▸ Hospital · TX · CCN 670060
Baylor Scott And White Medical Center Sunnyvale
231 S COLLINS, SUNNYVALE, TX, 75182
70 bedsAcute Care Hospitals5
Compliance grade
A
93/100
Procedures tracked
181
of 209 target codes
Payers
2
with negotiated rates
Rates published
4,893
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 2 | — | — | $9,264.72 | $16,364 | $18,183 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 1 | — | — | $145.26 | $145.26 | $145.26 |
| Psychiatric eval with medical services | CPT | 90792 | 1 | — | — | $145.26 | $145.26 | $145.26 |
| Psychotherapy 30 minutes | CPT | 90832 | 1 | — | — | $145.26 | $145.26 | $145.26 |
| Psychotherapy 45 minutes | CPT | 90834 | 1 | — | — | $145.26 | $145.26 | $145.26 |
| Psychotherapy 60 minutes | CPT | 90837 | 1 | — | — | $145.26 | $145.26 | $145.26 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 1 | — | — | $145.26 | $145.26 | $145.26 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 2 | $348 | $208.8 | $80.89 | $306 | $2,048 |
| ED visit level 2 | CPT | 99282 | 2 | $679 | $407.4 | $149.01 | $581.5 | $2,048 |
| ED visit level 3 | CPT | 99283 | 2 | $2,045 | $1,227 | $259.94 | $2,210.5 | $3,067 |
| ED visit level 4 | CPT | 99284 | 2 | $3,273 | $1,963.8 | $403.52 | $3,146 | $6,143 |
| ED visit level 5 | CPT | 99285 | 2 | $6,574 | $3,944.4 | $585.19 | $6,854 | $10,230 |
| Critical care, first hour | CPT | 99291 | 2 | $4,909 | $2,945.4 | $808.45 | $6,354.5 | $9,348 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 1 | $2,218 | $1,330.8 | $100.16 | $1,374.02 | $2,050.77 |
| CT head with contrast | CPT | 70460 | 1 | $2,444 | $1,466.4 | $167.39 | $1,514.2 | $2,260.01 |
| CT head with and without contrast | CPT | 70470 | 1 | $2,968 | $1,780.8 | $167.39 | $1,838.57 | $2,744.14 |
| CT neck with contrast | CPT | 70491 | 1 | $2,474 | $1,484.4 | $167.39 | $1,532.88 | $2,287.88 |
| MRI brain without contrast | CPT | 70551 | 1 | $3,028 | $1,816.8 | $223.25 | $1,876.01 | $2,800.01 |
| MRI brain with contrast | CPT | 70552 | 1 | $3,505 | $2,103 | $350.37 | $2,171.22 | $3,240.63 |
| MRI brain with and without contrast | CPT | 70553 | 1 | $4,285 | $2,571 | $350.37 | $2,653.99 | $3,961.18 |
| Chest X-ray single view | CPT | 71045 | 1 | $212 | $127.2 | $82.79 | $135.54 | $202.3 |
| Chest X-ray 2 views | CPT | 71046 | 1 | $285 | $171 | $82.79 | $181.99 | $271.62 |
| Chest X-ray 3 views | CPT | 71047 | 1 | $350 | $210 | $82.79 | $223.35 | $333.36 |
| CT chest without contrast | CPT | 71250 | 1 | $2,395 | $1,437 | $100.16 | $1,483.38 | $2,214.01 |
| CT chest with contrast | CPT | 71260 | 1 | $2,856 | $1,713.6 | $167.39 | $1,769.26 | $2,640.68 |
| CT chest with and without contrast | CPT | 71270 | 1 | $3,233 | $1,939.8 | $167.39 | $2,003.13 | $2,989.75 |
| MRI chest without contrast | CPT | 71550 | 1 | $2,193 | $1,315.8 | $223.25 | $1,358.97 | $2,028.32 |
| MRI chest with contrast | CPT | 71551 | 1 | $2,260 | $1,356 | $729.47 | $1,399.74 | $2,089.17 |
| MRI chest with and without contrast | CPT | 71552 | 1 | $3,253 | $1,951.8 | $350.37 | $2,015.18 | $3,007.73 |
| Lumbosacral spine X-ray | CPT | 72100 | 1 | $442 | $265.2 | $100.16 | $273.78 | $408.63 |
| CT cervical spine without contrast | CPT | 72125 | 1 | $2,264 | $1,358.4 | $100.16 | $1,402.33 | $2,093.03 |
| CT thoracic spine without contrast | CPT | 72128 | 1 | $2,624 | $1,574.4 | $100.16 | $1,625.09 | $2,425.51 |
| CT lumbar spine without contrast | CPT | 72131 | 1 | $2,541 | $1,524.6 | $100.16 | $1,574.13 | $2,349.44 |
| MRI cervical spine without contrast | CPT | 72141 | 1 | $3,083 | $1,849.8 | $223.25 | $1,909.8 | $2,850.45 |
