▸ Hospital · TX · CCN 670075
St Luke's Hospital At The Vintage
20171 CHASEWOOD PARK DR., HOUSTON, TX, 77070
102 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
191
of 209 target codes
Payers
25
with negotiated rates
Rates published
7,948
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 16 | — | — | $7,510.41 | $12,517 | $33,901 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 21 | $429 | $150.15 | $30.82 | $109.52 | $1,240.2 |
| ED visit level 2 | CPT | 99282 | 21 | $923 | $323.05 | $30.82 | $206.82 | $1,240.2 |
| ED visit level 3 | CPT | 99283 | 21 | $2,090 | $731.5 | $30.82 | $447.55 | $2,073 |
| ED visit level 4 | CPT | 99284 | 21 | $3,180 | $1,113 | $262.22 | $1,240.2 | $5,166 |
| ED visit level 5 | CPT | 99285 | 21 | $3,894 | $1,362.9 | $376.4 | $1,699.04 | $6,582 |
| Critical care, first hour | CPT | 99291 | 21 | $5,351 | $1,872.85 | $499.36 | $1,438.49 | $4,548.35 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 22 | $2,859 | $1,000.65 | $78.56 | $171.03 | $2,430.15 |
| CT head with contrast | CPT | 70460 | 22 | $4,062 | $1,421.7 | $128.71 | $360.67 | $3,452.7 |
| CT head with and without contrast | CPT | 70470 | 22 | $4,214 | $1,474.9 | $128.71 | $380.97 | $3,581.9 |
| CT neck with contrast | CPT | 70491 | 22 | $3,880 | $1,358 | $128.71 | $360.67 | $3,298 |
| MRI brain without contrast | CPT | 70551 | 22 | $5,302 | $1,855.7 | $165.9 | $717.84 | $4,506.7 |
| MRI brain with contrast | CPT | 70552 | 22 | $5,140 | $1,799 | $252.74 | $577.5 | $4,369 |
| MRI brain with and without contrast | CPT | 70553 | 22 | $7,814 | $2,734.9 | $265.38 | $685.13 | $6,641.9 |
| Chest X-ray single view | CPT | 71045 | 20 | $641 | $224.35 | $20.71 | $113.4 | $544.85 |
| Chest X-ray 2 views | CPT | 71046 | 20 | $736 | $257.6 | $28.74 | $113.4 | $625.6 |
| Chest X-ray 3 views | CPT | 71047 | 20 | $653 | $228.55 | $36.75 | $113.4 | $555.05 |
| CT chest without contrast | CPT | 71250 | 22 | $3,796 | $1,328.6 | $78.56 | $171.03 | $3,226.6 |
| CT chest with contrast | CPT | 71260 | 22 | $4,382 | $1,533.7 | $128.71 | $360.67 | $3,724.7 |
| CT chest with and without contrast | CPT | 71270 | 22 | $4,695 | $1,643.25 | $128.71 | $380.97 | $3,990.75 |
| MRI chest without contrast | CPT | 71550 | 22 | $4,977 | $1,741.95 | $165.9 | $717.84 | $4,230.45 |
| MRI chest with contrast | CPT | 71551 | 22 | $4,489 | $1,571.15 | $432.7 | $1,052.5 | $3,815.65 |
| MRI chest with and without contrast | CPT | 71552 | 22 | $6,046 | $2,116.1 | $265.38 | $685.13 | $5,139.1 |
| Lumbosacral spine X-ray | CPT | 72100 | 20 | $1,043 | $365.05 | $33.08 | $153.38 | $886.55 |
| CT cervical spine without contrast | CPT | 72125 | 22 | $2,348 | $821.8 | $78.56 | $171.03 | $1,995.8 |
| CT thoracic spine without contrast | CPT | 72128 | 22 | $2,348 | $821.8 | $78.56 | $171.03 | $1,995.8 |
| CT lumbar spine without contrast | CPT | 72131 | 22 | $2,348 | $821.8 | $78.56 | $171.03 | $1,995.8 |
| MRI cervical spine without contrast | CPT | 72141 | 22 | $5,612 | $1,964.2 | $165.9 | $717.84 | $4,770.2 |
| MRI thoracic spine without contrast | CPT | 72146 | 22 | $4,880 | $1,708 | $165.9 | $717.84 | $4,148 |
| MRI lumbar spine without contrast | CPT | 72148 | 22 | $5,612 | $1,964.2 | $165.9 | $717.84 | $4,770.2 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 22 | $5,434 | $1,901.9 | $265.38 | $645.63 | $4,618.9 |
