▸ Hospital · · CCN 459814
Children's Medical Center Dallas
Compliance grade
A
100/100
Procedures tracked
197
of 209 target codes
Payers
30
with negotiated rates
Rates published
56,032
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 4 | — | — | $2,142.99 | $2,142.99 | $2,142.99 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 31 | $626 | $469.5 | $131.46 | $438.2 | $607.22 |
| Psychiatric eval with medical services | CPT | 90792 | 4 | — | — | $170.14 | $170.14 | $170.14 |
| Psychotherapy 30 minutes | CPT | 90832 | 31 | $471 | $353.25 | $71.89 | $329.7 | $456.87 |
| Psychotherapy 45 minutes | CPT | 90834 | 31 | $735 | $551.25 | $94.86 | $459 | $712.95 |
| Psychotherapy 60 minutes | CPT | 90837 | 31 | $920 | $690 | $140.51 | $599.25 | $892.4 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 29 | $458 | $343.5 | $96.18 | $320.6 | $444.26 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 31 | $431 | $323.25 | $9.93 | $301.7 | $418.07 |
| ED visit level 2 | CPT | 99282 | 31 | $911 | $683.25 | $36.56 | $637.7 | $883.67 |
| ED visit level 3 | CPT | 99283 | 31 | $1,635 | $1,226.25 | $61.84 | $1,144.5 | $1,585.95 |
| ED visit level 4 | CPT | 99284 | 31 | $2,618 | $1,963.5 | $105.51 | $1,832.6 | $2,539.46 |
| ED visit level 5 | CPT | 99285 | 31 | $3,908 | $2,931 | $153.05 | $2,735.6 | $3,790.76 |
| Critical care, first hour | CPT | 99291 | 31 | $5,605 | $4,203.75 | $235.36 | $3,923.5 | $5,436.85 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 31 | $3,977 | $2,982.75 | $90.39 | $2,783.9 | $3,857.69 |
| CT head with contrast | CPT | 70460 | 31 | $4,060 | $3,045 | $125.54 | $2,842 | $3,938.2 |
| CT head with and without contrast | CPT | 70470 | 31 | $4,237 | $3,177.75 | $146.48 | $2,965.9 | $4,109.89 |
| CT neck with contrast | CPT | 70491 | 31 | $3,375 | $2,531.25 | $155.48 | $2,362.5 | $3,273.75 |
| MRI brain without contrast | CPT | 70551 | 31 | $4,073 | $3,054.75 | $166.04 | $2,851.1 | $3,950.81 |
| MRI brain with contrast | CPT | 70552 | 31 | $5,069 | $3,801.75 | $227.97 | $3,548.3 | $4,916.93 |
| MRI brain with and without contrast | CPT | 70553 | 31 | $5,718 | $4,288.5 | $269.2 | $4,002.6 | $5,546.46 |
| Chest X-ray single view | CPT | 71045 | 31 | $685 | $513.75 | $21.6 | $479.5 | $664.45 |
| Chest X-ray 2 views | CPT | 71046 | 31 | $689 | $516.75 | $27.93 | $482.3 | $668.33 |
| Chest X-ray 3 views | CPT | 71047 | 31 | $911 | $683.25 | $34.84 | $637.7 | $883.67 |
| CT chest without contrast | CPT | 71250 | 31 | $3,032 | $2,274 | $109.99 | $2,122.4 | $2,941.04 |
| CT chest with contrast | CPT | 71260 | 31 | $3,614 | $2,710.5 | $140.75 | $2,529.8 | $3,505.58 |
| CT chest with and without contrast | CPT | 71270 | 31 | $4,573 | $3,429.75 | $165.04 | $3,201.1 | $4,435.81 |
| MRI chest without contrast | CPT | 71550 | 31 | $3,522 | $2,641.5 | $245.14 | $2,465.4 | $3,416.34 |
| MRI chest with contrast | CPT | 71551 | 31 | $4,057 | $3,042.75 | $311.73 | $2,839.9 | $3,935.29 |
| MRI chest with and without contrast | CPT | 71552 | 31 | $5,718 | $4,288.5 | $378.9 | $4,002.6 | $5,546.46 |
| Lumbosacral spine X-ray | CPT | 72100 | 31 | $734 | $550.5 | $32.79 | $513.8 | $711.98 |
| CT cervical spine without contrast | CPT | 72125 | 31 | $4,645 | $3,483.75 | $109.99 | $3,251.5 | $4,505.65 |
| CT thoracic spine without contrast | CPT | 72128 | 31 | $4,233 | $3,174.75 | $109.77 | $2,963.1 | $4,106.01 |