| MRI thoracic spine without contrast | CPT | 72146 | 1 | $2,767 | $1,660.2 | $223.25 | $1,714.56 | $2,559.05 |
| MRI lumbar spine without contrast | CPT | 72148 | 1 | $2,980 | $1,788 | $223.25 | $1,845.69 | $2,754.77 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 1 | $3,104 | $1,862.4 | $350.37 | $1,923.21 | $2,870.47 |
| MRI cervical spine with and without contrast | CPT | 72156 | 1 | $4,223 | $2,533.8 | $350.37 | $2,616.44 | $3,905.13 |
| MRI lumbar spine with contrast | CPT | 72158 | 1 | $4,348 | $2,608.8 | $350.37 | $2,693.79 | $4,020.58 |
| CT pelvis without contrast | CPT | 72192 | 1 | $2,251 | $1,350.6 | $100.16 | $1,394.21 | $2,080.91 |
| CT pelvis with contrast | CPT | 72193 | 1 | $2,744 | $1,646.4 | $167.39 | $1,699.19 | $2,536.11 |
| Shoulder X-ray | CPT | 73030 | 1 | $425 | $255 | $82.79 | $263.79 | $393.72 |
| Humerus X-ray | CPT | 73060 | 1 | $430 | $258 | $82.79 | $265.89 | $396.85 |
| Hand X-ray 3 views | CPT | 73130 | 1 | $462 | $277.2 | $82.79 | $286.19 | $427.15 |
| MRI upper extremity joint without contrast | CPT | 73221 | 1 | $3,309 | $1,985.4 | $223.25 | $2,049.78 | $3,059.38 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 1 | $3,120 | $1,872 | $350.37 | $1,932.94 | $2,884.99 |
| Knee X-ray 1-2 views | CPT | 73560 | 1 | $380 | $228 | $82.79 | $234.85 | $350.52 |
| Ankle X-ray 3 views | CPT | 73610 | 1 | $411 | $246.6 | $82.79 | $254.66 | $380.09 |
| MRI lower extremity joint without contrast | CPT | 73721 | 1 | $3,405 | $2,043 | $223.25 | $2,109.37 | $3,148.31 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 1 | $3,174 | $1,904.4 | $350.37 | $1,965.9 | $2,934.18 |
| CT abdomen without contrast | CPT | 74150 | 1 | $2,309 | $1,385.4 | $100.16 | $1,430.36 | $2,134.86 |
| CT abdomen with contrast | CPT | 74160 | 1 | $2,913 | $1,747.8 | $167.39 | $1,804.58 | $2,693.4 |
| CT abdomen with and without contrast | CPT | 74170 | 1 | $2,965 | $1,779 | $167.39 | $1,836.65 | $2,741.26 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 1 | $4,559 | $2,735.4 | $223.25 | $2,824.55 | $4,215.75 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 1 | $5,657 | $3,394.2 | $350.37 | $3,503.76 | $5,229.5 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 1 | $5,947 | $3,568.2 | $350.37 | $3,683.62 | $5,497.94 |
| MRI abdomen without contrast | CPT | 74181 | 1 | $2,896 | $1,737.6 | $223.25 | $1,794.05 | $2,677.68 |
| MRI abdomen with and without contrast | CPT | 74183 | 1 | $4,000 | $2,400 | $350.37 | $2,477.52 | $3,697.79 |
| Abdominal ultrasound complete | CPT | 76700 | 1 | $1,032 | $619.2 | $100.16 | $639.16 | $953.98 |
| Abdominal ultrasound limited | CPT | 76705 | 1 | $743 | $445.8 | $100.16 | $459.95 | $686.5 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 1 | $702 | $421.2 | $100.16 | $434.8 | $648.96 |
| Obstetric ultrasound first trimester | CPT | 76801 | 1 | $608 | $364.8 | $100.16 | $377.11 | $562.84 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 1 | $483 | $289.8 | $100.16 | $298.68 | $445.78 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 1 | $664 | $398.4 | $223.25 | $411.11 | $613.6 |
| Transvaginal ultrasound | CPT | 76830 | 1 | $712 | $427.2 | $100.16 | $440.97 | $658.17 |
| Pelvic ultrasound complete | CPT | 76856 | 1 | $879 | $527.4 | $100.16 | $544.08 | $812.06 |
| Scrotal ultrasound | CPT | 76870 | 1 | $664 | $398.4 | $100.16 | $411.14 | $613.64 |
| Diagnostic mammography unilateral | CPT | 77065 | 1 | $203 | $121.8 | $91.46 | $129.55 | $193.36 |
| Diagnostic mammography bilateral | CPT | 77066 | 1 | $250 | $150 | $112.43 | $159.26 | $237.7 |
