Shoulder MRI 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 73221; Medicaid and Medicare Advantage are shown separately below.
| Hospital | Published cash price | Typical insured rate | Lowest insured rate |
|---|---|---|---|
| Ascension Seton Cedar ParkAscension Seton · file Jan 2026 | $521–$2,198Cash ÷ typical 0.3× | $1,54018 plans | $211 |
| Ascension Seton Edgar B. DavisAscension Seton · file Jan 2026 | $708Cash ÷ typical 0.6× | $1,24718 plans | $211 |
| Ascension Seton HaysAscension Seton · file Jan 2026 | $738–$1,104Cash ÷ typical 0.8× | $89824 plans | $211 |
| Dell Seton Medical Center at The University of TexasAscension Seton · file Jan 2026 | $775Cash ÷ typical 0.5× | $1,54018 plans | $211 |
| Ascension Seton NorthwestAscension Seton · file Jan 2026 | $775Cash ÷ typical 0.9× | $89824 plans | $211 |
| Ascension Seton SmithvilleAscension Seton · file Jan 2026 | $775–$1,104Cash ÷ typical 0.5× | $1,54019 plans | $211 |
| Ascension Seton Medical Center AustinAscension Seton · file Jan 2026 | $775Cash ÷ typical 0.9× | $85526 plans | $211 |
| Ascension Seton SouthwestAscension Seton · file Jan 2026 | $775Cash ÷ typical 0.9× | $89824 plans | $211 |
| Baylor Scott & White Medical Center – LakewayBaylor Scott & White Health · file Jun 2026 | $2,312Cash ÷ typical 1.1× | $2,11926 plans | $288 |
| Baylor Scott & White Medical Center – Round RockBaylor Scott & White Health · file Jun 2026 | $2,312Cash ÷ typical 1.1× | $2,11927 plans | $288 |
| Baylor Scott & White Medical Center – TaylorBaylor Scott & White Health · file Jun 2026 | $2,312Cash ÷ typical 1.1× | $2,11927 plans | $607 |
| Baylor Scott & White Medical Center – AustinBaylor Scott & White Health · file Jun 2026 | $2,312Cash ÷ typical 1.1× | $2,02522 plans | $288 |
| Baylor Scott & White Medical Center – BudaBaylor Scott & White Health · file Jun 2026 | $2,312Cash ÷ typical 1.1× | $2,02522 plans | $288 |
| Baylor Scott & White Medical Center – PflugervilleBaylor Scott & White Health · file Jun 2026 | $2,312Cash ÷ typical 1.1× | $2,11926 plans | $288 |
| CHRISTUS Santa Rosa Hospital – San MarcosCHRISTUS Health · file Jan 2026 | — | $79718 plans | $234 |
| Dell Children's Medical CenterAscension Seton · children's hospital (not in the summary above) · file Jan 2026 | $1,507–$2,146Cash ÷ typical 1.0× | $1,54018 plans | $211 |
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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.
| Hospital | Blue Cross Blue Shield | Aetna | Cigna | UnitedHealthcare | Humana | Ambetter | Medicaid / CHIP | Medicare Advantage |
|---|---|---|---|---|---|---|---|---|
| Ascension Seton Cedar Park | $247–$1,042 | $1,540–$1,972 | $1,750 | — | — | $211–$224 | $211–$2,748 | — |
| Ascension Seton Edgar B. Davis | $247–$1,042 | $1,232–$1,706 | $1,750 | — | — | $211–$224 | $176–$885 | — |
| Ascension Seton Hays | $247–$1,042 | $1,540–$1,972 | $1,750 | — | — | $211–$422 | $211–$969 | $230–$246 |
| Dell Seton Medical Center at The University of Texas | $247–$1,042 | $1,540–$1,972 | $1,750 | — | — | $211–$224 | $211–$969 | — |
| Ascension Seton Northwest | $247–$1,042 | $1,540–$1,972 | $1,750 | — | — | $211–$422 | $211–$969 | $230–$246 |
| Ascension Seton Smithville | $247–$1,042 | $1,540–$1,972 | $1,750 | — | — | $211–$224 | $211–$1,380 | — |
| Ascension Seton Medical Center Austin | $247–$1,042 | $1,540–$1,972 | $1,750 | $234 | — | $211–$422 | $211–$969 | $230–$246 |
| Ascension Seton Southwest | $247–$1,042 | $1,540–$1,972 | $1,750 | — | — | $211–$422 | $211–$969 | $230–$246 |
| Baylor Scott & White Medical Center – Lakeway | $974–$1,189 | $2,119 | $1,711–$2,013 | $2,472 | $2,504–$2,697 | — | $209–$224 | $228–$268 |
| Baylor Scott & White Medical Center – Round Rock | $974–$1,189 | $2,119 | $1,711–$2,013 | $2,472 | $2,504–$2,697 | — | $209–$224 | $228–$268 |
| Baylor Scott & White Medical Center – Taylor | $974–$1,189 | $2,119 | $1,711–$2,013 | $2,472 | $2,504–$2,697 | — | $315 | $732–$850 |
| Baylor Scott & White Medical Center – Austin | $974–$1,189 | $2,119 | $1,711–$2,013 | $2,472 | $2,504–$2,697 | — | $209–$224 | $228–$268 |
| Baylor Scott & White Medical Center – Buda | $974–$1,189 | $2,119 | $1,711–$2,013 | $2,472 | $2,504–$2,697 | — | $209–$224 | $228–$268 |
| Baylor Scott & White Medical Center – Pflugerville | $974–$1,189 | $2,119 | $1,711–$2,013 | $2,472 | $2,504–$2,697 | — | $209–$224 | $228–$268 |
| CHRISTUS Santa Rosa Hospital – San Marcos | $895–$1,328 | $239 | $1,764–$2,240 | $234–$1,587 | $234–$713 | — | $225–$338 | $234–$253 |
| Dell Children's Medical Center | $247–$1,042 | $1,540–$1,972 | $1,750 | — | — | $211–$224 | $211–$1,380 | — |
Ascension Seton Cedar Park: all 56 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $176 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $224 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $229 | FEE SCHEDULE |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $247 | FEE SCHEDULE |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $264 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $282 | OTHER |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $855 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $855 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $941 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $1,042 | FEE SCHEDULE |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $1,540 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $1,540 | OTHER |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $1,969 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $1,972 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $1,972 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $2,443 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $2,443 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $2,443 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $2,443 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $2,443 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $2,443 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $2,443 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $2,443 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $2,748 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $2,748 | FEE SCHEDULE |
Ascension Seton Edgar B. Davis: all 85 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| BCBS STAR | 4221_CHIRP BLUE CROSS STAR (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $176 | FEE SCHEDULE |
| DELL STAR | 4232_CHIRP DELL STAR (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $176 | FEE SCHEDULE |
| UHC STAR | 4255_CHIRP UHC STAR (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $176 | FEE SCHEDULE |
| UHC STAR KIDS | 4313_UHC STAR KIDS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $176 | FEE SCHEDULE |
| UHC STAR PLUS | 4266_CHIRP UHC STAR PLUS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $176 | FEE SCHEDULE |
| WELLPOINT STAR | 4199_CHIRP AMERIGROUP STAR (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $176 | FEE SCHEDULE |
| WELLPOINT STAR | 4199_CHIRP WELLPOINT/AMERIGROUP STAR (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $176 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4210_CHIRP AMERIGROUP STAR PLUS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $176 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $176 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $224 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $229 | FEE SCHEDULE |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $247 | FEE SCHEDULE |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $264 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $282 | OTHER |
| BCBS CHIP/CHIP PERINATE | 3596_BLUE CROSS CHIP/STAR KIDS (EBD) INPATIENT 20240901 | Medicaid / CHIP | $290 | FEE SCHEDULE |
| BCBS STAR | 3695_CHIRP BLUE CROSS STAR (EBD) INPATIENT 20240901 | Medicaid / CHIP | $290 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3607_DELL CHIP/STAR KIDS (EBD) INPATIENT 20240901 | Medicaid / CHIP | $290 | FEE SCHEDULE |
| DELL STAR | 3706_CHIRP DELL STAR (EBD) INPATIENT 20240901 | Medicaid / CHIP | $290 | FEE SCHEDULE |
| UHC STAR | 3739_CHIRP UHC STAR (EBD) INPATIENT 20240901 | Medicaid / CHIP | $290 | FEE SCHEDULE |
| UHC STAR KIDS | 4324_UHC STAR KIDS (EBD) INPATIENT 20240901 | Medicaid / CHIP | $290 | FEE SCHEDULE |
| UHC STAR PLUS | 3750_CHIRP UHC STAR PLUS (EBD) INPATIENT 20240901 | Medicaid / CHIP | $290 | FEE SCHEDULE |
| WELLPOINT STAR | 3673_CHIRP WELLPOINT/AMERIGROUP STAR (EBD) INPATIENT 20240901 | Medicaid / CHIP | $290 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3684_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (EBD) INPATIENT 20240901 | Medicaid / CHIP | $290 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4170_BLUE CROSS CHIP (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $294 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4170_BLUE CROSS CHIP/STAR KIDS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $294 | FEE SCHEDULE |