| CT lumbar spine without contrast | CPT | 72131 | 31 | $4,221 | $3,165.75 | $109.5 | $2,954.7 | $4,094.37 |
| MRI cervical spine without contrast | CPT | 72141 | 31 | $4,512 | $3,384 | $161.19 | $3,158.4 | $4,376.64 |
| MRI thoracic spine without contrast | CPT | 72146 | 31 | $4,578 | $3,433.5 | $161.45 | $3,204.6 | $4,440.66 |
| MRI lumbar spine without contrast | CPT | 72148 | 31 | $4,020 | $3,015 | $161.72 | $2,814 | $3,899.4 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 31 | $4,543 | $3,407.25 | $227.65 | $3,180.1 | $4,406.71 |
| MRI cervical spine with and without contrast | CPT | 72156 | 31 | $6,806 | $5,104.5 | $270.01 | $4,764.2 | $6,601.82 |
| MRI lumbar spine with contrast | CPT | 72158 | 31 | $5,981 | $4,485.75 | $269.47 | $4,186.7 | $5,801.57 |
| CT pelvis without contrast | CPT | 72192 | 31 | $3,741 | $2,805.75 | $109.99 | $2,618.7 | $3,628.77 |
| CT pelvis with contrast | CPT | 72193 | 31 | $4,245 | $3,183.75 | $183.81 | $2,971.5 | $4,117.65 |
| Shoulder X-ray | CPT | 73030 | 31 | $622 | $466.5 | $28.61 | $435.4 | $603.34 |
| Humerus X-ray | CPT | 73060 | 31 | $533 | $399.75 | $26.39 | $373.1 | $517.01 |
| Hand X-ray 3 views | CPT | 73130 | 31 | $673 | $504.75 | $30.74 | $471.1 | $652.81 |
| MRI upper extremity joint without contrast | CPT | 73221 | 31 | $4,700 | $3,525 | $171.55 | $3,290 | $4,559 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 31 | $5,042 | $3,781.5 | $322.47 | $3,529.4 | $4,890.74 |
| Knee X-ray 1-2 views | CPT | 73560 | 31 | $715 | $536.25 | $28.01 | $500.5 | $693.55 |
| Ankle X-ray 3 views | CPT | 73610 | 31 | $737 | $552.75 | $29.93 | $515.9 | $714.89 |
| MRI lower extremity joint without contrast | CPT | 73721 | 31 | $5,100 | $3,825 | $171.28 | $3,570 | $4,947 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 31 | $5,910 | $4,432.5 | $321.66 | $4,137 | $5,732.7 |
| CT abdomen without contrast | CPT | 74150 | 31 | $3,830 | $2,872.5 | $109.99 | $2,681 | $3,715.1 |
| CT abdomen with contrast | CPT | 74160 | 31 | $4,551 | $3,413.25 | $183.81 | $3,185.7 | $4,414.47 |
| CT abdomen with and without contrast | CPT | 74170 | 31 | $6,217 | $4,662.75 | $183.81 | $4,351.9 | $6,030.49 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 31 | $4,710 | $3,532.5 | $156.35 | $3,297 | $4,568.7 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 31 | $5,758 | $4,318.5 | $253.72 | $4,030.6 | $5,585.26 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 31 | $6,279 | $4,709.25 | $284 | $4,395.3 | $6,090.63 |
| MRI abdomen without contrast | CPT | 74181 | 31 | $3,665 | $2,748.75 | $165.17 | $2,565.5 | $3,555.05 |
| MRI abdomen with and without contrast | CPT | 74183 | 31 | $5,718 | $4,288.5 | $284.31 | $4,002.6 | $5,546.46 |
| Abdominal ultrasound complete | CPT | 76700 | 31 | $1,713 | $1,284.75 | $95.9 | $1,199.1 | $1,661.61 |
| Abdominal ultrasound limited | CPT | 76705 | 31 | $1,233 | $924.75 | $72.01 | $863.1 | $1,196.01 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 31 | $1,098 | $823.5 | $89.46 | $768.6 | $1,065.06 |
| Obstetric ultrasound first trimester | CPT | 76801 | 5 | — | — | $97.33 | $97.33 | $109.99 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 5 | — | — | $109.99 | $111.61 | $111.61 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 5 | — | — | $149.67 | $149.67 | $186.65 |
| Transvaginal ultrasound | CPT | 76830 | 31 | $633 | $474.75 | $97.42 | $443.1 | $614.01 |
