | — | — | $28,170 | $28,170 | $42,255 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 20 | — | — | $21,083 | $21,083 | $31,624 |
| Heart failure & shock w MCC | MS-DRG | 291 | 20 | — | — | $33,939 | $33,939 | $50,909 |
| Heart failure & shock w CC | MS-DRG | 292 | 20 | — | — | $24,099 | $24,099 | $36,149 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 20 | — | — | $21,083 | $21,083 | $31,624 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 20 | — | — | $36,925 | $36,925 | $55,388 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 20 | — | — | $21,083 | $21,083 | $31,624 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 20 | — | — | $21,083 | $21,083 | $31,624 |
| GI hemorrhage w CC | MS-DRG | 378 | 20 | — | — | $28,170 | $28,170 | $42,255 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 20 | — | — | $28,170 | $28,170 | $42,255 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 20 | — | — | $27,628 | $27,628 | $41,442 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 20 | — | — | $31,994 | $31,994 | $47,991 |
| Kidney/UTI w MCC | MS-DRG | 689 | 20 | — | — | $27,866 | $27,866 | $41,799 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 20 | — | — | $20,730 | $20,730 | $31,094 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 20 | — | — | $37,441 | $37,441 | $56,162 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 20 | — | — | $25,087 | $25,087 | $37,631 |
| Initial hospital care, low complexity | CPT | 99221 | 1 | — | — | $77.17 | $77.17 | $77.17 |
| Initial hospital care, moderate complexity | CPT | 99222 | 1 | — | — | $104.37 | $104.37 | $104.37 |
| Initial hospital care, high complexity | CPT | 99223 | 1 | — | — | $153.33 | $153.33 | $153.33 |
| Hospital discharge, <30 min | CPT | 99238 | 1 | — | — | $55.66 | $55.66 | $55.66 |
| Hospital discharge, >30 min | CPT | 99239 | 1 | — | — | $81.51 | $81.51 | $81.51 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 11 | $878.62 | $878.62 | $5.58 | $658.97 | $790.76 |
| General health panel | CPT | 80050 | 1 | — | — | $25.96 | $25.96 | $25.96 |
| Electrolyte panel | CPT | 80051 | 11 | $574.64 | $574.64 | $4.63 | $430.98 | $517.18 |
| Comprehensive metabolic panel | CPT | 80053 | 11 | $1,449.63 | $1,449.63 | $6.97 | $1,087.22 | $1,304.67 |
| Lipid panel | CPT | 80061 | 11 | $1,018.56 | $1,018.56 | $8.84 | $763.92 | $916.7 |
| Renal function panel | CPT | 80069 | 11 | $1,445.66 | $1,445.66 | $5.73 | $1,084.25 | $1,301.09 |
| Hepatic function panel | CPT | 80076 | 11 | $1,010.79 | $1,010.79 | $5.39 | $758.09 | $909.71 |
| Urinalysis non-automated | CPT | 81002 | 1 | — | — | $2.3 | $2.3 | $2.3 |
| Urinalysis automated | CPT | 81003 | 11 | $82.75 | $82.75 | $1.49 | $62.06 | $74.48 |
| Glucose quantitative | CPT | 82947 | 11 | $157.9 | $157.9 | $2.59 | $118.43 | $142.11 |
| Hemoglobin A1c | CPT | 83036 | 11 | $212.25 | $212.25 | $6.41 | $87.39 | $191.03 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 11 | $473.69 | $473.69 | $11.09 | $355.27 | $426.32 |
| Complete blood count with automated differential | CPT | 85025 | 11 | $359.7 | $359.7 | $5.13 | $269.78 | $323.73 |
| Complete blood count without differential | CPT | 85027 | 11 | $216.22 | $216.22 | $4.27 | $162.17 | $194.6 |
| Urine culture bacterial | CPT | 87086 | 11 | $159.19 | $159.19 | $5.33 | $119.39 | $143.27 |
| Urine culture identification | CPT | 87088 | 1 | — | — | $5.34 | $5.34 | $5.34 |
| Tissue exam by pathologist level IV | CPT | 88305 | 11 | $629.64 | $629.64 | $21.73 | $472.23 | $566.68 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 1 | — | — | $15.8 | $15.8 | $15.8 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 1 | — | — | $1,800 | $1,800 | $1,800 |
| Vaginal delivery only | CPT | 59409 | 1 | — | — | $629.75 | $629.75 | $629.75 |
| Vaginal delivery with postpartum | CPT | 59410 | 1 | — | — | $833.86 | $833.86 | $833.86 |