| BCBS STAR KIDS | 5007_BLUE CROSS STAR KIDS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $294 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4181_DELL CHIP/STAR KIDS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $294 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4159_AMERIGROUP CHIP/STAR KIDS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $294 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4159_WELLPOINT/AMERIGROUP CHIP (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $294 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4974_WELLPOINT/AMERIGROUP STAR KIDS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $294 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4210_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $294 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $787 | FEE SCHEDULE |
| SUPERIOR STAR | 4243_CHIRP SUPERIOR STAR (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $787 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $787 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $787 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $787 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $787 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $787 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4393_CHIRP SUPERIOR STAR PLUS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $787 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $787 | FEE SCHEDULE |
| SUPERIOR STAR | 3511_CHIRP SUPERIOR STAR (EBD) INPATIENT 20240901 | Medicaid / CHIP | $787 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $787 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4377_CHIRP SUPERIOR STAR PLUS (EBD) INPATIENT 20240901 | Medicaid / CHIP | $787 | FEE SCHEDULE |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $855 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $855 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $885 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $885 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $941 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $1,042 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $1,232 | OTHER |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $1,263 | OTHER |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $1,386 | OTHER |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $1,540 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $1,540 | OTHER |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $1,706 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
Ascension Seton Hays: all 126 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $176 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4171_BLUE CROSS CHIP (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4171_BLUE CROSS CHIP/STAR KIDS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR KIDS | 5009_BLUE CROSS STAR KIDS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4182_DELL CHIP/STAR KIDS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4160_AMERIGROUP CHIP/STAR KIDS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4160_WELLPOINT/AMERIGROUP CHIP (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4976_WELLPOINT/AMERIGROUP STAR KIDS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4211_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS STAR | 4222_CHIRP BLUE CROSS STAR (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL STAR | 3707_CHIRP DELL STAR (HAY) INPATIENT 20240901 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL STAR | 4233_CHIRP DELL STAR (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $224 | FEE SCHEDULE |
| UHC STAR | 3740_CHIRP UHC STAR (HAY) INPATIENT 20240901 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR | 4256_CHIRP UHC STAR (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR KIDS | 4314_UHC STAR KIDS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR KIDS | 4325_UHC STAR KIDS (HAY) INPATIENT 20240901 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR PLUS | 3751_CHIRP UHC STAR PLUS (HAY) INPATIENT 20240901 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR PLUS | 4267_CHIRP UHC STAR PLUS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 3674_CHIRP WELLPOINT/AMERIGROUP STAR (HAY) INPATIENT 20240901 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4200_CHIRP AMERIGROUP STAR (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4200_CHIRP WELLPOINT/AMERIGROUP STAR (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3685_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (HAY) INPATIENT 20240901 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4211_CHIRP AMERIGROUP STAR PLUS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3597_BLUE CROSS CHIP/STAR KIDS (HAY) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| BCBS STAR | 3696_CHIRP BLUE CROSS STAR (HAY) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3608_DELL CHIP/STAR KIDS (HAY) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $229 | FEE SCHEDULE |
| AARP MC WELLMED | 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001 | Medicare Advantage | $230 | OTHER |
| AARP MC WELLMED | 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811 | Medicare Advantage | $230 | OTHER |
| SENDERO CHAP | 4651_SENDERO CHAP INPATIENT 20251001 | Commercial | $232 | OTHER |
| SENDERO CHAP | 4932_SENDERO CHAP OUTPATIENT 20250811 | Commercial | $232 | OTHER |
| AETNA MCR REPLACEMENT | 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| COVID HRSA | 4693_COVID HRSA UNIN Q80 INPATIENT 20251001 | Public program | $234 | OTHER |
| CSHCN CIDC | 4694_CSHCN CIDC IP (ADULT) 20251001 | Public program | $234 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| HUMANA MCR REPLACEMENT | 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001 | Medicare Advantage | $234 | OTHER |
| MEDICARE OON | 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001 | Medicare Advantage | $234 | OTHER |
| MEDICARE REPLACEMENT | 4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001 | Medicare Advantage | $234 | OTHER |
| SUPERIOR ALLWELL | 4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| TRICARE | 4696_TRICARE INPATIENT 20251001 | Military / VA | $234 | OTHER |
| UTMB | 4677_UTMB PRISONS (HAY) IP 20251001 | Public program | $234 | OTHER |
| WELLCARE MED ADVANTAGE | 4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| WELMED MEDICARE | 4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001 | Medicare Advantage | $234 | OTHER |
| AETNA MCR REPLACEMENT | 4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811 | Medicare Advantage | $234 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811 | Medicare Advantage | $234 | OTHER |
| COVID HRSA | 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811 | Public program | $234 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811 | Medicare Advantage | $234 | OTHER |
| HUMANA MCR REPLACEMENT | 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811 | Medicare Advantage | $234 | OTHER |
| MEDICARE REPLACEMENT | 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811 | Medicare Advantage | $234 | OTHER |
| SUPERIOR ALLWELL | 4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101 | Medicare Advantage | $234 | OTHER |
| UTMB | 4125_UTMB PRISONS (HAY) OP 20250101 | Public program | $234 | OTHER |
| WELLCARE MED ADVANTAGE | 4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811 | Medicare Advantage | $234 | OTHER |
| WELMED MEDICARE | 4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811 | Medicare Advantage | $234 | OTHER |
| UHC MCR REPLACEMENT | 4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001 | Medicare Advantage | $239 | OTHER |
| UHC MCR REPLACEMENT | 4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811 | Medicare Advantage | $239 | OTHER |
| CONNECTED SENIOR CARE | 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001 | Medicare Advantage | $241 | OTHER |
| CONNECTED SENIOR CARE | 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001 | Medicare Advantage | $241 | OTHER |
| PPHP MCR ADVANTAGE | 4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001 | Medicare Advantage | $246 | OTHER |
| TX INDEPENDENCE HP | 4671_TX INDEPENDENCE HP IP 20251001 | Medicare Advantage | $246 | OTHER |
| PPHP MCR ADVANTAGE | 4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811 | Medicare Advantage | $246 | OTHER |
| TX INDEPENDENCE HP | 4741_TX INDEPENDENCE HP OP 20250811 | Medicare Advantage | $246 | OTHER |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $247 | FEE SCHEDULE |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $264 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $282 | OTHER |