| MRI cervical spine with and without contrast | CPT | 72156 | 22 | $6,583 | $2,304.05 | $265.38 | $1,050 | $5,595.55 |
| MRI lumbar spine with contrast | CPT | 72158 | 22 | $6,892 | $2,412.2 | $265.38 | $1,050 | $5,858.2 |
| CT pelvis without contrast | CPT | 72192 | 22 | $1,835 | $642.25 | $78.56 | $171.03 | $1,937 |
| CT pelvis with contrast | CPT | 72193 | 22 | $2,314 | $809.9 | $128.71 | $360.67 | $1,966.9 |
| Shoulder X-ray | CPT | 73030 | 20 | $1,034 | $361.9 | $27.74 | $121.5 | $878.9 |
| Humerus X-ray | CPT | 73060 | 20 | $668 | $233.8 | $27.4 | $133.43 | $567.8 |
| Hand X-ray 3 views | CPT | 73130 | 20 | $772 | $270.2 | $30.08 | $113.4 | $656.2 |
| MRI upper extremity joint without contrast | CPT | 73221 | 22 | $5,058 | $1,770.3 | $165.9 | $717.84 | $4,299.3 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 22 | $5,904 | $2,066.4 | $265.38 | $685.13 | $5,018.4 |
| Knee X-ray 1-2 views | CPT | 73560 | 20 | $363 | $127.05 | $29.4 | $113.4 | $308.55 |
| Ankle X-ray 3 views | CPT | 73610 | 20 | $830 | $290.5 | $29.74 | $121.5 | $705.5 |
| MRI lower extremity joint without contrast | CPT | 73721 | 22 | $5,619 | $1,966.65 | $165.9 | $717.84 | $4,776.15 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 22 | $5,948 | $2,081.8 | $265.38 | $685.13 | $5,055.8 |
| CT abdomen without contrast | CPT | 74150 | 22 | $4,015 | $1,405.25 | $78.56 | $171.03 | $3,412.75 |
| CT abdomen with contrast | CPT | 74160 | 22 | $5,320 | $1,862 | $128.71 | $360.67 | $4,522 |
| CT abdomen with and without contrast | CPT | 74170 | 22 | $5,381 | $1,883.35 | $128.71 | $380.97 | $4,573.85 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 22 | $9,174 | $3,210.9 | $165.9 | $348.21 | $7,797.9 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 22 | $9,719 | $3,401.65 | $252.74 | $552.87 | $8,261.15 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 22 | $9,859 | $3,450.65 | $252.74 | $552.87 | $8,380.15 |
| MRI abdomen without contrast | CPT | 74181 | 22 | $4,721 | $1,652.35 | $165.9 | $717.84 | $4,012.85 |
| MRI abdomen with and without contrast | CPT | 74183 | 22 | $5,484 | $1,919.4 | $265.38 | $685.13 | $4,661.4 |
| Abdominal ultrasound complete | CPT | 76700 | 20 | $2,264 | $792.4 | $78.56 | $163.66 | $1,924.4 |
| Abdominal ultrasound limited | CPT | 76705 | 20 | $1,309 | $458.15 | $78.56 | $163.66 | $1,112.65 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 20 | $1,731 | $605.85 | $78.56 | $163.66 | $1,471.35 |
| Obstetric ultrasound first trimester | CPT | 76801 | 20 | $1,574 | $550.9 | $78.56 | $158.21 | $1,337.9 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 20 | $1,761 | $616.35 | $78.56 | $158.21 | $1,496.85 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 20 | $1,046 | $366.1 | $114.46 | $262.09 | $889.1 |
| Transvaginal ultrasound | CPT | 76830 | 20 | $1,510 | $528.5 | $78.56 | $158.21 | $1,283.5 |
| Pelvic ultrasound complete | CPT | 76856 | 20 | $1,949 | $682.15 | $78.56 | $163.66 | $1,656.65 |
| Scrotal ultrasound | CPT | 76870 | 20 | $1,519 | $531.65 | $64.49 | $163.66 | $1,291.15 |
| Diagnostic mammography unilateral | CPT | 77065 | 20 | $511 | $178.85 | $67.7 | $198.33 | $434.35 |
| Diagnostic mammography bilateral | CPT | 77066 | 20 | $953 | $333.55 | $86.57 | $286.37 | $810.05 |
