ER visit cost in Austin, TX

What 17 Austin hospitals list as their cash price for ER visits, next to the rates insurers negotiated in the same files.

Hospital files dated January 1, 2026 – June 13, 2026 · Data checked October 2, 2026 · How we read these files · Report an error

Emergency room visit, level 3 (moderate) (CPT 99283)

Published cash price

$154–$1,006

what 15 hospitals list for a self-pay ER visit level 3

Typical insured rate

$1,006

median of every commercial plan rate in the files

Lowest insured rate

$37.41

Blue Cross Blue Shield Of Texas (PPO), CHRISTUS Santa Rosa Hospital – San Marcos

ER visit level 3 prices by hospital in Austin

Sorted by published cash price. “Typical insured rate” is the median of all commercial plan rates each hospital lists for CPT 99283; Medicaid and Medicare Advantage are shown separately below.

Emergency room visit, level 3 (moderate) (CPT 99283) — Austin
Hospital	Published cash price	Typical insured rate	Lowest insured rate
Ascension Seton WilliamsonAscension Seton · file Jan 2026	$154–$731	$6532 plans	$653
Ascension Seton HaysAscension Seton · file Jan 2026	$154–$731Cash ÷ typical 0.2×	$86729 plans	$77.47
Ascension Seton SmithvilleAscension Seton · file Jan 2026	$225–$731Cash ÷ typical 0.2×	$91424 plans	$77.47
Ascension Seton Edgar B. DavisAscension Seton · file Jan 2026	$500Cash ÷ typical 0.6×	$90223 plans	$77.47
Dell Seton Medical Center at The University of TexasAscension Seton · file Jan 2026	$522–$731Cash ÷ typical 0.5×	$96224 plans	$77.47
Ascension Seton NorthwestAscension Seton · file Jan 2026	$522–$731Cash ÷ typical 0.6×	$86729 plans	$77.47
Ascension Seton Medical Center AustinAscension Seton · file Jan 2026	$522–$731Cash ÷ typical 0.6×	$83831 plans	$77.47
Ascension Seton SouthwestAscension Seton · file Jan 2026	$522–$731Cash ÷ typical 0.6×	$86729 plans	$77.47
Ascension Seton Cedar ParkAscension Seton · file Jan 2026	$601Cash ÷ typical 0.7×	$90223 plans	$77.47
Baylor Scott & White Medical Center – LakewayBaylor Scott & White Health · file Jun 2026	$1,006Cash ÷ typical 0.9×	$1,13022 plans	$329
Baylor Scott & White Medical Center – Round RockBaylor Scott & White Health · file Jun 2026	$1,006Cash ÷ typical 0.9×	$1,16923 plans	$329
Baylor Scott & White Medical Center – TaylorBaylor Scott & White Health · file Jun 2026	$1,006Cash ÷ typical 0.9×	$1,16923 plans	$402
Baylor Scott & White Medical Center – AustinBaylor Scott & White Health · file Jun 2026	$1,006Cash ÷ typical 1.0×	$1,05818 plans	$329
Baylor Scott & White Medical Center – BudaBaylor Scott & White Health · file Jun 2026	$1,006Cash ÷ typical 1.0×	$1,05818 plans	$329
Baylor Scott & White Medical Center – PflugervilleBaylor Scott & White Health · file Jun 2026	$1,006Cash ÷ typical 0.9×	$1,13022 plans	$329
CHRISTUS Santa Rosa Hospital – San MarcosCHRISTUS Health · file Jan 2026	—	$67917 plans	$37.41
Dell Children's Medical CenterAscension Seton · children's hospital (not in the summary above) · file Jan 2026	$438–$1,422Cash ÷ typical 0.5×	$91423 plans	$77.47

↓ Download this table (CSV)free to reuse with attribution (CC BY 4.0)

Negotiated rates by insurer

If you have a high deductible, you usually pay the rate your insurer negotiated until you meet it. Ranges cover every plan of that insurer in the file; open a hospital to see plan by plan.

Negotiated rates by insurer
Hospital	Blue Cross Blue Shield	Aetna	Cigna	UnitedHealthcare	Humana	Oscar	Ambetter	Medicaid / CHIP	Medicare Advantage
Ascension Seton Williamson	—	—	$653	—	—	—	—	—	—
Ascension Seton Hays	$360–$1,295	$902–$1,301	$914	$1,483	—	$831	$77–$483	$11.12–$93.46	$263–$282
Ascension Seton Smithville	$360–$1,295	$902–$1,301	$914	$1,483	—	$831	$77.47	$11.12–$98.52	—
Ascension Seton Edgar B. Davis	$360–$1,295	$902–$1,301	$626	$1,483	—	$831	$77.47	$14–$200	—
Dell Seton Medical Center at The University of Texas	$360–$1,295	$902–$1,301	$914	$1,483	—	$831	$77.47	$11.12–$98.04	—
Ascension Seton Northwest	$360–$1,295	$902–$1,301	$914	$1,483	—	$831	$77–$483	$11.12–$98.52	$263–$282
Ascension Seton Medical Center Austin	$360–$1,295	$902–$1,301	$914	$268–$1,483	—	$831	$77–$483	$11.12–$98.04	$263–$282
Ascension Seton Southwest	$360–$1,295	$902–$1,301	$914	$1,483	—	$831	$77–$483	$11.12–$95.69	$263–$282
Ascension Seton Cedar Park	$360–$1,295	$902–$1,301	$751	$1,483	—	$831	$77.47	$14.47–$79.37	—
Baylor Scott & White Medical Center – Lakeway	$945–$1,407	$2,805	—	—	$1,174	—	—	$335–$359	$261–$307
Baylor Scott & White Medical Center – Round Rock	$945–$1,407	$2,805	—	—	$1,174	—	—	$335–$359	$261–$307
Baylor Scott & White Medical Center – Taylor	$945–$1,407	$2,805	—	—	$1,174	—	—	$405	$319–$370
Baylor Scott & White Medical Center – Austin	$945–$1,407	$2,805	—	—	$1,174	—	—	$319–$341	$261–$307
Baylor Scott & White Medical Center – Buda	$945–$1,407	$2,805	—	—	$1,174	—	—	$201–$215	$261–$307
Baylor Scott & White Medical Center – Pflugerville	$945–$1,407	$2,805	—	—	$1,174	—	—	$184–$197	$261–$307
CHRISTUS Santa Rosa Hospital – San Marcos	$37–$1,862	$274	$1,766–$2,241	$268–$2,040	$268–$2,280	—	—	$51–$290	$268–$290
Dell Children's Medical Center	$360–$1,295	$902–$1,301	$914	$1,483	—	$831	$77.47	$14.47–$79.37	—

Ascension Seton Williamson: all 4 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$653	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$653	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$1,450	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$1,450	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Hays: all 125 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
UHC STAR PLUS	4267_CHIRP UHC STAR PLUS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$11.12	FEE SCHEDULE
WELLPOINT STAR PLUS	4211_CHIRP AMERIGROUP STAR PLUS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$11.12	FEE SCHEDULE
WELLPOINT STAR PLUS	4211_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$11.12	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
UHC STAR KIDS	4314_UHC STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$15.71	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$18.47	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
BCBS STAR	3696_CHIRP BLUE CROSS STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$23.89	FEE SCHEDULE
DELL STAR	3707_CHIRP DELL STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$23.89	FEE SCHEDULE
UHC STAR	3740_CHIRP UHC STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$23.89	FEE SCHEDULE
UHC STAR KIDS	4325_UHC STAR KIDS (HAY) INPATIENT 20240901	Medicaid / CHIP	$23.89	FEE SCHEDULE
UHC STAR PLUS	3751_CHIRP UHC STAR PLUS (HAY) INPATIENT 20240901	Medicaid / CHIP	$23.89	FEE SCHEDULE
WELLPOINT STAR	3674_CHIRP WELLPOINT/AMERIGROUP STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$23.89	FEE SCHEDULE
WELLPOINT STAR PLUS	3685_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (HAY) INPATIENT 20240901	Medicaid / CHIP	$23.89	FEE SCHEDULE
BCBS STAR	4222_CHIRP BLUE CROSS STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
DELL STAR	4233_CHIRP DELL STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
UHC STAR	4256_CHIRP UHC STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
WELLPOINT STAR	4200_CHIRP AMERIGROUP STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
WELLPOINT STAR	4200_CHIRP WELLPOINT/AMERIGROUP STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4171_BLUE CROSS CHIP (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4171_BLUE CROSS CHIP/STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR KIDS	5009_BLUE CROSS STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4182_DELL CHIP/STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4160_AMERIGROUP CHIP/STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4160_WELLPOINT/AMERIGROUP CHIP (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR KIDS	4976_WELLPOINT/AMERIGROUP STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3597_BLUE CROSS CHIP/STAR KIDS (HAY) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3608_DELL CHIP/STAR KIDS (HAY) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
SUPERIOR STAR	3512_CHIRP SUPERIOR STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$93.02	CASE RATE
SUPERIOR STAR PLUS	4378_CHIRP SUPERIOR STAR PLUS (HAY) INPATIENT 20240901	Medicaid / CHIP	$93.02	CASE RATE
SUPERIOR STAR	4244_CHIRP SUPERIOR STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$93.46	CASE RATE
SUPERIOR STAR PLUS	4395_CHIRP SUPERIOR STAR PLUS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$93.46	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$189	FEE SCHEDULE
AARP MC WELLMED	4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811	Medicare Advantage	$263	OTHER
AARP MC WELLMED	4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001	Medicare Advantage	$263	OTHER
SENDERO CHAP	4932_SENDERO CHAP OUTPATIENT 20250811	Commercial	$266	OTHER
SENDERO CHAP	4651_SENDERO CHAP INPATIENT 20251001	Commercial	$266	OTHER
AETNA MCR REPLACEMENT	4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811	Medicare Advantage	$268	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811	Medicare Advantage	$268	OTHER
COVID HRSA	4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811	Public program	$268	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811	Medicare Advantage	$268	OTHER
HUMANA MCR REPLACEMENT	4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811	Medicare Advantage	$268	OTHER
MEDICARE REPLACEMENT	4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811	Medicare Advantage	$268	OTHER
SUPERIOR ALLWELL	4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101	Medicare Advantage	$268	OTHER
UTMB	4125_UTMB PRISONS (HAY) OP 20250101	Public program	$268	OTHER
WELLCARE MED ADVANTAGE	4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811	Medicare Advantage	$268	OTHER
WELMED MEDICARE	4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811	Medicare Advantage	$268	OTHER
AETNA MCR REPLACEMENT	4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001	Medicare Advantage	$268	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001	Medicare Advantage	$268	OTHER
COVID HRSA	4693_COVID HRSA UNIN Q80 INPATIENT 20251001	Public program	$268	OTHER
CSHCN CIDC	4694_CSHCN CIDC IP (ADULT) 20251001	Public program	$268	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001	Medicare Advantage	$268	OTHER
HUMANA MCR REPLACEMENT	4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001	Medicare Advantage	$268	OTHER
MEDICARE OON	4666_MEDICARE ADVANTAGE INPATIENT OON 20251001	Medicare Advantage	$268	OTHER
MEDICARE REPLACEMENT	4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001	Medicare Advantage	$268	OTHER
SUPERIOR ALLWELL	4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001	Medicare Advantage	$268	OTHER
TRICARE	4696_TRICARE INPATIENT 20251001	Military / VA	$268	OTHER
UTMB	4677_UTMB PRISONS (HAY) IP 20251001	Public program	$268	OTHER
WELLCARE MED ADVANTAGE	4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001	Medicare Advantage	$268	OTHER
WELMED MEDICARE	4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001	Medicare Advantage	$268	OTHER
UHC MCR REPLACEMENT	4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811	Medicare Advantage	$274	OTHER
UHC MCR REPLACEMENT	4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001	Medicare Advantage	$274	OTHER
CONNECTED SENIOR CARE	2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001	Medicare Advantage	$276	OTHER
CONNECTED SENIOR CARE	4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001	Medicare Advantage	$276	OTHER
PPHP MCR ADVANTAGE	4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811	Medicare Advantage	$282	OTHER
TX INDEPENDENCE HP	4741_TX INDEPENDENCE HP OP 20250811	Medicare Advantage	$282	OTHER
PPHP MCR ADVANTAGE	4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001	Medicare Advantage	$282	OTHER
TX INDEPENDENCE HP	4671_TX INDEPENDENCE HP IP 20251001	Medicare Advantage	$282	OTHER
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$360	OTHER
OCCUNET	4123_OCCUNET OP 20250101	Workers' comp	$376	OTHER
OCCUNET	4674_OCCUNET IP 20251001	Workers' comp	$376	OTHER
SENDERO IDEALCARE	1571_SENDERO IDEALCARE OP 20200101	Commercial	$470	OTHER
SENDERO IDEALCARE	4675_SENDERO IDEALCARE IP 20251001	Commercial	$470	OTHER
SUPERIOR AMBETTER	4960_SUPERIOR AMBETTER OUTPATIENT 20250811	Commercial	$483	OTHER
SUPERIOR AMBETTER	4652_SUPERIOR AMBETTER INPATIENT 20251001	Commercial	$483	OTHER
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$684	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$759	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$759	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$831	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$838	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$867	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$902	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$914	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$914	PERCENT OF TOTAL BILLED CHARGES
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,009	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,009	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,041	FEE SCHEDULE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,067	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,171	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$1,295	FEE SCHEDULE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,301	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,301	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$1,483	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$1,483	CASE RATE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$1,980	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$2,032	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$2,032	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Smithville: all 86 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
UHC STAR PLUS	4270_CHIRP UHC STAR PLUS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$11.12	FEE SCHEDULE
WELLPOINT STAR PLUS	4214_CHIRP AMERIGROUP STAR PLUS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$11.12	FEE SCHEDULE
WELLPOINT STAR PLUS	4214_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$11.12	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$18.47	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
BCBS STAR	4225_CHIRP BLUE CROSS STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
DELL STAR	4236_CHIRP DELL STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
UHC STAR	4259_CHIRP UHC STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
WELLPOINT STAR	4203_CHIRP AMERIGROUP STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
WELLPOINT STAR	4203_CHIRP WELLPOINT/AMERIGROUP STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
BCBS STAR	3699_CHIRP BLUE CROSS STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$25.30	FEE SCHEDULE
DELL STAR	3710_CHIRP DELL STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$25.30	FEE SCHEDULE
UHC STAR	3743_CHIRP UHC STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$25.30	FEE SCHEDULE
UHC STAR KIDS	4328_UHC STAR KIDS (SMV) INPATIENT 20240901	Medicaid / CHIP	$25.30	FEE SCHEDULE
UHC STAR PLUS	3754_CHIRP UHC STAR PLUS (SMV) INPATIENT 20240901	Medicaid / CHIP	$25.30	FEE SCHEDULE
WELLPOINT STAR	3677_CHIRP WELLPOINT/AMERIGROUP STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$25.30	FEE SCHEDULE
WELLPOINT STAR PLUS	3688_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SMV) INPATIENT 20240901	Medicaid / CHIP	$25.30	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4174_BLUE CROSS CHIP (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4174_BLUE CROSS CHIP/STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR KIDS	5015_BLUE CROSS STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4185_DELL CHIP/STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
UHC STAR KIDS	4317_UHC STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4163_AMERIGROUP CHIP/STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4163_WELLPOINT/AMERIGROUP CHIP (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR KIDS	4982_WELLPOINT/AMERIGROUP STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3600_BLUE CROSS CHIP/STAR KIDS (SMV) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3611_DELL CHIP/STAR KIDS (SMV) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	3589_WELLPOINT CHIP/STAR KIDS (SMV) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
SUPERIOR STAR	4247_CHIRP SUPERIOR STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$93.46	CASE RATE
SUPERIOR STAR PLUS	4401_CHIRP SUPERIOR STAR PLUS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$93.46	CASE RATE
SUPERIOR STAR	3515_CHIRP SUPERIOR STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$98.52	CASE RATE
SUPERIOR STAR PLUS	4381_CHIRP SUPERIOR STAR PLUS (SMV) INPATIENT 20240901	Medicaid / CHIP	$98.52	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$189	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$360	OTHER
SENDERO IDEALCARE	1571_SENDERO IDEALCARE OP 20200101	Commercial	$470	OTHER
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$684	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$759	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$759	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$831	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$838	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$867	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$902	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$914	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$914	PERCENT OF TOTAL BILLED CHARGES
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,009	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,009	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,041	FEE SCHEDULE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,067	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,171	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$1,295	FEE SCHEDULE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,301	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,301	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$1,483	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$1,483	CASE RATE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$1,980	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$2,032	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$2,032	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Edgar B. Davis: all 84 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$18.47	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4170_BLUE CROSS CHIP (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4170_BLUE CROSS CHIP/STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR KIDS	5007_BLUE CROSS STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4181_DELL CHIP/STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4159_AMERIGROUP CHIP/STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4159_WELLPOINT/AMERIGROUP CHIP (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR KIDS	4974_WELLPOINT/AMERIGROUP STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR PLUS	4210_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3596_BLUE CROSS CHIP/STAR KIDS (EBD) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR	3695_CHIRP BLUE CROSS STAR (EBD) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3607_DELL CHIP/STAR KIDS (EBD) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
BCBS STAR	4221_CHIRP BLUE CROSS STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$90.37	FEE SCHEDULE
DELL STAR	3706_CHIRP DELL STAR (EBD) INPATIENT 20240901	Medicaid / CHIP	$90.37	FEE SCHEDULE
DELL STAR	4232_CHIRP DELL STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$90.37	FEE SCHEDULE
UHC STAR	3739_CHIRP UHC STAR (EBD) INPATIENT 20240901	Medicaid / CHIP	$90.37	FEE SCHEDULE
UHC STAR	4255_CHIRP UHC STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$90.37	FEE SCHEDULE
UHC STAR KIDS	4313_UHC STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$90.37	FEE SCHEDULE
UHC STAR KIDS	4324_UHC STAR KIDS (EBD) INPATIENT 20240901	Medicaid / CHIP	$90.37	FEE SCHEDULE
UHC STAR PLUS	3750_CHIRP UHC STAR PLUS (EBD) INPATIENT 20240901	Medicaid / CHIP	$90.37	FEE SCHEDULE
UHC STAR PLUS	4266_CHIRP UHC STAR PLUS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$90.37	FEE SCHEDULE
WELLPOINT STAR	3673_CHIRP WELLPOINT/AMERIGROUP STAR (EBD) INPATIENT 20240901	Medicaid / CHIP	$90.37	FEE SCHEDULE
WELLPOINT STAR	4199_CHIRP AMERIGROUP STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$90.37	FEE SCHEDULE
WELLPOINT STAR	4199_CHIRP WELLPOINT/AMERIGROUP STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$90.37	FEE SCHEDULE
WELLPOINT STAR PLUS	3684_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (EBD) INPATIENT 20240901	Medicaid / CHIP	$90.37	FEE SCHEDULE
WELLPOINT STAR PLUS	4210_CHIRP AMERIGROUP STAR PLUS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$90.37	FEE SCHEDULE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$189	FEE SCHEDULE
SUPERIOR STAR	4243_CHIRP SUPERIOR STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4393_CHIRP SUPERIOR STAR PLUS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3511_CHIRP SUPERIOR STAR (EBD) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4377_CHIRP SUPERIOR STAR PLUS (EBD) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$360	OTHER
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$626	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$626	PERCENT OF TOTAL BILLED CHARGES
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$684	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$759	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$759	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$831	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$838	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$867	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$902	CASE RATE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,009	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,009	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,041	FEE SCHEDULE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,067	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,171	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$1,295	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,301	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,301	FEE SCHEDULE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$1,390	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$1,390	PERCENT OF TOTAL BILLED CHARGES
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$1,483	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$1,483	CASE RATE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$1,980	CASE RATE