| OCCUNET | 4674_OCCUNET IP 20251001 | Workers' comp | $328 | OTHER |
| OCCUNET | 4123_OCCUNET OP 20250101 | Workers' comp | $328 | OTHER |
| SENDERO IDEALCARE | 4675_SENDERO IDEALCARE IP 20251001 | Commercial | $410 | OTHER |
| SENDERO IDEALCARE | 1571_SENDERO IDEALCARE OP 20200101 | Commercial | $410 | OTHER |
| SUPERIOR AMBETTER | 4652_SUPERIOR AMBETTER INPATIENT 20251001 | Commercial | $422 | OTHER |
| SUPERIOR AMBETTER | 4960_SUPERIOR AMBETTER OUTPATIENT 20250811 | Commercial | $422 | OTHER |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $855 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $855 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR | 3512_CHIRP SUPERIOR STAR (HAY) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4378_CHIRP SUPERIOR STAR PLUS (HAY) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR | 4244_CHIRP SUPERIOR STAR (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4395_CHIRP SUPERIOR STAR PLUS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $941 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $969 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $969 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $1,042 | FEE SCHEDULE |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $1,540 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $1,540 | OTHER |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $1,969 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $1,972 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $1,972 | FEE SCHEDULE |
Dell Seton Medical Center at The University of Texas: all 83 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $176 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4169_BLUE CROSS CHIP (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4169_BLUE CROSS CHIP/STAR KIDS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR KIDS | 5005_BLUE CROSS STAR KIDS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4180_DELL CHIP/STAR KIDS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4158_AMERIGROUP CHIP/STAR KIDS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4158_WELLPOINT/AMERIGROUP CHIP (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4972_WELLPOINT/AMERIGROUP STAR KIDS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4209_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS STAR | 4220_CHIRP BLUE CROSS STAR (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL STAR | 4231_CHIRP DELL STAR (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $224 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR | 4254_CHIRP UHC STAR (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR KIDS | 4312_UHC STAR KIDS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR PLUS | 4265_CHIRP UHC STAR PLUS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4198_CHIRP AMERIGROUP STAR (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4198_CHIRP WELLPOINT/AMERIGROUP STAR (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4209_CHIRP AMERIGROUP STAR PLUS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3595_BLUE CROSS CHIP/STAR KIDS (DEL) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| BCBS STAR | 3694_CHIRP BLUE CROSS STAR (DEL) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3606_DELL CHIP/STAR KIDS (DEL) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL STAR | 3705_CHIRP DELL STAR (DEL) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR | 3738_CHIRP UHC STAR (DEL) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR KIDS | 4323_UHC STAR KIDS (DEL) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR PLUS | 3749_CHIRP UHC STAR PLUS (DEL) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR | 3672_CHIRP WELLPOINT/AMERIGROUP STAR (DEL) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3683_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (DEL) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $229 | FEE SCHEDULE |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $247 | FEE SCHEDULE |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $264 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $282 | OTHER |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $855 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $855 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR | 4242_CHIRP SUPERIOR STAR (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4391_CHIRP SUPERIOR STAR PLUS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $941 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $969 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $969 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $1,042 | FEE SCHEDULE |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $1,540 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $1,540 | OTHER |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $1,969 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $1,972 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $1,972 | FEE SCHEDULE |
Ascension Seton Northwest: all 123 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $176 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR KIDS | 5011_BLUE CROSS STAR KIDS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4161_WELLPOINT/AMERIGROUP CHIP (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4978_WELLPOINT/AMERIGROUP STAR KIDS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4212_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS STAR | 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4183_DELL CHIP/STAR KIDS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL STAR | 4234_CHIRP DELL STAR (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $224 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR | 4257_CHIRP UHC STAR (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR KIDS | 4315_UHC STAR KIDS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR PLUS | 4268_CHIRP UHC STAR PLUS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4161_AMERIGROUP CHIP/STAR KIDS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4201_CHIRP AMERIGROUP STAR (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4201_CHIRP WELLPOINT/AMERIGROUP STAR (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4212_CHIRP AMERIGROUP STAR PLUS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| BCBS STAR | 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3609_DELL CHIP/STAR KIDS (NW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL STAR | 3708_CHIRP DELL STAR (NW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR | 3741_CHIRP UHC STAR (NW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR KIDS | 4326_UHC STAR KIDS (NW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR PLUS | 3752_CHIRP UHC STAR PLUS (NW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR | 3675_CHIRP WELLPOINT/AMERIGROUP STAR (NW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3686_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (NW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $229 | FEE SCHEDULE |
| AARP MC WELLMED | 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001 | Medicare Advantage | $230 | OTHER |
| AARP MC WELLMED | 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811 | Medicare Advantage | $230 | OTHER |
| SENDERO CHAP | 4651_SENDERO CHAP INPATIENT 20251001 | Commercial | $232 | OTHER |
| SENDERO CHAP | 4932_SENDERO CHAP OUTPATIENT 20250811 | Commercial | $232 | OTHER |
| AETNA MCR REPLACEMENT | 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| COVID HRSA | 4693_COVID HRSA UNIN Q80 INPATIENT 20251001 | Public program | $234 | OTHER |
| CSHCN CIDC | 4694_CSHCN CIDC IP (ADULT) 20251001 | Public program | $234 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| HUMANA MCR REPLACEMENT | 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001 | Medicare Advantage | $234 | OTHER |
| MEDICARE OON | 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001 | Medicare Advantage | $234 | OTHER |
| MEDICARE REPLACEMENT | 4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001 | Medicare Advantage | $234 | OTHER |
| SUPERIOR ALLWELL | 4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| TRICARE | 4696_TRICARE INPATIENT 20251001 | Military / VA | $234 | OTHER |
| WELLCARE MED ADVANTAGE | 4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| WELMED MEDICARE | 4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001 | Medicare Advantage | $234 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811 | Medicare Advantage | $234 | OTHER |
| COVID HRSA | 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811 | Public program | $234 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811 | Medicare Advantage | $234 | OTHER |
| HUMANA MCR REPLACEMENT | 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811 | Medicare Advantage | $234 | OTHER |
