Published cash price
$183–$586
what 14 hospitals list for a self-pay transvaginal ultrasound
Typical insured rate
$361
median of every commercial plan rate in the files
Lowest insured rate
$88.30
BCBS BAV EXCHANGE (4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101), Ascension Seton Smithville
Transvaginal ultrasound 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 76830; Medicaid and Medicare Advantage are shown separately below.
| Hospital | Published cash price | Typical insured rate | Lowest insured rate |
|---|---|---|---|
| Ascension Seton SmithvilleAscension Seton · file Jan 2026 | $183–$266Cash ÷ typical 0.5× | $35019 plans | $88.30 |
| Ascension Seton HaysAscension Seton · file Jan 2026 | $183–$331Cash ÷ typical 0.6× | $30924 plans | $88.30 |
| Ascension Seton Cedar ParkAscension Seton · file Jan 2026 | $246–$586Cash ÷ typical 0.7× | $35418 plans | $88.30 |
| Ascension Seton Edgar B. DavisAscension Seton · file Jan 2026 | $251–$288Cash ÷ typical 0.7× | $35418 plans | $88.30 |
| Dell Seton Medical Center at The University of TexasAscension Seton · file Jan 2026 | $266Cash ÷ typical 0.8× | $35418 plans | $88.30 |
| Ascension Seton NorthwestAscension Seton · file Jan 2026 | $266Cash ÷ typical 0.9× | $30924 plans | $88.30 |
| Ascension Seton Medical Center AustinAscension Seton · file Jan 2026 | $266Cash ÷ typical 0.9× | $29326 plans | $88.30 |
| Ascension Seton SouthwestAscension Seton · file Jan 2026 | $266Cash ÷ typical 0.9× | $30924 plans | $88.30 |
| Baylor Scott & White Medical Center – LakewayBaylor Scott & White Health · file Jun 2026 | $543Cash ÷ typical 1.1× | $49826 plans | $126 |
| Baylor Scott & White Medical Center – Round RockBaylor Scott & White Health · file Jun 2026 | $543Cash ÷ typical 1.1× | $49827 plans | $126 |
| Baylor Scott & White Medical Center – TaylorBaylor Scott & White Health · file Jun 2026 | $543Cash ÷ typical 1.1× | $49827 plans | $217 |
| Baylor Scott & White Medical Center – AustinBaylor Scott & White Health · file Jun 2026 | $543Cash ÷ typical 1.2× | $45522 plans | $126 |
| Baylor Scott & White Medical Center – BudaBaylor Scott & White Health · file Jun 2026 | $543Cash ÷ typical 1.2× | $45522 plans | $126 |
| Baylor Scott & White Medical Center – PflugervilleBaylor Scott & White Health · file Jun 2026 | $543Cash ÷ typical 1.1× | $49826 plans | $126 |
| CHRISTUS Santa Rosa Hospital – San MarcosCHRISTUS Health · file Jan 2026 | — | $26016 plans | $103 |
| Dell Children's Medical CenterAscension Seton · children's hospital (not in the summary above) · file Jan 2026 | $356–$517Cash ÷ typical 1.0× | $35418 plans | $88.30 |
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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 Smithville | $88–$358 | $541–$883 | $350 | — | — | $107–$119 | $107–$332 | — |
| Ascension Seton Hays | $88–$358 | $541–$883 | $350 | — | — | $107–$185 | $107–$332 | $101–$108 |
| Ascension Seton Cedar Park | $88–$358 | $541–$883 | $350 | — | — | $107–$119 | $107–$733 | — |
| Ascension Seton Edgar B. Davis | $88–$358 | $541–$883 | $350 | — | — | $107–$119 | $99–$361 | — |
| Dell Seton Medical Center at The University of Texas | $88–$358 | $541–$883 | $350 | — | — | $107–$119 | $107–$332 | — |
| Ascension Seton Northwest | $88–$358 | $541–$883 | $350 | — | — | $107–$185 | $107–$332 | $101–$108 |
| Ascension Seton Medical Center Austin | $88–$358 | $541–$883 | $350 | $103 | — | $107–$185 | $107–$332 | $101–$108 |
| Ascension Seton Southwest | $88–$358 | $541–$883 | $350 | — | — | $107–$185 | $107–$332 | $101–$108 |
| Baylor Scott & White Medical Center – Lakeway | $297–$361 | $498 | $420–$491 | $625 | $588–$634 | — | $105–$112 | $100–$118 |
| Baylor Scott & White Medical Center – Round Rock | $297–$361 | $498 | $454–$534 | $625 | $588–$634 | — | $105–$112 | $100–$118 |
| Baylor Scott & White Medical Center – Taylor | $297–$361 | $498 | $454–$534 | $625 | $588–$634 | — | $141 | $172–$200 |
| Baylor Scott & White Medical Center – Austin | $297–$361 | $498 | $420–$491 | $625 | $588–$634 | — | $105–$112 | $100–$118 |
| Baylor Scott & White Medical Center – Buda | $297–$361 | $498 | $420–$491 | $625 | $588–$634 | — | $105–$112 | $100–$118 |
| Baylor Scott & White Medical Center – Pflugerville | $297–$361 | $498 | $420–$491 | $625 | $588–$634 | — | $105–$112 | $100–$118 |
| CHRISTUS Santa Rosa Hospital – San Marcos | $302–$371 | $105 | $260–$329 | $103–$1,408 | $103–$500 | — | $111–$155 | $103–$111 |
| Dell Children's Medical Center | $88–$358 | $541–$883 | $350 | — | — | $107–$119 | $107–$332 | — |
Ascension Seton Smithville: all 87 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $88.30 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $91.43 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4174_BLUE CROSS CHIP (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS STAR KIDS | 5015_BLUE CROSS STAR KIDS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4185_DELL CHIP/STAR KIDS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| DELL STAR | 4236_CHIRP DELL STAR (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $107 | FEE SCHEDULE |
| UHC STAR | 4259_CHIRP UHC STAR (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| UHC STAR KIDS | 4317_UHC STAR KIDS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| UHC STAR PLUS | 4270_CHIRP UHC STAR PLUS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4163_AMERIGROUP CHIP/STAR KIDS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4163_WELLPOINT/AMERIGROUP CHIP (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR | 4203_CHIRP AMERIGROUP STAR (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR | 4203_CHIRP WELLPOINT/AMERIGROUP STAR (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4982_WELLPOINT/AMERIGROUP STAR KIDS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4214_CHIRP AMERIGROUP STAR PLUS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4214_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3600_BLUE CROSS CHIP/STAR KIDS (SMV) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| BCBS STAR | 3699_CHIRP BLUE CROSS STAR (SMV) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3611_DELL CHIP/STAR KIDS (SMV) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL STAR | 3710_CHIRP DELL STAR (SMV) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR | 3743_CHIRP UHC STAR (SMV) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR KIDS | 4328_UHC STAR KIDS (SMV) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR PLUS | 3754_CHIRP UHC STAR PLUS (SMV) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 3589_WELLPOINT CHIP/STAR KIDS (SMV) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR | 3677_CHIRP WELLPOINT/AMERIGROUP STAR (SMV) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3688_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SMV) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $119 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4174_BLUE CROSS CHIP/STAR KIDS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS STAR | 4225_CHIRP BLUE CROSS STAR (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $119 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $148 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $162 | OTHER |
| SENDERO IDEALCARE | 1571_SENDERO IDEALCARE OP 20200101 | Commercial | $180 | OTHER |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $293 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $293 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 4247_CHIRP SUPERIOR STAR (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4401_CHIRP SUPERIOR STAR PLUS (SMV) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 3515_CHIRP SUPERIOR STAR (SMV) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4381_CHIRP SUPERIOR STAR PLUS (SMV) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $324 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $332 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $332 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $350 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $350 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $358 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $541 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $541 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $706 | OTHER |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $846 | FEE SCHEDULE |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $883 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $883 | OTHER |
Ascension Seton Hays: all 126 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $88.30 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $91.43 | FEE SCHEDULE |
| AARP MC WELLMED | 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001 | Medicare Advantage | $101 | OTHER |
| AARP MC WELLMED | 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811 | Medicare Advantage | $101 | OTHER |
| SENDERO CHAP | 4651_SENDERO CHAP INPATIENT 20251001 | Commercial | $102 | OTHER |