Dell Seton Medical Center at The University of Texas: all 85 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
WELLPOINT STAR PLUS	4209_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$11.12	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$18.47	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
BCBS STAR	3694_CHIRP BLUE CROSS STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$25.18	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4169_BLUE CROSS CHIP (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4169_BLUE CROSS CHIP/STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR KIDS	5005_BLUE CROSS STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4180_DELL CHIP/STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4158_AMERIGROUP CHIP/STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4158_WELLPOINT/AMERIGROUP CHIP (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR KIDS	4972_WELLPOINT/AMERIGROUP STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3595_BLUE CROSS CHIP/STAR KIDS (DEL) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR	4220_CHIRP BLUE CROSS STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3606_DELL CHIP/STAR KIDS (DEL) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL STAR	3705_CHIRP DELL STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL STAR	4231_CHIRP DELL STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
UHC STAR	3738_CHIRP UHC STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
UHC STAR	4254_CHIRP UHC STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
UHC STAR KIDS	4312_UHC STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
UHC STAR KIDS	4323_UHC STAR KIDS (DEL) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
UHC STAR PLUS	3749_CHIRP UHC STAR PLUS (DEL) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
UHC STAR PLUS	4265_CHIRP UHC STAR PLUS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR	3672_CHIRP WELLPOINT/AMERIGROUP STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR	4198_CHIRP AMERIGROUP STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR	4198_CHIRP WELLPOINT/AMERIGROUP STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR PLUS	3683_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (DEL) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR PLUS	4209_CHIRP AMERIGROUP STAR PLUS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
SUPERIOR STAR	4242_CHIRP SUPERIOR STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$93.46	CASE RATE
SUPERIOR STAR PLUS	4391_CHIRP SUPERIOR STAR PLUS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$93.46	CASE RATE
SUPERIOR STAR	3510_CHIRP SUPERIOR STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$98.04	CASE RATE
SUPERIOR STAR PLUS	4376_CHIRP SUPERIOR STAR PLUS (DEL) INPATIENT 20240901	Medicaid / CHIP	$98.04	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$189	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$360	OTHER
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$684	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$759	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$759	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$831	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$838	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$867	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$902	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$914	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$914	PERCENT OF TOTAL BILLED CHARGES
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,009	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,009	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,041	FEE SCHEDULE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,067	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,171	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$1,295	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,301	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,301	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$1,483	CASE RATE
UHC	4499_UNITED HEALTHCARE (DEL) 20250701	Commercial	$1,483	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$1,483	CASE RATE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$1,980	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$2,032	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$2,032	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Northwest: all 122 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
UHC STAR PLUS	4268_CHIRP UHC STAR PLUS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$11.12	FEE SCHEDULE
WELLPOINT STAR PLUS	4212_CHIRP AMERIGROUP STAR PLUS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$11.12	FEE SCHEDULE
WELLPOINT STAR PLUS	4212_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$11.12	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
UHC STAR KIDS	4315_UHC STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$15.56	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$18.47	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
BCBS STAR	4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
DELL STAR	4234_CHIRP DELL STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
UHC STAR	4257_CHIRP UHC STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
WELLPOINT STAR	4201_CHIRP AMERIGROUP STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
WELLPOINT STAR	4201_CHIRP WELLPOINT/AMERIGROUP STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
BCBS STAR	3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$25.30	FEE SCHEDULE
DELL STAR	3708_CHIRP DELL STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$25.30	FEE SCHEDULE
UHC STAR	3741_CHIRP UHC STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$25.30	FEE SCHEDULE
UHC STAR KIDS	4326_UHC STAR KIDS (NW) INPATIENT 20240901	Medicaid / CHIP	$25.30	FEE SCHEDULE
UHC STAR PLUS	3752_CHIRP UHC STAR PLUS (NW) INPATIENT 20240901	Medicaid / CHIP	$25.30	FEE SCHEDULE
WELLPOINT STAR	3675_CHIRP WELLPOINT/AMERIGROUP STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$25.30	FEE SCHEDULE
WELLPOINT STAR PLUS	3686_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (NW) INPATIENT 20240901	Medicaid / CHIP	$25.30	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR KIDS	5011_BLUE CROSS STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4183_DELL CHIP/STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4161_AMERIGROUP CHIP/STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4161_WELLPOINT/AMERIGROUP CHIP (NW) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR KIDS	4978_WELLPOINT/AMERIGROUP STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3609_DELL CHIP/STAR KIDS (NW) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
SUPERIOR STAR	4245_CHIRP SUPERIOR STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$93.46	CASE RATE
SUPERIOR STAR PLUS	4397_CHIRP SUPERIOR STAR PLUS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$93.46	CASE RATE
SUPERIOR STAR	3513_CHIRP SUPERIOR STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$98.52	CASE RATE
SUPERIOR STAR PLUS	4379_CHIRP SUPERIOR STAR PLUS (NW) INPATIENT 20240901	Medicaid / CHIP	$98.52	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$189	FEE SCHEDULE
AARP MC WELLMED	4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811	Medicare Advantage	$263	OTHER
AARP MC WELLMED	4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001	Medicare Advantage	$263	OTHER
SENDERO CHAP	4932_SENDERO CHAP OUTPATIENT 20250811	Commercial	$266	OTHER
SENDERO CHAP	4651_SENDERO CHAP INPATIENT 20251001	Commercial	$266	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811	Medicare Advantage	$268	OTHER
COVID HRSA	4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811	Public program	$268	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811	Medicare Advantage	$268	OTHER
HUMANA MCR REPLACEMENT	4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811	Medicare Advantage	$268	OTHER
MEDICARE REPLACEMENT	4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811	Medicare Advantage	$268	OTHER
SUPERIOR ALLWELL	4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101	Medicare Advantage	$268	OTHER
WELLCARE MED ADVANTAGE	4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811	Medicare Advantage	$268	OTHER
WELMED MEDICARE	4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811	Medicare Advantage	$268	OTHER
AETNA MCR REPLACEMENT	4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001	Medicare Advantage	$268	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001	Medicare Advantage	$268	OTHER
COVID HRSA	4693_COVID HRSA UNIN Q80 INPATIENT 20251001	Public program	$268	OTHER
CSHCN CIDC	4694_CSHCN CIDC IP (ADULT) 20251001	Public program	$268	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001	Medicare Advantage	$268	OTHER
HUMANA MCR REPLACEMENT	4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001	Medicare Advantage	$268	OTHER
MEDICARE OON	4666_MEDICARE ADVANTAGE INPATIENT OON 20251001	Medicare Advantage	$268	OTHER
MEDICARE REPLACEMENT	4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001	Medicare Advantage	$268	OTHER
SUPERIOR ALLWELL	4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001	Medicare Advantage	$268	OTHER
TRICARE	4696_TRICARE INPATIENT 20251001	Military / VA	$268	OTHER
WELLCARE MED ADVANTAGE	4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001	Medicare Advantage	$268	OTHER
WELMED MEDICARE	4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001	Medicare Advantage	$268	OTHER
UHC MCR REPLACEMENT	4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811	Medicare Advantage	$274	OTHER
UHC MCR REPLACEMENT	4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001	Medicare Advantage	$274	OTHER
CONNECTED SENIOR CARE	2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001	Medicare Advantage	$276	OTHER
CONNECTED SENIOR CARE	4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001	Medicare Advantage	$276	OTHER
PPHP MCR ADVANTAGE	4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811	Medicare Advantage	$282	OTHER
TX INDEPENDENCE HP	4741_TX INDEPENDENCE HP OP 20250811	Medicare Advantage	$282	OTHER
PPHP MCR ADVANTAGE	4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001	Medicare Advantage	$282	OTHER
TX INDEPENDENCE HP	4671_TX INDEPENDENCE HP IP 20251001	Medicare Advantage	$282	OTHER
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$360	OTHER
OCCUNET	4123_OCCUNET OP 20250101	Workers' comp	$376	OTHER
OCCUNET	4674_OCCUNET IP 20251001	Workers' comp	$376	OTHER
SENDERO IDEALCARE	1571_SENDERO IDEALCARE OP 20200101	Commercial	$470	OTHER
SENDERO IDEALCARE	4675_SENDERO IDEALCARE IP 20251001	Commercial	$470	OTHER
SUPERIOR AMBETTER	4960_SUPERIOR AMBETTER OUTPATIENT 20250811	Commercial	$483	OTHER
SUPERIOR AMBETTER	4652_SUPERIOR AMBETTER INPATIENT 20251001	Commercial	$483	OTHER
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$684	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$759	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$759	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$831	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$838	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$867	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$902	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$914	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$914	PERCENT OF TOTAL BILLED CHARGES
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,009	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,009	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,041	FEE SCHEDULE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,067	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,171	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$1,295	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,301	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,301	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$1,483	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$1,483	CASE RATE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$1,980	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$2,032	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$2,032	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Medical Center Austin: all 125 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
UHC STAR PLUS	4262_CHIRP UHC STAR PLUS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$11.12	FEE SCHEDULE
WELLPOINT STAR PLUS	4206_CHIRP AMERIGROUP STAR PLUS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$11.12	FEE SCHEDULE
WELLPOINT STAR PLUS	4206_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$11.12	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
UHC STAR KIDS	4309_UHC STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$16.95	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$18.47	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
BCBS STAR	4217_CHIRP BLUE CROSS STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
DELL STAR	4228_CHIRP DELL STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
UHC STAR	4251_CHIRP UHC STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
WELLPOINT STAR	4195_CHIRP AMERIGROUP STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
WELLPOINT STAR	4195_CHIRP WELLPOINT/AMERIGROUP STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
BCBS STAR	3691_CHIRP BLUE CROSS STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$25.18	FEE SCHEDULE
DELL STAR	3702_CHIRP DELL STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$25.18	FEE SCHEDULE
UHC STAR	3735_CHIRP UHC STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$25.18	FEE SCHEDULE
UHC STAR KIDS	4320_UHC STAR KIDS (AUS) INPATIENT 20240901	Medicaid / CHIP	$25.18	FEE SCHEDULE
UHC STAR PLUS	3746_CHIRP UHC STAR PLUS (AUS) INPATIENT 20240901	Medicaid / CHIP	$25.18	FEE SCHEDULE
WELLPOINT STAR	3669_CHIRP WELLPOINT/AMERIGROUP STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$25.18	FEE SCHEDULE
WELLPOINT STAR PLUS	3680_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (AUS) INPATIENT 20240901	Medicaid / CHIP	$25.18	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4166_BLUE CROSS CHIP (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4166_BLUE CROSS CHIP/STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR KIDS	4999_BLUE CROSS STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4177_DELL CHIP/STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4155_AMERIGROUP CHIP/STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4155_WELLPOINT/AMERIGROUP CHIP (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR KIDS	4966_WELLPOINT/AMERIGROUP STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3592_BLUE CROSS CHIP/STAR KIDS (AUS) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3603_DELL CHIP/STAR KIDS (AUS) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
SUPERIOR STAR	4239_CHIRP SUPERIOR STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$93.46	CASE RATE
SUPERIOR STAR PLUS	4385_CHIRP SUPERIOR STAR PLUS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$93.46	CASE RATE
SUPERIOR STAR	3507_CHIRP SUPERIOR STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$98.04	CASE RATE
SUPERIOR STAR PLUS	4373_CHIRP SUPERIOR STAR PLUS (AUS) INPATIENT 20240901	Medicaid / CHIP	$98.04	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$189	FEE SCHEDULE
AARP MC WELLMED	4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811	Medicare Advantage	$263	OTHER
AARP MC WELLMED	4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001	Medicare Advantage	$263	OTHER
SENDERO CHAP	4932_SENDERO CHAP OUTPATIENT 20250811	Commercial	$266	OTHER
SENDERO CHAP	4651_SENDERO CHAP INPATIENT 20251001	Commercial	$266	OTHER
AETNA MCR REPLACEMENT	4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811	Medicare Advantage	$268	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811	Medicare Advantage	$268	OTHER
COVID HRSA	4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811	Public program	$268	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811	Medicare Advantage	$268	OTHER
HUMANA MCR REPLACEMENT	4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811	Medicare Advantage	$268	OTHER
MEDICARE REPLACEMENT	4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811	Medicare Advantage	$268	OTHER
SUPERIOR ALLWELL	4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101	Medicare Advantage	$268	OTHER
UHCPCIP	4126_UNITED HEALTHCARE PCIP (AUS) OP 20250101	Commercial	$268	OTHER
WELLCARE MED ADVANTAGE	4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811	Medicare Advantage	$268	OTHER
WELMED MEDICARE	4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811	Medicare Advantage	$268	OTHER
AETNA MCR REPLACEMENT	4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001	Medicare Advantage	$268	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001	Medicare Advantage	$268	OTHER
COVID HRSA	4693_COVID HRSA UNIN Q80 INPATIENT 20251001	Public program	$268	OTHER
CSHCN CIDC	4694_CSHCN CIDC IP (ADULT) 20251001	Public program	$268	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001	Medicare Advantage	$268	OTHER
HUMANA MCR REPLACEMENT	4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001	Medicare Advantage	$268	OTHER
MEDICARE OON	4666_MEDICARE ADVANTAGE INPATIENT OON 20251001	Medicare Advantage	$268	OTHER
MEDICARE REPLACEMENT	4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001	Medicare Advantage	$268	OTHER
SUPERIOR ALLWELL	4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001	Medicare Advantage	$268	OTHER
TRICARE	4696_TRICARE INPATIENT 20251001	Military / VA	$268	OTHER
UHCPCIP	4678_UNITED HEALTHCARE PCIP (AUS) IP 20251001	Commercial	$268	OTHER
WELLCARE MED ADVANTAGE	4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001	Medicare Advantage	$268	OTHER
WELMED MEDICARE	4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001	Medicare Advantage	$268	OTHER
UHC MCR REPLACEMENT	4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811	Medicare Advantage	$274	OTHER
UHC MCR REPLACEMENT	4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001	Medicare Advantage	$274	OTHER
CONNECTED SENIOR CARE	2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001	Medicare Advantage	$276	OTHER
CONNECTED SENIOR CARE	4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001	Medicare Advantage	$276	OTHER
PPHP MCR ADVANTAGE	4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811	Medicare Advantage	$282	OTHER
TX INDEPENDENCE HP	4741_TX INDEPENDENCE HP OP 20250811	Medicare Advantage	$282	OTHER
PPHP MCR ADVANTAGE	4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001	Medicare Advantage	$282	OTHER
TX INDEPENDENCE HP	4671_TX INDEPENDENCE HP IP 20251001	Medicare Advantage	$282	OTHER
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$360	OTHER
OCCUNET	4123_OCCUNET OP 20250101	Workers' comp	$376	OTHER
OCCUNET	4674_OCCUNET IP 20251001	Workers' comp	$376	OTHER
SENDERO IDEALCARE	1571_SENDERO IDEALCARE OP 20200101	Commercial	$470	OTHER
SENDERO IDEALCARE	4675_SENDERO IDEALCARE IP 20251001	Commercial	$470	OTHER
SUPERIOR AMBETTER	4960_SUPERIOR AMBETTER OUTPATIENT 20250811	Commercial	$483	OTHER
SUPERIOR AMBETTER	4652_SUPERIOR AMBETTER INPATIENT 20251001	Commercial	$483	OTHER
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$684	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$759	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$759	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$831	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$838	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$867	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$902	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$914	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$914	PERCENT OF TOTAL BILLED CHARGES
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,009	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,009	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,041	FEE SCHEDULE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,067	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,171	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$1,295	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,301	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,301	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$1,483	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$1,483	CASE RATE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$1,980	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$2,032	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$2,032	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Southwest: all 123 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
UHC STAR PLUS	4271_CHIRP UHC STAR PLUS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$11.12	FEE SCHEDULE
WELLPOINT STAR PLUS	4215_CHIRP AMERIGROUP STAR PLUS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$11.12	FEE SCHEDULE
WELLPOINT STAR PLUS	4215_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$11.12	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4204_CHIRP AMERIGROUP STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$15.02	FEE SCHEDULE
WELLPOINT STAR	4204_CHIRP WELLPOINT/AMERIGROUP STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$15.02	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$18.47	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
BCBS STAR	4226_CHIRP BLUE CROSS STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
DELL STAR	4237_CHIRP DELL STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
UHC STAR	4260_CHIRP UHC STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$24.00	FEE SCHEDULE
BCBS STAR	3700_CHIRP BLUE CROSS STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$24.57	FEE SCHEDULE
DELL STAR	3711_CHIRP DELL STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$24.57	FEE SCHEDULE
UHC STAR	3744_CHIRP UHC STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$24.57	FEE SCHEDULE
UHC STAR KIDS	4329_UHC STAR KIDS (SW) INPATIENT 20240901	Medicaid / CHIP	$24.57	FEE SCHEDULE
UHC STAR PLUS	3755_CHIRP UHC STAR PLUS (SW) INPATIENT 20240901	Medicaid / CHIP	$24.57	FEE SCHEDULE
WELLPOINT STAR	3678_CHIRP WELLPOINT/AMERIGROUP STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$24.57	FEE SCHEDULE
WELLPOINT STAR PLUS	3689_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SW) INPATIENT 20240901	Medicaid / CHIP	$24.57	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4175_BLUE CROSS CHIP (SW) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4175_BLUE CROSS CHIP/STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR KIDS	5017_BLUE CROSS STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4186_DELL CHIP/STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
UHC STAR KIDS	4318_UHC STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4164_AMERIGROUP CHIP/STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4164_WELLPOINT/AMERIGROUP CHIP (SW) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR KIDS	4984_WELLPOINT/AMERIGROUP STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3601_BLUE CROSS CHIP/STAR KIDS (SW) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3612_DELL CHIP/STAR KIDS (SW) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
SUPERIOR STAR	4248_CHIRP SUPERIOR STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$93.46	CASE RATE
SUPERIOR STAR PLUS	4403_CHIRP SUPERIOR STAR PLUS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$93.46	CASE RATE
SUPERIOR STAR	3516_CHIRP SUPERIOR STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$95.69	CASE RATE
SUPERIOR STAR PLUS	4382_CHIRP SUPERIOR STAR PLUS (SW) INPATIENT 20240901	Medicaid / CHIP	$95.69	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$189	FEE SCHEDULE
AARP MC WELLMED	4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811	Medicare Advantage	$263	OTHER
AARP MC WELLMED	4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001	Medicare Advantage	$263	OTHER
SENDERO CHAP	4932_SENDERO CHAP OUTPATIENT 20250811	Commercial	$266	OTHER
SENDERO CHAP	4651_SENDERO CHAP INPATIENT 20251001	Commercial	$266	OTHER
AETNA MCR REPLACEMENT	4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811	Medicare Advantage	$268	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811	Medicare Advantage	$268	OTHER
COVID HRSA	4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811	Public program	$268	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811	Medicare Advantage	$268	OTHER
HUMANA MCR REPLACEMENT	4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811	Medicare Advantage	$268	OTHER
MEDICARE REPLACEMENT	4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811	Medicare Advantage	$268	OTHER
SUPERIOR ALLWELL	4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101	Medicare Advantage	$268	OTHER
WELLCARE MED ADVANTAGE	4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811	Medicare Advantage	$268	OTHER
WELMED MEDICARE	4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811	Medicare Advantage	$268	OTHER
AETNA MCR REPLACEMENT	4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001	Medicare Advantage	$268	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001	Medicare Advantage	$268	OTHER
COVID HRSA	4693_COVID HRSA UNIN Q80 INPATIENT 20251001	Public program	$268	OTHER
CSHCN CIDC	4694_CSHCN CIDC IP (ADULT) 20251001	Public program	$268	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001	Medicare Advantage	$268	OTHER
HUMANA MCR REPLACEMENT	4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001	Medicare Advantage	$268	OTHER
MEDICARE OON	4666_MEDICARE ADVANTAGE INPATIENT OON 20251001	Medicare Advantage	$268	OTHER
MEDICARE REPLACEMENT	4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001	Medicare Advantage	$268	OTHER
SUPERIOR ALLWELL	4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001	Medicare Advantage	$268	OTHER
TRICARE	4696_TRICARE INPATIENT 20251001	Military / VA	$268	OTHER
WELLCARE MED ADVANTAGE	4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001	Medicare Advantage	$268	OTHER
WELMED MEDICARE	4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001	Medicare Advantage	$268	OTHER
UHC MCR REPLACEMENT	4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811	Medicare Advantage	$274	OTHER
UHC MCR REPLACEMENT	4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001	Medicare Advantage	$274	OTHER
CONNECTED SENIOR CARE	2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001	Medicare Advantage	$276	OTHER
CONNECTED SENIOR CARE	4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001	Medicare Advantage	$276	OTHER
PPHP MCR ADVANTAGE	4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811	Medicare Advantage	$282	OTHER
TX INDEPENDENCE HP	4741_TX INDEPENDENCE HP OP 20250811	Medicare Advantage	$282	OTHER
PPHP MCR ADVANTAGE	4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001	Medicare Advantage	$282	OTHER
TX INDEPENDENCE HP	4671_TX INDEPENDENCE HP IP 20251001	Medicare Advantage	$282	OTHER
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$360	OTHER
OCCUNET	4123_OCCUNET OP 20250101	Workers' comp	$376	OTHER
OCCUNET	4674_OCCUNET IP 20251001	Workers' comp	$376	OTHER
SENDERO IDEALCARE	1571_SENDERO IDEALCARE OP 20200101	Commercial	$470	OTHER
SENDERO IDEALCARE	4675_SENDERO IDEALCARE IP 20251001	Commercial	$470	OTHER
SUPERIOR AMBETTER	4960_SUPERIOR AMBETTER OUTPATIENT 20250811	Commercial	$483	OTHER
SUPERIOR AMBETTER	4652_SUPERIOR AMBETTER INPATIENT 20251001	Commercial	$483	OTHER
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$684	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$759	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$759	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$831	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$838	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$867	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$902	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$914	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$914	PERCENT OF TOTAL BILLED CHARGES
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,009	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,009	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,041	FEE SCHEDULE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,067	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,171	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$1,295	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,301	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,301	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$1,483	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$1,483	CASE RATE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$1,980	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$2,032	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$2,032	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Cedar Park: all 55 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$18.47	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$189	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$360	OTHER
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$684	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$751	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$751	PERCENT OF TOTAL BILLED CHARGES
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$759	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$759	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$831	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$838	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$867	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$902	CASE RATE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,009	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,009	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,041	FEE SCHEDULE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,067	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,171	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$1,295	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,301	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,301	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$1,483	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$1,483	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$1,669	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$1,669	PERCENT OF TOTAL BILLED CHARGES
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$1,980	CASE RATE

Baylor Scott & White Medical Center – Lakeway: all 36 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$261	fee schedule
CORVEL	Worker's Compensation	Workers' comp	$266	fee schedule
Humana	Medicare	Medicare Advantage	$274	fee schedule
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$274	fee schedule
TriWest	Community Care Network	Military / VA	$274	fee schedule
Aetna	Medicare Advantage	Medicare Advantage	$288	fee schedule
American Health Plan	Medicare Advantage	Medicare Advantage	$288	fee schedule
HealthSpring	Medicare Advantage	Medicare Advantage	$288	fee schedule
ProCare Advantage	Medicare Advantage	Medicare Advantage	$288	fee schedule
United Healthcare	Medicare Advantage	Medicare Advantage	$307	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$329	fee schedule
Superior Health Plan	Medicaid	Medicaid / CHIP	$335	percent of total billed charges
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$344	fee schedule
Prime Health Services	Worker's Compensation	Workers' comp	$346	fee schedule
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$359	percent of total billed charges
Sedgwick	Preferred Network	Workers' comp	$410	fee schedule
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$452	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$868	case rate
QuikTrip	Employee Benefit Plan	Commercial	$922	percent of total billed charges
MidCoast	Commercial	Commercial	$922	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$945	case rate
Independent Medical System	Commercial PPO	Commercial	$1,006	percent of total billed charges
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,021	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,026	case rate
Curative	Commercial	Commercial	$1,090	percent of total billed charges
Blue Cross Blue Shield	Blue Advantage	Commercial	$1,169	case rate
First Health	PPO	Commercial	$1,174	percent of total billed charges
Humana	Commercial PPO	Commercial	$1,174	percent of total billed charges
HealthSmart	Accel Network	Commercial	$1,258	percent of total billed charges
HealthSmart	Preferred Network	Commercial	$1,258	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$1,258	percent of total billed charges
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$1,337	case rate
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$1,407	case rate
Three Rivers	Three Rivers Provider Network	Commercial	$1,509	percent of total billed charges
Mark Cuban	Commercial	Commercial	$2,410	case rate
Aetna	Commercial	Commercial	$2,805	case rate