| MEDICARE REPLACEMENT | 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811 | Medicare Advantage | $234 | OTHER |
| SUPERIOR ALLWELL | 4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101 | Medicare Advantage | $234 | OTHER |
| WELLCARE MED ADVANTAGE | 4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811 | Medicare Advantage | $234 | OTHER |
| WELMED MEDICARE | 4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811 | Medicare Advantage | $234 | OTHER |
| UHC MCR REPLACEMENT | 4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001 | Medicare Advantage | $239 | OTHER |
| UHC MCR REPLACEMENT | 4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811 | Medicare Advantage | $239 | OTHER |
| CONNECTED SENIOR CARE | 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001 | Medicare Advantage | $241 | OTHER |
| CONNECTED SENIOR CARE | 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001 | Medicare Advantage | $241 | OTHER |
| PPHP MCR ADVANTAGE | 4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001 | Medicare Advantage | $246 | OTHER |
| TX INDEPENDENCE HP | 4671_TX INDEPENDENCE HP IP 20251001 | Medicare Advantage | $246 | OTHER |
| PPHP MCR ADVANTAGE | 4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811 | Medicare Advantage | $246 | OTHER |
| TX INDEPENDENCE HP | 4741_TX INDEPENDENCE HP OP 20250811 | Medicare Advantage | $246 | OTHER |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $247 | FEE SCHEDULE |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $264 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $282 | OTHER |
| OCCUNET | 4674_OCCUNET IP 20251001 | Workers' comp | $328 | OTHER |
| OCCUNET | 4123_OCCUNET OP 20250101 | Workers' comp | $328 | OTHER |
| SENDERO IDEALCARE | 4675_SENDERO IDEALCARE IP 20251001 | Commercial | $410 | OTHER |
| SENDERO IDEALCARE | 1571_SENDERO IDEALCARE OP 20200101 | Commercial | $410 | OTHER |
| SUPERIOR AMBETTER | 4652_SUPERIOR AMBETTER INPATIENT 20251001 | Commercial | $422 | OTHER |
| SUPERIOR AMBETTER | 4960_SUPERIOR AMBETTER OUTPATIENT 20250811 | Commercial | $422 | OTHER |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $855 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $855 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR | 3513_CHIRP SUPERIOR STAR (NW) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4379_CHIRP SUPERIOR STAR PLUS (NW) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR | 4245_CHIRP SUPERIOR STAR (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4397_CHIRP SUPERIOR STAR PLUS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $941 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $969 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $969 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $1,042 | FEE SCHEDULE |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $1,540 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $1,540 | OTHER |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $1,969 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $1,972 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $1,972 | FEE SCHEDULE |
Ascension Seton Smithville: all 87 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $176 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4174_BLUE CROSS CHIP (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR KIDS | 5015_BLUE CROSS STAR KIDS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4185_DELL CHIP/STAR KIDS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| DELL STAR | 4236_CHIRP DELL STAR (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $211 | FEE SCHEDULE |
| UHC STAR | 4259_CHIRP UHC STAR (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| UHC STAR KIDS | 4317_UHC STAR KIDS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| UHC STAR PLUS | 4270_CHIRP UHC STAR PLUS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4163_AMERIGROUP CHIP/STAR KIDS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4163_WELLPOINT/AMERIGROUP CHIP (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR | 4203_CHIRP AMERIGROUP STAR (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR | 4203_CHIRP WELLPOINT/AMERIGROUP STAR (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4982_WELLPOINT/AMERIGROUP STAR KIDS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4214_CHIRP AMERIGROUP STAR PLUS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4214_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4174_BLUE CROSS CHIP/STAR KIDS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS STAR | 4225_CHIRP BLUE CROSS STAR (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $224 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3600_BLUE CROSS CHIP/STAR KIDS (SMV) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| BCBS STAR | 3699_CHIRP BLUE CROSS STAR (SMV) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3611_DELL CHIP/STAR KIDS (SMV) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL STAR | 3710_CHIRP DELL STAR (SMV) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR | 3743_CHIRP UHC STAR (SMV) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR KIDS | 4328_UHC STAR KIDS (SMV) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR PLUS | 3754_CHIRP UHC STAR PLUS (SMV) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 3589_WELLPOINT CHIP/STAR KIDS (SMV) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR | 3677_CHIRP WELLPOINT/AMERIGROUP STAR (SMV) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3688_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SMV) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $229 | FEE SCHEDULE |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $247 | FEE SCHEDULE |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $264 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $282 | OTHER |
| SENDERO IDEALCARE | 1571_SENDERO IDEALCARE OP 20200101 | Commercial | $410 | OTHER |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $855 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $855 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $941 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $1,042 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR | 3515_CHIRP SUPERIOR STAR (SMV) INPATIENT 20240901 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4381_CHIRP SUPERIOR STAR PLUS (SMV) INPATIENT 20240901 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR | 4247_CHIRP SUPERIOR STAR (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4401_CHIRP SUPERIOR STAR PLUS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $1,380 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $1,380 | FEE SCHEDULE |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $1,540 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $1,540 | OTHER |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $1,969 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $1,972 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $1,972 | FEE SCHEDULE |
Ascension Seton Medical Center Austin: all 126 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $176 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4166_BLUE CROSS CHIP (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4166_BLUE CROSS CHIP/STAR KIDS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR KIDS | 4999_BLUE CROSS STAR KIDS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4177_DELL CHIP/STAR KIDS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4155_AMERIGROUP CHIP/STAR KIDS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4155_WELLPOINT/AMERIGROUP CHIP (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4966_WELLPOINT/AMERIGROUP STAR KIDS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4206_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS STAR | 4217_CHIRP BLUE CROSS STAR (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL STAR | 4228_CHIRP DELL STAR (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $224 | FEE SCHEDULE |
| UHC STAR | 4251_CHIRP UHC STAR (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR KIDS | 4309_UHC STAR KIDS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR PLUS | 4262_CHIRP UHC STAR PLUS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4195_CHIRP AMERIGROUP STAR (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4195_CHIRP WELLPOINT/AMERIGROUP STAR (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4206_CHIRP AMERIGROUP STAR PLUS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3592_BLUE CROSS CHIP/STAR KIDS (AUS) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| BCBS STAR | 3691_CHIRP BLUE CROSS STAR (AUS) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3603_DELL CHIP/STAR KIDS (AUS) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL STAR | 3702_CHIRP DELL STAR (AUS) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR | 3735_CHIRP UHC STAR (AUS) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR KIDS | 4320_UHC STAR KIDS (AUS) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR PLUS | 3746_CHIRP UHC STAR PLUS (AUS) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR | 3669_CHIRP WELLPOINT/AMERIGROUP STAR (AUS) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3680_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (AUS) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $229 | FEE SCHEDULE |