| SENDERO CHAP | 4932_SENDERO CHAP OUTPATIENT 20250811 | Commercial | $102 | OTHER |
| AETNA MCR REPLACEMENT | 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| COVID HRSA | 4693_COVID HRSA UNIN Q80 INPATIENT 20251001 | Public program | $103 | OTHER |
| CSHCN CIDC | 4694_CSHCN CIDC IP (ADULT) 20251001 | Public program | $103 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| HUMANA MCR REPLACEMENT | 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001 | Medicare Advantage | $103 | OTHER |
| MEDICARE OON | 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001 | Medicare Advantage | $103 | OTHER |
| MEDICARE REPLACEMENT | 4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001 | Medicare Advantage | $103 | OTHER |
| SUPERIOR ALLWELL | 4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| TRICARE | 4696_TRICARE INPATIENT 20251001 | Military / VA | $103 | OTHER |
| UTMB | 4677_UTMB PRISONS (HAY) IP 20251001 | Public program | $103 | OTHER |
| WELLCARE MED ADVANTAGE | 4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| WELMED MEDICARE | 4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001 | Medicare Advantage | $103 | OTHER |
| AETNA MCR REPLACEMENT | 4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811 | Medicare Advantage | $103 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811 | Medicare Advantage | $103 | OTHER |
| COVID HRSA | 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811 | Public program | $103 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811 | Medicare Advantage | $103 | OTHER |
| HUMANA MCR REPLACEMENT | 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811 | Medicare Advantage | $103 | OTHER |
| MEDICARE REPLACEMENT | 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811 | Medicare Advantage | $103 | OTHER |
| SUPERIOR ALLWELL | 4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101 | Medicare Advantage | $103 | OTHER |
| UTMB | 4125_UTMB PRISONS (HAY) OP 20250101 | Public program | $103 | OTHER |
| WELLCARE MED ADVANTAGE | 4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811 | Medicare Advantage | $103 | OTHER |
| WELMED MEDICARE | 4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811 | Medicare Advantage | $103 | OTHER |
| UHC MCR REPLACEMENT | 4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001 | Medicare Advantage | $105 | OTHER |
| UHC MCR REPLACEMENT | 4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811 | Medicare Advantage | $105 | OTHER |
| CONNECTED SENIOR CARE | 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001 | Medicare Advantage | $106 | OTHER |
| CONNECTED SENIOR CARE | 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001 | Medicare Advantage | $106 | OTHER |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4171_BLUE CROSS CHIP (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4171_BLUE CROSS CHIP/STAR KIDS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS STAR KIDS | 5009_BLUE CROSS STAR KIDS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4182_DELL CHIP/STAR KIDS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4160_AMERIGROUP CHIP/STAR KIDS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4160_WELLPOINT/AMERIGROUP CHIP (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4976_WELLPOINT/AMERIGROUP STAR KIDS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4211_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| PPHP MCR ADVANTAGE | 4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001 | Medicare Advantage | $108 | OTHER |
| TX INDEPENDENCE HP | 4671_TX INDEPENDENCE HP IP 20251001 | Medicare Advantage | $108 | OTHER |
| PPHP MCR ADVANTAGE | 4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811 | Medicare Advantage | $108 | OTHER |
| TX INDEPENDENCE HP | 4741_TX INDEPENDENCE HP OP 20250811 | Medicare Advantage | $108 | OTHER |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3597_BLUE CROSS CHIP/STAR KIDS (HAY) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| BCBS STAR | 3696_CHIRP BLUE CROSS STAR (HAY) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3608_DELL CHIP/STAR KIDS (HAY) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $119 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS STAR | 4222_CHIRP BLUE CROSS STAR (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL STAR | 3707_CHIRP DELL STAR (HAY) INPATIENT 20240901 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL STAR | 4233_CHIRP DELL STAR (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $119 | FEE SCHEDULE |
| UHC STAR | 3740_CHIRP UHC STAR (HAY) INPATIENT 20240901 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR | 4256_CHIRP UHC STAR (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR KIDS | 4314_UHC STAR KIDS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR KIDS | 4325_UHC STAR KIDS (HAY) INPATIENT 20240901 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR PLUS | 3751_CHIRP UHC STAR PLUS (HAY) INPATIENT 20240901 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR PLUS | 4267_CHIRP UHC STAR PLUS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 3674_CHIRP WELLPOINT/AMERIGROUP STAR (HAY) INPATIENT 20240901 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4200_CHIRP AMERIGROUP STAR (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4200_CHIRP WELLPOINT/AMERIGROUP STAR (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3685_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (HAY) INPATIENT 20240901 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4211_CHIRP AMERIGROUP STAR PLUS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| OCCUNET | 4674_OCCUNET IP 20251001 | Workers' comp | $144 | OTHER |
| OCCUNET | 4123_OCCUNET OP 20250101 | Workers' comp | $144 | OTHER |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $148 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $162 | OTHER |
| SENDERO IDEALCARE | 4675_SENDERO IDEALCARE IP 20251001 | Commercial | $180 | OTHER |
| SENDERO IDEALCARE | 1571_SENDERO IDEALCARE OP 20200101 | Commercial | $180 | OTHER |
| SUPERIOR AMBETTER | 4652_SUPERIOR AMBETTER INPATIENT 20251001 | Commercial | $185 | OTHER |
| SUPERIOR AMBETTER | 4960_SUPERIOR AMBETTER OUTPATIENT 20250811 | Commercial | $185 | OTHER |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $293 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $293 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 4244_CHIRP SUPERIOR STAR (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4395_CHIRP SUPERIOR STAR PLUS (HAY) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 3512_CHIRP SUPERIOR STAR (HAY) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4378_CHIRP SUPERIOR STAR PLUS (HAY) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $324 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $332 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $332 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $350 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $350 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $358 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $541 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $541 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $706 | OTHER |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $846 | FEE SCHEDULE |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $883 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $883 | OTHER |
Ascension Seton Cedar Park: all 56 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $88.30 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $91.43 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $119 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $119 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $148 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $162 | OTHER |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $293 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $293 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $324 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $350 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $350 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $358 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $541 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $541 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $652 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $652 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $652 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $652 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $652 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $652 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $652 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $652 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $706 | OTHER |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $733 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $733 | FEE SCHEDULE |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $846 | FEE SCHEDULE |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $883 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $883 | OTHER |
