500 WEST 4TH STREET, ODESSA, TX, 79761-5001
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| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| imaging | ||||||||
| EKG tracing only | CPT | 93005 | 1 | $165 | $165 | $182 | $182 | $182 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 6 | $85,441 | $85,441 | $850 | $1,500 | $3,166 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 6 | $39,451 | $39,451 | $850 | $1,500 | $3,166 |
| Kidney/UTI w MCC | MS-DRG | 689 | 6 | $74,744 | $74,744 | $850 | $1,500 | $3,166 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 6 | $63,875 | $63,875 | $850 | $1,500 | $3,166 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 6 | $124,353 | $124,353 | $850 | $1,500 | $3,166 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 6 | $66,010 | $66,010 | $850 | $1,500 | $3,166 |
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 7 | $1,195 |
| healthsmart | 6 | $1,800 |
| odessa medical center | 6 | $850 |
| scott and white health plan | 6 | $1,500 |
| triwest va | 6 | $1,809 |
| velocity | 6 | $3,166 |