| AARP MC WELLMED | 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001 | Medicare Advantage | $230 | OTHER |
| AARP MC WELLMED | 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811 | Medicare Advantage | $230 | OTHER |
| SENDERO CHAP | 4651_SENDERO CHAP INPATIENT 20251001 | Commercial | $232 | OTHER |
| SENDERO CHAP | 4932_SENDERO CHAP OUTPATIENT 20250811 | Commercial | $232 | OTHER |
| AETNA MCR REPLACEMENT | 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| COVID HRSA | 4693_COVID HRSA UNIN Q80 INPATIENT 20251001 | Public program | $234 | OTHER |
| CSHCN CIDC | 4694_CSHCN CIDC IP (ADULT) 20251001 | Public program | $234 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| HUMANA MCR REPLACEMENT | 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001 | Medicare Advantage | $234 | OTHER |
| MEDICARE OON | 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001 | Medicare Advantage | $234 | OTHER |
| MEDICARE REPLACEMENT | 4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001 | Medicare Advantage | $234 | OTHER |
| SUPERIOR ALLWELL | 4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| TRICARE | 4696_TRICARE INPATIENT 20251001 | Military / VA | $234 | OTHER |
| UHCPCIP | 4678_UNITED HEALTHCARE PCIP (AUS) IP 20251001 | Commercial | $234 | OTHER |
| WELLCARE MED ADVANTAGE | 4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| WELMED MEDICARE | 4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001 | Medicare Advantage | $234 | OTHER |
| AETNA MCR REPLACEMENT | 4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811 | Medicare Advantage | $234 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811 | Medicare Advantage | $234 | OTHER |
| COVID HRSA | 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811 | Public program | $234 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811 | Medicare Advantage | $234 | OTHER |
| HUMANA MCR REPLACEMENT | 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811 | Medicare Advantage | $234 | OTHER |
| MEDICARE REPLACEMENT | 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811 | Medicare Advantage | $234 | OTHER |
| SUPERIOR ALLWELL | 4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101 | Medicare Advantage | $234 | OTHER |
| UHCPCIP | 4126_UNITED HEALTHCARE PCIP (AUS) OP 20250101 | Commercial | $234 | OTHER |
| WELLCARE MED ADVANTAGE | 4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811 | Medicare Advantage | $234 | OTHER |
| WELMED MEDICARE | 4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811 | Medicare Advantage | $234 | OTHER |
| UHC MCR REPLACEMENT | 4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001 | Medicare Advantage | $239 | OTHER |
| UHC MCR REPLACEMENT | 4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811 | Medicare Advantage | $239 | OTHER |
| CONNECTED SENIOR CARE | 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001 | Medicare Advantage | $241 | OTHER |
| CONNECTED SENIOR CARE | 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001 | Medicare Advantage | $241 | OTHER |
| PPHP MCR ADVANTAGE | 4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001 | Medicare Advantage | $246 | OTHER |
| TX INDEPENDENCE HP | 4671_TX INDEPENDENCE HP IP 20251001 | Medicare Advantage | $246 | OTHER |
| PPHP MCR ADVANTAGE | 4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811 | Medicare Advantage | $246 | OTHER |
| TX INDEPENDENCE HP | 4741_TX INDEPENDENCE HP OP 20250811 | Medicare Advantage | $246 | OTHER |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $247 | FEE SCHEDULE |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $264 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $282 | OTHER |
| OCCUNET | 4674_OCCUNET IP 20251001 | Workers' comp | $328 | OTHER |
| OCCUNET | 4123_OCCUNET OP 20250101 | Workers' comp | $328 | OTHER |
| SENDERO IDEALCARE | 4675_SENDERO IDEALCARE IP 20251001 | Commercial | $410 | OTHER |
| SENDERO IDEALCARE | 1571_SENDERO IDEALCARE OP 20200101 | Commercial | $410 | OTHER |
| SUPERIOR AMBETTER | 4652_SUPERIOR AMBETTER INPATIENT 20251001 | Commercial | $422 | OTHER |
| SUPERIOR AMBETTER | 4960_SUPERIOR AMBETTER OUTPATIENT 20250811 | Commercial | $422 | OTHER |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $855 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $855 | FEE SCHEDULE |
| SUPERIOR STAR | 3507_CHIRP SUPERIOR STAR (AUS) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4373_CHIRP SUPERIOR STAR PLUS (AUS) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR | 4239_CHIRP SUPERIOR STAR (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4385_CHIRP SUPERIOR STAR PLUS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $941 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $969 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $969 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $1,042 | FEE SCHEDULE |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $1,540 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $1,540 | OTHER |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $1,969 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $1,972 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $1,972 | FEE SCHEDULE |
Ascension Seton Southwest: all 124 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $176 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4175_BLUE CROSS CHIP (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR KIDS | 5017_BLUE CROSS STAR KIDS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4164_WELLPOINT/AMERIGROUP CHIP (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4984_WELLPOINT/AMERIGROUP STAR KIDS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4215_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4175_BLUE CROSS CHIP/STAR KIDS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS STAR | 4226_CHIRP BLUE CROSS STAR (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4186_DELL CHIP/STAR KIDS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL STAR | 4237_CHIRP DELL STAR (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $224 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR | 4260_CHIRP UHC STAR (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR KIDS | 4318_UHC STAR KIDS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR PLUS | 4271_CHIRP UHC STAR PLUS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4164_AMERIGROUP CHIP/STAR KIDS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4204_CHIRP AMERIGROUP STAR (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4204_CHIRP WELLPOINT/AMERIGROUP STAR (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4215_CHIRP AMERIGROUP STAR PLUS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3601_BLUE CROSS CHIP/STAR KIDS (SW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| BCBS STAR | 3700_CHIRP BLUE CROSS STAR (SW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3612_DELL CHIP/STAR KIDS (SW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL STAR | 3711_CHIRP DELL STAR (SW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR | 3744_CHIRP UHC STAR (SW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR KIDS | 4329_UHC STAR KIDS (SW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR PLUS | 3755_CHIRP UHC STAR PLUS (SW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR | 3678_CHIRP WELLPOINT/AMERIGROUP STAR (SW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3689_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SW) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $229 | FEE SCHEDULE |
| AARP MC WELLMED | 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001 | Medicare Advantage | $230 | OTHER |
| AARP MC WELLMED | 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811 | Medicare Advantage | $230 | OTHER |
| SENDERO CHAP | 4651_SENDERO CHAP INPATIENT 20251001 | Commercial | $232 | OTHER |
| SENDERO CHAP | 4932_SENDERO CHAP OUTPATIENT 20250811 | Commercial | $232 | OTHER |
| AETNA MCR REPLACEMENT | 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| COVID HRSA | 4693_COVID HRSA UNIN Q80 INPATIENT 20251001 | Public program | $234 | OTHER |
| CSHCN CIDC | 4694_CSHCN CIDC IP (ADULT) 20251001 | Public program | $234 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| HUMANA MCR REPLACEMENT | 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001 | Medicare Advantage | $234 | OTHER |