Baylor Scott & White Medical Center – Round Rock: all 39 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$261	fee schedule
CORVEL	Worker's Compensation	Workers' comp	$266	fee schedule
Humana	Medicare	Medicare Advantage	$274	fee schedule
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$274	fee schedule
TriWest	Community Care Network	Military / VA	$274	fee schedule
American Health Plan	Medicare Advantage	Medicare Advantage	$288	fee schedule
Blue Cross Blue Shield	Medicare Advantage	Medicare Advantage	$288	fee schedule
HealthSpring	Medicare Advantage	Medicare Advantage	$288	fee schedule
ProCare Advantage	Medicare Advantage	Medicare Advantage	$288	fee schedule
United Healthcare	Medicare Advantage	Medicare Advantage	$307	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$329	fee schedule
Superior Health Plan	Medicaid	Medicaid / CHIP	$335	percent of total billed charges
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$344	fee schedule
Prime Health Services	Worker's Compensation	Workers' comp	$346	fee schedule
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$359	percent of total billed charges
CareWorks fka Rockport	Worker's Compensation	Workers' comp	$410	fee schedule
Injury Management Organization	Med Select Network	Workers' comp	$410	fee schedule
Sedgwick	Preferred Network	Workers' comp	$410	fee schedule
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$452	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$868	case rate
QuikTrip	Employee Benefit Plan	Commercial	$922	percent of total billed charges
MidCoast	Commercial	Commercial	$922	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$945	case rate
Independent Medical System	Commercial PPO	Commercial	$1,006	percent of total billed charges
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,021	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,026	case rate
Curative	Commercial	Commercial	$1,090	percent of total billed charges
Blue Cross Blue Shield	Blue Advantage	Commercial	$1,169	case rate
First Health	PPO	Commercial	$1,174	percent of total billed charges
Humana	Commercial PPO	Commercial	$1,174	percent of total billed charges
BlueBell Creameries	Self Insured	Commercial	$1,258	percent of total billed charges
HealthSmart	Accel Network	Commercial	$1,258	percent of total billed charges
HealthSmart	Preferred Network	Commercial	$1,258	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$1,258	percent of total billed charges
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$1,337	case rate
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$1,407	case rate
Three Rivers	Three Rivers Provider Network	Commercial	$1,509	percent of total billed charges
Mark Cuban	Commercial	Commercial	$2,410	case rate
Aetna	Commercial	Commercial	$2,805	case rate

Baylor Scott & White Medical Center – Taylor: all 36 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$319	percent of total billed charges
American Health Plan	Medicare Advantage	Medicare Advantage	$335	percent of total billed charges
TriWest	Community Care Network	Military / VA	$335	percent of total billed charges
CORVEL	Worker's Compensation	Workers' comp	$351	percent of total billed charges
Prime Health Services	Worker's Compensation	Workers' comp	$351	percent of total billed charges
Blue Cross Blue Shield	Medicare Advantage	Medicare Advantage	$352	percent of total billed charges
HealthSpring	Medicare Advantage	Medicare Advantage	$352	percent of total billed charges
ProCare Advantage	Medicare Advantage	Medicare Advantage	$352	percent of total billed charges
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$370	percent of total billed charges
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$402	percent of total billed charges
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$405	percent of total billed charges
CareWorks fka Rockport	Worker's Compensation	Workers' comp	$417	percent of total billed charges
Injury Management Organization	Med Select Network	Workers' comp	$417	percent of total billed charges
Sedgwick	Preferred Network	Workers' comp	$417	percent of total billed charges
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$421	percent of total billed charges
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$604	percent of total billed charges
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$868	case rate
QuikTrip	Employee Benefit Plan	Commercial	$922	percent of total billed charges
MidCoast	Commercial	Commercial	$922	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$945	case rate
Independent Medical System	Commercial PPO	Commercial	$1,006	percent of total billed charges
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,021	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,026	case rate
Curative	Commercial	Commercial	$1,090	percent of total billed charges
Blue Cross Blue Shield	Blue Advantage	Commercial	$1,169	case rate
First Health	PPO	Commercial	$1,174	percent of total billed charges
Humana	Commercial PPO	Commercial	$1,174	percent of total billed charges
HealthSmart	Accel Network	Commercial	$1,258	percent of total billed charges
HealthSmart	Preferred Network	Commercial	$1,258	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$1,258	percent of total billed charges
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$1,337	case rate
BlueBell Creameries	Self Insured	Commercial	$1,342	percent of total billed charges
Three Rivers	Three Rivers Provider Network	Commercial	$1,342	percent of total billed charges
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$1,407	case rate
Mark Cuban	Commercial	Commercial	$2,410	case rate
Aetna	Commercial	Commercial	$2,805	case rate

Baylor Scott & White Medical Center – Austin: all 28 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$261	fee schedule
Humana	Medicare	Medicare Advantage	$274	fee schedule
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$274	fee schedule
TriWest	Community Care Network	Military / VA	$274	fee schedule
American Health Plan	Medicare Advantage	Medicare Advantage	$288	fee schedule
HealthSpring	Medicare Advantage	Medicare Advantage	$288	fee schedule
ProCare Advantage	Medicare Advantage	Medicare Advantage	$288	fee schedule
United Healthcare	Medicare Advantage	Medicare Advantage	$307	fee schedule
Superior Health Plan	Medicaid	Medicaid / CHIP	$319	percent of total billed charges
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$329	fee schedule
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$341	percent of total billed charges
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$344	fee schedule
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$452	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$868	case rate
QuikTrip	Employee Benefit Plan	Commercial	$922	percent of total billed charges
MidCoast	Commercial	Commercial	$922	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$945	case rate
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,021	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,026	case rate
Curative	Commercial	Commercial	$1,090	percent of total billed charges
Blue Cross Blue Shield	Blue Advantage	Commercial	$1,169	case rate
First Health	PPO	Commercial	$1,174	percent of total billed charges
Humana	Commercial PPO	Commercial	$1,174	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$1,258	percent of total billed charges
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$1,337	case rate
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$1,407	case rate
Mark Cuban	Commercial	Commercial	$2,410	case rate
Aetna	Commercial	Commercial	$2,805	case rate

Baylor Scott & White Medical Center – Buda: all 29 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Superior Health Plan	Medicaid	Medicaid / CHIP	$201	percent of total billed charges
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$215	percent of total billed charges
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$261	fee schedule
Humana	Medicare	Medicare Advantage	$274	fee schedule
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$274	fee schedule
TriWest	Community Care Network	Military / VA	$274	fee schedule
American Health Plan	Medicare Advantage	Medicare Advantage	$288	fee schedule
Blue Cross Blue Shield	Medicare Advantage	Medicare Advantage	$288	fee schedule
HealthSpring	Medicare Advantage	Medicare Advantage	$288	fee schedule
ProCare Advantage	Medicare Advantage	Medicare Advantage	$288	fee schedule
United Healthcare	Medicare Advantage	Medicare Advantage	$307	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$329	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$344	fee schedule
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$452	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$868	case rate
QuikTrip	Employee Benefit Plan	Commercial	$922	percent of total billed charges
MidCoast	Commercial	Commercial	$922	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$945	case rate
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,021	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,026	case rate
Curative	Commercial	Commercial	$1,090	percent of total billed charges
Blue Cross Blue Shield	Blue Advantage	Commercial	$1,169	case rate
First Health	PPO	Commercial	$1,174	percent of total billed charges
Humana	Commercial PPO	Commercial	$1,174	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$1,258	percent of total billed charges
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$1,337	case rate
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$1,407	case rate
Mark Cuban	Commercial	Commercial	$2,410	case rate
Aetna	Commercial	Commercial	$2,805	case rate

Baylor Scott & White Medical Center – Pflugerville: all 35 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Superior Health Plan	Medicaid	Medicaid / CHIP	$184	percent of total billed charges
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$197	percent of total billed charges
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$261	fee schedule
CORVEL	Worker's Compensation	Workers' comp	$266	fee schedule
Humana	Medicare	Medicare Advantage	$274	fee schedule
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$274	fee schedule
TriWest	Community Care Network	Military / VA	$274	fee schedule
American Health Plan	Medicare Advantage	Medicare Advantage	$288	fee schedule
HealthSpring	Medicare Advantage	Medicare Advantage	$288	fee schedule
ProCare Advantage	Medicare Advantage	Medicare Advantage	$288	fee schedule
United Healthcare	Medicare Advantage	Medicare Advantage	$307	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$329	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$344	fee schedule
Prime Health Services	Worker's Compensation	Workers' comp	$346	fee schedule
Sedgwick	Preferred Network	Workers' comp	$410	fee schedule
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$452	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$868	case rate
QuikTrip	Employee Benefit Plan	Commercial	$922	percent of total billed charges
MidCoast	Commercial	Commercial	$922	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$945	case rate
Independent Medical System	Commercial PPO	Commercial	$1,006	percent of total billed charges
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,021	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,026	case rate
Curative	Commercial	Commercial	$1,090	percent of total billed charges
Blue Cross Blue Shield	Blue Advantage	Commercial	$1,169	case rate
First Health	PPO	Commercial	$1,174	percent of total billed charges
Humana	Commercial PPO	Commercial	$1,174	percent of total billed charges
HealthSmart	Accel Network	Commercial	$1,258	percent of total billed charges
HealthSmart	Preferred Network	Commercial	$1,258	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$1,258	percent of total billed charges
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$1,337	case rate
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$1,407	case rate
Three Rivers	Three Rivers Provider Network	Commercial	$1,509	percent of total billed charges
Mark Cuban	Commercial	Commercial	$2,410	case rate
Aetna	Commercial	Commercial	$2,805	case rate

CHRISTUS Santa Rosa Hospital – San Marcos: all 31 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Blue Cross Blue Shield Of Texas	PPO	Commercial	$37.41	fee schedule
United Healthcare	Star KM	Medicaid / CHIP	$51.36	fee schedule
United Healthcare	Star Kids KM	Medicaid / CHIP	$51.36	fee schedule
Superior	Chip KM	Medicaid / CHIP	$78.91	case rate
Superior	Star KM	Medicaid / CHIP	$78.91	case rate
Superior	Star Kids KM	Medicaid / CHIP	$78.91	case rate
Allwell	Superior Medicare Advantage	Medicare Advantage	$268	fee schedule
Christus Health	Med Adv MM	Medicare Advantage	$268	fee schedule
Humana	MM	Commercial	$268	fee schedule
Triwest	VA MM	Military / VA	$268	fee schedule
United Healthcare	MM	Commercial	$268	fee schedule
Washington National	Supp MM	Commercial	$268	fee schedule
Wellcare	MM	Medicare Advantage	$268	fee schedule
Aetna	MM	Commercial	$274	fee schedule
Cigna	Healthspring Medicare Advantage MM	Medicare Advantage	$276	fee schedule
Provider Partners Health Plan	MM	Medicare Advantage	$276	fee schedule
Shared Health Insurance Company	MM	Commercial	$282	fee schedule
Amerigroup	MM	Medicaid / CHIP	$290	fee schedule
Devoted Health Plan	MM	Medicare Advantage	$290	fee schedule
Christus Health	HIX	Commercial	$376	fee schedule
Sendero	HMO HIX	Commercial	$459	fee schedule
Naphcare Inc.	RRMB	Public program	$537	fee schedule
Healthcare Highways	PPO	Commercial	$679	fee schedule
Blue Cross Blue Shield Of Texas	HMO	Commercial	$806	fee schedule
Blue Cross Blue Shield Of Texas	Blue Advantage HMO	Commercial	$1,722	case rate
Cigna	New Business	Commercial	$1,766	fee schedule
Blue Cross Blue Shield Of Texas	HEB	Commercial	$1,862	case rate
United Healthcare	All Payer	Commercial	$2,040	case rate
Five Point Credit Union	PPO	Commercial	$2,128	case rate
Cigna	PPO	Commercial	$2,241	fee schedule
Humana	Choicecare	Commercial	$2,280	case rate

Dell Children's Medical Center: all 55 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$14.47	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$18.47	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$20.38	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$42.80	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$51.36	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$51.36	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$56.34	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$77.47	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$79.37	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$189	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$360	OTHER
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$684	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$759	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$759	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$831	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$838	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$867	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$902	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$914	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$914	PERCENT OF TOTAL BILLED CHARGES
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,009	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,009	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,041	FEE SCHEDULE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,067	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,171	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$1,295	FEE SCHEDULE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,301	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,301	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$1,483	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$1,483	CASE RATE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$1,980	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$2,032	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$2,032	PERCENT OF TOTAL BILLED CHARGES

Emergency room visit, level 4 (high) (CPT 99284)

Published cash price

$883–$1,676

what 15 hospitals list for a self-pay ER visit level 4

Typical insured rate

$1,499

median of every commercial plan rate in the files

Lowest insured rate

$5.69

Blue Cross Blue Shield Of Texas (PPO), CHRISTUS Santa Rosa Hospital – San Marcos

ER visit level 4 prices by hospital in Austin

Sorted by published cash price. “Typical insured rate” is the median of all commercial plan rates each hospital lists for CPT 99284; Medicaid and Medicare Advantage are shown separately below.

Emergency room visit, level 4 (high) (CPT 99284) — Austin
Hospital	Published cash price	Typical insured rate	Lowest insured rate
Ascension Seton SmithvilleAscension Seton · file Jan 2026	$883–$1,170Cash ÷ typical 0.6×	$1,46124 plans	$348
Ascension Seton WilliamsonAscension Seton · file Jan 2026	$883–$1,170	$1,3532 plans	$1,353
Ascension Seton HaysAscension Seton · file Jan 2026	$883–$1,170Cash ÷ typical 0.6×	$1,36829 plans	$348
Dell Seton Medical Center at The University of TexasAscension Seton · file Jan 2026	$1,082–$1,170Cash ÷ typical 0.7×	$1,46324 plans	$348
Ascension Seton NorthwestAscension Seton · file Jan 2026	$1,082–$1,170Cash ÷ typical 0.8×	$1,36829 plans	$348
Ascension Seton Medical Center AustinAscension Seton · file Jan 2026	$1,082–$1,170Cash ÷ typical 0.8×	$1,32531 plans	$348
Ascension Seton SouthwestAscension Seton · file Jan 2026	$1,082–$1,170Cash ÷ typical 0.8×	$1,36829 plans	$348
Ascension Seton Edgar B. DavisAscension Seton · file Jan 2026	$1,120Cash ÷ typical 0.8×	$1,40023 plans	$348
Ascension Seton Cedar ParkAscension Seton · file Jan 2026	$1,277Cash ÷ typical 0.8×	$1,59623 plans	$348
Baylor Scott & White Medical Center – LakewayBaylor Scott & White Health · file Jun 2026	$1,676Cash ÷ typical 0.9×	$1,95622 plans	$503
Baylor Scott & White Medical Center – Round RockBaylor Scott & White Health · file Jun 2026	$1,676Cash ÷ typical 0.9×	$1,95623 plans	$503
Baylor Scott & White Medical Center – TaylorBaylor Scott & White Health · file Jun 2026	$1,676Cash ÷ typical 0.9×	$1,95623 plans	$671
Baylor Scott & White Medical Center – AustinBaylor Scott & White Health · file Jun 2026	$1,676Cash ÷ typical 0.9×	$1,88618 plans	$503
Baylor Scott & White Medical Center – BudaBaylor Scott & White Health · file Jun 2026	$1,676Cash ÷ typical 0.9×	$1,88618 plans	$503
Baylor Scott & White Medical Center – PflugervilleBaylor Scott & White Health · file Jun 2026	$1,676Cash ÷ typical 0.9×	$1,95622 plans	$503
CHRISTUS Santa Rosa Hospital – San MarcosCHRISTUS Health · file Jan 2026	—	$1,04417 plans	$5.69
Dell Children's Medical CenterAscension Seton · children's hospital (not in the summary above) · file Jan 2026	$1,717–$2,275Cash ÷ typical 1.2×	$1,46323 plans	$348

↓ Download this table (CSV)free to reuse with attribution (CC BY 4.0)

Negotiated rates by insurer

If you have a high deductible, you usually pay the rate your insurer negotiated until you meet it. Ranges cover every plan of that insurer in the file; open a hospital to see plan by plan.

Negotiated rates by insurer
Hospital	Blue Cross Blue Shield	Aetna	Cigna	UnitedHealthcare	Humana	Oscar	Ambetter	Medicaid / CHIP	Medicare Advantage
Ascension Seton Smithville	$566–$3,040	$1,185–$1,710	$1,463	$2,074	—	$1,381	$348	$200–$355	—
Ascension Seton Williamson	—	—	$1,353	—	—	—	—	—	—
Ascension Seton Hays	$566–$3,040	$1,185–$1,710	$1,463	$2,074	—	$1,381	$348–$743	$200–$434	$404–$433
Dell Seton Medical Center at The University of Texas	$566–$3,040	$1,185–$1,710	$1,463	$2,074	—	$1,381	$348	$200–$434	—
Ascension Seton Northwest	$566–$3,040	$1,185–$1,710	$1,463	$2,074	—	$1,381	$348–$743	$187–$434	$404–$433
Ascension Seton Medical Center Austin	$566–$3,040	$1,185–$1,710	$1,463	$413–$2,074	—	$1,381	$348–$743	$200–$434	$404–$433
Ascension Seton Southwest	$566–$3,040	$1,185–$1,710	$1,463	$2,074	—	$1,381	$348–$743	$187–$434	$404–$433
Ascension Seton Edgar B. Davis	$566–$3,040	$1,185–$1,710	$1,400	$2,074	—	$1,381	$348	$200–$529	—
Ascension Seton Cedar Park	$566–$3,360	$1,185–$1,710	$1,596	$2,074	—	$1,381	$348	$200–$513	—
Baylor Scott & White Medical Center – Lakeway	$2,700–$4,020	$4,008	—	—	$1,956	—	—	$559–$598	$398–$469
Baylor Scott & White Medical Center – Round Rock	$2,700–$4,020	$4,008	—	—	$1,956	—	—	$559–$598	$398–$469
Baylor Scott & White Medical Center – Taylor	$2,700–$4,020	$4,008	—	—	$1,956	—	—	$676	$531–$616
Baylor Scott & White Medical Center – Austin	$2,700–$4,020	$4,008	—	—	$1,956	—	—	$531–$568	$398–$469
Baylor Scott & White Medical Center – Buda	$2,700–$4,020	$4,008	—	—	$1,956	—	—	$335–$359	$398–$469
Baylor Scott & White Medical Center – Pflugerville	$2,700–$4,020	$4,008	—	—	$1,956	—	—	$307–$329	$398–$469
CHRISTUS Santa Rosa Hospital – San Marcos	$6–$2,980	$421	$2,648–$3,361	$413–$2,730	$413–$2,518	—	—	$446–$552	$413–$446
Dell Children's Medical Center	$566–$3,040	$1,185–$1,710	$1,463	$2,074	—	$1,381	$348	$200–$355	—