| Screening mammography bilateral | CPT | 77067 | 20 | $570 | $199.5 | $71.58 | $208 | $484.5 |
| EKG tracing only | CPT | 93005 | 20 | $760 | $266 | $40.13 | $83.6 | $646 |
| Transthoracic echocardiogram complete | CPT | 93306 | 20 | $5,411 | $1,893.85 | $203.64 | $652.72 | $4,599.35 |
| Transthoracic echocardiogram | CPT | 93307 | 20 | $1,849 | $647.15 | $120.72 | $246.55 | $1,571.65 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 16 | — | — | $10,646 | $16,565 | $48,055 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 16 | — | — | $6,494.92 | $9,871.78 | $29,317 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 16 | — | — | $5,069.33 | $7,353.01 | $22,882 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 16 | — | — | $10,332 | $17,252 | $46,637 |
| COPD w MCC | MS-DRG | 190 | 16 | — | — | $6,985.27 | $10,454 | $31,531 |
| COPD w CC | MS-DRG | 191 | 16 | — | — | $5,868.18 | $8,557.77 | $26,488 |
| COPD w/o CC/MCC | MS-DRG | 192 | 16 | — | — | $4,995.11 | $7,128.02 | $22,547 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 16 | — | — | $5,774.93 | $8,421.78 | $26,067 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 16 | — | — | $4,418.65 | $6,934.34 | $21,921 |
| AMI discharged alive w MCC | MS-DRG | 280 | 16 | — | — | $9,315.47 | $15,379 | $42,049 |
| AMI discharged alive w CC | MS-DRG | 281 | 16 | — | — | $6,095.5 | $9,348.42 | $27,514 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 16 | — | — | $5,137.06 | $7,487.71 | $23,188 |
| Heart failure & shock w MCC | MS-DRG | 291 | 16 | — | — | $7,991.94 | $12,780 | $36,075 |
| Heart failure & shock w CC | MS-DRG | 292 | 16 | — | — | $5,923.85 | $8,638.95 | $26,740 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 16 | — | — | $4,798.88 | $6,798.41 | $21,662 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 16 | — | — | $7,335.05 | $11,067 | $33,110 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 16 | — | — | $5,247.94 | $7,531.51 | $23,689 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 16 | — | — | $4,182.19 | $6,179.32 | $19,689 |
| GI hemorrhage w CC | MS-DRG | 378 | 16 | — | — | $6,378.94 | $9,391.56 | $28,794 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 16 | — | — | $4,726.97 | $6,696.54 | $21,337 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 16 | — | — | $5,312.26 | $7,570.09 | $24,003 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 16 | — | — | $8,324.57 | $13,553 | $37,576 |
| Kidney/UTI w MCC | MS-DRG | 689 | 16 | — | — | $6,926.82 | $10,352 | $31,267 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 16 | — | — | $4,952.84 | $7,783.64 | $24,585 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 16 | — | — | $10,438 | $16,726 | $47,117 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 16 | — | — | $6,510.69 | $9,622.47 | $29,389 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 20 | $665 | $232.75 | $6.09 | $12.69 | $565.25 |
| Electrolyte panel | CPT | 80051 | 20 | $500 | $175 | $5.05 | $10.52 | $425 |
| Comprehensive metabolic panel | CPT | 80053 | 20 | $869 | $304.15 | $7.6 | $15.84 | $738.65 |
| Lipid panel | CPT | 80061 | 20 | $285 | $99.75 | $9.64 | $20.08 | $242.25 |
| Hepatic function panel | CPT | 80076 | 20 | $634 | $221.9 | $5.88 | $12.26 | $538.9 |
| Urinalysis non-automated | CPT | 81002 | 20 | $42 | $14.7 | $2.51 | $5.07 | $35.7 |