| Screening mammography bilateral | CPT | 77067 | 1 | $203 | $121.8 | $91.46 | $129.55 | $193.36 |
| EKG tracing only | CPT | 93005 | 1 | $470 | $282 | $55.73 | $55.73 | $55.73 |
| Transthoracic echocardiogram complete | CPT | 93306 | 1 | $3,076 | $1,845.6 | $502.61 | $502.61 | $502.61 |
| Transthoracic echocardiogram | CPT | 93307 | 1 | $2,516 | $1,509.6 | $223.25 | $223.25 | $223.25 |
| Stress echocardiogram | CPT | 93350 | 1 | $3,226 | $1,935.6 | $502.61 | $502.61 | $502.61 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 2 | — | — | $10,487 | $13,400 | $22,574 |
| COPD w MCC | MS-DRG | 190 | 2 | — | — | $6,395.77 | $8,400.93 | $14,664 |
| COPD w CC | MS-DRG | 191 | 2 | — | — | $5,091.87 | $6,592.18 | $11,298 |
| COPD w/o CC/MCC | MS-DRG | 192 | 2 | — | — | $3,842.17 | $4,978.23 | $8,540.43 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 2 | — | — | $4,950.46 | $6,398.18 | $10,941 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 2 | — | — | $3,781.49 | $4,879.04 | $8,324.86 |
| AMI discharged alive w MCC | MS-DRG | 280 | 2 | — | — | $9,464.91 | $12,282 | $21,112 |
| AMI discharged alive w CC | MS-DRG | 281 | 2 | — | — | $5,412.39 | $7,042.93 | $12,149 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 2 | — | — | $4,222.8 | $5,514.52 | $9,555.76 |
| Heart failure & shock w MCC | MS-DRG | 291 | 2 | — | — | $7,540.58 | $9,852.61 | $17,085 |
| Heart failure & shock w CC | MS-DRG | 292 | 2 | — | — | $5,083.62 | $6,611.59 | $11,397 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 2 | — | — | $3,301.29 | $4,311.49 | $7,471.88 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 2 | — | — | $6,908.96 | $9,114.94 | $15,998 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 2 | — | — | $4,345.94 | $5,694.52 | $9,909.72 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 2 | — | — | $3,247.67 | $4,243.56 | $7,358.77 |
| GI hemorrhage w CC | MS-DRG | 378 | 2 | — | — | $5,803.62 | $7,568.32 | $13,091 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 2 | — | — | $3,734.35 | $4,870.43 | $8,425.99 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 2 | — | — | $4,640.54 | $6,048.05 | $10,454 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 2 | — | — | $8,403.76 | $11,660 | $21,709 |
| Kidney/UTI w MCC | MS-DRG | 689 | 2 | — | — | $6,758.71 | $8,911.11 | $15,628 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 2 | — | — | $4,687.68 | $6,154.64 | $10,737 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 2 | — | — | $11,532 | $15,132 | $26,382 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 2 | — | — | $6,056.98 | $7,909.39 | $13,705 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 1 | $558 | $334.8 | $48.55 | $68.78 | $102.65 |
| General health panel | CPT | 80050 | 1 | $493 | $295.8 | $121.58 | $172.21 | $257.04 |
| Electrolyte panel | CPT | 80051 | 1 | $338 | $202.8 | $44.14 | $62.52 | $93.32 |
| Comprehensive metabolic panel | CPT | 80053 | 1 | $746 | $447.6 | $71.54 | $101.34 | $151.26 |
| Lipid panel | CPT | 80061 | 1 | $494 | $296.4 | $67.21 | $95.19 | $142.08 |
| Renal function panel | CPT | 80069 | 1 | $659 | $395.4 | $108.94 | $154.32 | $230.33 |
| Hepatic function panel | CPT | 80076 | 1 | $684 | $410.4 | $79.94 | $113.23 | $169 |
| Urinalysis non-automated | CPT | 81002 | 1 | — | — | $14.88 | $21.08 | $31.46 |
| Urinalysis automated | CPT | 81003 | 1 | $137 | $82.2 | $26.99 | $38.22 | $57.05 |
| Glucose quantitative | CPT | 82947 | 1 | $176 | $105.6 | $20.27 | $28.72 | $42.86 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 1 | $564 | $338.4 | $70.53 | $99.93 | $149.14 |