Ascension Seton Smithville: all 86 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
SUPERIOR STAR	4247_CHIRP SUPERIOR STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4401_CHIRP SUPERIOR STAR PLUS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3515_CHIRP SUPERIOR STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4381_CHIRP SUPERIOR STAR PLUS (SMV) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
BCBS CHIP/CHIP PERINATE	4174_BLUE CROSS CHIP (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$281	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4174_BLUE CROSS CHIP/STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$281	FEE SCHEDULE
BCBS STAR	4225_CHIRP BLUE CROSS STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$281	FEE SCHEDULE
BCBS STAR KIDS	5015_BLUE CROSS STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$281	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4185_DELL CHIP/STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$281	FEE SCHEDULE
DELL STAR	4236_CHIRP DELL STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$281	FEE SCHEDULE
UHC STAR	4259_CHIRP UHC STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$281	FEE SCHEDULE
UHC STAR KIDS	4317_UHC STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$281	FEE SCHEDULE
UHC STAR PLUS	4270_CHIRP UHC STAR PLUS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$281	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4163_AMERIGROUP CHIP/STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$281	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4163_WELLPOINT/AMERIGROUP CHIP (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$281	FEE SCHEDULE
WELLPOINT STAR	4203_CHIRP AMERIGROUP STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$281	FEE SCHEDULE
WELLPOINT STAR	4203_CHIRP WELLPOINT/AMERIGROUP STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$281	FEE SCHEDULE
WELLPOINT STAR KIDS	4982_WELLPOINT/AMERIGROUP STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$281	FEE SCHEDULE
WELLPOINT STAR PLUS	4214_CHIRP AMERIGROUP STAR PLUS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$281	FEE SCHEDULE
WELLPOINT STAR PLUS	4214_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$281	FEE SCHEDULE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$316	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$348	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$348	CASE RATE
BCBS CHIP/CHIP PERINATE	3600_BLUE CROSS CHIP/STAR KIDS (SMV) INPATIENT 20240901	Medicaid / CHIP	$351	FEE SCHEDULE
BCBS STAR	3699_CHIRP BLUE CROSS STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$351	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3611_DELL CHIP/STAR KIDS (SMV) INPATIENT 20240901	Medicaid / CHIP	$351	FEE SCHEDULE
DELL STAR	3710_CHIRP DELL STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$351	FEE SCHEDULE
UHC STAR	3743_CHIRP UHC STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$351	FEE SCHEDULE
UHC STAR KIDS	4328_UHC STAR KIDS (SMV) INPATIENT 20240901	Medicaid / CHIP	$351	FEE SCHEDULE
UHC STAR PLUS	3754_CHIRP UHC STAR PLUS (SMV) INPATIENT 20240901	Medicaid / CHIP	$351	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	3589_WELLPOINT CHIP/STAR KIDS (SMV) INPATIENT 20240901	Medicaid / CHIP	$351	FEE SCHEDULE
WELLPOINT STAR	3677_CHIRP WELLPOINT/AMERIGROUP STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$351	FEE SCHEDULE
WELLPOINT STAR PLUS	3688_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SMV) INPATIENT 20240901	Medicaid / CHIP	$351	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$566	OTHER
SENDERO IDEALCARE	1571_SENDERO IDEALCARE OP 20200101	Commercial	$722	OTHER
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,106	CASE RATE
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,140	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$1,185	CASE RATE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,325	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,325	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,368	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,381	CASE RATE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$1,460	FEE SCHEDULE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$1,463	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$1,463	PERCENT OF TOTAL BILLED CHARGES
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,499	CASE RATE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,646	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,710	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,710	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,074	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,074	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$2,760	CASE RATE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$2,760	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$3,040	CASE RATE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$3,194	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$3,250	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$3,250	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Williamson: all 4 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$1,353	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$1,353	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$3,006	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$3,006	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Hays: all 125 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
BCBS CHIP/CHIP PERINATE	4171_BLUE CROSS CHIP (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4171_BLUE CROSS CHIP/STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	FEE SCHEDULE
BCBS STAR KIDS	5009_BLUE CROSS STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4182_DELL CHIP/STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	FEE SCHEDULE
UHC STAR KIDS	4314_UHC STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4160_AMERIGROUP CHIP/STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4160_WELLPOINT/AMERIGROUP CHIP (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	FEE SCHEDULE
WELLPOINT STAR KIDS	4976_WELLPOINT/AMERIGROUP STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3597_BLUE CROSS CHIP/STAR KIDS (HAY) INPATIENT 20240901	Medicaid / CHIP	$200	FEE SCHEDULE
BCBS STAR	3696_CHIRP BLUE CROSS STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$200	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3608_DELL CHIP/STAR KIDS (HAY) INPATIENT 20240901	Medicaid / CHIP	$200	FEE SCHEDULE
DELL STAR	3707_CHIRP DELL STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$200	FEE SCHEDULE
UHC STAR	3740_CHIRP UHC STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$200	FEE SCHEDULE
UHC STAR KIDS	4325_UHC STAR KIDS (HAY) INPATIENT 20240901	Medicaid / CHIP	$200	FEE SCHEDULE
UHC STAR PLUS	3751_CHIRP UHC STAR PLUS (HAY) INPATIENT 20240901	Medicaid / CHIP	$200	FEE SCHEDULE
WELLPOINT STAR	3674_CHIRP WELLPOINT/AMERIGROUP STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$200	FEE SCHEDULE
WELLPOINT STAR PLUS	3685_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (HAY) INPATIENT 20240901	Medicaid / CHIP	$200	FEE SCHEDULE
SUPERIOR STAR	4244_CHIRP SUPERIOR STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4395_CHIRP SUPERIOR STAR PLUS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3512_CHIRP SUPERIOR STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4378_CHIRP SUPERIOR STAR PLUS (HAY) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
BCBS STAR	4222_CHIRP BLUE CROSS STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	FEE SCHEDULE
DELL STAR	4233_CHIRP DELL STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	FEE SCHEDULE
UHC STAR	4256_CHIRP UHC STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	FEE SCHEDULE
UHC STAR PLUS	4267_CHIRP UHC STAR PLUS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	FEE SCHEDULE
WELLPOINT STAR	4200_CHIRP AMERIGROUP STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	FEE SCHEDULE
WELLPOINT STAR	4200_CHIRP WELLPOINT/AMERIGROUP STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	FEE SCHEDULE
WELLPOINT STAR PLUS	4211_CHIRP AMERIGROUP STAR PLUS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	FEE SCHEDULE
WELLPOINT STAR PLUS	4211_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	FEE SCHEDULE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$316	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$348	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$348	CASE RATE
AARP MC WELLMED	4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811	Medicare Advantage	$404	OTHER
AARP MC WELLMED	4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001	Medicare Advantage	$404	OTHER
SENDERO CHAP	4932_SENDERO CHAP OUTPATIENT 20250811	Commercial	$409	OTHER
SENDERO CHAP	4651_SENDERO CHAP INPATIENT 20251001	Commercial	$409	OTHER
AETNA MCR REPLACEMENT	4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811	Medicare Advantage	$413	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811	Medicare Advantage	$413	OTHER
COVID HRSA	4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811	Public program	$413	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811	Medicare Advantage	$413	OTHER
HUMANA MCR REPLACEMENT	4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811	Medicare Advantage	$413	OTHER
MEDICARE REPLACEMENT	4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811	Medicare Advantage	$413	OTHER
SUPERIOR ALLWELL	4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101	Medicare Advantage	$413	OTHER
UTMB	4125_UTMB PRISONS (HAY) OP 20250101	Public program	$413	OTHER
WELLCARE MED ADVANTAGE	4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811	Medicare Advantage	$413	OTHER
WELMED MEDICARE	4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811	Medicare Advantage	$413	OTHER
AETNA MCR REPLACEMENT	4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001	Medicare Advantage	$413	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001	Medicare Advantage	$413	OTHER
COVID HRSA	4693_COVID HRSA UNIN Q80 INPATIENT 20251001	Public program	$413	OTHER
CSHCN CIDC	4694_CSHCN CIDC IP (ADULT) 20251001	Public program	$413	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001	Medicare Advantage	$413	OTHER
HUMANA MCR REPLACEMENT	4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001	Medicare Advantage	$413	OTHER
MEDICARE OON	4666_MEDICARE ADVANTAGE INPATIENT OON 20251001	Medicare Advantage	$413	OTHER
MEDICARE REPLACEMENT	4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001	Medicare Advantage	$413	OTHER
SUPERIOR ALLWELL	4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001	Medicare Advantage	$413	OTHER
TRICARE	4696_TRICARE INPATIENT 20251001	Military / VA	$413	OTHER
UTMB	4677_UTMB PRISONS (HAY) IP 20251001	Public program	$413	OTHER
WELLCARE MED ADVANTAGE	4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001	Medicare Advantage	$413	OTHER
WELMED MEDICARE	4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001	Medicare Advantage	$413	OTHER
UHC MCR REPLACEMENT	4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811	Medicare Advantage	$421	OTHER
UHC MCR REPLACEMENT	4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001	Medicare Advantage	$421	OTHER
CONNECTED SENIOR CARE	2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001	Medicare Advantage	$425	OTHER
CONNECTED SENIOR CARE	4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001	Medicare Advantage	$425	OTHER
PPHP MCR ADVANTAGE	4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811	Medicare Advantage	$433	OTHER
TX INDEPENDENCE HP	4741_TX INDEPENDENCE HP OP 20250811	Medicare Advantage	$433	OTHER
PPHP MCR ADVANTAGE	4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001	Medicare Advantage	$433	OTHER
TX INDEPENDENCE HP	4671_TX INDEPENDENCE HP IP 20251001	Medicare Advantage	$433	OTHER
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$566	OTHER
OCCUNET	4123_OCCUNET OP 20250101	Workers' comp	$578	OTHER
OCCUNET	4674_OCCUNET IP 20251001	Workers' comp	$578	OTHER
SENDERO IDEALCARE	1571_SENDERO IDEALCARE OP 20200101	Commercial	$722	OTHER
SENDERO IDEALCARE	4675_SENDERO IDEALCARE IP 20251001	Commercial	$722	OTHER
SUPERIOR AMBETTER	4960_SUPERIOR AMBETTER OUTPATIENT 20250811	Commercial	$743	OTHER
SUPERIOR AMBETTER	4652_SUPERIOR AMBETTER INPATIENT 20251001	Commercial	$743	OTHER
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,106	CASE RATE
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,140	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$1,185	CASE RATE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,325	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,325	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,368	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,381	CASE RATE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$1,460	FEE SCHEDULE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$1,463	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$1,463	PERCENT OF TOTAL BILLED CHARGES
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,499	CASE RATE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,646	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,710	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,710	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,074	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,074	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$2,760	CASE RATE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$2,760	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$3,040	CASE RATE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$3,194	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$3,250	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$3,250	PERCENT OF TOTAL BILLED CHARGES

Dell Seton Medical Center at The University of Texas: all 85 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	4242_CHIRP SUPERIOR STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4391_CHIRP SUPERIOR STAR PLUS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3510_CHIRP SUPERIOR STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4376_CHIRP SUPERIOR STAR PLUS (DEL) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$316	CASE RATE
BCBS CHIP/CHIP PERINATE	4169_BLUE CROSS CHIP (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$328	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4169_BLUE CROSS CHIP/STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$328	FEE SCHEDULE
BCBS STAR KIDS	5005_BLUE CROSS STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$328	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4180_DELL CHIP/STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$328	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4158_AMERIGROUP CHIP/STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$328	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4158_WELLPOINT/AMERIGROUP CHIP (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$328	FEE SCHEDULE
WELLPOINT STAR KIDS	4972_WELLPOINT/AMERIGROUP STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$328	FEE SCHEDULE
WELLPOINT STAR PLUS	4209_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$328	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3595_BLUE CROSS CHIP/STAR KIDS (DEL) INPATIENT 20240901	Medicaid / CHIP	$328	FEE SCHEDULE
BCBS STAR	3694_CHIRP BLUE CROSS STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$328	FEE SCHEDULE
BCBS STAR	4220_CHIRP BLUE CROSS STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$328	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3606_DELL CHIP/STAR KIDS (DEL) INPATIENT 20240901	Medicaid / CHIP	$328	FEE SCHEDULE
DELL STAR	3705_CHIRP DELL STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$328	FEE SCHEDULE
DELL STAR	4231_CHIRP DELL STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$328	FEE SCHEDULE
UHC STAR	3738_CHIRP UHC STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$328	FEE SCHEDULE
UHC STAR	4254_CHIRP UHC STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$328	FEE SCHEDULE
UHC STAR KIDS	4312_UHC STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$328	FEE SCHEDULE
UHC STAR KIDS	4323_UHC STAR KIDS (DEL) INPATIENT 20240901	Medicaid / CHIP	$328	FEE SCHEDULE
UHC STAR PLUS	3749_CHIRP UHC STAR PLUS (DEL) INPATIENT 20240901	Medicaid / CHIP	$328	FEE SCHEDULE
UHC STAR PLUS	4265_CHIRP UHC STAR PLUS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$328	FEE SCHEDULE
WELLPOINT STAR	3672_CHIRP WELLPOINT/AMERIGROUP STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$328	FEE SCHEDULE
WELLPOINT STAR	4198_CHIRP AMERIGROUP STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$328	FEE SCHEDULE
WELLPOINT STAR	4198_CHIRP WELLPOINT/AMERIGROUP STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$328	FEE SCHEDULE
WELLPOINT STAR PLUS	3683_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (DEL) INPATIENT 20240901	Medicaid / CHIP	$328	FEE SCHEDULE
WELLPOINT STAR PLUS	4209_CHIRP AMERIGROUP STAR PLUS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$328	FEE SCHEDULE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$348	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$348	CASE RATE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$566	OTHER
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,106	CASE RATE
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,140	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$1,185	CASE RATE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,325	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,325	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,368	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,381	CASE RATE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$1,460	FEE SCHEDULE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$1,463	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$1,463	PERCENT OF TOTAL BILLED CHARGES
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,499	CASE RATE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,646	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,710	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,710	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,074	CASE RATE
UHC	4499_UNITED HEALTHCARE (DEL) 20250701	Commercial	$2,074	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,074	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$2,760	CASE RATE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$2,760	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$3,040	CASE RATE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$3,194	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$3,250	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$3,250	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Northwest: all 122 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
BCBS CHIP/CHIP PERINATE	4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
BCBS STAR KIDS	5011_BLUE CROSS STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4183_DELL CHIP/STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
UHC STAR KIDS	4315_UHC STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4161_AMERIGROUP CHIP/STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4161_WELLPOINT/AMERIGROUP CHIP (NW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
WELLPOINT STAR KIDS	4978_WELLPOINT/AMERIGROUP STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
BCBS STAR	3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3609_DELL CHIP/STAR KIDS (NW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
DELL STAR	3708_CHIRP DELL STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
UHC STAR	3741_CHIRP UHC STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
UHC STAR KIDS	4326_UHC STAR KIDS (NW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
UHC STAR PLUS	3752_CHIRP UHC STAR PLUS (NW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
WELLPOINT STAR	3675_CHIRP WELLPOINT/AMERIGROUP STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
WELLPOINT STAR PLUS	3686_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (NW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
BCBS STAR	4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
DELL STAR	4234_CHIRP DELL STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
UHC STAR	4257_CHIRP UHC STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
UHC STAR PLUS	4268_CHIRP UHC STAR PLUS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
WELLPOINT STAR	4201_CHIRP AMERIGROUP STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
WELLPOINT STAR	4201_CHIRP WELLPOINT/AMERIGROUP STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
WELLPOINT STAR PLUS	4212_CHIRP AMERIGROUP STAR PLUS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
WELLPOINT STAR PLUS	4212_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
SUPERIOR STAR	4245_CHIRP SUPERIOR STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4397_CHIRP SUPERIOR STAR PLUS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3513_CHIRP SUPERIOR STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4379_CHIRP SUPERIOR STAR PLUS (NW) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$316	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$348	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$348	CASE RATE
AARP MC WELLMED	4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811	Medicare Advantage	$404	OTHER
AARP MC WELLMED	4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001	Medicare Advantage	$404	OTHER
SENDERO CHAP	4932_SENDERO CHAP OUTPATIENT 20250811	Commercial	$409	OTHER
SENDERO CHAP	4651_SENDERO CHAP INPATIENT 20251001	Commercial	$409	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811	Medicare Advantage	$413	OTHER
COVID HRSA	4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811	Public program	$413	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811	Medicare Advantage	$413	OTHER
HUMANA MCR REPLACEMENT	4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811	Medicare Advantage	$413	OTHER
MEDICARE REPLACEMENT	4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811	Medicare Advantage	$413	OTHER
SUPERIOR ALLWELL	4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101	Medicare Advantage	$413	OTHER
WELLCARE MED ADVANTAGE	4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811	Medicare Advantage	$413	OTHER
WELMED MEDICARE	4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811	Medicare Advantage	$413	OTHER
AETNA MCR REPLACEMENT	4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001	Medicare Advantage	$413	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001	Medicare Advantage	$413	OTHER
COVID HRSA	4693_COVID HRSA UNIN Q80 INPATIENT 20251001	Public program	$413	OTHER
CSHCN CIDC	4694_CSHCN CIDC IP (ADULT) 20251001	Public program	$413	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001	Medicare Advantage	$413	OTHER
HUMANA MCR REPLACEMENT	4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001	Medicare Advantage	$413	OTHER
MEDICARE OON	4666_MEDICARE ADVANTAGE INPATIENT OON 20251001	Medicare Advantage	$413	OTHER
MEDICARE REPLACEMENT	4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001	Medicare Advantage	$413	OTHER
SUPERIOR ALLWELL	4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001	Medicare Advantage	$413	OTHER
TRICARE	4696_TRICARE INPATIENT 20251001	Military / VA	$413	OTHER
WELLCARE MED ADVANTAGE	4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001	Medicare Advantage	$413	OTHER
WELMED MEDICARE	4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001	Medicare Advantage	$413	OTHER
UHC MCR REPLACEMENT	4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811	Medicare Advantage	$421	OTHER
UHC MCR REPLACEMENT	4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001	Medicare Advantage	$421	OTHER
CONNECTED SENIOR CARE	2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001	Medicare Advantage	$425	OTHER
CONNECTED SENIOR CARE	4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001	Medicare Advantage	$425	OTHER
PPHP MCR ADVANTAGE	4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811	Medicare Advantage	$433	OTHER
TX INDEPENDENCE HP	4741_TX INDEPENDENCE HP OP 20250811	Medicare Advantage	$433	OTHER
PPHP MCR ADVANTAGE	4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001	Medicare Advantage	$433	OTHER
TX INDEPENDENCE HP	4671_TX INDEPENDENCE HP IP 20251001	Medicare Advantage	$433	OTHER
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$566	OTHER
OCCUNET	4123_OCCUNET OP 20250101	Workers' comp	$578	OTHER
OCCUNET	4674_OCCUNET IP 20251001	Workers' comp	$578	OTHER
SENDERO IDEALCARE	1571_SENDERO IDEALCARE OP 20200101	Commercial	$722	OTHER
SENDERO IDEALCARE	4675_SENDERO IDEALCARE IP 20251001	Commercial	$722	OTHER
SUPERIOR AMBETTER	4960_SUPERIOR AMBETTER OUTPATIENT 20250811	Commercial	$743	OTHER
SUPERIOR AMBETTER	4652_SUPERIOR AMBETTER INPATIENT 20251001	Commercial	$743	OTHER
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,106	CASE RATE
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,140	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$1,185	CASE RATE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,325	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,325	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,368	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,381	CASE RATE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$1,460	FEE SCHEDULE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$1,463	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$1,463	PERCENT OF TOTAL BILLED CHARGES
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,499	CASE RATE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,646	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,710	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,710	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,074	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,074	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$2,760	CASE RATE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$2,760	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$3,040	CASE RATE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$3,194	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$3,250	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$3,250	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Medical Center Austin: all 125 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
SUPERIOR STAR	4239_CHIRP SUPERIOR STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4385_CHIRP SUPERIOR STAR PLUS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3507_CHIRP SUPERIOR STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4373_CHIRP SUPERIOR STAR PLUS (AUS) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
BCBS CHIP/CHIP PERINATE	4166_BLUE CROSS CHIP (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$234	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4166_BLUE CROSS CHIP/STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$234	FEE SCHEDULE
BCBS STAR	4217_CHIRP BLUE CROSS STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$234	FEE SCHEDULE
BCBS STAR KIDS	4999_BLUE CROSS STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$234	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4177_DELL CHIP/STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$234	FEE SCHEDULE
DELL STAR	4228_CHIRP DELL STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$234	FEE SCHEDULE
UHC STAR	4251_CHIRP UHC STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$234	FEE SCHEDULE
UHC STAR KIDS	4309_UHC STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$234	FEE SCHEDULE
UHC STAR PLUS	4262_CHIRP UHC STAR PLUS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$234	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4155_AMERIGROUP CHIP/STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$234	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4155_WELLPOINT/AMERIGROUP CHIP (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$234	FEE SCHEDULE
WELLPOINT STAR	4195_CHIRP AMERIGROUP STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$234	FEE SCHEDULE
WELLPOINT STAR	4195_CHIRP WELLPOINT/AMERIGROUP STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$234	FEE SCHEDULE
WELLPOINT STAR KIDS	4966_WELLPOINT/AMERIGROUP STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$234	FEE SCHEDULE
WELLPOINT STAR PLUS	4206_CHIRP AMERIGROUP STAR PLUS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$234	FEE SCHEDULE
WELLPOINT STAR PLUS	4206_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$234	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3592_BLUE CROSS CHIP/STAR KIDS (AUS) INPATIENT 20240901	Medicaid / CHIP	$234	FEE SCHEDULE
BCBS STAR	3691_CHIRP BLUE CROSS STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$234	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3603_DELL CHIP/STAR KIDS (AUS) INPATIENT 20240901	Medicaid / CHIP	$234	FEE SCHEDULE
DELL STAR	3702_CHIRP DELL STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$234	FEE SCHEDULE
UHC STAR	3735_CHIRP UHC STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$234	FEE SCHEDULE
UHC STAR KIDS	4320_UHC STAR KIDS (AUS) INPATIENT 20240901	Medicaid / CHIP	$234	FEE SCHEDULE
UHC STAR PLUS	3746_CHIRP UHC STAR PLUS (AUS) INPATIENT 20240901	Medicaid / CHIP	$234	FEE SCHEDULE
WELLPOINT STAR	3669_CHIRP WELLPOINT/AMERIGROUP STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$234	FEE SCHEDULE
WELLPOINT STAR PLUS	3680_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (AUS) INPATIENT 20240901	Medicaid / CHIP	$234	FEE SCHEDULE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$316	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$348	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$348	CASE RATE
AARP MC WELLMED	4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811	Medicare Advantage	$404	OTHER
AARP MC WELLMED	4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001	Medicare Advantage	$404	OTHER
SENDERO CHAP	4932_SENDERO CHAP OUTPATIENT 20250811	Commercial	$409	OTHER
SENDERO CHAP	4651_SENDERO CHAP INPATIENT 20251001	Commercial	$409	OTHER
AETNA MCR REPLACEMENT	4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811	Medicare Advantage	$413	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811	Medicare Advantage	$413	OTHER
COVID HRSA	4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811	Public program	$413	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811	Medicare Advantage	$413	OTHER
HUMANA MCR REPLACEMENT	4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811	Medicare Advantage	$413	OTHER
MEDICARE REPLACEMENT	4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811	Medicare Advantage	$413	OTHER
SUPERIOR ALLWELL	4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101	Medicare Advantage	$413	OTHER
UHCPCIP	4126_UNITED HEALTHCARE PCIP (AUS) OP 20250101	Commercial	$413	OTHER
WELLCARE MED ADVANTAGE	4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811	Medicare Advantage	$413	OTHER
WELMED MEDICARE	4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811	Medicare Advantage	$413	OTHER
AETNA MCR REPLACEMENT	4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001	Medicare Advantage	$413	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001	Medicare Advantage	$413	OTHER
COVID HRSA	4693_COVID HRSA UNIN Q80 INPATIENT 20251001	Public program	$413	OTHER
CSHCN CIDC	4694_CSHCN CIDC IP (ADULT) 20251001	Public program	$413	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001	Medicare Advantage	$413	OTHER
HUMANA MCR REPLACEMENT	4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001	Medicare Advantage	$413	OTHER
MEDICARE OON	4666_MEDICARE ADVANTAGE INPATIENT OON 20251001	Medicare Advantage	$413	OTHER
MEDICARE REPLACEMENT	4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001	Medicare Advantage	$413	OTHER
SUPERIOR ALLWELL	4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001	Medicare Advantage	$413	OTHER
TRICARE	4696_TRICARE INPATIENT 20251001	Military / VA	$413	OTHER
UHCPCIP	4678_UNITED HEALTHCARE PCIP (AUS) IP 20251001	Commercial	$413	OTHER
WELLCARE MED ADVANTAGE	4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001	Medicare Advantage	$413	OTHER
WELMED MEDICARE	4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001	Medicare Advantage	$413	OTHER
UHC MCR REPLACEMENT	4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811	Medicare Advantage	$421	OTHER
UHC MCR REPLACEMENT	4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001	Medicare Advantage	$421	OTHER
CONNECTED SENIOR CARE	2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001	Medicare Advantage	$425	OTHER
CONNECTED SENIOR CARE	4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001	Medicare Advantage	$425	OTHER
PPHP MCR ADVANTAGE	4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811	Medicare Advantage	$433	OTHER
TX INDEPENDENCE HP	4741_TX INDEPENDENCE HP OP 20250811	Medicare Advantage	$433	OTHER
PPHP MCR ADVANTAGE	4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001	Medicare Advantage	$433	OTHER
TX INDEPENDENCE HP	4671_TX INDEPENDENCE HP IP 20251001	Medicare Advantage	$433	OTHER
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$566	OTHER
OCCUNET	4123_OCCUNET OP 20250101	Workers' comp	$578	OTHER
OCCUNET	4674_OCCUNET IP 20251001	Workers' comp	$578	OTHER
SENDERO IDEALCARE	1571_SENDERO IDEALCARE OP 20200101	Commercial	$722	OTHER
SENDERO IDEALCARE	4675_SENDERO IDEALCARE IP 20251001	Commercial	$722	OTHER
SUPERIOR AMBETTER	4960_SUPERIOR AMBETTER OUTPATIENT 20250811	Commercial	$743	OTHER
SUPERIOR AMBETTER	4652_SUPERIOR AMBETTER INPATIENT 20251001	Commercial	$743	OTHER
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,106	CASE RATE
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,140	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$1,185	CASE RATE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,325	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,325	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,368	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,381	CASE RATE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$1,460	FEE SCHEDULE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$1,463	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$1,463	PERCENT OF TOTAL BILLED CHARGES
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,499	CASE RATE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,646	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,710	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,710	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,074	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,074	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$2,760	CASE RATE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$2,760	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$3,040	CASE RATE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$3,194	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$3,250	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$3,250	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Southwest: all 123 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
WELLPOINT STAR	4204_CHIRP AMERIGROUP STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
WELLPOINT STAR	4204_CHIRP WELLPOINT/AMERIGROUP STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3601_BLUE CROSS CHIP/STAR KIDS (SW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
BCBS STAR	3700_CHIRP BLUE CROSS STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3612_DELL CHIP/STAR KIDS (SW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
DELL STAR	3711_CHIRP DELL STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
UHC STAR	3744_CHIRP UHC STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
UHC STAR KIDS	4329_UHC STAR KIDS (SW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
UHC STAR PLUS	3755_CHIRP UHC STAR PLUS (SW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
WELLPOINT STAR	3678_CHIRP WELLPOINT/AMERIGROUP STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
WELLPOINT STAR PLUS	3689_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SW) INPATIENT 20240901	Medicaid / CHIP	$187	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4175_BLUE CROSS CHIP (SW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4175_BLUE CROSS CHIP/STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
BCBS STAR	4226_CHIRP BLUE CROSS STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
BCBS STAR KIDS	5017_BLUE CROSS STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4186_DELL CHIP/STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
DELL STAR	4237_CHIRP DELL STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
UHC STAR	4260_CHIRP UHC STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
UHC STAR KIDS	4318_UHC STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
UHC STAR PLUS	4271_CHIRP UHC STAR PLUS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4164_AMERIGROUP CHIP/STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4164_WELLPOINT/AMERIGROUP CHIP (SW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
WELLPOINT STAR KIDS	4984_WELLPOINT/AMERIGROUP STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
WELLPOINT STAR PLUS	4215_CHIRP AMERIGROUP STAR PLUS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
WELLPOINT STAR PLUS	4215_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$187	FEE SCHEDULE
SUPERIOR STAR	4248_CHIRP SUPERIOR STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4403_CHIRP SUPERIOR STAR PLUS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3516_CHIRP SUPERIOR STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4382_CHIRP SUPERIOR STAR PLUS (SW) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$316	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$348	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$348	CASE RATE
AARP MC WELLMED	4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811	Medicare Advantage	$404	OTHER
AARP MC WELLMED	4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001	Medicare Advantage	$404	OTHER
SENDERO CHAP	4932_SENDERO CHAP OUTPATIENT 20250811	Commercial	$409	OTHER
SENDERO CHAP	4651_SENDERO CHAP INPATIENT 20251001	Commercial	$409	OTHER
AETNA MCR REPLACEMENT	4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811	Medicare Advantage	$413	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811	Medicare Advantage	$413	OTHER
COVID HRSA	4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811	Public program	$413	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811	Medicare Advantage	$413	OTHER
HUMANA MCR REPLACEMENT	4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811	Medicare Advantage	$413	OTHER
MEDICARE REPLACEMENT	4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811	Medicare Advantage	$413	OTHER
SUPERIOR ALLWELL	4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101	Medicare Advantage	$413	OTHER
WELLCARE MED ADVANTAGE	4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811	Medicare Advantage	$413	OTHER
WELMED MEDICARE	4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811	Medicare Advantage	$413	OTHER
AETNA MCR REPLACEMENT	4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001	Medicare Advantage	$413	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001	Medicare Advantage	$413	OTHER
COVID HRSA	4693_COVID HRSA UNIN Q80 INPATIENT 20251001	Public program	$413	OTHER
CSHCN CIDC	4694_CSHCN CIDC IP (ADULT) 20251001	Public program	$413	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001	Medicare Advantage	$413	OTHER
HUMANA MCR REPLACEMENT	4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001	Medicare Advantage	$413	OTHER
MEDICARE OON	4666_MEDICARE ADVANTAGE INPATIENT OON 20251001	Medicare Advantage	$413	OTHER
MEDICARE REPLACEMENT	4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001	Medicare Advantage	$413	OTHER
SUPERIOR ALLWELL	4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001	Medicare Advantage	$413	OTHER
TRICARE	4696_TRICARE INPATIENT 20251001	Military / VA	$413	OTHER
WELLCARE MED ADVANTAGE	4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001	Medicare Advantage	$413	OTHER
WELMED MEDICARE	4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001	Medicare Advantage	$413	OTHER
UHC MCR REPLACEMENT	4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811	Medicare Advantage	$421	OTHER
UHC MCR REPLACEMENT	4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001	Medicare Advantage	$421	OTHER
CONNECTED SENIOR CARE	2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001	Medicare Advantage	$425	OTHER
CONNECTED SENIOR CARE	4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001	Medicare Advantage	$425	OTHER
PPHP MCR ADVANTAGE	4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811	Medicare Advantage	$433	OTHER
TX INDEPENDENCE HP	4741_TX INDEPENDENCE HP OP 20250811	Medicare Advantage	$433	OTHER
PPHP MCR ADVANTAGE	4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001	Medicare Advantage	$433	OTHER
TX INDEPENDENCE HP	4671_TX INDEPENDENCE HP IP 20251001	Medicare Advantage	$433	OTHER
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$434	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$566	OTHER
OCCUNET	4123_OCCUNET OP 20250101	Workers' comp	$578	OTHER
OCCUNET	4674_OCCUNET IP 20251001	Workers' comp	$578	OTHER
SENDERO IDEALCARE	1571_SENDERO IDEALCARE OP 20200101	Commercial	$722	OTHER
SENDERO IDEALCARE	4675_SENDERO IDEALCARE IP 20251001	Commercial	$722	OTHER
SUPERIOR AMBETTER	4960_SUPERIOR AMBETTER OUTPATIENT 20250811	Commercial	$743	OTHER
SUPERIOR AMBETTER	4652_SUPERIOR AMBETTER INPATIENT 20251001	Commercial	$743	OTHER
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,106	CASE RATE
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,140	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$1,185	CASE RATE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,325	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,325	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,368	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,381	CASE RATE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$1,460	FEE SCHEDULE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$1,463	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$1,463	PERCENT OF TOTAL BILLED CHARGES
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,499	CASE RATE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,646	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,710	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,710	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,074	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,074	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$2,760	CASE RATE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$2,760	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$3,040	CASE RATE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$3,194	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$3,250	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$3,250	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Edgar B. Davis: all 84 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	4243_CHIRP SUPERIOR STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4393_CHIRP SUPERIOR STAR PLUS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3511_CHIRP SUPERIOR STAR (EBD) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4377_CHIRP SUPERIOR STAR PLUS (EBD) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
BCBS STAR	4221_CHIRP BLUE CROSS STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$311	FEE SCHEDULE
DELL STAR	3706_CHIRP DELL STAR (EBD) INPATIENT 20240901	Medicaid / CHIP	$311	FEE SCHEDULE
DELL STAR	4232_CHIRP DELL STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$311	FEE SCHEDULE
UHC STAR	3739_CHIRP UHC STAR (EBD) INPATIENT 20240901	Medicaid / CHIP	$311	FEE SCHEDULE
UHC STAR	4255_CHIRP UHC STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$311	FEE SCHEDULE
UHC STAR KIDS	4313_UHC STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$311	FEE SCHEDULE
UHC STAR KIDS	4324_UHC STAR KIDS (EBD) INPATIENT 20240901	Medicaid / CHIP	$311	FEE SCHEDULE
UHC STAR PLUS	3750_CHIRP UHC STAR PLUS (EBD) INPATIENT 20240901	Medicaid / CHIP	$311	FEE SCHEDULE
UHC STAR PLUS	4266_CHIRP UHC STAR PLUS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$311	FEE SCHEDULE
WELLPOINT STAR	3673_CHIRP WELLPOINT/AMERIGROUP STAR (EBD) INPATIENT 20240901	Medicaid / CHIP	$311	FEE SCHEDULE
WELLPOINT STAR	4199_CHIRP AMERIGROUP STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$311	FEE SCHEDULE
WELLPOINT STAR	4199_CHIRP WELLPOINT/AMERIGROUP STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$311	FEE SCHEDULE
WELLPOINT STAR PLUS	3684_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (EBD) INPATIENT 20240901	Medicaid / CHIP	$311	FEE SCHEDULE
WELLPOINT STAR PLUS	4210_CHIRP AMERIGROUP STAR PLUS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$311	FEE SCHEDULE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$316	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$348	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$348	CASE RATE
BCBS CHIP/CHIP PERINATE	4170_BLUE CROSS CHIP (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$405	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4170_BLUE CROSS CHIP/STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$405	FEE SCHEDULE
BCBS STAR KIDS	5007_BLUE CROSS STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$405	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4181_DELL CHIP/STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$405	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4159_AMERIGROUP CHIP/STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$405	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4159_WELLPOINT/AMERIGROUP CHIP (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$405	FEE SCHEDULE
WELLPOINT STAR KIDS	4974_WELLPOINT/AMERIGROUP STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$405	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$450	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$450	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$450	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$450	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$450	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$450	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$450	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$450	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$450	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$450	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$450	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$450	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$450	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$450	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$450	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$450	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$450	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$450	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$450	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$450	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$450	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$450	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$450	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$450	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$450	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3596_BLUE CROSS CHIP/STAR KIDS (EBD) INPATIENT 20240901	Medicaid / CHIP	$498	FEE SCHEDULE
BCBS STAR	3695_CHIRP BLUE CROSS STAR (EBD) INPATIENT 20240901	Medicaid / CHIP	$498	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3607_DELL CHIP/STAR KIDS (EBD) INPATIENT 20240901	Medicaid / CHIP	$498	FEE SCHEDULE
WELLPOINT STAR PLUS	4210_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$529	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$566	OTHER
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,106	CASE RATE
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,140	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$1,185	CASE RATE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,325	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,325	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,368	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,381	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$1,400	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$1,400	PERCENT OF TOTAL BILLED CHARGES
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$1,460	FEE SCHEDULE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,499	CASE RATE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,646	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,710	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,710	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,074	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,074	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$2,760	CASE RATE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$2,760	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$3,040	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$3,112	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$3,112	PERCENT OF TOTAL BILLED CHARGES
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$3,194	CASE RATE