| MEDICARE OON | 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001 | Medicare Advantage | $234 | OTHER |
| MEDICARE REPLACEMENT | 4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001 | Medicare Advantage | $234 | OTHER |
| SUPERIOR ALLWELL | 4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| TRICARE | 4696_TRICARE INPATIENT 20251001 | Military / VA | $234 | OTHER |
| WELLCARE MED ADVANTAGE | 4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001 | Medicare Advantage | $234 | OTHER |
| WELMED MEDICARE | 4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001 | Medicare Advantage | $234 | OTHER |
| AETNA MCR REPLACEMENT | 4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811 | Medicare Advantage | $234 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811 | Medicare Advantage | $234 | OTHER |
| COVID HRSA | 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811 | Public program | $234 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811 | Medicare Advantage | $234 | OTHER |
| HUMANA MCR REPLACEMENT | 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811 | Medicare Advantage | $234 | OTHER |
| MEDICARE REPLACEMENT | 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811 | Medicare Advantage | $234 | OTHER |
| SUPERIOR ALLWELL | 4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101 | Medicare Advantage | $234 | OTHER |
| WELLCARE MED ADVANTAGE | 4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811 | Medicare Advantage | $234 | OTHER |
| WELMED MEDICARE | 4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811 | Medicare Advantage | $234 | OTHER |
| UHC MCR REPLACEMENT | 4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001 | Medicare Advantage | $239 | OTHER |
| UHC MCR REPLACEMENT | 4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811 | Medicare Advantage | $239 | OTHER |
| CONNECTED SENIOR CARE | 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001 | Medicare Advantage | $241 | OTHER |
| CONNECTED SENIOR CARE | 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001 | Medicare Advantage | $241 | OTHER |
| PPHP MCR ADVANTAGE | 4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001 | Medicare Advantage | $246 | OTHER |
| TX INDEPENDENCE HP | 4671_TX INDEPENDENCE HP IP 20251001 | Medicare Advantage | $246 | OTHER |
| PPHP MCR ADVANTAGE | 4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811 | Medicare Advantage | $246 | OTHER |
| TX INDEPENDENCE HP | 4741_TX INDEPENDENCE HP OP 20250811 | Medicare Advantage | $246 | OTHER |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $247 | FEE SCHEDULE |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $264 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $282 | OTHER |
| OCCUNET | 4674_OCCUNET IP 20251001 | Workers' comp | $328 | OTHER |
| OCCUNET | 4123_OCCUNET OP 20250101 | Workers' comp | $328 | OTHER |
| SENDERO IDEALCARE | 4675_SENDERO IDEALCARE IP 20251001 | Commercial | $410 | OTHER |
| SENDERO IDEALCARE | 1571_SENDERO IDEALCARE OP 20200101 | Commercial | $410 | OTHER |
| SUPERIOR AMBETTER | 4652_SUPERIOR AMBETTER INPATIENT 20251001 | Commercial | $422 | OTHER |
| SUPERIOR AMBETTER | 4960_SUPERIOR AMBETTER OUTPATIENT 20250811 | Commercial | $422 | OTHER |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $855 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $855 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR | 3516_CHIRP SUPERIOR STAR (SW) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4382_CHIRP SUPERIOR STAR PLUS (SW) INPATIENT 20240901 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR | 4248_CHIRP SUPERIOR STAR (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4403_CHIRP SUPERIOR STAR PLUS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $861 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $941 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $969 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $969 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $1,042 | FEE SCHEDULE |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $1,540 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $1,540 | OTHER |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $1,969 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $1,972 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $1,972 | FEE SCHEDULE |
Baylor Scott & White Medical Center – Lakeway: all 40 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| Superior Health Plan | Medicaid | Medicaid / CHIP | $209 | fee schedule |
| United Healthcare | Medicaid/CHIP | Medicaid / CHIP | $224 | fee schedule |
| Baylor Scott & White Health Plan | Medicare Advantage | Medicare Advantage | $228 | fee schedule |
| CORVEL | Worker's Compensation | Workers' comp | $233 | fee schedule |
| Humana | Medicare | Medicare Advantage | $240 | fee schedule |
| Superior Health Plan | Medicare HMO/Medicare PPO | Medicare Advantage | $240 | fee schedule |
| TriWest | Community Care Network | Military / VA | $240 | fee schedule |
| Aetna | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| American Health Plan | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| HealthSpring | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| ProCare Advantage | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| United Healthcare | Medicare Advantage | Medicare Advantage | $268 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | Commercial | $288 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Individual | Commercial | $301 | fee schedule |
| Prime Health Services | Worker's Compensation | Workers' comp | $302 | fee schedule |
| Sedgwick | Preferred Network | Workers' comp | $358 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | Commercial | $395 | fee schedule |
| Mark Cuban | Commercial | Commercial | $607 | fee schedule |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $974 | fee schedule |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $986 | fee schedule |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $1,128 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $1,189 | fee schedule |
| Cigna | Local Plus | Commercial | $1,711 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $1,731 | fee schedule |
| Cigna | HMO/PPO | Commercial | $2,013 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $2,037 | fee schedule |
| Aetna | Commercial | Commercial | $2,119 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $2,119 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $2,119 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $2,149 | fee schedule |
| Independent Medical System | Commercial PPO | Commercial | $2,312 | percent of total billed charges |
| United Healthcare | Commercial | Commercial | $2,472 | fee schedule |
| Curative | Commercial | Commercial | $2,504 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $2,504 | percent of total billed charges |
| First Health | PPO | Commercial | $2,697 | percent of total billed charges |
| HealthSmart | Accel Network | Commercial | $2,697 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $2,697 | percent of total billed charges |
| HealthSmart | Preferred Network | Commercial | $2,890 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $2,890 | percent of total billed charges |
| Three Rivers | Three Rivers Provider Network | Commercial | $3,468 | percent of total billed charges |
Baylor Scott & White Medical Center – Round Rock: all 43 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| Superior Health Plan | Medicaid | Medicaid / CHIP | $209 | fee schedule |
| United Healthcare | Medicaid/CHIP | Medicaid / CHIP | $224 | fee schedule |
| Baylor Scott & White Health Plan | Medicare Advantage | Medicare Advantage | $228 | fee schedule |
| CORVEL | Worker's Compensation | Workers' comp | $233 | fee schedule |
| Humana | Medicare | Medicare Advantage | $240 | fee schedule |
| Superior Health Plan | Medicare HMO/Medicare PPO | Medicare Advantage | $240 | fee schedule |
| TriWest | Community Care Network | Military / VA | $240 | fee schedule |
| American Health Plan | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| Blue Cross Blue Shield | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| HealthSpring | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| ProCare Advantage | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| United Healthcare | Medicare Advantage | Medicare Advantage | $268 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | Commercial | $288 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Individual | Commercial | $301 | fee schedule |
| Prime Health Services | Worker's Compensation | Workers' comp | $302 | fee schedule |