Ascension Seton Edgar B. Davis: all 85 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $88.30 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $91.43 | FEE SCHEDULE |
| BCBS STAR | 4221_CHIRP BLUE CROSS STAR (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $98.60 | FEE SCHEDULE |
| DELL STAR | 4232_CHIRP DELL STAR (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $98.60 | FEE SCHEDULE |
| UHC STAR | 4255_CHIRP UHC STAR (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $98.60 | FEE SCHEDULE |
| UHC STAR KIDS | 4313_UHC STAR KIDS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $98.60 | FEE SCHEDULE |
| UHC STAR PLUS | 4266_CHIRP UHC STAR PLUS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $98.60 | FEE SCHEDULE |
| WELLPOINT STAR | 4199_CHIRP AMERIGROUP STAR (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $98.60 | FEE SCHEDULE |
| WELLPOINT STAR | 4199_CHIRP WELLPOINT/AMERIGROUP STAR (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $98.60 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4210_CHIRP AMERIGROUP STAR PLUS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $98.60 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $119 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $119 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4170_BLUE CROSS CHIP (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $135 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4170_BLUE CROSS CHIP/STAR KIDS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $135 | FEE SCHEDULE |
| BCBS STAR KIDS | 5007_BLUE CROSS STAR KIDS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $135 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4181_DELL CHIP/STAR KIDS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $135 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4159_AMERIGROUP CHIP/STAR KIDS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $135 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4159_WELLPOINT/AMERIGROUP CHIP (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $135 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4974_WELLPOINT/AMERIGROUP STAR KIDS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $135 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4210_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $135 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3596_BLUE CROSS CHIP/STAR KIDS (EBD) INPATIENT 20240901 | Medicaid / CHIP | $137 | FEE SCHEDULE |
| BCBS STAR | 3695_CHIRP BLUE CROSS STAR (EBD) INPATIENT 20240901 | Medicaid / CHIP | $137 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3607_DELL CHIP/STAR KIDS (EBD) INPATIENT 20240901 | Medicaid / CHIP | $137 | FEE SCHEDULE |
| DELL STAR | 3706_CHIRP DELL STAR (EBD) INPATIENT 20240901 | Medicaid / CHIP | $137 | FEE SCHEDULE |
| UHC STAR | 3739_CHIRP UHC STAR (EBD) INPATIENT 20240901 | Medicaid / CHIP | $137 | FEE SCHEDULE |
| UHC STAR KIDS | 4324_UHC STAR KIDS (EBD) INPATIENT 20240901 | Medicaid / CHIP | $137 | FEE SCHEDULE |
| UHC STAR PLUS | 3750_CHIRP UHC STAR PLUS (EBD) INPATIENT 20240901 | Medicaid / CHIP | $137 | FEE SCHEDULE |
| WELLPOINT STAR | 3673_CHIRP WELLPOINT/AMERIGROUP STAR (EBD) INPATIENT 20240901 | Medicaid / CHIP | $137 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3684_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (EBD) INPATIENT 20240901 | Medicaid / CHIP | $137 | FEE SCHEDULE |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $148 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $162 | OTHER |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $293 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $293 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $321 | FEE SCHEDULE |
| SUPERIOR STAR | 3511_CHIRP SUPERIOR STAR (EBD) INPATIENT 20240901 | Medicaid / CHIP | $321 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $321 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4377_CHIRP SUPERIOR STAR PLUS (EBD) INPATIENT 20240901 | Medicaid / CHIP | $321 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $321 | FEE SCHEDULE |
| SUPERIOR STAR | 4243_CHIRP SUPERIOR STAR (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $321 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $321 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $321 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $321 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $321 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $321 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4393_CHIRP SUPERIOR STAR PLUS (EBD) OUTPATIENT 20241201 | Medicaid / CHIP | $321 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $324 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $350 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $350 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $358 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $361 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $361 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $541 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $541 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $706 | OTHER |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $846 | FEE SCHEDULE |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $883 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $883 | OTHER |
Dell Seton Medical Center at The University of Texas: all 83 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $88.30 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $91.43 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4169_BLUE CROSS CHIP (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4169_BLUE CROSS CHIP/STAR KIDS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS STAR KIDS | 5005_BLUE CROSS STAR KIDS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4180_DELL CHIP/STAR KIDS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4158_AMERIGROUP CHIP/STAR KIDS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4158_WELLPOINT/AMERIGROUP CHIP (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4972_WELLPOINT/AMERIGROUP STAR KIDS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4209_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3595_BLUE CROSS CHIP/STAR KIDS (DEL) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| BCBS STAR | 3694_CHIRP BLUE CROSS STAR (DEL) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3606_DELL CHIP/STAR KIDS (DEL) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL STAR | 3705_CHIRP DELL STAR (DEL) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR | 3738_CHIRP UHC STAR (DEL) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR KIDS | 4323_UHC STAR KIDS (DEL) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR PLUS | 3749_CHIRP UHC STAR PLUS (DEL) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR | 3672_CHIRP WELLPOINT/AMERIGROUP STAR (DEL) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3683_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (DEL) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $119 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS STAR | 4220_CHIRP BLUE CROSS STAR (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL STAR | 4231_CHIRP DELL STAR (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $119 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR | 4254_CHIRP UHC STAR (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR KIDS | 4312_UHC STAR KIDS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR PLUS | 4265_CHIRP UHC STAR PLUS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4198_CHIRP AMERIGROUP STAR (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4198_CHIRP WELLPOINT/AMERIGROUP STAR (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4209_CHIRP AMERIGROUP STAR PLUS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $148 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $162 | OTHER |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $293 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $293 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 4242_CHIRP SUPERIOR STAR (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4391_CHIRP SUPERIOR STAR PLUS (DEL) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $324 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $332 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $332 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $350 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $350 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $358 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $541 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $541 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $706 | OTHER |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $846 | FEE SCHEDULE |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $883 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $883 | OTHER |