| Pelvic ultrasound complete | CPT | 76856 | 31 | $1,457 | $1,092.75 | $86.89 | $1,019.9 | $1,413.29 |
| Scrotal ultrasound | CPT | 76870 | 31 | $1,362 | $1,021.5 | $82.68 | $953.4 | $1,321.14 |
| Diagnostic mammography unilateral | CPT | 77065 | 4 | — | — | $104.27 | $104.27 | $104.27 |
| Diagnostic mammography bilateral | CPT | 77066 | 4 | — | — | $131.34 | $131.34 | $131.34 |
| Screening mammography bilateral | CPT | 77067 | 4 | — | — | $106.28 | $106.28 | $106.28 |
| EKG complete | CPT | 93000 | 4 | — | — | $12.12 | $12.12 | $12.12 |
| EKG tracing only | CPT | 93005 | 31 | $551 | $413.25 | $5.1 | $385.7 | $534.47 |
| EKG interpretation only | CPT | 93010 | 4 | — | — | $7.01 | $7.01 | $7.01 |
| Transthoracic echocardiogram complete | CPT | 93306 | 31 | $4,584 | $3,438 | $161.44 | $3,208.8 | $4,446.48 |
| Transthoracic echocardiogram | CPT | 93307 | 31 | $3,673 | $2,754.75 | $112.21 | $2,571.1 | $3,562.81 |
| Stress echocardiogram | CPT | 93350 | 31 | $2,580 | $1,935 | $152.28 | $1,806 | $2,502.6 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 4 | — | — | $12,099 | $12,099 | $12,099 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 4 | — | — | $5,149 | $5,149 | $5,149 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 4 | — | — | $4,432.88 | $4,432.88 | $4,432.88 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 4 | — | — | $6,032.66 | $6,032.66 | $6,032.66 |
| COPD w MCC | MS-DRG | 190 | 4 | — | — | $4,505.45 | $4,505.45 | $4,505.45 |
| COPD w CC | MS-DRG | 191 | 4 | — | — | $3,580.04 | $3,580.04 | $3,580.04 |
| COPD w/o CC/MCC | MS-DRG | 192 | 4 | — | — | $3,113.98 | $3,113.98 | $3,113.98 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 4 | — | — | $3,466.89 | $3,466.89 | $3,466.89 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 4 | — | — | $2,609.99 | $2,609.99 | $2,609.99 |
| AMI discharged alive w MCC | MS-DRG | 280 | 4 | — | — | $6,025.89 | $6,025.89 | $6,025.89 |
| AMI discharged alive w CC | MS-DRG | 281 | 4 | — | — | $4,494.57 | $4,494.57 | $4,494.57 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 4 | — | — | $3,839.68 | $3,839.68 | $3,839.68 |
| Heart failure & shock w MCC | MS-DRG | 291 | 4 | — | — | $7,405.54 | $7,405.54 | $7,405.54 |
| Heart failure & shock w CC | MS-DRG | 292 | 4 | — | — | $3,585.33 | $3,585.33 | $3,585.33 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 4 | — | — | $2,808.47 | $2,808.47 | $2,808.47 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 4 | — | — | $5,606.47 | $5,606.47 | $5,606.47 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 4 | — | — | $3,033.88 | $3,033.88 | $3,033.88 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 4 | — | — | $2,721.02 | $2,721.02 | $2,721.02 |
| GI hemorrhage w CC | MS-DRG | 378 | 4 | — | — | $4,214.11 | $4,214.11 | $4,214.11 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 4 | — | — | $2,763.07 | $2,763.07 | $2,763.07 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 4 | — | — | $2,811.94 | $2,811.94 | $2,811.94 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 4 | — | — | $8,136.95 | $8,136.95 | $8,136.95 |
| Kidney/UTI w MCC | MS-DRG | 689 | 4 | — | — | $4,779.03 | $4,779.03 | $4,779.03 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 4 | — | — | $2,948.73 | $2,948.73 | $2,948.73 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 4 | — | — | $7,620.96 | $7,620.96 | $7,620.96 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 4 | — | — | $3,622.15 | $3,622.15 | $3,622.15 |