Ascension Seton Cedar Park: all 55 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$316	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$348	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$348	CASE RATE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$513	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$513	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$513	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$513	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$513	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$513	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$513	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$513	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$513	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$513	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$513	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$513	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$513	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$513	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$513	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$513	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$513	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$513	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$513	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$513	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$513	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$513	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$513	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$513	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$513	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$566	OTHER
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,106	CASE RATE
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,140	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$1,185	CASE RATE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,325	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,325	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,368	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,381	CASE RATE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,499	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$1,596	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$1,596	PERCENT OF TOTAL BILLED CHARGES
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,646	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,710	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,710	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,074	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,074	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$2,760	CASE RATE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$2,760	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$3,040	CASE RATE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$3,194	CASE RATE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$3,360	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$3,548	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$3,548	PERCENT OF TOTAL BILLED CHARGES

Baylor Scott & White Medical Center – Lakeway: all 36 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$398	fee schedule
CORVEL	Worker's Compensation	Workers' comp	$407	fee schedule
Humana	Medicare	Medicare Advantage	$419	fee schedule
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$419	fee schedule
TriWest	Community Care Network	Military / VA	$419	fee schedule
Aetna	Medicare Advantage	Medicare Advantage	$440	fee schedule
American Health Plan	Medicare Advantage	Medicare Advantage	$440	fee schedule
HealthSpring	Medicare Advantage	Medicare Advantage	$440	fee schedule
ProCare Advantage	Medicare Advantage	Medicare Advantage	$440	fee schedule
United Healthcare	Medicare Advantage	Medicare Advantage	$469	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$503	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$526	fee schedule
Prime Health Services	Worker's Compensation	Workers' comp	$529	fee schedule
Superior Health Plan	Medicaid	Medicaid / CHIP	$559	percent of total billed charges
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$598	percent of total billed charges
Sedgwick	Preferred Network	Workers' comp	$627	fee schedule
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$692	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$1,100	case rate
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,295	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,301	case rate
QuikTrip	Employee Benefit Plan	Commercial	$1,537	percent of total billed charges
MidCoast	Commercial	Commercial	$1,537	percent of total billed charges
Independent Medical System	Commercial PPO	Commercial	$1,676	percent of total billed charges
Curative	Commercial	Commercial	$1,816	percent of total billed charges
First Health	PPO	Commercial	$1,956	percent of total billed charges
Humana	Commercial PPO	Commercial	$1,956	percent of total billed charges
HealthSmart	Accel Network	Commercial	$2,095	percent of total billed charges
HealthSmart	Preferred Network	Commercial	$2,095	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$2,095	percent of total billed charges
Three Rivers	Three Rivers Provider Network	Commercial	$2,515	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$2,700	case rate
Blue Cross Blue Shield	Blue Advantage	Commercial	$3,340	case rate
Mark Cuban	Commercial	Commercial	$3,780	case rate
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$3,820	case rate
Aetna	Commercial	Commercial	$4,008	case rate
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$4,020	case rate

Baylor Scott & White Medical Center – Round Rock: all 39 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$398	fee schedule
CORVEL	Worker's Compensation	Workers' comp	$407	fee schedule
Humana	Medicare	Medicare Advantage	$419	fee schedule
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$419	fee schedule
TriWest	Community Care Network	Military / VA	$419	fee schedule
American Health Plan	Medicare Advantage	Medicare Advantage	$440	fee schedule
Blue Cross Blue Shield	Medicare Advantage	Medicare Advantage	$440	fee schedule
HealthSpring	Medicare Advantage	Medicare Advantage	$440	fee schedule
ProCare Advantage	Medicare Advantage	Medicare Advantage	$440	fee schedule
United Healthcare	Medicare Advantage	Medicare Advantage	$469	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$503	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$526	fee schedule
Prime Health Services	Worker's Compensation	Workers' comp	$529	fee schedule
Superior Health Plan	Medicaid	Medicaid / CHIP	$559	percent of total billed charges
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$598	percent of total billed charges
CareWorks fka Rockport	Worker's Compensation	Workers' comp	$627	fee schedule
Injury Management Organization	Med Select Network	Workers' comp	$627	fee schedule
Sedgwick	Preferred Network	Workers' comp	$627	fee schedule
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$692	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$1,100	case rate
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,295	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,301	case rate
QuikTrip	Employee Benefit Plan	Commercial	$1,537	percent of total billed charges
MidCoast	Commercial	Commercial	$1,537	percent of total billed charges
Independent Medical System	Commercial PPO	Commercial	$1,676	percent of total billed charges
Curative	Commercial	Commercial	$1,816	percent of total billed charges
First Health	PPO	Commercial	$1,956	percent of total billed charges
Humana	Commercial PPO	Commercial	$1,956	percent of total billed charges
BlueBell Creameries	Self Insured	Commercial	$2,095	percent of total billed charges
HealthSmart	Accel Network	Commercial	$2,095	percent of total billed charges
HealthSmart	Preferred Network	Commercial	$2,095	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$2,095	percent of total billed charges
Three Rivers	Three Rivers Provider Network	Commercial	$2,515	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$2,700	case rate
Blue Cross Blue Shield	Blue Advantage	Commercial	$3,340	case rate
Mark Cuban	Commercial	Commercial	$3,780	case rate
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$3,820	case rate
Aetna	Commercial	Commercial	$4,008	case rate
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$4,020	case rate

Baylor Scott & White Medical Center – Taylor: all 36 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$531	percent of total billed charges
American Health Plan	Medicare Advantage	Medicare Advantage	$559	percent of total billed charges
TriWest	Community Care Network	Military / VA	$559	percent of total billed charges
CORVEL	Worker's Compensation	Workers' comp	$585	percent of total billed charges
Prime Health Services	Worker's Compensation	Workers' comp	$585	percent of total billed charges
Blue Cross Blue Shield	Medicare Advantage	Medicare Advantage	$587	percent of total billed charges
HealthSpring	Medicare Advantage	Medicare Advantage	$587	percent of total billed charges
ProCare Advantage	Medicare Advantage	Medicare Advantage	$587	percent of total billed charges
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$616	percent of total billed charges
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$671	percent of total billed charges
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$676	percent of total billed charges
CareWorks fka Rockport	Worker's Compensation	Workers' comp	$694	percent of total billed charges
Injury Management Organization	Med Select Network	Workers' comp	$694	percent of total billed charges
Sedgwick	Preferred Network	Workers' comp	$694	percent of total billed charges
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$701	percent of total billed charges
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$1,006	percent of total billed charges
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$1,100	case rate
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,295	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,301	case rate
QuikTrip	Employee Benefit Plan	Commercial	$1,537	percent of total billed charges
MidCoast	Commercial	Commercial	$1,537	percent of total billed charges
Independent Medical System	Commercial PPO	Commercial	$1,676	percent of total billed charges
Curative	Commercial	Commercial	$1,816	percent of total billed charges
First Health	PPO	Commercial	$1,956	percent of total billed charges
Humana	Commercial PPO	Commercial	$1,956	percent of total billed charges
HealthSmart	Accel Network	Commercial	$2,095	percent of total billed charges
HealthSmart	Preferred Network	Commercial	$2,095	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$2,095	percent of total billed charges
BlueBell Creameries	Self Insured	Commercial	$2,235	percent of total billed charges
Three Rivers	Three Rivers Provider Network	Commercial	$2,235	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$2,700	case rate
Blue Cross Blue Shield	Blue Advantage	Commercial	$3,340	case rate
Mark Cuban	Commercial	Commercial	$3,780	case rate
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$3,820	case rate
Aetna	Commercial	Commercial	$4,008	case rate
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$4,020	case rate

Baylor Scott & White Medical Center – Austin: all 28 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$398	fee schedule
Humana	Medicare	Medicare Advantage	$419	fee schedule
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$419	fee schedule
TriWest	Community Care Network	Military / VA	$419	fee schedule
American Health Plan	Medicare Advantage	Medicare Advantage	$440	fee schedule
HealthSpring	Medicare Advantage	Medicare Advantage	$440	fee schedule
ProCare Advantage	Medicare Advantage	Medicare Advantage	$440	fee schedule
United Healthcare	Medicare Advantage	Medicare Advantage	$469	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$503	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$526	fee schedule
Superior Health Plan	Medicaid	Medicaid / CHIP	$531	percent of total billed charges
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$568	percent of total billed charges
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$692	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$1,100	case rate
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,295	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,301	case rate
QuikTrip	Employee Benefit Plan	Commercial	$1,537	percent of total billed charges
MidCoast	Commercial	Commercial	$1,537	percent of total billed charges
Curative	Commercial	Commercial	$1,816	percent of total billed charges
First Health	PPO	Commercial	$1,956	percent of total billed charges
Humana	Commercial PPO	Commercial	$1,956	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$2,095	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$2,700	case rate
Blue Cross Blue Shield	Blue Advantage	Commercial	$3,340	case rate
Mark Cuban	Commercial	Commercial	$3,780	case rate
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$3,820	case rate
Aetna	Commercial	Commercial	$4,008	case rate
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$4,020	case rate

Baylor Scott & White Medical Center – Buda: all 29 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Superior Health Plan	Medicaid	Medicaid / CHIP	$335	percent of total billed charges
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$359	percent of total billed charges
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$398	fee schedule
Humana	Medicare	Medicare Advantage	$419	fee schedule
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$419	fee schedule
TriWest	Community Care Network	Military / VA	$419	fee schedule
American Health Plan	Medicare Advantage	Medicare Advantage	$440	fee schedule
Blue Cross Blue Shield	Medicare Advantage	Medicare Advantage	$440	fee schedule
HealthSpring	Medicare Advantage	Medicare Advantage	$440	fee schedule
ProCare Advantage	Medicare Advantage	Medicare Advantage	$440	fee schedule
United Healthcare	Medicare Advantage	Medicare Advantage	$469	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$503	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$526	fee schedule
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$692	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$1,100	case rate
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,295	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,301	case rate
QuikTrip	Employee Benefit Plan	Commercial	$1,537	percent of total billed charges
MidCoast	Commercial	Commercial	$1,537	percent of total billed charges
Curative	Commercial	Commercial	$1,816	percent of total billed charges
First Health	PPO	Commercial	$1,956	percent of total billed charges
Humana	Commercial PPO	Commercial	$1,956	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$2,095	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$2,700	case rate
Blue Cross Blue Shield	Blue Advantage	Commercial	$3,340	case rate
Mark Cuban	Commercial	Commercial	$3,780	case rate
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$3,820	case rate
Aetna	Commercial	Commercial	$4,008	case rate
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$4,020	case rate

Baylor Scott & White Medical Center – Pflugerville: all 35 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Superior Health Plan	Medicaid	Medicaid / CHIP	$307	percent of total billed charges
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$329	percent of total billed charges
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$398	fee schedule
CORVEL	Worker's Compensation	Workers' comp	$407	fee schedule
Humana	Medicare	Medicare Advantage	$419	fee schedule
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$419	fee schedule
TriWest	Community Care Network	Military / VA	$419	fee schedule
American Health Plan	Medicare Advantage	Medicare Advantage	$440	fee schedule
HealthSpring	Medicare Advantage	Medicare Advantage	$440	fee schedule
ProCare Advantage	Medicare Advantage	Medicare Advantage	$440	fee schedule
United Healthcare	Medicare Advantage	Medicare Advantage	$469	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$503	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$526	fee schedule
Prime Health Services	Worker's Compensation	Workers' comp	$529	fee schedule
Sedgwick	Preferred Network	Workers' comp	$627	fee schedule
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$692	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$1,100	case rate
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,295	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,301	case rate
QuikTrip	Employee Benefit Plan	Commercial	$1,537	percent of total billed charges
MidCoast	Commercial	Commercial	$1,537	percent of total billed charges
Independent Medical System	Commercial PPO	Commercial	$1,676	percent of total billed charges
Curative	Commercial	Commercial	$1,816	percent of total billed charges
First Health	PPO	Commercial	$1,956	percent of total billed charges
Humana	Commercial PPO	Commercial	$1,956	percent of total billed charges
HealthSmart	Accel Network	Commercial	$2,095	percent of total billed charges
HealthSmart	Preferred Network	Commercial	$2,095	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$2,095	percent of total billed charges
Three Rivers	Three Rivers Provider Network	Commercial	$2,515	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$2,700	case rate
Blue Cross Blue Shield	Blue Advantage	Commercial	$3,340	case rate
Mark Cuban	Commercial	Commercial	$3,780	case rate
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$3,820	case rate
Aetna	Commercial	Commercial	$4,008	case rate
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$4,020	case rate