| Urinalysis automated | CPT | 81003 | 20 | $104 | $36.4 | $1.62 | $3.38 | $88.4 |
| Glucose quantitative | CPT | 82947 | 20 | $141 | $49.35 | $2.83 | $5.9 | $119.85 |
| Hemoglobin A1c | CPT | 83036 | 20 | $145 | $50.75 | $6.99 | $14.57 | $123.25 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 20 | $293 | $102.55 | $12.1 | $25.2 | $249.05 |
| Complete blood count with automated differential | CPT | 85025 | 20 | $225 | $78.75 | $5.59 | $11.66 | $191.25 |
| Complete blood count without differential | CPT | 85027 | 20 | $267 | $93.45 | $4.66 | $9.7 | $226.95 |
| Urine culture bacterial | CPT | 87086 | 20 | $335 | $117.25 | $5.81 | $12.1 | $284.75 |
| Tissue exam by pathologist level IV | CPT | 88305 | 20 | $1,002 | $350.7 | $35.87 | $73.13 | $851.7 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 24 | $1,209 | $423.15 | $13.62 | $234.48 | $2,468 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 3 | — | — | $1,406.9 | $2,430 | $3,440.72 |
| Vaginal delivery only | CPT | 59409 | 24 | $4,346 | $1,521.1 | $447 | $3,042.2 | $8,536.19 |
| Vaginal delivery with postpartum | CPT | 59410 | 4 | — | — | $212.55 | $942.3 | $2,430 |
| Routine obstetric care with C-section | CPT | 59510 | 3 | — | — | $1,533.5 | $2,430 | $3,816.26 |
| C-section delivery only | CPT | 59514 | 3 | — | — | $719.8 | $1,363.82 | $2,430 |
| C-section with postpartum | CPT | 59515 | 4 | — | — | $737.94 | $1,879.59 | $2,430 |
| Cesarean section w CC/MCC | MS-DRG | 765 | 4 | — | — | $5,727.99 | $10,367 | $12,794 |
| Cesarean section w/o CC/MCC | MS-DRG | 766 | 4 | — | — | $4,760.56 | $7,373.18 | $12,112 |
| Vaginal delivery w complicating dx | MS-DRG | 774 | 4 | — | — | $3,626.35 | $6,726.24 | $8,743.5 |
| Vaginal delivery w/o complicating dx | MS-DRG | 775 | 4 | — | — | $2,977.38 | $5,684.68 | $8,529.3 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 9 | $426 | $149.1 | $71.22 | $176.94 | $362.1 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 9 | $534 | $186.9 | $98 | $237.58 | $453.9 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 9 | $612 | $214.2 | $98 | $321.33 | $520.2 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 9 | $719 | $251.65 | $98 | $397.58 | $611.15 |
| Office visit, established patient, 5 min | CPT | 99211 | 9 | $229 | $80.15 | $13.13 | $117.48 | $194.65 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 9 | $305 | $106.75 | $36.36 | $138.38 | $259.25 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 9 | $382 | $133.7 | $72.23 | $165.68 | $324.7 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 9 | $433 | $151.55 | $98 | $211.89 | $368.05 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 9 | $504 | $176.4 | $98 | $269.89 | $428.4 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 19 | — | — | $287.68 | $950.15 | $4,487 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 19 | — | — | $287.68 | $1,073.32 | $5,185 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 15 | — | — | $93.1 | $810.54 | $2,582.61 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 18 | — | — | $287.68 | $937.17 | $4,487 |
| Colonoscopy diagnostic | CPT | 45378 | 18 | — | — | $287.68 | $1,022.37 | $5,185 |
| Colonoscopy with biopsy | CPT | 45380 | 18 | — | — | $385.2 | $1,236.03 | $5,185 |