| Initial hospital care, low complexity | CPT | 99221 | 4 | — | — | $71.36 | $71.36 | $71.36 |
| Initial hospital care, moderate complexity | CPT | 99222 | 4 | — | — | $112.76 | $112.76 | $112.76 |
| Initial hospital care, high complexity | CPT | 99223 | 4 | — | — | $150.4 | $150.4 | $150.4 |
| Hospital discharge, <30 min | CPT | 99238 | 4 | — | — | $74.73 | $74.73 | $74.73 |
| Hospital discharge, >30 min | CPT | 99239 | 4 | — | — | $105.74 | $105.74 | $105.74 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 31 | $356 | $267 | $7.11 | $249.2 | $345.32 |
| General health panel | CPT | 80050 | 31 | $601 | $450.75 | $31.24 | $420.7 | $582.97 |
| Electrolyte panel | CPT | 80051 | 31 | $444 | $333 | $6.24 | $310.8 | $430.68 |
| Comprehensive metabolic panel | CPT | 80053 | 31 | $507 | $380.25 | $8.87 | $354.9 | $491.79 |
| Lipid panel | CPT | 80061 | 31 | $457 | $342.75 | $11.91 | $315.33 | $443.29 |
| Renal function panel | CPT | 80069 | 31 | $479 | $359.25 | $7.72 | $335.3 | $464.63 |
| Hepatic function panel | CPT | 80076 | 31 | $324 | $243 | $7.27 | $226.8 | $314.28 |
| Urinalysis non-automated | CPT | 81002 | 5 | — | — | $3.1 | $3.1 | $3.65 |
| Urinalysis automated | CPT | 81003 | 31 | $134 | $100.5 | $1.89 | $75 | $129.98 |
| Glucose quantitative | CPT | 82947 | 31 | $134 | $100.5 | $3.5 | $71.25 | $129.98 |
| Hemoglobin A1c | CPT | 83036 | 31 | $249 | $186.75 | $8.16 | $174.3 | $241.53 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 31 | $536 | $402 | $14.11 | $375.2 | $519.92 |
| Complete blood count with automated differential | CPT | 85025 | 31 | $236 | $177 | $6.53 | $135 | $228.92 |
| Complete blood count without differential | CPT | 85027 | 31 | $383 | $287.25 | $5.43 | $268.1 | $371.51 |
| Urine culture bacterial | CPT | 87086 | 31 | $421 | $315.75 | $6.78 | $294.7 | $408.37 |
| Urine culture identification | CPT | 87088 | 31 | $75 | $56.25 | $7.2 | $52.5 | $72.75 |
| Tissue exam by pathologist level IV | CPT | 88305 | 31 | $780 | $585 | $60.45 | $546 | $756.6 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 5 | — | — | $16.57 | $41.36 | $41.36 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 4 | — | — | $2,063.41 | $2,063.41 | $2,063.41 |
| Vaginal delivery only | CPT | 59409 | 4 | — | — | $685.69 | $685.69 | $685.69 |
| Vaginal delivery with postpartum | CPT | 59410 | 4 | — | — | $926.57 | $926.57 | $926.57 |
| Routine obstetric care with C-section | CPT | 59510 | 4 | — | — | $2,289.26 | $2,289.26 | $2,289.26 |
| C-section delivery only | CPT | 59514 | 4 | — | — | $776.28 | $776.28 | $776.28 |
| C-section with postpartum | CPT | 59515 | 4 | — | — | $1,146.56 | $1,146.56 | $1,146.56 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 31 | $463 | $347.25 | $61.19 | $324.1 | $449.11 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 31 | $715 | $536.25 | $95.84 | $500.5 | $693.55 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 31 | $916 | $687 | $144.29 | $641.2 | $888.52 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 31 | $1,133 | $849.75 | $190.74 | $793.1 | $1,099.01 |