Ascension Seton Northwest: all 123 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $88.30 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $91.43 | FEE SCHEDULE |
| AARP MC WELLMED | 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001 | Medicare Advantage | $101 | OTHER |
| AARP MC WELLMED | 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811 | Medicare Advantage | $101 | OTHER |
| SENDERO CHAP | 4651_SENDERO CHAP INPATIENT 20251001 | Commercial | $102 | OTHER |
| SENDERO CHAP | 4932_SENDERO CHAP OUTPATIENT 20250811 | Commercial | $102 | OTHER |
| AETNA MCR REPLACEMENT | 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| COVID HRSA | 4693_COVID HRSA UNIN Q80 INPATIENT 20251001 | Public program | $103 | OTHER |
| CSHCN CIDC | 4694_CSHCN CIDC IP (ADULT) 20251001 | Public program | $103 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| HUMANA MCR REPLACEMENT | 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001 | Medicare Advantage | $103 | OTHER |
| MEDICARE OON | 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001 | Medicare Advantage | $103 | OTHER |
| MEDICARE REPLACEMENT | 4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001 | Medicare Advantage | $103 | OTHER |
| SUPERIOR ALLWELL | 4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| TRICARE | 4696_TRICARE INPATIENT 20251001 | Military / VA | $103 | OTHER |
| WELLCARE MED ADVANTAGE | 4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| WELMED MEDICARE | 4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001 | Medicare Advantage | $103 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811 | Medicare Advantage | $103 | OTHER |
| COVID HRSA | 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811 | Public program | $103 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811 | Medicare Advantage | $103 | OTHER |
| HUMANA MCR REPLACEMENT | 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811 | Medicare Advantage | $103 | OTHER |
| MEDICARE REPLACEMENT | 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811 | Medicare Advantage | $103 | OTHER |
| SUPERIOR ALLWELL | 4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101 | Medicare Advantage | $103 | OTHER |
| WELLCARE MED ADVANTAGE | 4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811 | Medicare Advantage | $103 | OTHER |
| WELMED MEDICARE | 4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811 | Medicare Advantage | $103 | OTHER |
| UHC MCR REPLACEMENT | 4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001 | Medicare Advantage | $105 | OTHER |
| UHC MCR REPLACEMENT | 4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811 | Medicare Advantage | $105 | OTHER |
| CONNECTED SENIOR CARE | 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001 | Medicare Advantage | $106 | OTHER |
| CONNECTED SENIOR CARE | 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001 | Medicare Advantage | $106 | OTHER |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS STAR KIDS | 5011_BLUE CROSS STAR KIDS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4161_WELLPOINT/AMERIGROUP CHIP (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4978_WELLPOINT/AMERIGROUP STAR KIDS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4212_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| PPHP MCR ADVANTAGE | 4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001 | Medicare Advantage | $108 | OTHER |
| TX INDEPENDENCE HP | 4671_TX INDEPENDENCE HP IP 20251001 | Medicare Advantage | $108 | OTHER |
| PPHP MCR ADVANTAGE | 4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811 | Medicare Advantage | $108 | OTHER |
| TX INDEPENDENCE HP | 4741_TX INDEPENDENCE HP OP 20250811 | Medicare Advantage | $108 | OTHER |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| BCBS STAR | 3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3609_DELL CHIP/STAR KIDS (NW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL STAR | 3708_CHIRP DELL STAR (NW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR | 3741_CHIRP UHC STAR (NW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR KIDS | 4326_UHC STAR KIDS (NW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR PLUS | 3752_CHIRP UHC STAR PLUS (NW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR | 3675_CHIRP WELLPOINT/AMERIGROUP STAR (NW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3686_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (NW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $119 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS STAR | 4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4183_DELL CHIP/STAR KIDS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL STAR | 4234_CHIRP DELL STAR (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $119 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR | 4257_CHIRP UHC STAR (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR KIDS | 4315_UHC STAR KIDS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR PLUS | 4268_CHIRP UHC STAR PLUS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4161_AMERIGROUP CHIP/STAR KIDS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4201_CHIRP AMERIGROUP STAR (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4201_CHIRP WELLPOINT/AMERIGROUP STAR (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4212_CHIRP AMERIGROUP STAR PLUS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| OCCUNET | 4674_OCCUNET IP 20251001 | Workers' comp | $144 | OTHER |
| OCCUNET | 4123_OCCUNET OP 20250101 | Workers' comp | $144 | OTHER |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $148 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $162 | OTHER |
| SENDERO IDEALCARE | 4675_SENDERO IDEALCARE IP 20251001 | Commercial | $180 | OTHER |
| SENDERO IDEALCARE | 1571_SENDERO IDEALCARE OP 20200101 | Commercial | $180 | OTHER |
| SUPERIOR AMBETTER | 4652_SUPERIOR AMBETTER INPATIENT 20251001 | Commercial | $185 | OTHER |
| SUPERIOR AMBETTER | 4960_SUPERIOR AMBETTER OUTPATIENT 20250811 | Commercial | $185 | OTHER |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $293 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $293 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 3513_CHIRP SUPERIOR STAR (NW) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4379_CHIRP SUPERIOR STAR PLUS (NW) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 4245_CHIRP SUPERIOR STAR (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4397_CHIRP SUPERIOR STAR PLUS (NW) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $324 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $332 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $332 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $350 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $350 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $358 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $541 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $541 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $706 | OTHER |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $846 | FEE SCHEDULE |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $883 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $883 | OTHER |
Ascension Seton Medical Center Austin: all 126 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $88.30 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $91.43 | FEE SCHEDULE |
| AARP MC WELLMED | 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001 | Medicare Advantage | $101 | OTHER |
| AARP MC WELLMED | 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811 | Medicare Advantage | $101 | OTHER |
| SENDERO CHAP | 4651_SENDERO CHAP INPATIENT 20251001 | Commercial | $102 | OTHER |
| SENDERO CHAP | 4932_SENDERO CHAP OUTPATIENT 20250811 | Commercial | $102 | OTHER |
| AETNA MCR REPLACEMENT | 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| COVID HRSA | 4693_COVID HRSA UNIN Q80 INPATIENT 20251001 | Public program | $103 | OTHER |
| CSHCN CIDC | 4694_CSHCN CIDC IP (ADULT) 20251001 | Public program | $103 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| HUMANA MCR REPLACEMENT | 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001 | Medicare Advantage | $103 | OTHER |
| MEDICARE OON | 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001 | Medicare Advantage | $103 | OTHER |
| MEDICARE REPLACEMENT | 4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001 | Medicare Advantage | $103 | OTHER |
| SUPERIOR ALLWELL | 4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| TRICARE | 4696_TRICARE INPATIENT 20251001 | Military / VA | $103 | OTHER |
| UHCPCIP | 4678_UNITED HEALTHCARE PCIP (AUS) IP 20251001 | Commercial | $103 | OTHER |
| WELLCARE MED ADVANTAGE | 4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| WELMED MEDICARE | 4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001 | Medicare Advantage | $103 | OTHER |
| AETNA MCR REPLACEMENT | 4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811 | Medicare Advantage | $103 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811 | Medicare Advantage | $103 | OTHER |