| Colonoscopy with polyp removal | CPT | 45385 | 18 | — | — | $385.2 | $1,236.03 | $5,185 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 14 | — | — | $964.81 | $12,454 | $40,073 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 17 | — | — | $1,808.2 | $28,777 | $73,449 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 17 | — | — | $1,808.2 | $19,510 | $49,629 |
| Hip hemiarthroplasty | CPT | 27125 | 14 | — | — | $408.78 | $12,454 | $40,073 |
| Total hip replacement | CPT | 27130 | 14 | — | — | $853.2 | $12,330 | $40,073 |
| Total knee replacement | CPT | 27447 | 14 | — | — | $851.87 | $12,577 | $40,073 |
| Knee revision arthroplasty single component | CPT | 27486 | 14 | — | — | $919.17 | $12,454 | $40,073 |
| Knee revision arthroplasty all components | CPT | 27487 | 14 | — | — | $1,209.34 | $12,454 | $40,073 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 7 | — | — | $1,233 | $2,222 | $5,252 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 18 | — | — | $1,121.47 | $6,398.3 | $20,387 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 19 | — | — | $601.39 | $2,890.65 | $9,210.4 |
| ACL reconstruction | CPT | 29888 | 18 | — | — | $1,121.47 | $6,398.3 | $20,387 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 16 | — | — | $24,272 | $41,865 | $109,562 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 16 | — | — | $13,550 | $22,165 | $61,163 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 16 | — | — | $9,704.69 | $15,389 | $43,806 |
| CABG single arterial graft | CPT | 33533 | 4 | — | — | $1,292.63 | $2,560.98 | $4,048 |
| CABG 2 arterial grafts | CPT | 33534 | 4 | — | — | $1,490.86 | $3,012.93 | $4,048 |
| CABG 3 arterial grafts | CPT | 33535 | 4 | — | — | $1,608.79 | $3,356.85 | $4,068.91 |
| CABG 4+ arterial grafts | CPT | 33536 | 4 | — | — | $1,687.75 | $3,605.57 | $4,370.38 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 16 | — | — | $9,602.63 | $15,244 | $43,345 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 16 | — | — | $7,872.72 | $12,010 | $35,537 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 16 | — | — | $18,074 | $32,894 | $81,582 |
| Open appendectomy | CPT | 44950 | 14 | — | — | $805.34 | $3,346.79 | $10,359 |
| Laparoscopic appendectomy | CPT | 44970 | 14 | — | — | $1,233 | $5,673.28 | $16,467 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 16 | — | — | $33,001 | $54,092 | $148,961 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 16 | — | — | $20,015 | $34,361 | $90,348 |
| Major joint replacement w MCC | MS-DRG | 469 | 16 | — | — | $16,080 | $27,497 | $72,584 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 16 | — | — | $10,585 | $17,719 | $47,780 |
| Laparoscopic cholecystectomy | CPT | 47562 | 17 | — | — | $1,121.47 | $5,320.16 | $16,467 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 17 | — | — | $1,121.47 | $5,320.16 | $16,467 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 16 | — | — | $15,802 | $26,468 | $71,330 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 16 | — | — | $11,493 | $18,606 | $51,876 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 16 | — | — | $9,411.03 | $15,064 | $42,480 |
| Open umbilical hernia repair | CPT | 49560 | 18 | — | — | $907.57 | $3,251.17 | $10,359 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 18 | — | — | $907.57 | $3,251.17 | $10,359 |
| Lap inguinal hernia repair | CPT | 49650 | 18 | — | — | $1,121.47 | $5,168.16 | $16,467 |