CHRISTUS Santa Rosa Hospital – San Marcos: all 29 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Blue Cross Blue Shield Of Texas	PPO	Commercial	$5.69	fee schedule
Allwell	Superior Medicare Advantage	Medicare Advantage	$413	fee schedule
Christus Health	Med Adv MM	Medicare Advantage	$413	fee schedule
Humana	MM	Commercial	$413	fee schedule
Triwest	VA MM	Military / VA	$413	fee schedule
United Healthcare	MM	Commercial	$413	fee schedule
Washington National	Supp MM	Commercial	$413	fee schedule
Wellcare	MM	Medicare Advantage	$413	fee schedule
Aetna	MM	Commercial	$421	fee schedule
Cigna	Healthspring Medicare Advantage MM	Medicare Advantage	$425	fee schedule
Provider Partners Health Plan	MM	Medicare Advantage	$425	fee schedule
Shared Health Insurance Company	MM	Commercial	$433	fee schedule
Amerigroup	MM	Medicaid / CHIP	$446	fee schedule
Devoted Health Plan	MM	Medicare Advantage	$446	fee schedule
Superior	Chip KM	Medicaid / CHIP	$552	case rate
Superior	Star KM	Medicaid / CHIP	$552	case rate
Superior	Star Kids KM	Medicaid / CHIP	$552	case rate
Christus Health	HIX	Commercial	$578	fee schedule
Sendero	HMO HIX	Commercial	$706	fee schedule
Naphcare Inc.	RRMB	Public program	$825	fee schedule
Healthcare Highways	PPO	Commercial	$1,044	fee schedule
Blue Cross Blue Shield Of Texas	HMO	Commercial	$1,270	fee schedule
Humana	Choicecare	Commercial	$2,518	case rate
Cigna	New Business	Commercial	$2,648	fee schedule
United Healthcare	All Payer	Commercial	$2,730	case rate
Blue Cross Blue Shield Of Texas	Blue Advantage HMO	Commercial	$2,760	case rate
Blue Cross Blue Shield Of Texas	HEB	Commercial	$2,980	case rate
Cigna	PPO	Commercial	$3,361	fee schedule
Five Point Credit Union	PPO	Commercial	$3,549	case rate

Dell Children's Medical Center: all 55 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$316	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$348	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$348	CASE RATE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$355	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$355	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$566	OTHER
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,106	CASE RATE
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,140	CASE RATE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$1,185	CASE RATE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$1,325	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$1,325	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$1,368	FEE SCHEDULE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,381	CASE RATE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$1,460	FEE SCHEDULE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$1,463	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$1,463	PERCENT OF TOTAL BILLED CHARGES
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$1,499	CASE RATE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$1,646	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$1,710	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$1,710	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,074	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,074	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$2,760	CASE RATE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$2,760	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$3,040	CASE RATE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$3,194	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$3,250	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$3,250	PERCENT OF TOTAL BILLED CHARGES

Emergency room visit, level 5 (highest) (CPT 99285)

Published cash price

$1,380–$2,378

what 15 hospitals list for a self-pay ER visit level 5

Typical insured rate

$2,576

median of every commercial plan rate in the files

Lowest insured rate

$320

Blue Cross Blue Shield Of Texas (PPO), CHRISTUS Santa Rosa Hospital – San Marcos

ER visit level 5 prices by hospital in Austin

Sorted by published cash price. “Typical insured rate” is the median of all commercial plan rates each hospital lists for CPT 99285; Medicaid and Medicare Advantage are shown separately below.

Emergency room visit, level 5 (highest) (CPT 99285) — Austin
Hospital	Published cash price	Typical insured rate	Lowest insured rate
Ascension Seton Edgar B. DavisAscension Seton · file Jan 2026	$1,380Cash ÷ typical 0.7×	$2,09423 plans	$435
Ascension Seton SmithvilleAscension Seton · file Jan 2026	$1,522–$2,007Cash ÷ typical 0.6×	$2,64824 plans	$435
Ascension Seton WilliamsonAscension Seton · file Jan 2026	$1,522–$2,007	$2,5091 plan	$2,509
Ascension Seton HaysAscension Seton · file Jan 2026	$1,522–$2,007Cash ÷ typical 0.6×	$2,50929 plans	$435
Dell Seton Medical Center at The University of TexasAscension Seton · file Jan 2026	$2,007Cash ÷ typical 0.8×	$2,67124 plans	$435
Ascension Seton NorthwestAscension Seton · file Jan 2026	$2,007Cash ÷ typical 0.8×	$2,50929 plans	$435
Ascension Seton Medical Center AustinAscension Seton · file Jan 2026	$2,007Cash ÷ typical 0.8×	$2,36831 plans	$435
Ascension Seton SouthwestAscension Seton · file Jan 2026	$2,007Cash ÷ typical 0.8×	$2,50929 plans	$435
Ascension Seton Cedar ParkAscension Seton · file Jan 2026	$2,046Cash ÷ typical 0.8×	$2,64823 plans	$435
Baylor Scott & White Medical Center – LakewayBaylor Scott & White Health · file Jun 2026	$2,378Cash ÷ typical 0.9×	$2,77422 plans	$718
Baylor Scott & White Medical Center – Round RockBaylor Scott & White Health · file Jun 2026	$2,378Cash ÷ typical 0.9×	$2,77423 plans	$718
Baylor Scott & White Medical Center – TaylorBaylor Scott & White Health · file Jun 2026	$2,378Cash ÷ typical 0.9×	$2,77423 plans	$951
Baylor Scott & White Medical Center – AustinBaylor Scott & White Health · file Jun 2026	$2,378Cash ÷ typical 0.9×	$2,67518 plans	$718
Baylor Scott & White Medical Center – BudaBaylor Scott & White Health · file Jun 2026	$2,378Cash ÷ typical 0.9×	$2,67518 plans	$718
Baylor Scott & White Medical Center – PflugervilleBaylor Scott & White Health · file Jun 2026	$2,378Cash ÷ typical 0.9×	$2,77422 plans	$718
CHRISTUS Santa Rosa Hospital – San MarcosCHRISTUS Health · file Jan 2026	—	$1,50317 plans	$320
Dell Children's Medical CenterAscension Seton · children's hospital (not in the summary above) · file Jan 2026	$2,959–$3,903Cash ÷ typical 1.1×	$2,64823 plans	$435

↓ Download this table (CSV)free to reuse with attribution (CC BY 4.0)

Negotiated rates by insurer

If you have a high deductible, you usually pay the rate your insurer negotiated until you meet it. Ranges cover every plan of that insurer in the file; open a hospital to see plan by plan.

Negotiated rates by insurer
Hospital	Blue Cross Blue Shield	Aetna	Cigna	UnitedHealthcare	Humana	Oscar	Ambetter	Medicaid / CHIP	Medicare Advantage
Ascension Seton Edgar B. Davis	$812–$2,094	$2,368–$3,416	$1,725	$2,845	—	$1,662	$435	$200–$1,400	$2,060
Ascension Seton Smithville	$812–$5,200	$2,368–$3,416	$2,509	$2,845	—	$1,662	$435	$200–$806	$2,060
Ascension Seton Williamson	—	—	$2,509	—	—	—	—	—	—
Ascension Seton Hays	$812–$5,200	$2,368–$3,416	$2,509	$2,845	—	$1,662	$435–$1,069	$200–$806	$582–$2,060
Dell Seton Medical Center at The University of Texas	$812–$5,200	$2,368–$3,416	$2,509	$2,845	—	$1,662	$435	$200–$806	$2,060
Ascension Seton Northwest	$812–$5,200	$2,368–$3,416	$2,509	$2,845	—	$1,662	$435–$1,069	$200–$806	$582–$2,060
Ascension Seton Medical Center Austin	$812–$5,200	$2,368–$3,416	$2,509	$594–$2,845	—	$1,662	$435–$1,069	$200–$806	$582–$2,060
Ascension Seton Southwest	$812–$5,200	$2,368–$3,416	$2,509	$2,845	—	$1,662	$435–$1,069	$200–$806	$582–$2,060
Ascension Seton Cedar Park	$812–$5,200	$2,368–$3,416	$2,558	$2,845	—	$1,662	$435	$200–$821	$2,060
Baylor Scott & White Medical Center – Lakeway	$7,280–$10,880	$6,643	—	—	$2,774	—	—	$793–$848	$568–$670
Baylor Scott & White Medical Center – Round Rock	$7,280–$10,880	$6,643	—	—	$2,774	—	—	$793–$848	$568–$670
Baylor Scott & White Medical Center – Taylor	$7,280–$10,880	$6,643	—	—	$2,774	—	—	$958	$753–$874
Baylor Scott & White Medical Center – Austin	$7,280–$10,880	$6,643	—	—	$2,774	—	—	$753–$806	$568–$670
Baylor Scott & White Medical Center – Buda	$7,280–$10,880	$6,643	—	—	$2,774	—	—	$476–$509	$568–$670
Baylor Scott & White Medical Center – Pflugerville	$7,280–$10,880	$6,643	—	—	$2,774	—	—	$436–$466	$568–$670
CHRISTUS Santa Rosa Hospital – San Marcos	$320–$4,720	$606	$2,648–$3,361	$594–$2,730	$594–$2,518	—	—	$552–$642	$594–$642
Dell Children's Medical Center	$812–$5,200	$2,368–$3,416	$2,509	$2,845	—	$1,662	$435	$200–$806	$2,060

Ascension Seton Edgar B. Davis: all 88 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3511_CHIRP SUPERIOR STAR (EBD) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4377_CHIRP SUPERIOR STAR PLUS (EBD) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
BCBS STAR	4221_CHIRP BLUE CROSS STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$383	FEE SCHEDULE
DELL STAR	3706_CHIRP DELL STAR (EBD) INPATIENT 20240901	Medicaid / CHIP	$383	FEE SCHEDULE
DELL STAR	4232_CHIRP DELL STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$383	FEE SCHEDULE
UHC STAR	3739_CHIRP UHC STAR (EBD) INPATIENT 20240901	Medicaid / CHIP	$383	FEE SCHEDULE
UHC STAR	4255_CHIRP UHC STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$383	FEE SCHEDULE
UHC STAR KIDS	4313_UHC STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$383	FEE SCHEDULE
UHC STAR KIDS	4324_UHC STAR KIDS (EBD) INPATIENT 20240901	Medicaid / CHIP	$383	FEE SCHEDULE
UHC STAR PLUS	3750_CHIRP UHC STAR PLUS (EBD) INPATIENT 20240901	Medicaid / CHIP	$383	FEE SCHEDULE
UHC STAR PLUS	4266_CHIRP UHC STAR PLUS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$383	FEE SCHEDULE
WELLPOINT STAR	3673_CHIRP WELLPOINT/AMERIGROUP STAR (EBD) INPATIENT 20240901	Medicaid / CHIP	$383	FEE SCHEDULE
WELLPOINT STAR	4199_CHIRP AMERIGROUP STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$383	FEE SCHEDULE
WELLPOINT STAR	4199_CHIRP WELLPOINT/AMERIGROUP STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$383	FEE SCHEDULE
WELLPOINT STAR PLUS	3684_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (EBD) INPATIENT 20240901	Medicaid / CHIP	$383	FEE SCHEDULE
WELLPOINT STAR PLUS	4210_CHIRP AMERIGROUP STAR PLUS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$383	FEE SCHEDULE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$435	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$435	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$470	CASE RATE
BCBS CHIP/CHIP PERINATE	4170_BLUE CROSS CHIP (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$498	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4170_BLUE CROSS CHIP/STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$498	FEE SCHEDULE
BCBS STAR KIDS	5007_BLUE CROSS STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$498	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4181_DELL CHIP/STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$498	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4159_AMERIGROUP CHIP/STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$498	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4159_WELLPOINT/AMERIGROUP CHIP (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$498	FEE SCHEDULE
WELLPOINT STAR KIDS	4974_WELLPOINT/AMERIGROUP STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$498	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$554	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$554	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$554	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$554	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$554	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$554	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$554	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$554	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$554	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$554	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$554	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$554	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$554	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$554	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$554	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$554	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$554	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$554	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$554	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$554	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$554	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$554	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$554	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$554	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$554	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3596_BLUE CROSS CHIP/STAR KIDS (EBD) INPATIENT 20240901	Medicaid / CHIP	$613	FEE SCHEDULE
BCBS STAR	3695_CHIRP BLUE CROSS STAR (EBD) INPATIENT 20240901	Medicaid / CHIP	$613	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3607_DELL CHIP/STAR KIDS (EBD) INPATIENT 20240901	Medicaid / CHIP	$613	FEE SCHEDULE
WELLPOINT STAR PLUS	4210_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$652	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$812	OTHER
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,368	CASE RATE
SUPERIOR STAR	4243_CHIRP SUPERIOR STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$1,400	CASE RATE
SUPERIOR STAR PLUS	4393_CHIRP SUPERIOR STAR PLUS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$1,400	CASE RATE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,662	CASE RATE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,668	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$1,715	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$1,715	FEE SCHEDULE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$1,725	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$1,725	PERCENT OF TOTAL BILLED CHARGES
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$1,892	FEE SCHEDULE
HUMANA MCR REPLACEMENT	4111_MEDICARE ADVANTAGE HUMANA OUTPATIENT (BRK,WIL,DEL,BAS) 20250101	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4662_MEDICARE ADVANTAGE HUMANA INPATIENT (BRK,WIL,DEL,BAS) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811	Medicare Advantage	$2,060	CASE RATE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$2,094	FEE SCHEDULE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$2,368	CASE RATE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$2,648	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$2,648	CASE RATE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$2,693	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$2,733	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,845	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,845	CASE RATE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$2,955	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$3,416	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$3,416	FEE SCHEDULE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$3,833	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$3,833	PERCENT OF TOTAL BILLED CHARGES
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$4,212	CASE RATE

Ascension Seton Smithville: all 90 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
SUPERIOR STAR	4247_CHIRP SUPERIOR STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4401_CHIRP SUPERIOR STAR PLUS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3515_CHIRP SUPERIOR STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4381_CHIRP SUPERIOR STAR PLUS (SMV) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$435	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$435	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$470	CASE RATE
BCBS CHIP/CHIP PERINATE	4174_BLUE CROSS CHIP (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$482	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4174_BLUE CROSS CHIP/STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$482	FEE SCHEDULE
BCBS STAR	4225_CHIRP BLUE CROSS STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$482	FEE SCHEDULE
BCBS STAR KIDS	5015_BLUE CROSS STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$482	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4185_DELL CHIP/STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$482	FEE SCHEDULE
DELL STAR	4236_CHIRP DELL STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$482	FEE SCHEDULE
UHC STAR	4259_CHIRP UHC STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$482	FEE SCHEDULE
UHC STAR KIDS	4317_UHC STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$482	FEE SCHEDULE
UHC STAR PLUS	4270_CHIRP UHC STAR PLUS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$482	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4163_AMERIGROUP CHIP/STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$482	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4163_WELLPOINT/AMERIGROUP CHIP (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$482	FEE SCHEDULE
WELLPOINT STAR	4203_CHIRP AMERIGROUP STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$482	FEE SCHEDULE
WELLPOINT STAR	4203_CHIRP WELLPOINT/AMERIGROUP STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$482	FEE SCHEDULE
WELLPOINT STAR KIDS	4982_WELLPOINT/AMERIGROUP STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$482	FEE SCHEDULE
WELLPOINT STAR PLUS	4214_CHIRP AMERIGROUP STAR PLUS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$482	FEE SCHEDULE
WELLPOINT STAR PLUS	4214_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$482	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3600_BLUE CROSS CHIP/STAR KIDS (SMV) INPATIENT 20240901	Medicaid / CHIP	$602	FEE SCHEDULE
BCBS STAR	3699_CHIRP BLUE CROSS STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$602	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3611_DELL CHIP/STAR KIDS (SMV) INPATIENT 20240901	Medicaid / CHIP	$602	FEE SCHEDULE
DELL STAR	3710_CHIRP DELL STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$602	FEE SCHEDULE
UHC STAR	3743_CHIRP UHC STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$602	FEE SCHEDULE
UHC STAR KIDS	4328_UHC STAR KIDS (SMV) INPATIENT 20240901	Medicaid / CHIP	$602	FEE SCHEDULE
UHC STAR PLUS	3754_CHIRP UHC STAR PLUS (SMV) INPATIENT 20240901	Medicaid / CHIP	$602	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	3589_WELLPOINT CHIP/STAR KIDS (SMV) INPATIENT 20240901	Medicaid / CHIP	$602	FEE SCHEDULE
WELLPOINT STAR	3677_CHIRP WELLPOINT/AMERIGROUP STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$602	FEE SCHEDULE
WELLPOINT STAR PLUS	3688_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SMV) INPATIENT 20240901	Medicaid / CHIP	$602	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$812	OTHER
SENDERO IDEALCARE	1571_SENDERO IDEALCARE OP 20200101	Commercial	$1,040	OTHER
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,368	CASE RATE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,662	CASE RATE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,668	CASE RATE
HUMANA MCR REPLACEMENT	4111_MEDICARE ADVANTAGE HUMANA OUTPATIENT (BRK,WIL,DEL,BAS) 20250101	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4662_MEDICARE ADVANTAGE HUMANA INPATIENT (BRK,WIL,DEL,BAS) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811	Medicare Advantage	$2,060	CASE RATE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$2,094	FEE SCHEDULE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$2,368	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$2,509	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$2,509	PERCENT OF TOTAL BILLED CHARGES
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$2,648	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$2,648	CASE RATE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$2,693	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$2,733	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,845	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,845	CASE RATE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$2,955	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$3,416	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$3,416	FEE SCHEDULE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$4,212	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$4,760	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$4,760	FEE SCHEDULE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$5,200	FEE SCHEDULE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$5,575	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$5,575	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Williamson: all 3 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$2,509	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$5,575	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$5,575	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Hays: all 127 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
SUPERIOR STAR	4244_CHIRP SUPERIOR STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4395_CHIRP SUPERIOR STAR PLUS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3512_CHIRP SUPERIOR STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4378_CHIRP SUPERIOR STAR PLUS (HAY) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
BCBS CHIP/CHIP PERINATE	4171_BLUE CROSS CHIP (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$343	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4171_BLUE CROSS CHIP/STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$343	FEE SCHEDULE
BCBS STAR KIDS	5009_BLUE CROSS STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$343	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4182_DELL CHIP/STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$343	FEE SCHEDULE
UHC STAR KIDS	4314_UHC STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$343	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4160_AMERIGROUP CHIP/STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$343	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4160_WELLPOINT/AMERIGROUP CHIP (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$343	FEE SCHEDULE
WELLPOINT STAR KIDS	4976_WELLPOINT/AMERIGROUP STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$343	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3597_BLUE CROSS CHIP/STAR KIDS (HAY) INPATIENT 20240901	Medicaid / CHIP	$343	FEE SCHEDULE
BCBS STAR	3696_CHIRP BLUE CROSS STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$343	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3608_DELL CHIP/STAR KIDS (HAY) INPATIENT 20240901	Medicaid / CHIP	$343	FEE SCHEDULE
DELL STAR	3707_CHIRP DELL STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$343	FEE SCHEDULE
UHC STAR	3740_CHIRP UHC STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$343	FEE SCHEDULE
UHC STAR KIDS	4325_UHC STAR KIDS (HAY) INPATIENT 20240901	Medicaid / CHIP	$343	FEE SCHEDULE
UHC STAR PLUS	3751_CHIRP UHC STAR PLUS (HAY) INPATIENT 20240901	Medicaid / CHIP	$343	FEE SCHEDULE
WELLPOINT STAR	3674_CHIRP WELLPOINT/AMERIGROUP STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$343	FEE SCHEDULE
WELLPOINT STAR PLUS	3685_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (HAY) INPATIENT 20240901	Medicaid / CHIP	$343	FEE SCHEDULE
BCBS STAR	4222_CHIRP BLUE CROSS STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$343	FEE SCHEDULE
DELL STAR	4233_CHIRP DELL STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$343	FEE SCHEDULE
UHC STAR	4256_CHIRP UHC STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$343	FEE SCHEDULE
UHC STAR PLUS	4267_CHIRP UHC STAR PLUS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$343	FEE SCHEDULE
WELLPOINT STAR	4200_CHIRP AMERIGROUP STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$343	FEE SCHEDULE
WELLPOINT STAR	4200_CHIRP WELLPOINT/AMERIGROUP STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$343	FEE SCHEDULE
WELLPOINT STAR PLUS	4211_CHIRP AMERIGROUP STAR PLUS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$343	FEE SCHEDULE
WELLPOINT STAR PLUS	4211_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$343	FEE SCHEDULE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$435	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$435	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$470	CASE RATE
AARP MC WELLMED	4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811	Medicare Advantage	$582	OTHER
AARP MC WELLMED	4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001	Medicare Advantage	$582	OTHER
SENDERO CHAP	4932_SENDERO CHAP OUTPATIENT 20250811	Commercial	$588	OTHER
SENDERO CHAP	4651_SENDERO CHAP INPATIENT 20251001	Commercial	$588	OTHER
AETNA MCR REPLACEMENT	4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811	Medicare Advantage	$594	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811	Medicare Advantage	$594	OTHER
COVID HRSA	4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811	Public program	$594	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811	Medicare Advantage	$594	OTHER
MEDICARE REPLACEMENT	4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811	Medicare Advantage	$594	OTHER
SUPERIOR ALLWELL	4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101	Medicare Advantage	$594	OTHER
UTMB	4125_UTMB PRISONS (HAY) OP 20250101	Public program	$594	OTHER
WELLCARE MED ADVANTAGE	4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811	Medicare Advantage	$594	OTHER
WELMED MEDICARE	4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811	Medicare Advantage	$594	OTHER
AETNA MCR REPLACEMENT	4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001	Medicare Advantage	$594	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001	Medicare Advantage	$594	OTHER
COVID HRSA	4693_COVID HRSA UNIN Q80 INPATIENT 20251001	Public program	$594	OTHER
CSHCN CIDC	4694_CSHCN CIDC IP (ADULT) 20251001	Public program	$594	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001	Medicare Advantage	$594	OTHER
MEDICARE OON	4666_MEDICARE ADVANTAGE INPATIENT OON 20251001	Medicare Advantage	$594	OTHER
MEDICARE REPLACEMENT	4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001	Medicare Advantage	$594	OTHER
SUPERIOR ALLWELL	4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001	Medicare Advantage	$594	OTHER
TRICARE	4696_TRICARE INPATIENT 20251001	Military / VA	$594	OTHER
UTMB	4677_UTMB PRISONS (HAY) IP 20251001	Public program	$594	OTHER
WELLCARE MED ADVANTAGE	4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001	Medicare Advantage	$594	OTHER
WELMED MEDICARE	4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001	Medicare Advantage	$594	OTHER
UHC MCR REPLACEMENT	4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811	Medicare Advantage	$606	OTHER
UHC MCR REPLACEMENT	4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001	Medicare Advantage	$606	OTHER
CONNECTED SENIOR CARE	2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001	Medicare Advantage	$612	OTHER
CONNECTED SENIOR CARE	4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001	Medicare Advantage	$612	OTHER
PPHP MCR ADVANTAGE	4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811	Medicare Advantage	$624	OTHER
TX INDEPENDENCE HP	4741_TX INDEPENDENCE HP OP 20250811	Medicare Advantage	$624	OTHER
PPHP MCR ADVANTAGE	4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001	Medicare Advantage	$624	OTHER
TX INDEPENDENCE HP	4671_TX INDEPENDENCE HP IP 20251001	Medicare Advantage	$624	OTHER
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$812	OTHER
OCCUNET	4123_OCCUNET OP 20250101	Workers' comp	$832	OTHER
OCCUNET	4674_OCCUNET IP 20251001	Workers' comp	$832	OTHER
SENDERO IDEALCARE	1571_SENDERO IDEALCARE OP 20200101	Commercial	$1,040	OTHER
SENDERO IDEALCARE	4675_SENDERO IDEALCARE IP 20251001	Commercial	$1,040	OTHER
SUPERIOR AMBETTER	4960_SUPERIOR AMBETTER OUTPATIENT 20250811	Commercial	$1,069	OTHER
SUPERIOR AMBETTER	4652_SUPERIOR AMBETTER INPATIENT 20251001	Commercial	$1,069	OTHER
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,368	CASE RATE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,662	CASE RATE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,668	CASE RATE
HUMANA MCR REPLACEMENT	4111_MEDICARE ADVANTAGE HUMANA OUTPATIENT (BRK,WIL,DEL,BAS) 20250101	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4662_MEDICARE ADVANTAGE HUMANA INPATIENT (BRK,WIL,DEL,BAS) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811	Medicare Advantage	$2,060	CASE RATE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$2,094	FEE SCHEDULE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$2,368	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$2,509	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$2,509	PERCENT OF TOTAL BILLED CHARGES
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$2,648	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$2,648	CASE RATE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$2,693	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$2,733	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,845	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,845	CASE RATE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$2,955	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$3,416	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$3,416	FEE SCHEDULE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$4,212	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$4,760	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$4,760	FEE SCHEDULE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$5,200	FEE SCHEDULE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$5,575	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$5,575	PERCENT OF TOTAL BILLED CHARGES