| COVID HRSA | 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811 | Public program | $103 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811 | Medicare Advantage | $103 | OTHER |
| HUMANA MCR REPLACEMENT | 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811 | Medicare Advantage | $103 | OTHER |
| MEDICARE REPLACEMENT | 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811 | Medicare Advantage | $103 | OTHER |
| SUPERIOR ALLWELL | 4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101 | Medicare Advantage | $103 | OTHER |
| UHCPCIP | 4126_UNITED HEALTHCARE PCIP (AUS) OP 20250101 | Commercial | $103 | OTHER |
| WELLCARE MED ADVANTAGE | 4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811 | Medicare Advantage | $103 | OTHER |
| WELMED MEDICARE | 4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811 | Medicare Advantage | $103 | OTHER |
| UHC MCR REPLACEMENT | 4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001 | Medicare Advantage | $105 | OTHER |
| UHC MCR REPLACEMENT | 4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811 | Medicare Advantage | $105 | OTHER |
| CONNECTED SENIOR CARE | 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001 | Medicare Advantage | $106 | OTHER |
| CONNECTED SENIOR CARE | 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001 | Medicare Advantage | $106 | OTHER |
| BCBS CHIP/CHIP PERINATE | 4166_BLUE CROSS CHIP (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4166_BLUE CROSS CHIP/STAR KIDS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS STAR KIDS | 4999_BLUE CROSS STAR KIDS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4177_DELL CHIP/STAR KIDS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4155_AMERIGROUP CHIP/STAR KIDS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4155_WELLPOINT/AMERIGROUP CHIP (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4966_WELLPOINT/AMERIGROUP STAR KIDS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4206_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| PPHP MCR ADVANTAGE | 4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001 | Medicare Advantage | $108 | OTHER |
| TX INDEPENDENCE HP | 4671_TX INDEPENDENCE HP IP 20251001 | Medicare Advantage | $108 | OTHER |
| PPHP MCR ADVANTAGE | 4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811 | Medicare Advantage | $108 | OTHER |
| TX INDEPENDENCE HP | 4741_TX INDEPENDENCE HP OP 20250811 | Medicare Advantage | $108 | OTHER |
| BCBS CHIP/CHIP PERINATE | 3592_BLUE CROSS CHIP/STAR KIDS (AUS) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| BCBS STAR | 3691_CHIRP BLUE CROSS STAR (AUS) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3603_DELL CHIP/STAR KIDS (AUS) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL STAR | 3702_CHIRP DELL STAR (AUS) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR | 3735_CHIRP UHC STAR (AUS) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR KIDS | 4320_UHC STAR KIDS (AUS) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR PLUS | 3746_CHIRP UHC STAR PLUS (AUS) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR | 3669_CHIRP WELLPOINT/AMERIGROUP STAR (AUS) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3680_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (AUS) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $119 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS STAR | 4217_CHIRP BLUE CROSS STAR (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL STAR | 4228_CHIRP DELL STAR (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $119 | FEE SCHEDULE |
| UHC STAR | 4251_CHIRP UHC STAR (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR KIDS | 4309_UHC STAR KIDS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR PLUS | 4262_CHIRP UHC STAR PLUS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4195_CHIRP AMERIGROUP STAR (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4195_CHIRP WELLPOINT/AMERIGROUP STAR (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4206_CHIRP AMERIGROUP STAR PLUS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| OCCUNET | 4674_OCCUNET IP 20251001 | Workers' comp | $144 | OTHER |
| OCCUNET | 4123_OCCUNET OP 20250101 | Workers' comp | $144 | OTHER |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $148 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $162 | OTHER |
| SENDERO IDEALCARE | 4675_SENDERO IDEALCARE IP 20251001 | Commercial | $180 | OTHER |
| SENDERO IDEALCARE | 1571_SENDERO IDEALCARE OP 20200101 | Commercial | $180 | OTHER |
| SUPERIOR AMBETTER | 4652_SUPERIOR AMBETTER INPATIENT 20251001 | Commercial | $185 | OTHER |
| SUPERIOR AMBETTER | 4960_SUPERIOR AMBETTER OUTPATIENT 20250811 | Commercial | $185 | OTHER |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $293 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $293 | FEE SCHEDULE |
| SUPERIOR STAR | 3507_CHIRP SUPERIOR STAR (AUS) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4373_CHIRP SUPERIOR STAR PLUS (AUS) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 4239_CHIRP SUPERIOR STAR (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4385_CHIRP SUPERIOR STAR PLUS (AUS) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $324 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $332 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $332 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $350 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $350 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $358 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $541 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $541 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $706 | OTHER |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $846 | FEE SCHEDULE |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $883 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $883 | OTHER |
Ascension Seton Southwest: all 124 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $88.30 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $91.43 | FEE SCHEDULE |
| AARP MC WELLMED | 4656_MEDICARE ADVANTAGE AARP WELLMED INPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS) 20251001 | Medicare Advantage | $101 | OTHER |
| AARP MC WELLMED | 4748_MEDICARE ADVANTAGE AARP WELLMED OUTPATIENT (AUS,NW,SW,HAY,WIL,BRK,DEL,BAS,SMV) 20250811 | Medicare Advantage | $101 | OTHER |
| SENDERO CHAP | 4651_SENDERO CHAP INPATIENT 20251001 | Commercial | $102 | OTHER |
| SENDERO CHAP | 4932_SENDERO CHAP OUTPATIENT 20250811 | Commercial | $102 | OTHER |
| AETNA MCR REPLACEMENT | 4659_MEDICARE ADVANTAGE AETNA INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4682_MEDICARE ADVANTAGE ASCENSION COMPLETE INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| COVID HRSA | 4693_COVID HRSA UNIN Q80 INPATIENT 20251001 | Public program | $103 | OTHER |
| CSHCN CIDC | 4694_CSHCN CIDC IP (ADULT) 20251001 | Public program | $103 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4684_MEDICARE ADVANTAGE DEVOTED HEALTH INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| HUMANA MCR REPLACEMENT | 4661_MEDICARE ADVANTAGE HUMANA INPATIENT (AUS,HAY,NW,SW) 20251001 | Medicare Advantage | $103 | OTHER |
| MEDICARE OON | 4666_MEDICARE ADVANTAGE INPATIENT OON 20251001 | Medicare Advantage | $103 | OTHER |
| MEDICARE REPLACEMENT | 4665_MEDICARE ADVANTAGE INPATIENT 100% 20251001 | Medicare Advantage | $103 | OTHER |
| SUPERIOR ALLWELL | 4686_MEDICARE ADVANTAGE SUPERIOR ALLWELL INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| TRICARE | 4696_TRICARE INPATIENT 20251001 | Military / VA | $103 | OTHER |
| WELLCARE MED ADVANTAGE | 4691_MEDICARE ADVANTAGE WELLCARE INPATIENT 20251001 | Medicare Advantage | $103 | OTHER |
| WELMED MEDICARE | 4669_MEDICARE ADVANTAGE WELMED INPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20251001 | Medicare Advantage | $103 | OTHER |
| AETNA MCR REPLACEMENT | 4749_MEDICARE ADVANTAGE AETNA OUTPATIENT 20250811 | Medicare Advantage | $103 | OTHER |
| ASCENSION COMPLETE MEDICARE REPLACEMENT | 4764_MEDICARE ADVANTAGE ASCENSION COMPLETE OUTPATIENT 20250811 | Medicare Advantage | $103 | OTHER |
| COVID HRSA | 4765_COVID HRSA UNIN Q80 OUTPATIENT 20250811 | Public program | $103 | OTHER |
| DEVOTED HEALTH MCR REPLACEMENT | 4918_MEDICARE ADVANTAGE DEVOTED HEALTH OUTPATIENT 20250811 | Medicare Advantage | $103 | OTHER |
| HUMANA MCR REPLACEMENT | 4921_MEDICARE ADVANTAGE HUMANA OUTPATIENT (AUS,HAY,NW,SW.SMV) 20250811 | Medicare Advantage | $103 | OTHER |
| MEDICARE REPLACEMENT | 4922_MEDICARE ADVANTAGE OUTPATIENT 100% 20250811 | Medicare Advantage | $103 | OTHER |
| SUPERIOR ALLWELL | 4419_MEDICARE ADVANTAGE SUPERIOR ALLWELL OUTPATIENT 20250101 | Medicare Advantage | $103 | OTHER |
| WELLCARE MED ADVANTAGE | 4929_MEDICARE ADVANTAGE WELLCARE OUTPATIENT 20250811 | Medicare Advantage | $103 | OTHER |
| WELMED MEDICARE | 4930_MEDICARE ADVANTAGE WELMED OUTPATIENT (AUS,NW,SW,HAY,WIL,DEL,BAS) 20250811 | Medicare Advantage | $103 | OTHER |