| Office visit, established patient, 5 min | CPT | 99211 | 31 | $175 | $131.25 | $19.46 | $122.5 | $169.75 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 31 | $309 | $231.75 | $48.07 | $216.3 | $299.73 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 31 | $309 | $231.75 | $50 | $216.3 | $299.73 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 31 | $471 | $353.25 | $50 | $329.7 | $456.87 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 31 | $868 | $651 | $50 | $607.6 | $841.96 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 31 | $4,632 | $3,474 | $236.71 | $3,242.4 | $4,493.04 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 31 | $4,766 | $3,574.5 | $305.12 | $3,336.2 | $6,850 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 31 | $3,216 | $2,412 | $133.64 | $2,251.2 | $3,119.52 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 31 | $3,673 | $2,754.75 | $230.33 | $2,571.1 | $3,562.81 |
| Colonoscopy diagnostic | CPT | 45378 | 31 | $3,570 | $2,677.5 | $283.1 | $2,499 | $3,462.9 |
| Colonoscopy with biopsy | CPT | 45380 | 31 | $5,794 | $4,345.5 | $356.59 | $4,055.8 | $5,620.18 |
| Colonoscopy with polyp removal | CPT | 45385 | 31 | $4,960 | $3,720 | $376.98 | $3,472 | $4,811.2 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 4 | — | — | $1,243.12 | $1,243.12 | $1,243.12 |
| Hip hemiarthroplasty | CPT | 27125 | 4 | — | — | $975.49 | $975.49 | $975.49 |
| Total hip replacement | CPT | 27130 | 4 | — | — | $1,105.8 | $1,105.8 | $1,105.8 |
| Total knee replacement | CPT | 27447 | 4 | — | — | $1,104.47 | $1,104.47 | $1,104.47 |
| Knee revision arthroplasty single component | CPT | 27486 | 4 | — | — | $1,209.12 | $1,209.12 | $1,209.12 |
| Knee revision arthroplasty all components | CPT | 27487 | 4 | — | — | $1,506.65 | $1,506.65 | $1,506.65 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 4 | — | — | $147.48 | $147.48 | $147.48 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 5 | — | — | $920.5 | $2,518.45 | $3,153.25 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 5 | — | — | $468.95 | $1,142.68 | $1,418.32 |
| ACL reconstruction | CPT | 29888 | 5 | — | — | $839.51 | $3,465.05 | $4,156.87 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 4 | — | — | $22,212 | $22,212 | $22,212 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 4 | — | — | $10,415 | $10,415 | $10,415 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 4 | — | — | $8,102.13 | $8,102.13 | $8,102.13 |
| CABG single arterial graft | CPT | 33533 | 4 | — | — | $1,585 | $1,585 | $1,585 |
| CABG 2 arterial grafts | CPT | 33534 | 4 | — | — | $1,862.48 | $1,862.48 | $1,862.48 |
| CABG 3 arterial grafts | CPT | 33535 | 4 | — | — | $2,070.37 | $2,070.37 | $2,070.37 |
| CABG 4+ arterial grafts | CPT | 33536 | 4 | — | — | $2,230.72 | $2,230.72 | $2,230.72 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 4 | — | — | $7,138.73 | $7,138.73 | $7,138.73 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 4 | — | — | $6,351.57 | $6,351.57 | $6,351.57 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 4 | — | — | $14,244 | $14,244 | $14,244 |
| Open appendectomy | CPT | 44950 | 4 | — | — | $552.97 | $552.97 | $552.97 |
| Laparoscopic appendectomy | CPT | 44970 | 8 | — | — | $519.29 | $5,359.65 | $12,500 |
| Major joint replacement w MCC | MS-DRG | 469 | 4 | — | — | $13,986 | $13,986 | $13,986 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 4 | — | — | $8,276.62 | $8,276.62 | $8,276.62 |