Dell Seton Medical Center at The University of Texas: all 89 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	4242_CHIRP SUPERIOR STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4391_CHIRP SUPERIOR STAR PLUS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3510_CHIRP SUPERIOR STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4376_CHIRP SUPERIOR STAR PLUS (DEL) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$435	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$435	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$470	CASE RATE
BCBS CHIP/CHIP PERINATE	4169_BLUE CROSS CHIP (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$562	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4169_BLUE CROSS CHIP/STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$562	FEE SCHEDULE
BCBS STAR KIDS	5005_BLUE CROSS STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$562	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4180_DELL CHIP/STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$562	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4158_AMERIGROUP CHIP/STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$562	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4158_WELLPOINT/AMERIGROUP CHIP (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$562	FEE SCHEDULE
WELLPOINT STAR KIDS	4972_WELLPOINT/AMERIGROUP STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$562	FEE SCHEDULE
WELLPOINT STAR PLUS	4209_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$562	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3595_BLUE CROSS CHIP/STAR KIDS (DEL) INPATIENT 20240901	Medicaid / CHIP	$562	FEE SCHEDULE
BCBS STAR	3694_CHIRP BLUE CROSS STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$562	FEE SCHEDULE
BCBS STAR	4220_CHIRP BLUE CROSS STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$562	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3606_DELL CHIP/STAR KIDS (DEL) INPATIENT 20240901	Medicaid / CHIP	$562	FEE SCHEDULE
DELL STAR	3705_CHIRP DELL STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$562	FEE SCHEDULE
DELL STAR	4231_CHIRP DELL STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$562	FEE SCHEDULE
UHC STAR	3738_CHIRP UHC STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$562	FEE SCHEDULE
UHC STAR	4254_CHIRP UHC STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$562	FEE SCHEDULE
UHC STAR KIDS	4312_UHC STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$562	FEE SCHEDULE
UHC STAR KIDS	4323_UHC STAR KIDS (DEL) INPATIENT 20240901	Medicaid / CHIP	$562	FEE SCHEDULE
UHC STAR PLUS	3749_CHIRP UHC STAR PLUS (DEL) INPATIENT 20240901	Medicaid / CHIP	$562	FEE SCHEDULE
UHC STAR PLUS	4265_CHIRP UHC STAR PLUS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$562	FEE SCHEDULE
WELLPOINT STAR	3672_CHIRP WELLPOINT/AMERIGROUP STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$562	FEE SCHEDULE
WELLPOINT STAR	4198_CHIRP AMERIGROUP STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$562	FEE SCHEDULE
WELLPOINT STAR	4198_CHIRP WELLPOINT/AMERIGROUP STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$562	FEE SCHEDULE
WELLPOINT STAR PLUS	3683_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (DEL) INPATIENT 20240901	Medicaid / CHIP	$562	FEE SCHEDULE
WELLPOINT STAR PLUS	4209_CHIRP AMERIGROUP STAR PLUS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$562	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$812	OTHER
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,368	CASE RATE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,662	CASE RATE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,668	CASE RATE
HUMANA MCR REPLACEMENT	4111_MEDICARE ADVANTAGE HUMANA OUTPATIENT (BRK,WIL,DEL,BAS) 20250101	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4662_MEDICARE ADVANTAGE HUMANA INPATIENT (BRK,WIL,DEL,BAS) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811	Medicare Advantage	$2,060	CASE RATE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$2,094	FEE SCHEDULE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$2,368	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$2,509	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$2,509	PERCENT OF TOTAL BILLED CHARGES
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$2,648	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$2,648	CASE RATE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$2,693	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$2,733	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,845	CASE RATE
UHC	4499_UNITED HEALTHCARE (DEL) 20250701	Commercial	$2,845	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,845	CASE RATE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$2,955	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$3,416	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$3,416	FEE SCHEDULE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$4,212	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$4,760	CASE RATE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$4,760	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$5,200	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$5,575	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$5,575	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Northwest: all 124 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
SUPERIOR STAR	4245_CHIRP SUPERIOR STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4397_CHIRP SUPERIOR STAR PLUS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3513_CHIRP SUPERIOR STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4379_CHIRP SUPERIOR STAR PLUS (NW) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
BCBS CHIP/CHIP PERINATE	4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
BCBS STAR KIDS	5011_BLUE CROSS STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4183_DELL CHIP/STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
UHC STAR KIDS	4315_UHC STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4161_AMERIGROUP CHIP/STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4161_WELLPOINT/AMERIGROUP CHIP (NW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
WELLPOINT STAR KIDS	4978_WELLPOINT/AMERIGROUP STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
BCBS STAR	3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3609_DELL CHIP/STAR KIDS (NW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
DELL STAR	3708_CHIRP DELL STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
UHC STAR	3741_CHIRP UHC STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
UHC STAR KIDS	4326_UHC STAR KIDS (NW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
UHC STAR PLUS	3752_CHIRP UHC STAR PLUS (NW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
WELLPOINT STAR	3675_CHIRP WELLPOINT/AMERIGROUP STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
WELLPOINT STAR PLUS	3686_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (NW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
BCBS STAR	4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
DELL STAR	4234_CHIRP DELL STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
UHC STAR	4257_CHIRP UHC STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
UHC STAR PLUS	4268_CHIRP UHC STAR PLUS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
WELLPOINT STAR	4201_CHIRP AMERIGROUP STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
WELLPOINT STAR	4201_CHIRP WELLPOINT/AMERIGROUP STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
WELLPOINT STAR PLUS	4212_CHIRP AMERIGROUP STAR PLUS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
WELLPOINT STAR PLUS	4212_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$435	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$435	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$470	CASE RATE
AARP MC WELLMED	4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811	Medicare Advantage	$582	OTHER
AARP MC WELLMED	4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001	Medicare Advantage	$582	OTHER
SENDERO CHAP	4932_SENDERO CHAP OUTPATIENT 20250811	Commercial	$588	OTHER
SENDERO CHAP	4651_SENDERO CHAP INPATIENT 20251001	Commercial	$588	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811	Medicare Advantage	$594	OTHER
COVID HRSA	4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811	Public program	$594	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811	Medicare Advantage	$594	OTHER
MEDICARE REPLACEMENT	4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811	Medicare Advantage	$594	OTHER
SUPERIOR ALLWELL	4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101	Medicare Advantage	$594	OTHER
WELLCARE MED ADVANTAGE	4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811	Medicare Advantage	$594	OTHER
WELMED MEDICARE	4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811	Medicare Advantage	$594	OTHER
AETNA MCR REPLACEMENT	4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001	Medicare Advantage	$594	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001	Medicare Advantage	$594	OTHER
COVID HRSA	4693_COVID HRSA UNIN Q80 INPATIENT 20251001	Public program	$594	OTHER
CSHCN CIDC	4694_CSHCN CIDC IP (ADULT) 20251001	Public program	$594	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001	Medicare Advantage	$594	OTHER
MEDICARE OON	4666_MEDICARE ADVANTAGE INPATIENT OON 20251001	Medicare Advantage	$594	OTHER
MEDICARE REPLACEMENT	4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001	Medicare Advantage	$594	OTHER
SUPERIOR ALLWELL	4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001	Medicare Advantage	$594	OTHER
TRICARE	4696_TRICARE INPATIENT 20251001	Military / VA	$594	OTHER
WELLCARE MED ADVANTAGE	4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001	Medicare Advantage	$594	OTHER
WELMED MEDICARE	4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001	Medicare Advantage	$594	OTHER
UHC MCR REPLACEMENT	4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811	Medicare Advantage	$606	OTHER
UHC MCR REPLACEMENT	4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001	Medicare Advantage	$606	OTHER
CONNECTED SENIOR CARE	2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001	Medicare Advantage	$612	OTHER
CONNECTED SENIOR CARE	4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001	Medicare Advantage	$612	OTHER
PPHP MCR ADVANTAGE	4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811	Medicare Advantage	$624	OTHER
TX INDEPENDENCE HP	4741_TX INDEPENDENCE HP OP 20250811	Medicare Advantage	$624	OTHER
PPHP MCR ADVANTAGE	4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001	Medicare Advantage	$624	OTHER
TX INDEPENDENCE HP	4671_TX INDEPENDENCE HP IP 20251001	Medicare Advantage	$624	OTHER
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$812	OTHER
OCCUNET	4123_OCCUNET OP 20250101	Workers' comp	$832	OTHER
OCCUNET	4674_OCCUNET IP 20251001	Workers' comp	$832	OTHER
SENDERO IDEALCARE	1571_SENDERO IDEALCARE OP 20200101	Commercial	$1,040	OTHER
SENDERO IDEALCARE	4675_SENDERO IDEALCARE IP 20251001	Commercial	$1,040	OTHER
SUPERIOR AMBETTER	4960_SUPERIOR AMBETTER OUTPATIENT 20250811	Commercial	$1,069	OTHER
SUPERIOR AMBETTER	4652_SUPERIOR AMBETTER INPATIENT 20251001	Commercial	$1,069	OTHER
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,368	CASE RATE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,662	CASE RATE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,668	CASE RATE
HUMANA MCR REPLACEMENT	4111_MEDICARE ADVANTAGE HUMANA OUTPATIENT (BRK,WIL,DEL,BAS) 20250101	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4662_MEDICARE ADVANTAGE HUMANA INPATIENT (BRK,WIL,DEL,BAS) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811	Medicare Advantage	$2,060	CASE RATE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$2,094	FEE SCHEDULE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$2,368	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$2,509	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$2,509	PERCENT OF TOTAL BILLED CHARGES
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$2,648	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$2,648	CASE RATE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$2,693	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$2,733	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,845	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,845	CASE RATE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$2,955	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$3,416	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$3,416	FEE SCHEDULE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$4,212	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$4,760	CASE RATE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$4,760	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$5,200	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$5,575	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$5,575	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Medical Center Austin: all 127 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
SUPERIOR STAR	4239_CHIRP SUPERIOR STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4385_CHIRP SUPERIOR STAR PLUS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3507_CHIRP SUPERIOR STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4373_CHIRP SUPERIOR STAR PLUS (AUS) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
BCBS CHIP/CHIP PERINATE	4166_BLUE CROSS CHIP (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$401	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4166_BLUE CROSS CHIP/STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$401	FEE SCHEDULE
BCBS STAR	4217_CHIRP BLUE CROSS STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$401	FEE SCHEDULE
BCBS STAR KIDS	4999_BLUE CROSS STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$401	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4177_DELL CHIP/STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$401	FEE SCHEDULE
DELL STAR	4228_CHIRP DELL STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$401	FEE SCHEDULE
UHC STAR	4251_CHIRP UHC STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$401	FEE SCHEDULE
UHC STAR KIDS	4309_UHC STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$401	FEE SCHEDULE
UHC STAR PLUS	4262_CHIRP UHC STAR PLUS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$401	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4155_AMERIGROUP CHIP/STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$401	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4155_WELLPOINT/AMERIGROUP CHIP (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$401	FEE SCHEDULE
WELLPOINT STAR	4195_CHIRP AMERIGROUP STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$401	FEE SCHEDULE
WELLPOINT STAR	4195_CHIRP WELLPOINT/AMERIGROUP STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$401	FEE SCHEDULE
WELLPOINT STAR KIDS	4966_WELLPOINT/AMERIGROUP STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$401	FEE SCHEDULE
WELLPOINT STAR PLUS	4206_CHIRP AMERIGROUP STAR PLUS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$401	FEE SCHEDULE
WELLPOINT STAR PLUS	4206_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$401	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3592_BLUE CROSS CHIP/STAR KIDS (AUS) INPATIENT 20240901	Medicaid / CHIP	$401	FEE SCHEDULE
BCBS STAR	3691_CHIRP BLUE CROSS STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$401	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3603_DELL CHIP/STAR KIDS (AUS) INPATIENT 20240901	Medicaid / CHIP	$401	FEE SCHEDULE
DELL STAR	3702_CHIRP DELL STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$401	FEE SCHEDULE
UHC STAR	3735_CHIRP UHC STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$401	FEE SCHEDULE
UHC STAR KIDS	4320_UHC STAR KIDS (AUS) INPATIENT 20240901	Medicaid / CHIP	$401	FEE SCHEDULE
UHC STAR PLUS	3746_CHIRP UHC STAR PLUS (AUS) INPATIENT 20240901	Medicaid / CHIP	$401	FEE SCHEDULE
WELLPOINT STAR	3669_CHIRP WELLPOINT/AMERIGROUP STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$401	FEE SCHEDULE
WELLPOINT STAR PLUS	3680_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (AUS) INPATIENT 20240901	Medicaid / CHIP	$401	FEE SCHEDULE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$435	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$435	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$470	CASE RATE
AARP MC WELLMED	4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811	Medicare Advantage	$582	OTHER
AARP MC WELLMED	4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001	Medicare Advantage	$582	OTHER
SENDERO CHAP	4932_SENDERO CHAP OUTPATIENT 20250811	Commercial	$588	OTHER
SENDERO CHAP	4651_SENDERO CHAP INPATIENT 20251001	Commercial	$588	OTHER
AETNA MCR REPLACEMENT	4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811	Medicare Advantage	$594	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811	Medicare Advantage	$594	OTHER
COVID HRSA	4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811	Public program	$594	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811	Medicare Advantage	$594	OTHER
MEDICARE REPLACEMENT	4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811	Medicare Advantage	$594	OTHER
SUPERIOR ALLWELL	4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101	Medicare Advantage	$594	OTHER
UHCPCIP	4126_UNITED HEALTHCARE PCIP (AUS) OP 20250101	Commercial	$594	OTHER
WELLCARE MED ADVANTAGE	4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811	Medicare Advantage	$594	OTHER
WELMED MEDICARE	4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811	Medicare Advantage	$594	OTHER
AETNA MCR REPLACEMENT	4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001	Medicare Advantage	$594	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001	Medicare Advantage	$594	OTHER
COVID HRSA	4693_COVID HRSA UNIN Q80 INPATIENT 20251001	Public program	$594	OTHER
CSHCN CIDC	4694_CSHCN CIDC IP (ADULT) 20251001	Public program	$594	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001	Medicare Advantage	$594	OTHER
MEDICARE OON	4666_MEDICARE ADVANTAGE INPATIENT OON 20251001	Medicare Advantage	$594	OTHER
MEDICARE REPLACEMENT	4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001	Medicare Advantage	$594	OTHER
SUPERIOR ALLWELL	4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001	Medicare Advantage	$594	OTHER
TRICARE	4696_TRICARE INPATIENT 20251001	Military / VA	$594	OTHER
UHCPCIP	4678_UNITED HEALTHCARE PCIP (AUS) IP 20251001	Commercial	$594	OTHER
WELLCARE MED ADVANTAGE	4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001	Medicare Advantage	$594	OTHER
WELMED MEDICARE	4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001	Medicare Advantage	$594	OTHER
UHC MCR REPLACEMENT	4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811	Medicare Advantage	$606	OTHER
UHC MCR REPLACEMENT	4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001	Medicare Advantage	$606	OTHER
CONNECTED SENIOR CARE	2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001	Medicare Advantage	$612	OTHER
CONNECTED SENIOR CARE	4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001	Medicare Advantage	$612	OTHER
PPHP MCR ADVANTAGE	4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811	Medicare Advantage	$624	OTHER
TX INDEPENDENCE HP	4741_TX INDEPENDENCE HP OP 20250811	Medicare Advantage	$624	OTHER
PPHP MCR ADVANTAGE	4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001	Medicare Advantage	$624	OTHER
TX INDEPENDENCE HP	4671_TX INDEPENDENCE HP IP 20251001	Medicare Advantage	$624	OTHER
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$812	OTHER
OCCUNET	4123_OCCUNET OP 20250101	Workers' comp	$832	OTHER
OCCUNET	4674_OCCUNET IP 20251001	Workers' comp	$832	OTHER
SENDERO IDEALCARE	1571_SENDERO IDEALCARE OP 20200101	Commercial	$1,040	OTHER
SENDERO IDEALCARE	4675_SENDERO IDEALCARE IP 20251001	Commercial	$1,040	OTHER
SUPERIOR AMBETTER	4960_SUPERIOR AMBETTER OUTPATIENT 20250811	Commercial	$1,069	OTHER
SUPERIOR AMBETTER	4652_SUPERIOR AMBETTER INPATIENT 20251001	Commercial	$1,069	OTHER
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,368	CASE RATE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,662	CASE RATE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,668	CASE RATE
HUMANA MCR REPLACEMENT	4111_MEDICARE ADVANTAGE HUMANA OUTPATIENT (BRK,WIL,DEL,BAS) 20250101	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4662_MEDICARE ADVANTAGE HUMANA INPATIENT (BRK,WIL,DEL,BAS) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811	Medicare Advantage	$2,060	CASE RATE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$2,094	FEE SCHEDULE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$2,368	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$2,509	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$2,509	PERCENT OF TOTAL BILLED CHARGES
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$2,648	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$2,648	CASE RATE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$2,693	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$2,733	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,845	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,845	CASE RATE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$2,955	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$3,416	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$3,416	FEE SCHEDULE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$4,212	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$4,760	CASE RATE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$4,760	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$5,200	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$5,575	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$5,575	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Southwest: all 125 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
SUPERIOR STAR	4248_CHIRP SUPERIOR STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4403_CHIRP SUPERIOR STAR PLUS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3516_CHIRP SUPERIOR STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4382_CHIRP SUPERIOR STAR PLUS (SW) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
WELLPOINT STAR	4204_CHIRP AMERIGROUP STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
WELLPOINT STAR	4204_CHIRP WELLPOINT/AMERIGROUP STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3601_BLUE CROSS CHIP/STAR KIDS (SW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
BCBS STAR	3700_CHIRP BLUE CROSS STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3612_DELL CHIP/STAR KIDS (SW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
DELL STAR	3711_CHIRP DELL STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
UHC STAR	3744_CHIRP UHC STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
UHC STAR KIDS	4329_UHC STAR KIDS (SW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
UHC STAR PLUS	3755_CHIRP UHC STAR PLUS (SW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
WELLPOINT STAR	3678_CHIRP WELLPOINT/AMERIGROUP STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
WELLPOINT STAR PLUS	3689_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SW) INPATIENT 20240901	Medicaid / CHIP	$321	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4175_BLUE CROSS CHIP (SW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4175_BLUE CROSS CHIP/STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
BCBS STAR	4226_CHIRP BLUE CROSS STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
BCBS STAR KIDS	5017_BLUE CROSS STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4186_DELL CHIP/STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
DELL STAR	4237_CHIRP DELL STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
UHC STAR	4260_CHIRP UHC STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
UHC STAR KIDS	4318_UHC STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
UHC STAR PLUS	4271_CHIRP UHC STAR PLUS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4164_AMERIGROUP CHIP/STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4164_WELLPOINT/AMERIGROUP CHIP (SW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
WELLPOINT STAR KIDS	4984_WELLPOINT/AMERIGROUP STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
WELLPOINT STAR PLUS	4215_CHIRP AMERIGROUP STAR PLUS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
WELLPOINT STAR PLUS	4215_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$321	FEE SCHEDULE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$435	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$435	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$470	CASE RATE
AARP MC WELLMED	4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811	Medicare Advantage	$582	OTHER
AARP MC WELLMED	4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001	Medicare Advantage	$582	OTHER
SENDERO CHAP	4932_SENDERO CHAP OUTPATIENT 20250811	Commercial	$588	OTHER
SENDERO CHAP	4651_SENDERO CHAP INPATIENT 20251001	Commercial	$588	OTHER
AETNA MCR REPLACEMENT	4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811	Medicare Advantage	$594	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811	Medicare Advantage	$594	OTHER
COVID HRSA	4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811	Public program	$594	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811	Medicare Advantage	$594	OTHER
MEDICARE REPLACEMENT	4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811	Medicare Advantage	$594	OTHER
SUPERIOR ALLWELL	4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101	Medicare Advantage	$594	OTHER
WELLCARE MED ADVANTAGE	4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811	Medicare Advantage	$594	OTHER
WELMED MEDICARE	4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811	Medicare Advantage	$594	OTHER
AETNA MCR REPLACEMENT	4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001	Medicare Advantage	$594	OTHER
ASCENSION COMPLETE MEDICARE REPLACEMENT	4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001	Medicare Advantage	$594	OTHER
COVID HRSA	4693_COVID HRSA UNIN Q80 INPATIENT 20251001	Public program	$594	OTHER
CSHCN CIDC	4694_CSHCN CIDC IP (ADULT) 20251001	Public program	$594	OTHER
DEVOTED HEALTH MCR REPLACEMENT	4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001	Medicare Advantage	$594	OTHER
MEDICARE OON	4666_MEDICARE ADVANTAGE INPATIENT OON 20251001	Medicare Advantage	$594	OTHER
MEDICARE REPLACEMENT	4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001	Medicare Advantage	$594	OTHER
SUPERIOR ALLWELL	4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001	Medicare Advantage	$594	OTHER
TRICARE	4696_TRICARE INPATIENT 20251001	Military / VA	$594	OTHER
WELLCARE MED ADVANTAGE	4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001	Medicare Advantage	$594	OTHER
WELMED MEDICARE	4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001	Medicare Advantage	$594	OTHER
UHC MCR REPLACEMENT	4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811	Medicare Advantage	$606	OTHER
UHC MCR REPLACEMENT	4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001	Medicare Advantage	$606	OTHER
CONNECTED SENIOR CARE	2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001	Medicare Advantage	$612	OTHER
CONNECTED SENIOR CARE	4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001	Medicare Advantage	$612	OTHER
PPHP MCR ADVANTAGE	4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811	Medicare Advantage	$624	OTHER
TX INDEPENDENCE HP	4741_TX INDEPENDENCE HP OP 20250811	Medicare Advantage	$624	OTHER
PPHP MCR ADVANTAGE	4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001	Medicare Advantage	$624	OTHER
TX INDEPENDENCE HP	4671_TX INDEPENDENCE HP IP 20251001	Medicare Advantage	$624	OTHER
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$812	OTHER
OCCUNET	4123_OCCUNET OP 20250101	Workers' comp	$832	OTHER
OCCUNET	4674_OCCUNET IP 20251001	Workers' comp	$832	OTHER
SENDERO IDEALCARE	1571_SENDERO IDEALCARE OP 20200101	Commercial	$1,040	OTHER
SENDERO IDEALCARE	4675_SENDERO IDEALCARE IP 20251001	Commercial	$1,040	OTHER
SUPERIOR AMBETTER	4960_SUPERIOR AMBETTER OUTPATIENT 20250811	Commercial	$1,069	OTHER
SUPERIOR AMBETTER	4652_SUPERIOR AMBETTER INPATIENT 20251001	Commercial	$1,069	OTHER
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,368	CASE RATE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,662	CASE RATE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,668	CASE RATE
HUMANA MCR REPLACEMENT	4111_MEDICARE ADVANTAGE HUMANA OUTPATIENT (BRK,WIL,DEL,BAS) 20250101	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4662_MEDICARE ADVANTAGE HUMANA INPATIENT (BRK,WIL,DEL,BAS) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811	Medicare Advantage	$2,060	CASE RATE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$2,094	FEE SCHEDULE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$2,368	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$2,509	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$2,509	PERCENT OF TOTAL BILLED CHARGES
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$2,648	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$2,648	CASE RATE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$2,693	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$2,733	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,845	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,845	CASE RATE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$2,955	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$3,416	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$3,416	FEE SCHEDULE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$4,212	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$4,760	CASE RATE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$4,760	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$5,200	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$5,575	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$5,575	PERCENT OF TOTAL BILLED CHARGES