| Complete blood count with automated differential | CPT | 85025 | 1 | $209 | $125.4 | $43.42 | $61.52 | $91.82 |
| Complete blood count without differential | CPT | 85027 | 1 | $275 | $165 | $32.53 | $46.07 | $68.76 |
| Urine culture bacterial | CPT | 87086 | 1 | $400 | $240 | $52.89 | $74.91 | $111.81 |
| Urine culture identification | CPT | 87088 | 1 | $158 | $94.8 | $53.58 | $75.89 | $113.27 |
| Tissue exam by pathologist level IV | CPT | 88305 | 1 | $598 | $358.8 | $49.37 | $176.07 | $262.78 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 2 | — | — | $181.55 | $308.74 | $3,193 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 1 | — | — | $3,011 | $4,265 | $6,366 |
| Vaginal delivery only | CPT | 59409 | 2 | $4,427 | $2,656.2 | $1,590 | $2,936.61 | $3,697 |
| Vaginal delivery with postpartum | CPT | 59410 | 1 | — | — | $1,590 | $2,252 | $3,361 |
| Routine obstetric care with C-section | CPT | 59510 | 1 | — | — | $3,359 | $4,758 | $7,101 |
| C-section delivery only | CPT | 59514 | 1 | — | — | $3,011 | $4,265 | $6,366 |
| C-section with postpartum | CPT | 59515 | 1 | — | — | $2,872 | $4,068 | $6,071 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 2 | $4,538 | $2,722.8 | $825.87 | $2,370 | $3,538 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 2 | $4,538 | $2,722.8 | $825.87 | $2,370 | $3,538 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 2 | $3,807 | $2,284.2 | $832.67 | $2,252 | $3,361 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 2 | $4,333 | $2,599.8 | $832.67 | $2,252 | $3,361 |
| Colonoscopy diagnostic | CPT | 45378 | 2 | $4,333 | $2,599.8 | $832.67 | $2,370 | $3,538 |
| Colonoscopy with biopsy | CPT | 45380 | 2 | $5,715 | $3,429 | $1,075.12 | $2,370 | $3,538 |
| Colonoscopy with polyp removal | CPT | 45385 | 2 | $5,715 | $3,429 | $1,075.12 | $2,370 | $3,538 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 2 | $29,879 | $17,927 | $7,568 | $12,541 | $16,979 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 1 | — | — | $17,649 | $19,168 | $28,606 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 1 | — | — | $11,251 | $12,219 | $18,236 |
| Hip hemiarthroplasty | CPT | 27125 | 2 | $5,570 | $3,342 | $6,931 | $10,719 | $15,999 |
| Total hip replacement | CPT | 27130 | 2 | $66,461 | $39,877 | $7,568 | $12,266 | $15,999 |
| Total knee replacement | CPT | 27447 | 2 | $61,776 | $37,066 | $7,568 | $12,266 | $15,999 |
| Knee revision arthroplasty single component | CPT | 27486 | 2 | $21,911 | $13,147 | $7,568 | $12,541 | $15,999 |
| Knee revision arthroplasty all components | CPT | 27487 | 2 | $20,248 | $12,149 | $7,568 | $12,541 | $15,999 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 2 | $28,018 | $16,811 | $1,481 | $8,059 | $12,028 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 2 | $34,214 | $20,528 | $5,689 | $8,059 | $12,028 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 2 | $16,143 | $9,685.8 | $2,872 | $4,277 | $6,071 |
| ACL reconstruction | CPT | 29888 | 2 | $34,214 | $20,528 | $5,689 | $8,059 | $12,028 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 2 | — | — | $27,240 | $35,181 | $60,105 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 2 | — | — | $14,467 | $18,594 | $31,566 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 2 | — | — | $10,068 | $13,012 | $22,249 |
| CABG single arterial graft | CPT | 33533 | 2 | — | — | $1,988 | $4,758 | $7,101 |
| CABG 2 arterial grafts | CPT | 33534 | 2 | — | — | $1,988 | $4,758 | $7,101 |
| CABG 3 arterial grafts | CPT | 33535 | 2 | — | — | $1,988 | $4,758 | $7,101 |