| Laparoscopic cholecystectomy | CPT | 47562 | 5 | — | — | $569.69 | $1,983.29 | $2,568.98 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 5 | — | — | $619.58 | $1,983.29 | $2,568.98 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 4 | — | — | $15,425 | $15,425 | $15,425 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 4 | — | — | $10,813 | $10,813 | $10,813 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 4 | — | — | $10,255 | $10,255 | $10,255 |
| Lap inguinal hernia repair | CPT | 49650 | 5 | — | — | $373.98 | $1,983.29 | $2,568.98 |
| Total abdominal hysterectomy | CPT | 58150 | 4 | — | — | $878.73 | $878.73 | $878.73 |
| Vaginal hysterectomy | CPT | 58260 | 5 | — | — | $722.82 | $722.82 | $1,603.34 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 5 | — | — | $761.74 | $1,983.29 | $2,568.98 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 5 | — | — | $847.15 | $3,265.51 | $4,397.32 |
| Lap salpingo-oophorectomy | CPT | 58661 | 5 | — | — | $563.21 | $1,983.29 | $2,568.98 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 4 | — | — | $14,987 | $14,987 | $14,987 |
| OR procedure for obesity w CC | MS-DRG | 620 | 4 | — | — | $9,230.2 | $9,230.2 | $9,230.2 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 4 | — | — | $8,919.63 | $8,919.63 | $8,919.63 |
| Complex cataract surgery | CPT | 66982 | 5 | — | — | $628.07 | $892.44 | $1,090.63 |
| Cataract surgery with lens implant | CPT | 66984 | 5 | — | — | $458.23 | $892.44 | $1,090.63 |
| Intravitreal injection | CPT | 67028 | 5 | — | — | $50.87 | $95.41 | $95.41 |
| Vitrectomy mechanical | CPT | 67042 | 5 | — | — | $962.46 | $1,610.16 | $1,881.01 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 4 | — | — | $4,976.57 | $4,976.57 | $4,976.57 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 4 | — | — | $7,366.38 | $7,366.38 | $7,366.38 |
| PCI single major coronary artery | CPT | 92920 | 31 | $13,906 | $10,430 | $445.27 | $9,734.2 | $13,489 |
| PCI with drug-eluting stent | CPT | 92928 | 31 | $23,932 | $17,949 | $494.8 | $16,752 | $23,214 |
| PCI bypass graft | CPT | 92937 | 4 | — | — | $494.5 | $494.5 | $494.5 |
| Left heart catheterization | CPT | 93452 | 31 | $32,099 | $24,074 | $705.23 | $22,469 | $31,136 |
| Coronary angiography with cath | CPT | 93455 | 31 | $35,420 | $26,565 | $793.52 | $24,794 | $34,357 |
| Coronary angiography with bypass cath | CPT | 93458 | 31 | $36,926 | $27,695 | $819.25 | $25,848 | $35,818 |
Payer mix (top 30)
| Payer | Codes covered | Median rate |
|---|---|---|
| Aetna | 197 | $563.21 |
| Humana | 197 | $628.07 |
| Medicaid | 196 | $284 |
| oklahoma complete health | 196 | $284 |
| superior health plan | 122 | $183.81 |
| methodist | 104 | $1,041.25 |
| Blue Cross Blue Shield | 104 | $1,079.5 |
| Cigna | 104 | $1,075 |
| UnitedHealthcare | 104 | $1,225 |
| galaxy health | 103 | $1,661.61 |
| healthscope benefit solutions | 103 | $1,284.75 |
| healthsmart | 103 | $1,422.9 |
| First Health | 103 | $1,370.4 |
| imagine health | 103 | $1,199.1 |
| equifax healthcare | 103 | $1,456.05 |
| employers health network | 103 | $1,199.1 |
| Molina | 103 | $328.11 |
| Multiplan | 103 | $1,456.05 |
| cookchildren's health plan | 103 | $582.42 |
| parkland community | 103 | $604.95 |
| phcs | 103 | $1,284.75 |
| quiktrip (qt) | 103 | $1,284.75 |
| scott & white | 103 | $1,216.23 |
| carelon | 103 | $820.26 |
| texas children's health plan | 103 | $654 |
| txp emerging therapy solutions | 103 | $1,216.23 |
| txp interlink | 103 | $1,284.75 |
| txp optum health (transplant) | 103 | $1,221.24 |
| wellpoint | 103 | $565.29 |
| usa managed care | 103 | $1,593.09 |