| CareWorks fka Rockport | Worker's Compensation | Workers' comp | $358 | fee schedule |
| Injury Management Organization | Med Select Network | Workers' comp | $358 | fee schedule |
| Sedgwick | Preferred Network | Workers' comp | $358 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | Commercial | $395 | fee schedule |
| Mark Cuban | Commercial | Commercial | $607 | fee schedule |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $974 | fee schedule |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $986 | fee schedule |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $1,128 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $1,189 | fee schedule |
| Cigna | Local Plus | Commercial | $1,711 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $1,731 | fee schedule |
| Cigna | HMO/PPO | Commercial | $2,013 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $2,037 | fee schedule |
| Aetna | Commercial | Commercial | $2,119 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $2,119 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $2,119 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $2,149 | fee schedule |
| Independent Medical System | Commercial PPO | Commercial | $2,312 | percent of total billed charges |
| United Healthcare | Commercial | Commercial | $2,472 | fee schedule |
| Curative | Commercial | Commercial | $2,504 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $2,504 | percent of total billed charges |
| First Health | PPO | Commercial | $2,697 | percent of total billed charges |
| HealthSmart | Accel Network | Commercial | $2,697 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $2,697 | percent of total billed charges |
| BlueBell Creameries | Self Insured | Commercial | $2,890 | percent of total billed charges |
| HealthSmart | Preferred Network | Commercial | $2,890 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $2,890 | percent of total billed charges |
| Three Rivers | Three Rivers Provider Network | Commercial | $3,468 | percent of total billed charges |
Baylor Scott & White Medical Center – Taylor: all 40 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| United Healthcare | Medicaid/CHIP | Medicaid / CHIP | $315 | fee schedule |
| Mark Cuban | Commercial | Commercial | $607 | fee schedule |
| Baylor Scott & White Health Plan | Medicare Advantage | Medicare Advantage | $732 | percent of total billed charges |
| American Health Plan | Medicare Advantage | Medicare Advantage | $771 | percent of total billed charges |
| TriWest | Community Care Network | Military / VA | $771 | percent of total billed charges |
| CORVEL | Worker's Compensation | Workers' comp | $807 | percent of total billed charges |
| Prime Health Services | Worker's Compensation | Workers' comp | $807 | percent of total billed charges |
| Blue Cross Blue Shield | Medicare Advantage | Medicare Advantage | $809 | percent of total billed charges |
| HealthSpring | Medicare Advantage | Medicare Advantage | $809 | percent of total billed charges |
| ProCare Advantage | Medicare Advantage | Medicare Advantage | $809 | percent of total billed charges |
| Superior Health Plan | Medicare HMO/Medicare PPO | Medicare Advantage | $850 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | Commercial | $925 | percent of total billed charges |
| CareWorks fka Rockport | Worker's Compensation | Workers' comp | $957 | percent of total billed charges |
| Injury Management Organization | Med Select Network | Workers' comp | $957 | percent of total billed charges |
| Sedgwick | Preferred Network | Workers' comp | $957 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Premier - Individual | Commercial | $967 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $974 | fee schedule |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $986 | fee schedule |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $1,128 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $1,189 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | Commercial | $1,387 | percent of total billed charges |
| Cigna | Local Plus | Commercial | $1,711 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $1,731 | fee schedule |
| Cigna | HMO/PPO | Commercial | $2,013 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $2,037 | fee schedule |
| Aetna | Commercial | Commercial | $2,119 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $2,119 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $2,119 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $2,149 | fee schedule |
| Independent Medical System | Commercial PPO | Commercial | $2,312 | percent of total billed charges |
| United Healthcare | Commercial | Commercial | $2,472 | fee schedule |
| Curative | Commercial | Commercial | $2,504 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $2,504 | percent of total billed charges |
| First Health | PPO | Commercial | $2,697 | percent of total billed charges |
| HealthSmart | Accel Network | Commercial | $2,697 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $2,697 | percent of total billed charges |
| HealthSmart | Preferred Network | Commercial | $2,890 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $2,890 | percent of total billed charges |
| BlueBell Creameries | Self Insured | Commercial | $3,082 | percent of total billed charges |
| Three Rivers | Three Rivers Provider Network | Commercial | $3,082 | percent of total billed charges |
Baylor Scott & White Medical Center – Austin: all 32 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| Superior Health Plan | Medicaid | Medicaid / CHIP | $209 | fee schedule |
| United Healthcare | Medicaid/CHIP | Medicaid / CHIP | $224 | fee schedule |
| Baylor Scott & White Health Plan | Medicare Advantage | Medicare Advantage | $228 | fee schedule |
| Humana | Medicare | Medicare Advantage | $240 | fee schedule |
| Superior Health Plan | Medicare HMO/Medicare PPO | Medicare Advantage | $240 | fee schedule |
| TriWest | Community Care Network | Military / VA | $240 | fee schedule |
| American Health Plan | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| HealthSpring | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| ProCare Advantage | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| United Healthcare | Medicare Advantage | Medicare Advantage | $268 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | Commercial | $288 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Individual | Commercial | $301 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | Commercial | $395 | fee schedule |
| Mark Cuban | Commercial | Commercial | $607 | fee schedule |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $974 | fee schedule |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $986 | fee schedule |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $1,128 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $1,189 | fee schedule |
| Cigna | Local Plus | Commercial | $1,711 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $1,731 | fee schedule |
| Cigna | HMO/PPO | Commercial | $2,013 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $2,037 | fee schedule |
| Aetna | Commercial | Commercial | $2,119 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $2,119 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $2,119 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $2,149 | fee schedule |
| United Healthcare | Commercial | Commercial | $2,472 | fee schedule |
| Curative | Commercial | Commercial | $2,504 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $2,504 | percent of total billed charges |
| First Health | PPO | Commercial | $2,697 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $2,697 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $2,890 | percent of total billed charges |
Baylor Scott & White Medical Center – Buda: all 33 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| Superior Health Plan | Medicaid | Medicaid / CHIP | $209 | fee schedule |
| United Healthcare | Medicaid/CHIP | Medicaid / CHIP | $224 | fee schedule |
| Baylor Scott & White Health Plan | Medicare Advantage | Medicare Advantage | $228 | fee schedule |
| Humana | Medicare | Medicare Advantage | $240 | fee schedule |
| Superior Health Plan | Medicare HMO/Medicare PPO | Medicare Advantage | $240 | fee schedule |
| TriWest | Community Care Network | Military / VA | $240 | fee schedule |
| American Health Plan | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| Blue Cross Blue Shield | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| HealthSpring | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| ProCare Advantage | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| United Healthcare | Medicare Advantage | Medicare Advantage | $268 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | Commercial | $288 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Individual | Commercial | $301 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | Commercial | $395 | fee schedule |