| Routine obstetric care with C-section | CPT | 59510 | 1 | — | — | $1,800 | $1,800 | $1,800 |
| C-section delivery only | CPT | 59514 | 1 | — | — | $708.75 | $708.75 | $708.75 |
| C-section with postpartum | CPT | 59515 | 1 | — | — | $1,021.72 | $1,021.72 | $1,021.72 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 1 | — | — | $38.04 | $38.04 | $38.04 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 1 | — | — | $64.76 | $64.76 | $64.76 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 1 | — | — | $105.21 | $105.21 | $105.21 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 1 | — | — | $142.79 | $142.79 | $142.79 |
| Office visit, established patient, 5 min | CPT | 99211 | 1 | — | — | $7 | $7 | $7 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 1 | — | — | $28.18 | $28.18 | $28.18 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 1 | — | — | $52.15 | $52.15 | $52.15 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 1 | — | — | $76.78 | $76.78 | $76.78 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 1 | — | — | $113.7 | $113.7 | $113.7 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 11 | $2,273.4 | $2,273.4 | $117.5 | $1,705.05 | $2,046.06 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 11 | $2,273.4 | $2,273.4 | $132.44 | $1,705.05 | $2,046.06 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 11 | $1,364.04 | $1,364.04 | $53.56 | $1,023.03 | $1,227.64 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 11 | $1,364.04 | $1,364.04 | $68.61 | $1,023.03 | $1,227.64 |
| Colonoscopy diagnostic | CPT | 45378 | 11 | $2,364.12 | $2,364.12 | $176.62 | $1,773.09 | $2,127.71 |
| Colonoscopy with biopsy | CPT | 45380 | 11 | $2,364.12 | $2,364.12 | $192.01 | $1,773.09 | $2,127.71 |
| Colonoscopy with polyp removal | CPT | 45385 | 11 | $2,364.12 | $2,364.12 | $243.93 | $1,773.09 | $2,127.71 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 1 | — | — | $1,351.78 | $1,351.78 | $1,351.78 |
| Hip hemiarthroplasty | CPT | 27125 | 1 | — | — | $1,057.88 | $1,057.88 | $1,057.88 |
| Total hip replacement | CPT | 27130 | 1 | — | — | $1,198.49 | $1,198.49 | $1,198.49 |
| Total knee replacement | CPT | 27447 | 1 | — | — | $1,197.33 | $1,197.33 | $1,197.33 |
| Knee revision arthroplasty single component | CPT | 27486 | 1 | — | — | $1,310.41 | $1,310.41 | $1,310.41 |
| Knee revision arthroplasty all components | CPT | 27487 | 1 | — | — | $1,633.89 | $1,633.89 | $1,633.89 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 1 | — | — | $160.55 | $160.55 | $160.55 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 1 | — | — | $1,001.98 | $1,001.98 | $1,001.98 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 1 | — | — | $509.83 | $509.83 | $509.83 |
| ACL reconstruction | CPT | 29888 | 1 | — | — | $916.08 | $916.08 | $916.08 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 20 | — | — | $55,675 | $55,675 | $83,512 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 20 | — | — | $28,170 | $28,170 | $42,255 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 20 | — | — | $28,170 | $28,170 | $42,255 |
| CABG single arterial graft | CPT | 33533 | 1 | — | — | $2,013.46 | $2,013.46 | $2,013.46 |
| CABG 2 arterial grafts | CPT | 33534 | 1 | — | — | $2,363.07 | $2,363.07 | $2,363.07 |
| CABG 3 arterial grafts | CPT | 33535 | 1 | — | — | $2,630.65 | $2,630.65 | $2,630.65 |
| CABG 4+ arterial grafts | CPT | 33536 | 1 | — | — | $2,833.82 | $2,833.82 | $2,833.82 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 20 | — | — | $31,994 | $31,994 | $47,991 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 20 | — | — | $31,994 | $31,994 | $47,991 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 20 | — | — | $31,716 | $31,716 | $47,575 |
| Open appendectomy | CPT | 44950 | 1 | — | — | $611.22 | $611.22 | $611.22 |