| Lap incisional hernia repair | CPT | 49652 | 15 | — | — | $1,121.47 | $5,168.16 | $16,467 |
| Total abdominal hysterectomy | CPT | 58150 | 5 | — | — | $127.26 | $2,403 | $5,416 |
| Vaginal hysterectomy | CPT | 58260 | 15 | — | — | $1,121.47 | $4,503.4 | $14,349 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 18 | — | — | $1,121.47 | $5,218.82 | $16,467 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 15 | — | — | $1,121.47 | $9,008.07 | $28,986 |
| Lap salpingo-oophorectomy | CPT | 58661 | 18 | — | — | $1,121.47 | $5,168.16 | $16,467 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 16 | — | — | $15,972 | $26,207 | $72,096 |
| OR procedure for obesity w CC | MS-DRG | 620 | 16 | — | — | $9,941.28 | $17,963 | $44,874 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 16 | — | — | $9,177.23 | $15,295 | $41,425 |
| Complex cataract surgery | CPT | 66982 | 19 | — | — | $400.01 | $2,573.92 | $8,158 |
| Cataract surgery with lens implant | CPT | 66984 | 19 | — | — | $400.01 | $2,573.92 | $8,158 |
| Intravitreal injection | CPT | 67028 | 15 | — | — | $36.94 | $318.92 | $2,468 |
| Vitrectomy mechanical | CPT | 67042 | 15 | — | — | $1,121.47 | $4,001.13 | $12,749 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 16 | — | — | $7,024.23 | $10,477 | $31,707 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 16 | — | — | $9,707.56 | $15,816 | $45,563 |
| PCI single major coronary artery | CPT | 92920 | 21 | $11,490 | $4,021.5 | $3,573.42 | $7,444.64 | $17,899 |
| PCI with drug-eluting stent | CPT | 92928 | 21 | $11,361 | $3,976.35 | $4,410 | $10,307 | $36,997 |
| PCI bypass graft | CPT | 92937 | 21 | $11,361 | $3,976.35 | $4,410 | $10,307 | $36,997 |
| Left heart catheterization | CPT | 93452 | 22 | $13,086 | $4,580.1 | $2,089.92 | $4,354 | $11,123 |
| Coronary angiography with cath | CPT | 93455 | 22 | $15,725 | $5,503.75 | $2,089.92 | $4,354 | $13,366 |
| Coronary angiography with bypass cath | CPT | 93458 | 22 | $22,056 | $7,719.6 | $2,089.92 | $4,354 | $18,748 |
Payer mix (top 25)
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 190 | $869.43 |
| UnitedHealthcare | 186 | $2,034 |
| Humana | 178 | $2,430 |
| Aetna | 171 | $1,055 |
| commercial | employerdirect | all plans | 167 | $1,112.51 |
| commercial | entrust | all plans | 167 | $1,875.37 |
| commercial | harris health | ers | 167 | $1,191.97 |
| commercial | kelseycare | exchange | 167 | $1,072.78 |
| commercial | nxhealth | all plans | 167 | $2,582.61 |
| commercial | renaissance | all plans | 167 | $572.15 |
| commercial | superior health plan | all plans | 167 | $1,191.97 |
| commercial | community health choice | exchange | 167 | $1,191.97 |
| Medicare | 167 | $818.49 |
| Medicaid | 121 | $284.37 |
| commercial | healthsmart | ap3 | 104 | $3,891.13 |
| First Health | 97 | $1,471.6 |
| Multiplan | 97 | $1,698 |
| commercial | galaxy | all plans | 97 | $1,924.4 |
| commercial | usa health network | all plans | 97 | $1,924.4 |
| commercial | healthsmart | ppo | 97 | $1,584.8 |
| commercial | nppn | all plans | 97 | $1,811.2 |
| commercial | kelseycare | all plans | 96 | $1,398.6 |
| commercial | phcs | all plans | 68 | $17,316 |
| commercial | independent med system | all plans | 57 | $14,954 |
| commercial | beechstreet | all plans | 24 | $2,353 |