| Mark Cuban | Commercial | Commercial | $607 | fee schedule |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $974 | fee schedule |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $986 | fee schedule |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $1,128 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $1,189 | fee schedule |
| Cigna | Local Plus | Commercial | $1,711 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $1,731 | fee schedule |
| Cigna | HMO/PPO | Commercial | $2,013 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $2,037 | fee schedule |
| Aetna | Commercial | Commercial | $2,119 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $2,119 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $2,119 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $2,149 | fee schedule |
| United Healthcare | Commercial | Commercial | $2,472 | fee schedule |
| Curative | Commercial | Commercial | $2,504 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $2,504 | percent of total billed charges |
| First Health | PPO | Commercial | $2,697 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $2,697 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $2,890 | percent of total billed charges |
Baylor Scott & White Medical Center – Pflugerville: all 39 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| Superior Health Plan | Medicaid | Medicaid / CHIP | $209 | fee schedule |
| United Healthcare | Medicaid/CHIP | Medicaid / CHIP | $224 | fee schedule |
| Baylor Scott & White Health Plan | Medicare Advantage | Medicare Advantage | $228 | fee schedule |
| CORVEL | Worker's Compensation | Workers' comp | $233 | fee schedule |
| Humana | Medicare | Medicare Advantage | $240 | fee schedule |
| Superior Health Plan | Medicare HMO/Medicare PPO | Medicare Advantage | $240 | fee schedule |
| TriWest | Community Care Network | Military / VA | $240 | fee schedule |
| American Health Plan | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| HealthSpring | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| ProCare Advantage | Medicare Advantage | Medicare Advantage | $252 | fee schedule |
| United Healthcare | Medicare Advantage | Medicare Advantage | $268 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | Commercial | $288 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Individual | Commercial | $301 | fee schedule |
| Prime Health Services | Worker's Compensation | Workers' comp | $302 | fee schedule |
| Sedgwick | Preferred Network | Workers' comp | $358 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | Commercial | $395 | fee schedule |
| Mark Cuban | Commercial | Commercial | $607 | fee schedule |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $974 | fee schedule |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $986 | fee schedule |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $1,128 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $1,189 | fee schedule |
| Cigna | Local Plus | Commercial | $1,711 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $1,731 | fee schedule |
| Cigna | HMO/PPO | Commercial | $2,013 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $2,037 | fee schedule |
| Aetna | Commercial | Commercial | $2,119 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $2,119 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $2,119 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $2,149 | fee schedule |
| Independent Medical System | Commercial PPO | Commercial | $2,312 | percent of total billed charges |
| United Healthcare | Commercial | Commercial | $2,472 | fee schedule |
| Curative | Commercial | Commercial | $2,504 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $2,504 | percent of total billed charges |
| First Health | PPO | Commercial | $2,697 | percent of total billed charges |
| HealthSmart | Accel Network | Commercial | $2,697 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $2,697 | percent of total billed charges |
| HealthSmart | Preferred Network | Commercial | $2,890 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $2,890 | percent of total billed charges |
| Three Rivers | Three Rivers Provider Network | Commercial | $3,468 | percent of total billed charges |
CHRISTUS Santa Rosa Hospital – San Marcos: all 37 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| United Healthcare | Star KM | Medicaid / CHIP | $225 | fee schedule |
| United Healthcare | Star Kids KM | Medicaid / CHIP | $225 | fee schedule |
| Allwell | Superior Medicare Advantage | Medicare Advantage | $234 | fee schedule |
| Christus Health | Med Adv MM | Medicare Advantage | $234 | fee schedule |
| Humana | MM | Commercial | $234 | fee schedule |
| Triwest | VA MM | Military / VA | $234 | fee schedule |
| United Healthcare | MM | Commercial | $234 | fee schedule |
| Washington National | Supp MM | Commercial | $234 | fee schedule |
| Wellcare | MM | Medicare Advantage | $234 | fee schedule |
| Aetna | MM | Commercial | $239 | fee schedule |
| Cigna | Healthspring Medicare Advantage MM | Medicare Advantage | $241 | fee schedule |
| Provider Partners Health Plan | MM | Medicare Advantage | $241 | fee schedule |
| Shared Health Insurance Company | MM | Commercial | $246 | fee schedule |
| Amerigroup | MM | Medicaid / CHIP | $253 | fee schedule |
| Devoted Health Plan | MM | Medicare Advantage | $253 | fee schedule |
| Community First | Star Kids KM | Medicaid / CHIP | $294 | fee schedule |
| Blue Cross Blue Shield Of Texas | Star KM | Medicaid / CHIP | $300 | fee schedule |
| Blue Cross Blue Shield Of Texas | Star Kids KM | Medicaid / CHIP | $300 | fee schedule |
| Amerigroup | Star KM | Medicaid / CHIP | $309 | fee schedule |
| Texas Childrens Health Plan | Star Plus KM | Medicaid / CHIP | $309 | fee schedule |
| Christus Health | HIX | Commercial | $328 | fee schedule |
| Superior | Chip KM | Medicaid / CHIP | $338 | fee schedule |
| Superior | Star KM | Medicaid / CHIP | $338 | fee schedule |
| Superior | Star Kids KM | Medicaid / CHIP | $338 | fee schedule |
| Sendero | HMO HIX | Commercial | $401 | fee schedule |
| Naphcare Inc. | RRMB | Public program | $469 | fee schedule |
| Healthcare Highways | PPO | Commercial | $593 | fee schedule |
| Humana | Choicecare | Commercial | $713 | fee schedule |
| Community First Health Plan | HMO | Commercial | $880 | other |
| Blue Cross Blue Shield Of Texas | HMO | Commercial | $895 | fee schedule |
| Blue Cross Blue Shield Of Texas | PPO | Commercial | $979 | fee schedule |
| Blue Cross Blue Shield Of Texas | Blue Advantage HMO | Commercial | $1,196 | fee schedule |
| Blue Cross Blue Shield Of Texas | HEB | Commercial | $1,328 | fee schedule |
| United Healthcare | All Payer | Commercial | $1,587 | fee schedule |
| Cigna | New Business | Commercial | $1,764 | fee schedule |
| Cigna | PPO | Commercial | $2,240 | fee schedule |
| Five Point Credit Union | PPO | Commercial | $2,251 | fee schedule |
Dell Children's Medical Center: all 56 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $176 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $211 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $211 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $224 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $224 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $225 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $229 | FEE SCHEDULE |
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $247 | FEE SCHEDULE |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $264 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $282 | OTHER |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $855 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $855 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $941 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $1,042 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $1,226 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $1,380 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $1,380 | FEE SCHEDULE |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $1,540 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $1,540 | OTHER |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $1,706 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $1,750 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $1,969 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $1,972 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $1,972 | FEE SCHEDULE |
What this price covers
These are hospital charges for CPT code 73221 (Shoulder MRI without contrast). 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.