| UHC MCR REPLACEMENT | 4687_MEDICARE ADVANTAGE UNITED HEALTHCARE INPATIENT (AUS,NW,SW,HAY) 20251001 | Medicare Advantage | $105 | OTHER |
| UHC MCR REPLACEMENT | 4928_MEDICARE ADVANTAGE UNITED HEALTHCARE OUTPATIENT (AUS,NW,SW,HAY,SMV) 20250811 | Medicare Advantage | $105 | OTHER |
| CONNECTED SENIOR CARE | 4660_MEDICARE ADVANTAGE CONNECTED SENIOR CARE INPATIENT 20251001 | Medicare Advantage | $106 | OTHER |
| CONNECTED SENIOR CARE | 2475_MEDICARE ADVANTAGE CONNECTED SENIOR CARE OUTPATIENT 20221001 | Medicare Advantage | $106 | OTHER |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4175_BLUE CROSS CHIP (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS STAR KIDS | 5017_BLUE CROSS STAR KIDS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4164_WELLPOINT/AMERIGROUP CHIP (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4984_WELLPOINT/AMERIGROUP STAR KIDS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4215_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| PPHP MCR ADVANTAGE | 4668_MEDICARE ADVANTAGE PPHP INPATIENT 20251001 | Medicare Advantage | $108 | OTHER |
| TX INDEPENDENCE HP | 4671_TX INDEPENDENCE HP IP 20251001 | Medicare Advantage | $108 | OTHER |
| PPHP MCR ADVANTAGE | 4925_MEDICARE ADVANTAGE PPHP OUTPATIENT 20250811 | Medicare Advantage | $108 | OTHER |
| TX INDEPENDENCE HP | 4741_TX INDEPENDENCE HP OP 20250811 | Medicare Advantage | $108 | OTHER |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3601_BLUE CROSS CHIP/STAR KIDS (SW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| BCBS STAR | 3700_CHIRP BLUE CROSS STAR (SW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3612_DELL CHIP/STAR KIDS (SW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL STAR | 3711_CHIRP DELL STAR (SW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR | 3744_CHIRP UHC STAR (SW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR KIDS | 4329_UHC STAR KIDS (SW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR PLUS | 3755_CHIRP UHC STAR PLUS (SW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR | 3678_CHIRP WELLPOINT/AMERIGROUP STAR (SW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3689_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SW) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $119 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4175_BLUE CROSS CHIP/STAR KIDS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS STAR | 4226_CHIRP BLUE CROSS STAR (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4186_DELL CHIP/STAR KIDS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL STAR | 4237_CHIRP DELL STAR (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $119 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR | 4260_CHIRP UHC STAR (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR KIDS | 4318_UHC STAR KIDS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR PLUS | 4271_CHIRP UHC STAR PLUS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4164_AMERIGROUP CHIP/STAR KIDS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4204_CHIRP AMERIGROUP STAR (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4204_CHIRP WELLPOINT/AMERIGROUP STAR (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4215_CHIRP AMERIGROUP STAR PLUS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| OCCUNET | 4674_OCCUNET IP 20251001 | Workers' comp | $144 | OTHER |
| OCCUNET | 4123_OCCUNET OP 20250101 | Workers' comp | $144 | OTHER |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $148 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $162 | OTHER |
| SENDERO IDEALCARE | 4675_SENDERO IDEALCARE IP 20251001 | Commercial | $180 | OTHER |
| SENDERO IDEALCARE | 1571_SENDERO IDEALCARE OP 20200101 | Commercial | $180 | OTHER |
| SUPERIOR AMBETTER | 4652_SUPERIOR AMBETTER INPATIENT 20251001 | Commercial | $185 | OTHER |
| SUPERIOR AMBETTER | 4960_SUPERIOR AMBETTER OUTPATIENT 20250811 | Commercial | $185 | OTHER |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $293 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $293 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 3516_CHIRP SUPERIOR STAR (SW) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4382_CHIRP SUPERIOR STAR PLUS (SW) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 4248_CHIRP SUPERIOR STAR (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4403_CHIRP SUPERIOR STAR PLUS (SW) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $324 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $332 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $332 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $350 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $350 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $358 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $541 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $541 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $706 | OTHER |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $846 | FEE SCHEDULE |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $883 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $883 | OTHER |
Baylor Scott & White Medical Center – Lakeway: all 40 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| Baylor Scott & White Health Plan | Medicare Advantage | Medicare Advantage | $99.77 | fee schedule |
| CORVEL | Worker's Compensation | Workers' comp | $102 | fee schedule |
| Superior Health Plan | Medicaid | Medicaid / CHIP | $105 | fee schedule |
| Humana | Medicare | Medicare Advantage | $105 | fee schedule |
| Superior Health Plan | Medicare HMO/Medicare PPO | Medicare Advantage | $105 | fee schedule |
| TriWest | Community Care Network | Military / VA | $105 | fee schedule |
| Aetna | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| American Health Plan | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| HealthSpring | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| ProCare Advantage | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| United Healthcare | Medicaid/CHIP | Medicaid / CHIP | $112 | fee schedule |
| United Healthcare | Medicare Advantage | Medicare Advantage | $118 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | Commercial | $126 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Individual | Commercial | $132 | fee schedule |
| Prime Health Services | Worker's Compensation | Workers' comp | $132 | fee schedule |
| Sedgwick | Preferred Network | Workers' comp | $157 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | Commercial | $173 | fee schedule |
| Mark Cuban | Commercial | Commercial | $272 | fee schedule |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $297 | fee schedule |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $300 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $329 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $343 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $361 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $387 | percent of total billed charges |
| Cigna | Local Plus | Commercial | $420 | percent of total billed charges |
| Cigna | HMO/PPO | Commercial | $491 | percent of total billed charges |
| Aetna | Commercial | Commercial | $498 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $498 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $498 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $525 | percent of total billed charges |
| Independent Medical System | Commercial PPO | Commercial | $543 | percent of total billed charges |
| Curative | Commercial | Commercial | $588 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $588 | percent of total billed charges |
| United Healthcare | Commercial | Commercial | $625 | percent of total billed charges |
| First Health | PPO | Commercial | $634 | percent of total billed charges |
| HealthSmart | Accel Network | Commercial | $634 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $634 | percent of total billed charges |
| HealthSmart | Preferred Network | Commercial | $679 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $679 | percent of total billed charges |
| Three Rivers | Three Rivers Provider Network | Commercial | $815 | 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 |
|---|---|---|---|---|
| Baylor Scott & White Health Plan | Medicare Advantage | Medicare Advantage | $99.77 | fee schedule |
| CORVEL | Worker's Compensation | Workers' comp | $102 | fee schedule |
| Superior Health Plan | Medicaid | Medicaid / CHIP | $105 | fee schedule |
| Humana | Medicare | Medicare Advantage | $105 | fee schedule |
| Superior Health Plan | Medicare HMO/Medicare PPO | Medicare Advantage | $105 | fee schedule |
| TriWest | Community Care Network | Military / VA | $105 | fee schedule |
| American Health Plan | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| Blue Cross Blue Shield | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| HealthSpring | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| ProCare Advantage | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| United Healthcare | Medicaid/CHIP | Medicaid / CHIP | $112 | fee schedule |