Ascension Seton Cedar Park: all 59 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$435	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$435	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$470	CASE RATE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$812	OTHER
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$821	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$821	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$821	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$821	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$821	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$821	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$821	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$821	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$821	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$821	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$821	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$821	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$821	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$821	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$821	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$821	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$821	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$821	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$821	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$821	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$821	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$821	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$821	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$821	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$821	FEE SCHEDULE
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,368	CASE RATE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,662	CASE RATE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,668	CASE RATE
HUMANA MCR REPLACEMENT	4111_MEDICARE ADVANTAGE HUMANA OUTPATIENT (BRK,WIL,DEL,BAS) 20250101	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4662_MEDICARE ADVANTAGE HUMANA INPATIENT (BRK,WIL,DEL,BAS) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811	Medicare Advantage	$2,060	CASE RATE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$2,094	FEE SCHEDULE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$2,368	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$2,558	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$2,558	PERCENT OF TOTAL BILLED CHARGES
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$2,648	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$2,648	CASE RATE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$2,693	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$2,733	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,845	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,845	CASE RATE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$2,955	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$3,416	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$3,416	FEE SCHEDULE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$4,212	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$4,760	CASE RATE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$4,760	CASE RATE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$5,200	CASE RATE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$5,683	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$5,683	PERCENT OF TOTAL BILLED CHARGES

Baylor Scott & White Medical Center – Lakeway: all 36 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$568	fee schedule
CORVEL	Worker's Compensation	Workers' comp	$580	fee schedule
Humana	Medicare	Medicare Advantage	$598	fee schedule
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$598	fee schedule
TriWest	Community Care Network	Military / VA	$598	fee schedule
Aetna	Medicare Advantage	Medicare Advantage	$628	fee schedule
American Health Plan	Medicare Advantage	Medicare Advantage	$628	fee schedule
HealthSpring	Medicare Advantage	Medicare Advantage	$628	fee schedule
ProCare Advantage	Medicare Advantage	Medicare Advantage	$628	fee schedule
United Healthcare	Medicare Advantage	Medicare Advantage	$670	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$718	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$751	fee schedule
Prime Health Services	Worker's Compensation	Workers' comp	$754	fee schedule
Superior Health Plan	Medicaid	Medicaid / CHIP	$793	percent of total billed charges
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$848	percent of total billed charges
Sedgwick	Preferred Network	Workers' comp	$894	fee schedule
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$987	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$1,505	case rate
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,770	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,779	case rate
QuikTrip	Employee Benefit Plan	Commercial	$2,179	percent of total billed charges
MidCoast	Commercial	Commercial	$2,179	percent of total billed charges
Independent Medical System	Commercial PPO	Commercial	$2,378	percent of total billed charges
Curative	Commercial	Commercial	$2,576	percent of total billed charges
First Health	PPO	Commercial	$2,774	percent of total billed charges
Humana	Commercial PPO	Commercial	$2,774	percent of total billed charges
HealthSmart	Accel Network	Commercial	$2,972	percent of total billed charges
HealthSmart	Preferred Network	Commercial	$2,972	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$2,972	percent of total billed charges
Three Rivers	Three Rivers Provider Network	Commercial	$3,566	percent of total billed charges
Mark Cuban	Commercial	Commercial	$5,475	case rate
Aetna	Commercial	Commercial	$6,643	case rate
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$7,280	case rate
Blue Cross Blue Shield	Blue Advantage	Commercial	$9,040	case rate
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$10,320	case rate
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$10,880	case rate

Baylor Scott & White Medical Center – Round Rock: all 39 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$568	fee schedule
CORVEL	Worker's Compensation	Workers' comp	$580	fee schedule
Humana	Medicare	Medicare Advantage	$598	fee schedule
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$598	fee schedule
TriWest	Community Care Network	Military / VA	$598	fee schedule
American Health Plan	Medicare Advantage	Medicare Advantage	$628	fee schedule
Blue Cross Blue Shield	Medicare Advantage	Medicare Advantage	$628	fee schedule
HealthSpring	Medicare Advantage	Medicare Advantage	$628	fee schedule
ProCare Advantage	Medicare Advantage	Medicare Advantage	$628	fee schedule
United Healthcare	Medicare Advantage	Medicare Advantage	$670	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$718	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$751	fee schedule
Prime Health Services	Worker's Compensation	Workers' comp	$754	fee schedule
Superior Health Plan	Medicaid	Medicaid / CHIP	$793	percent of total billed charges
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$848	percent of total billed charges
CareWorks fka Rockport	Worker's Compensation	Workers' comp	$894	fee schedule
Injury Management Organization	Med Select Network	Workers' comp	$894	fee schedule
Sedgwick	Preferred Network	Workers' comp	$894	fee schedule
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$987	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$1,505	case rate
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,770	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,779	case rate
QuikTrip	Employee Benefit Plan	Commercial	$2,179	percent of total billed charges
MidCoast	Commercial	Commercial	$2,179	percent of total billed charges
Independent Medical System	Commercial PPO	Commercial	$2,378	percent of total billed charges
Curative	Commercial	Commercial	$2,576	percent of total billed charges
First Health	PPO	Commercial	$2,774	percent of total billed charges
Humana	Commercial PPO	Commercial	$2,774	percent of total billed charges
BlueBell Creameries	Self Insured	Commercial	$2,972	percent of total billed charges
HealthSmart	Accel Network	Commercial	$2,972	percent of total billed charges
HealthSmart	Preferred Network	Commercial	$2,972	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$2,972	percent of total billed charges
Three Rivers	Three Rivers Provider Network	Commercial	$3,566	percent of total billed charges
Mark Cuban	Commercial	Commercial	$5,475	case rate
Aetna	Commercial	Commercial	$6,643	case rate
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$7,280	case rate
Blue Cross Blue Shield	Blue Advantage	Commercial	$9,040	case rate
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$10,320	case rate
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$10,880	case rate

Baylor Scott & White Medical Center – Taylor: all 36 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$753	percent of total billed charges
American Health Plan	Medicare Advantage	Medicare Advantage	$793	percent of total billed charges
TriWest	Community Care Network	Military / VA	$793	percent of total billed charges
CORVEL	Worker's Compensation	Workers' comp	$830	percent of total billed charges
Prime Health Services	Worker's Compensation	Workers' comp	$830	percent of total billed charges
Blue Cross Blue Shield	Medicare Advantage	Medicare Advantage	$832	percent of total billed charges
HealthSpring	Medicare Advantage	Medicare Advantage	$832	percent of total billed charges
ProCare Advantage	Medicare Advantage	Medicare Advantage	$832	percent of total billed charges
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$874	percent of total billed charges
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$951	percent of total billed charges
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$958	percent of total billed charges
CareWorks fka Rockport	Worker's Compensation	Workers' comp	$984	percent of total billed charges
Injury Management Organization	Med Select Network	Workers' comp	$984	percent of total billed charges
Sedgwick	Preferred Network	Workers' comp	$984	percent of total billed charges
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$995	percent of total billed charges
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$1,427	percent of total billed charges
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$1,505	case rate
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,770	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,779	case rate
QuikTrip	Employee Benefit Plan	Commercial	$2,179	percent of total billed charges
MidCoast	Commercial	Commercial	$2,179	percent of total billed charges
Independent Medical System	Commercial PPO	Commercial	$2,378	percent of total billed charges
Curative	Commercial	Commercial	$2,576	percent of total billed charges
First Health	PPO	Commercial	$2,774	percent of total billed charges
Humana	Commercial PPO	Commercial	$2,774	percent of total billed charges
HealthSmart	Accel Network	Commercial	$2,972	percent of total billed charges
HealthSmart	Preferred Network	Commercial	$2,972	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$2,972	percent of total billed charges
BlueBell Creameries	Self Insured	Commercial	$3,170	percent of total billed charges
Three Rivers	Three Rivers Provider Network	Commercial	$3,170	percent of total billed charges
Mark Cuban	Commercial	Commercial	$5,475	case rate
Aetna	Commercial	Commercial	$6,643	case rate
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$7,280	case rate
Blue Cross Blue Shield	Blue Advantage	Commercial	$9,040	case rate
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$10,320	case rate
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$10,880	case rate

Baylor Scott & White Medical Center – Austin: all 28 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$568	fee schedule
Humana	Medicare	Medicare Advantage	$598	fee schedule
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$598	fee schedule
TriWest	Community Care Network	Military / VA	$598	fee schedule
American Health Plan	Medicare Advantage	Medicare Advantage	$628	fee schedule
HealthSpring	Medicare Advantage	Medicare Advantage	$628	fee schedule
ProCare Advantage	Medicare Advantage	Medicare Advantage	$628	fee schedule
United Healthcare	Medicare Advantage	Medicare Advantage	$670	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$718	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$751	fee schedule
Superior Health Plan	Medicaid	Medicaid / CHIP	$753	percent of total billed charges
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$806	percent of total billed charges
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$987	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$1,505	case rate
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,770	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,779	case rate
QuikTrip	Employee Benefit Plan	Commercial	$2,179	percent of total billed charges
MidCoast	Commercial	Commercial	$2,179	percent of total billed charges
Curative	Commercial	Commercial	$2,576	percent of total billed charges
First Health	PPO	Commercial	$2,774	percent of total billed charges
Humana	Commercial PPO	Commercial	$2,774	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$2,972	percent of total billed charges
Mark Cuban	Commercial	Commercial	$5,475	case rate
Aetna	Commercial	Commercial	$6,643	case rate
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$7,280	case rate
Blue Cross Blue Shield	Blue Advantage	Commercial	$9,040	case rate
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$10,320	case rate
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$10,880	case rate

Baylor Scott & White Medical Center – Buda: all 29 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Superior Health Plan	Medicaid	Medicaid / CHIP	$476	percent of total billed charges
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$509	percent of total billed charges
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$568	fee schedule
Humana	Medicare	Medicare Advantage	$598	fee schedule
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$598	fee schedule
TriWest	Community Care Network	Military / VA	$598	fee schedule
American Health Plan	Medicare Advantage	Medicare Advantage	$628	fee schedule
Blue Cross Blue Shield	Medicare Advantage	Medicare Advantage	$628	fee schedule
HealthSpring	Medicare Advantage	Medicare Advantage	$628	fee schedule
ProCare Advantage	Medicare Advantage	Medicare Advantage	$628	fee schedule
United Healthcare	Medicare Advantage	Medicare Advantage	$670	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$718	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$751	fee schedule
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$987	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$1,505	case rate
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,770	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,779	case rate
QuikTrip	Employee Benefit Plan	Commercial	$2,179	percent of total billed charges
MidCoast	Commercial	Commercial	$2,179	percent of total billed charges
Curative	Commercial	Commercial	$2,576	percent of total billed charges
First Health	PPO	Commercial	$2,774	percent of total billed charges
Humana	Commercial PPO	Commercial	$2,774	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$2,972	percent of total billed charges
Mark Cuban	Commercial	Commercial	$5,475	case rate
Aetna	Commercial	Commercial	$6,643	case rate
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$7,280	case rate
Blue Cross Blue Shield	Blue Advantage	Commercial	$9,040	case rate
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$10,320	case rate
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$10,880	case rate

Baylor Scott & White Medical Center – Pflugerville: all 35 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Superior Health Plan	Medicaid	Medicaid / CHIP	$436	percent of total billed charges
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$466	percent of total billed charges
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$568	fee schedule
CORVEL	Worker's Compensation	Workers' comp	$580	fee schedule
Humana	Medicare	Medicare Advantage	$598	fee schedule
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$598	fee schedule
TriWest	Community Care Network	Military / VA	$598	fee schedule
American Health Plan	Medicare Advantage	Medicare Advantage	$628	fee schedule
HealthSpring	Medicare Advantage	Medicare Advantage	$628	fee schedule
ProCare Advantage	Medicare Advantage	Medicare Advantage	$628	fee schedule
United Healthcare	Medicare Advantage	Medicare Advantage	$670	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$718	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$751	fee schedule
Prime Health Services	Worker's Compensation	Workers' comp	$754	fee schedule
Sedgwick	Preferred Network	Workers' comp	$894	fee schedule
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$987	fee schedule
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$1,505	case rate
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$1,770	case rate
University of Mary Hardin-Baylor	Commercial	Commercial	$1,779	case rate
QuikTrip	Employee Benefit Plan	Commercial	$2,179	percent of total billed charges
MidCoast	Commercial	Commercial	$2,179	percent of total billed charges
Independent Medical System	Commercial PPO	Commercial	$2,378	percent of total billed charges
Curative	Commercial	Commercial	$2,576	percent of total billed charges
First Health	PPO	Commercial	$2,774	percent of total billed charges
Humana	Commercial PPO	Commercial	$2,774	percent of total billed charges
HealthSmart	Accel Network	Commercial	$2,972	percent of total billed charges
HealthSmart	Preferred Network	Commercial	$2,972	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$2,972	percent of total billed charges
Three Rivers	Three Rivers Provider Network	Commercial	$3,566	percent of total billed charges
Mark Cuban	Commercial	Commercial	$5,475	case rate
Aetna	Commercial	Commercial	$6,643	case rate
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$7,280	case rate
Blue Cross Blue Shield	Blue Advantage	Commercial	$9,040	case rate
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$10,320	case rate
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$10,880	case rate

CHRISTUS Santa Rosa Hospital – San Marcos: all 29 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Blue Cross Blue Shield Of Texas	PPO	Commercial	$320	fee schedule
Superior	Chip KM	Medicaid / CHIP	$552	case rate
Superior	Star KM	Medicaid / CHIP	$552	case rate
Superior	Star Kids KM	Medicaid / CHIP	$552	case rate
Allwell	Superior Medicare Advantage	Medicare Advantage	$594	fee schedule
Christus Health	Med Adv MM	Medicare Advantage	$594	fee schedule
Humana	MM	Commercial	$594	fee schedule
Triwest	VA MM	Military / VA	$594	fee schedule
United Healthcare	MM	Commercial	$594	fee schedule
Washington National	Supp MM	Commercial	$594	fee schedule
Wellcare	MM	Medicare Advantage	$594	fee schedule
Aetna	MM	Commercial	$606	fee schedule
Cigna	Healthspring Medicare Advantage MM	Medicare Advantage	$612	fee schedule
Provider Partners Health Plan	MM	Medicare Advantage	$612	fee schedule
Shared Health Insurance Company	MM	Commercial	$624	fee schedule
Amerigroup	MM	Medicaid / CHIP	$642	fee schedule
Devoted Health Plan	MM	Medicare Advantage	$642	fee schedule
Christus Health	HIX	Commercial	$832	fee schedule
Sendero	HMO HIX	Commercial	$1,016	fee schedule
Naphcare Inc.	RRMB	Public program	$1,188	fee schedule
Healthcare Highways	PPO	Commercial	$1,503	fee schedule
Blue Cross Blue Shield Of Texas	HMO	Commercial	$1,821	fee schedule
Humana	Choicecare	Commercial	$2,518	case rate
Cigna	New Business	Commercial	$2,648	fee schedule
United Healthcare	All Payer	Commercial	$2,730	case rate
Cigna	PPO	Commercial	$3,361	fee schedule
Five Point Credit Union	PPO	Commercial	$3,549	case rate
Blue Cross Blue Shield Of Texas	Blue Advantage HMO	Commercial	$4,320	case rate
Blue Cross Blue Shield Of Texas	HEB	Commercial	$4,720	case rate

Dell Children's Medical Center: all 59 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$200	CASE RATE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$435	CASE RATE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$435	CASE RATE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$470	CASE RATE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$806	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$812	OTHER
WHOLE FOODS	4512_WHOLE FOODS 20251001	Commercial	$1,368	CASE RATE
OSCAR HEALTH EXCHANGE	4511_OSCAR HEALTH PLAN 20251001	Commercial	$1,662	CASE RATE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$1,668	CASE RATE
HUMANA MCR REPLACEMENT	4111_MEDICARE ADVANTAGE HUMANA OUTPATIENT (BRK,WIL,DEL,BAS) 20250101	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4662_MEDICARE ADVANTAGE HUMANA INPATIENT (BRK,WIL,DEL,BAS) 20251001	Medicare Advantage	$2,060	CASE RATE
HUMANA MCR REPLACEMENT	4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811	Medicare Advantage	$2,060	CASE RATE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$2,094	FEE SCHEDULE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$2,368	CASE RATE
CIGNA HMO	4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701	Commercial	$2,509	PERCENT OF TOTAL BILLED CHARGES
CIGNA HMO	4476_CIGNA HMO (WIL,DEL) 20250701	Commercial	$2,509	PERCENT OF TOTAL BILLED CHARGES
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$2,648	CASE RATE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$2,648	CASE RATE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$2,693	CASE RATE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$2,733	FEE SCHEDULE
UHC	4498_UNITED HEALTHCARE (AUS,NW,SW, BAS) 20250701	Commercial	$2,845	CASE RATE
UHC	4500_UNITED HEALTHCARE (WIL,HAYS) 20250701	Commercial	$2,845	CASE RATE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$2,955	CASE RATE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$3,416	FEE SCHEDULE
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$3,416	FEE SCHEDULE
HUMANA PPO	2673_HUMANA PPO 20230701	Commercial	$4,212	CASE RATE
BCBS HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$4,760	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$4,760	FEE SCHEDULE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$5,200	FEE SCHEDULE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$5,575	PERCENT OF TOTAL BILLED CHARGES
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$5,575	PERCENT OF TOTAL BILLED CHARGES

What this price covers

These are hospital charges for CPT code 99285 (Emergency room visit, level 5 (highest)). A hospital price file covers the hospital's own charges. Doctors who are not hospital employees — for imaging, usually the radiologist who reads the scan — can bill you separately, and extra services on the same day (contrast, an injection, a consultation) have their own codes.

How to ask for a lower price without insurance

Ask the hospital for a Good Faith Estimate. If you are uninsured or not using insurance, federal law entitles you to a written estimate on request, and automatically when you schedule at least three business days ahead (CMS: No Surprises Act).
Ask whether the hospital has an uninsured discount or a financial assistance policy, and how to apply.
Compare with an independent imaging center or lab: they are not covered by the hospital price rule and often quote lower cash prices.

Hospitals in this comparison

Ascension Seton Cedar ParkAscension Seton · file Jan 2026 Ascension Seton Edgar B. DavisAscension Seton · file Jan 2026 Ascension Seton HaysAscension Seton · file Jan 2026 Ascension Seton Medical Center AustinAscension Seton · file Jan 2026 Ascension Seton NorthwestAscension Seton · file Jan 2026 Ascension Seton SmithvilleAscension Seton · file Jan 2026 Ascension Seton SouthwestAscension Seton · file Jan 2026

Ascension Seton WilliamsonAscension Seton · file Jan 2026