| CABG 4+ arterial grafts | CPT | 33536 | 2 | — | — | $1,988 | $4,758 | $7,101 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 2 | — | — | $9,786.61 | $12,680 | $21,753 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 2 | — | — | $7,689.06 | $10,060 | $17,475 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 2 | — | — | $19,215 | $24,866 | $42,593 |
| Open appendectomy | CPT | 44950 | 2 | $17,764 | $10,658 | $2,607 | $4,486 | $6,892.72 |
| Laparoscopic appendectomy | CPT | 44970 | 2 | $27,393 | $16,436 | $5,256.83 | $8,059 | $12,028 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 2 | — | — | $39,082 | $50,990 | $88,256 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 2 | — | — | $22,189 | $28,585 | $48,676 |
| Major joint replacement w MCC | MS-DRG | 469 | 2 | — | — | $19,039 | $25,176 | $44,310 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 2 | — | — | $11,265 | $14,596 | $25,040 |
| Laparoscopic cholecystectomy | CPT | 47562 | 2 | $27,393 | $16,436 | $5,256.83 | $8,059 | $12,028 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 2 | $27,393 | $16,436 | $5,256.83 | $8,059 | $12,028 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 2 | — | — | $17,476 | $22,744 | $39,241 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 2 | — | — | $32 | $12,982 | $27,611 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 2 | — | — | $9,698.82 | $12,459 | $21,137 |
| Lap inguinal hernia repair | CPT | 49650 | 2 | $23,993 | $14,396 | $5,256.83 | $8,059 | $12,028 |
| Total abdominal hysterectomy | CPT | 58150 | 2 | $5,570 | $3,342 | $4,486 | $8,059 | $12,028 |
| Vaginal hysterectomy | CPT | 58260 | 2 | $25,093 | $15,056 | $2,806 | $4,486 | $5,932 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 2 | $15,399 | $9,239.4 | $5,256.83 | $8,059 | $12,028 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 2 | $25,483 | $15,290 | $5,689 | $8,059 | $12,028 |
| Lap salpingo-oophorectomy | CPT | 58661 | 2 | $27,393 | $16,436 | $5,256.83 | $8,059 | $12,028 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 2 | — | — | $17,038 | $21,679 | $34,631 |
| OR procedure for obesity w CC | MS-DRG | 620 | 2 | — | — | $9,931.56 | $12,743 | $21,587 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 2 | — | — | $9,162.06 | $11,827 | $20,191 |
| Complex cataract surgery | CPT | 66982 | 2 | — | — | $2,123.11 | $3,974 | $5,932 |
| Cataract surgery with lens implant | CPT | 66984 | 2 | — | — | $2,123.11 | $4,617 | $6,891 |
| Intravitreal injection | CPT | 67028 | 2 | — | — | $308.55 | $2,252 | $3,361 |
| Vitrectomy mechanical | CPT | 67042 | 2 | — | — | $3,704.25 | $5,512 | $8,020 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 2 | — | — | $6,897.18 | $8,970.06 | $15,463 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 2 | — | — | $11,185 | $14,540 | $25,049 |
| PCI single major coronary artery | CPT | 92920 | 2 | $31,030 | $18,618 | $5,207.34 | $10,719 | $15,999 |
| PCI with drug-eluting stent | CPT | 92928 | 2 | $19,997 | $11,998 | $6,931 | $10,719 | $15,999 |
| PCI bypass graft | CPT | 92937 | 2 | $12,350 | $7,410 | $6,931 | $10,719 | $15,999 |
| Left heart catheterization | CPT | 93452 | 2 | $17,558 | $10,535 | $2,968.76 | $8,059 | $12,028 |
| Coronary angiography with cath | CPT | 93455 | 2 | $18,008 | $10,805 | $2,968.76 | $8,059 | $12,028 |
| Coronary angiography with bypass cath | CPT | 93458 | 2 | $18,586 | $11,152 | $2,968.76 | $5,512 | $8,020 |
Payer mix (top 2)
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 181 | $3,400 |
| UnitedHealthcare | 91 | $7,701 |