| United Healthcare | Medicare Advantage | Medicare Advantage | $118 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | Commercial | $126 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Individual | Commercial | $132 | fee schedule |
| Prime Health Services | Worker's Compensation | Workers' comp | $132 | fee schedule |
| CareWorks fka Rockport | Worker's Compensation | Workers' comp | $157 | fee schedule |
| Injury Management Organization | Med Select Network | Workers' comp | $157 | fee schedule |
| Sedgwick | Preferred Network | Workers' comp | $157 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | Commercial | $173 | fee schedule |
| Mark Cuban | Commercial | Commercial | $272 | fee schedule |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $297 | fee schedule |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $300 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $329 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $343 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $361 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $387 | percent of total billed charges |
| Cigna | Local Plus | Commercial | $454 | percent of total billed charges |
| Aetna | Commercial | Commercial | $498 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $498 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $498 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $525 | percent of total billed charges |
| Cigna | HMO/PPO | Commercial | $534 | percent of total billed charges |
| Independent Medical System | Commercial PPO | Commercial | $543 | percent of total billed charges |
| Curative | Commercial | Commercial | $588 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $588 | percent of total billed charges |
| United Healthcare | Commercial | Commercial | $625 | percent of total billed charges |
| First Health | PPO | Commercial | $634 | percent of total billed charges |
| HealthSmart | Accel Network | Commercial | $634 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $634 | percent of total billed charges |
| BlueBell Creameries | Self Insured | Commercial | $679 | percent of total billed charges |
| HealthSmart | Preferred Network | Commercial | $679 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $679 | percent of total billed charges |
| Three Rivers | Three Rivers Provider Network | Commercial | $815 | 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 | $141 | fee schedule |
| Baylor Scott & White Health Plan | Medicare Advantage | Medicare Advantage | $172 | percent of total billed charges |
| American Health Plan | Medicare Advantage | Medicare Advantage | $181 | percent of total billed charges |
| TriWest | Community Care Network | Military / VA | $181 | percent of total billed charges |
| CORVEL | Worker's Compensation | Workers' comp | $190 | percent of total billed charges |
| Prime Health Services | Worker's Compensation | Workers' comp | $190 | percent of total billed charges |
| Blue Cross Blue Shield | Medicare Advantage | Medicare Advantage | $190 | percent of total billed charges |
| HealthSpring | Medicare Advantage | Medicare Advantage | $190 | percent of total billed charges |
| ProCare Advantage | Medicare Advantage | Medicare Advantage | $190 | percent of total billed charges |
| Superior Health Plan | Medicare HMO/Medicare PPO | Medicare Advantage | $200 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | Commercial | $217 | percent of total billed charges |
| CareWorks fka Rockport | Worker's Compensation | Workers' comp | $225 | percent of total billed charges |
| Injury Management Organization | Med Select Network | Workers' comp | $225 | percent of total billed charges |
| Sedgwick | Preferred Network | Workers' comp | $225 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Premier - Individual | Commercial | $227 | percent of total billed charges |
| Mark Cuban | Commercial | Commercial | $272 | fee schedule |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $297 | fee schedule |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $300 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | Commercial | $326 | percent of total billed charges |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $329 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $343 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $361 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $387 | percent of total billed charges |
| Cigna | Local Plus | Commercial | $454 | percent of total billed charges |
| Aetna | Commercial | Commercial | $498 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $498 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $498 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $525 | percent of total billed charges |
| Cigna | HMO/PPO | Commercial | $534 | percent of total billed charges |
| Independent Medical System | Commercial PPO | Commercial | $543 | percent of total billed charges |
| Curative | Commercial | Commercial | $588 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $588 | percent of total billed charges |
| United Healthcare | Commercial | Commercial | $625 | percent of total billed charges |
| First Health | PPO | Commercial | $634 | percent of total billed charges |
| HealthSmart | Accel Network | Commercial | $634 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $634 | percent of total billed charges |
| HealthSmart | Preferred Network | Commercial | $679 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $679 | percent of total billed charges |
| BlueBell Creameries | Self Insured | Commercial | $724 | percent of total billed charges |
| Three Rivers | Three Rivers Provider Network | Commercial | $724 | 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 |
|---|---|---|---|---|
| Baylor Scott & White Health Plan | Medicare Advantage | Medicare Advantage | $99.77 | fee schedule |
| Superior Health Plan | Medicaid | Medicaid / CHIP | $105 | fee schedule |
| Humana | Medicare | Medicare Advantage | $105 | fee schedule |
| Superior Health Plan | Medicare HMO/Medicare PPO | Medicare Advantage | $105 | fee schedule |
| TriWest | Community Care Network | Military / VA | $105 | fee schedule |
| American Health Plan | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| HealthSpring | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| ProCare Advantage | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| United Healthcare | Medicaid/CHIP | Medicaid / CHIP | $112 | fee schedule |
| United Healthcare | Medicare Advantage | Medicare Advantage | $118 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | Commercial | $126 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Individual | Commercial | $132 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | Commercial | $173 | fee schedule |
| Mark Cuban | Commercial | Commercial | $272 | fee schedule |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $297 | fee schedule |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $300 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $329 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $343 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $361 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $387 | percent of total billed charges |
| Cigna | Local Plus | Commercial | $420 | percent of total billed charges |
| Cigna | HMO/PPO | Commercial | $491 | percent of total billed charges |
| Aetna | Commercial | Commercial | $498 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $498 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $498 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $525 | percent of total billed charges |
| Curative | Commercial | Commercial | $588 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $588 | percent of total billed charges |
| United Healthcare | Commercial | Commercial | $625 | percent of total billed charges |
| First Health | PPO | Commercial | $634 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $634 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $679 | 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 |
|---|---|---|---|---|
| Baylor Scott & White Health Plan | Medicare Advantage | Medicare Advantage | $99.77 | fee schedule |
| Superior Health Plan | Medicaid | Medicaid / CHIP | $105 | fee schedule |
| Humana | Medicare | Medicare Advantage | $105 | fee schedule |
| Superior Health Plan | Medicare HMO/Medicare PPO | Medicare Advantage | $105 | fee schedule |
| TriWest | Community Care Network | Military / VA | $105 | fee schedule |
| American Health Plan | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| Blue Cross Blue Shield | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| HealthSpring | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| ProCare Advantage | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| United Healthcare | Medicaid/CHIP | Medicaid / CHIP | $112 | fee schedule |