| Laparoscopic appendectomy | CPT | 44970 | 1 | — | — | $574.47 | $574.47 | $574.47 |
| Major joint replacement w MCC | MS-DRG | 469 | 20 | — | — | $55,675 | $55,675 | $83,512 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 20 | — | — | $30,058 | $30,058 | $45,087 |
| Laparoscopic cholecystectomy | CPT | 47562 | 1 | — | — | $629.48 | $629.48 | $629.48 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 1 | — | — | $684.9 | $684.9 | $684.9 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 20 | — | — | $30,058 | $30,058 | $45,087 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 20 | — | — | $30,058 | $30,058 | $45,087 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 20 | — | — | $30,058 | $30,058 | $45,087 |
| Lap inguinal hernia repair | CPT | 49650 | 1 | — | — | $413.55 | $413.55 | $413.55 |
| Total abdominal hysterectomy | CPT | 58150 | 1 | — | — | $1,013.33 | $1,013.33 | $1,013.33 |
| Vaginal hysterectomy | CPT | 58260 | 1 | — | — | $843.42 | $843.42 | $843.42 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 1 | — | — | $884.1 | $884.1 | $884.1 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 1 | — | — | $982.22 | $982.22 | $982.22 |
| Lap salpingo-oophorectomy | CPT | 58661 | 1 | — | — | $653.31 | $653.31 | $653.31 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 20 | — | — | $57,673 | $57,673 | $86,509 |
| OR procedure for obesity w CC | MS-DRG | 620 | 20 | — | — | $41,843 | $41,843 | $62,765 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 20 | — | — | $30,058 | $30,058 | $45,087 |
| Complex cataract surgery | CPT | 66982 | 1 | — | — | $747.36 | $747.36 | $747.36 |
| Cataract surgery with lens implant | CPT | 66984 | 1 | — | — | $545.42 | $545.42 | $545.42 |
| Intravitreal injection | CPT | 67028 | 1 | — | — | $91.95 | $91.95 | $91.95 |
| Vitrectomy mechanical | CPT | 67042 | 1 | — | — | $1,144.89 | $1,144.89 | $1,144.89 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 20 | — | — | $55,675 | $55,675 | $83,512 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 20 | — | — | $55,675 | $55,675 | $83,512 |
| PCI single major coronary artery | CPT | 92920 | 1 | — | — | $474.72 | $474.72 | $474.72 |
| PCI with drug-eluting stent | CPT | 92928 | 1 | — | — | $528.13 | $528.13 | $528.13 |
| PCI bypass graft | CPT | 92937 | 1 | — | — | $527.49 | $527.49 | $527.49 |
| Left heart catheterization | CPT | 93452 | 1 | — | — | $611.16 | $611.16 | $611.16 |
| Coronary angiography with cath | CPT | 93455 | 1 | — | — | $668.75 | $668.75 | $668.75 |
| Coronary angiography with bypass cath | CPT | 93458 | 1 | — | — | $682.89 | $682.89 | $682.89 |
Payer mix (top 30)
| Payer | Codes covered | Median rate |
|---|---|---|
| Aetna | 154 | $139.67 |
| prime health services | 111 | $27,407 |
| velocity provider ppo network | 111 | $4,597.56 |
| First Health | 71 | $21,504 |
| america's choice | 69 | $1,226.82 |
| evolutions healthcare system | 69 | $1,402.07 |
| medincrease | 69 | $1,577.34 |
| Multiplan | 69 | $1,402.07 |
| usa mco | 69 | $1,314.45 |
| provider network of america | 69 | $1,314.45 |
| quik trip | 69 | $1,314.45 |
| fortified provider network | 69 | $1,489.7 |
| scan health plan | 42 | $30,058 |
| texas independence health plan | 42 | $31,561 |
| UnitedHealthcare | 42 | $30,058 |
| WellCare | 42 | $30,058 |
| wellmed | 42 | $30,058 |
| wellpoint | 42 | $30,058 |
| Ambetter | 42 | $30,058 |
| amerigroup | 42 | $30,058 |
| baylor scott and white health plan | 42 | $30,058 |
| Blue Cross Blue Shield | 42 | $30,058 |
| christus health plan | 42 | $30,058 |
| Cigna | 42 | $30,058 |
| ilumed aco reach | 42 | $30,058 |
| integranet health | 42 | $30,058 |
| ninety degree benefits | 42 | $45,087 |
| provider partners health plan | 42 | $31,561 |
| sana benefits | 42 | $45,087 |
| oscar | 29 | $300 |