| United Healthcare | Medicare Advantage | Medicare Advantage | $118 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | Commercial | $126 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Individual | Commercial | $132 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | Commercial | $173 | fee schedule |
| Mark Cuban | Commercial | Commercial | $272 | fee schedule |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $297 | fee schedule |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $300 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $329 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $343 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $361 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $387 | percent of total billed charges |
| Cigna | Local Plus | Commercial | $420 | percent of total billed charges |
| Cigna | HMO/PPO | Commercial | $491 | percent of total billed charges |
| Aetna | Commercial | Commercial | $498 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $498 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $498 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $525 | percent of total billed charges |
| Curative | Commercial | Commercial | $588 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $588 | percent of total billed charges |
| United Healthcare | Commercial | Commercial | $625 | percent of total billed charges |
| First Health | PPO | Commercial | $634 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $634 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $679 | 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 |
|---|---|---|---|---|
| Baylor Scott & White Health Plan | Medicare Advantage | Medicare Advantage | $99.77 | fee schedule |
| CORVEL | Worker's Compensation | Workers' comp | $102 | fee schedule |
| Superior Health Plan | Medicaid | Medicaid / CHIP | $105 | fee schedule |
| Humana | Medicare | Medicare Advantage | $105 | fee schedule |
| Superior Health Plan | Medicare HMO/Medicare PPO | Medicare Advantage | $105 | fee schedule |
| TriWest | Community Care Network | Military / VA | $105 | fee schedule |
| American Health Plan | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| HealthSpring | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| ProCare Advantage | Medicare Advantage | Medicare Advantage | $110 | fee schedule |
| United Healthcare | Medicaid/CHIP | Medicaid / CHIP | $112 | fee schedule |
| United Healthcare | Medicare Advantage | Medicare Advantage | $118 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Small Group | Commercial | $126 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Individual | Commercial | $132 | fee schedule |
| Prime Health Services | Worker's Compensation | Workers' comp | $132 | fee schedule |
| Sedgwick | Preferred Network | Workers' comp | $157 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Small Group | Commercial | $173 | fee schedule |
| Mark Cuban | Commercial | Commercial | $272 | fee schedule |
| Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | Commercial | $297 | fee schedule |
| Blue Cross Blue Shield | Blue Advantage | Commercial | $300 | fee schedule |
| Baylor Scott & White Health Plan | BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee | Commercial | $329 | percent of total billed charges |
| Blue Cross Blue Shield | Blue Essentials (HMO) | Commercial | $343 | fee schedule |
| Blue Cross Blue Shield | BlueChoice (PPO) | Commercial | $361 | fee schedule |
| Baylor Scott & White Health Plan | BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2) | Commercial | $387 | percent of total billed charges |
| Cigna | Local Plus | Commercial | $420 | percent of total billed charges |
| Cigna | HMO/PPO | Commercial | $491 | percent of total billed charges |
| Aetna | Commercial | Commercial | $498 | percent of total billed charges |
| QuikTrip | Employee Benefit Plan | Commercial | $498 | percent of total billed charges |
| MidCoast | Commercial | Commercial | $498 | percent of total billed charges |
| University of Mary Hardin-Baylor | Commercial | Commercial | $525 | percent of total billed charges |
| Independent Medical System | Commercial PPO | Commercial | $543 | percent of total billed charges |
| Curative | Commercial | Commercial | $588 | percent of total billed charges |
| Humana | Commercial HMO | Commercial | $588 | percent of total billed charges |
| United Healthcare | Commercial | Commercial | $625 | percent of total billed charges |
| First Health | PPO | Commercial | $634 | percent of total billed charges |
| HealthSmart | Accel Network | Commercial | $634 | percent of total billed charges |
| Humana | Commercial PPO | Commercial | $634 | percent of total billed charges |
| HealthSmart | Preferred Network | Commercial | $679 | percent of total billed charges |
| Private Health Care System | PHCS Network | Commercial | $679 | percent of total billed charges |
| Three Rivers | Three Rivers Provider Network | Commercial | $815 | percent of total billed charges |
CHRISTUS Santa Rosa Hospital – San Marcos: all 35 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| Allwell | Superior Medicare Advantage | Medicare Advantage | $103 | fee schedule |
| Christus Health | Med Adv MM | Medicare Advantage | $103 | fee schedule |
| Humana | MM | Commercial | $103 | fee schedule |
| Triwest | VA MM | Military / VA | $103 | fee schedule |
| United Healthcare | MM | Commercial | $103 | fee schedule |
| Washington National | Supp MM | Commercial | $103 | fee schedule |
| Wellcare | MM | Medicare Advantage | $103 | fee schedule |
| Aetna | MM | Commercial | $105 | fee schedule |
| Cigna | Healthspring Medicare Advantage MM | Medicare Advantage | $106 | fee schedule |
| Provider Partners Health Plan | MM | Medicare Advantage | $106 | fee schedule |
| Shared Health Insurance Company | MM | Commercial | $108 | fee schedule |
| Amerigroup | MM | Medicaid / CHIP | $111 | fee schedule |
| Devoted Health Plan | MM | Medicare Advantage | $111 | fee schedule |
| United Healthcare | Star KM | Medicaid / CHIP | $114 | fee schedule |
| United Healthcare | Star Kids KM | Medicaid / CHIP | $114 | fee schedule |
| Community First | Star Kids KM | Medicaid / CHIP | $135 | fee schedule |
| Blue Cross Blue Shield Of Texas | Star KM | Medicaid / CHIP | $137 | fee schedule |
| Blue Cross Blue Shield Of Texas | Star Kids KM | Medicaid / CHIP | $137 | fee schedule |
| Amerigroup | Star KM | Medicaid / CHIP | $141 | fee schedule |
| Texas Childrens Health Plan | Star Plus KM | Medicaid / CHIP | $141 | fee schedule |
| Christus Health | HIX | Commercial | $144 | fee schedule |
| Superior | Chip KM | Medicaid / CHIP | $155 | fee schedule |
| Superior | Star KM | Medicaid / CHIP | $155 | fee schedule |
| Superior | Star Kids KM | Medicaid / CHIP | $155 | fee schedule |
| Sendero | HMO HIX | Commercial | $176 | fee schedule |
| Naphcare Inc. | RRMB | Public program | $206 | fee schedule |
| Cigna | New Business | Commercial | $260 | fee schedule |
| Healthcare Highways | PPO | Commercial | $261 | fee schedule |
| Blue Cross Blue Shield Of Texas | Blue Advantage HMO | Commercial | $302 | fee schedule |
| Cigna | PPO | Commercial | $329 | fee schedule |
| Blue Cross Blue Shield Of Texas | HEB | Commercial | $335 | fee schedule |
| Blue Cross Blue Shield Of Texas | HMO | Commercial | $339 | fee schedule |
| Blue Cross Blue Shield Of Texas | PPO | Commercial | $371 | fee schedule |
| Humana | Choicecare | Commercial | $500 | fee schedule |
| United Healthcare | All Payer | Commercial | $1,408 | fee schedule |
Dell Children's Medical Center: all 56 plan rates
| Payer | Plan (as written in the file) | Type | Rate | Method |
|---|---|---|---|---|
| BCBS BAV EXCHANGE | 4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101 | Commercial | $88.30 | FEE SCHEDULE |
| CHAMPVA | 1136_CHAMPVA AUSTIN 20180301 | Military / VA | $91.43 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS STAR KIDS | 5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901 | Commercial | $107 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR KIDS | 4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $107 | FEE SCHEDULE |
| BCBS CHIP/CHIP PERINATE | 3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| DELL STAR | 3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR | 3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR KIDS | 4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| UHC STAR PLUS | 3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR | 3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $114 | FEE SCHEDULE |
| CHAMPVA | 1135_CHAMPVA REST_TX 20180301 | Military / VA | $119 | FEE SCHEDULE |
| BCBS STAR | 3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| BCBS STAR | 4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL CHIP/CHIP PERINATE | 4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| DELL STAR | 4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| SUPERIOR AMBETTER | 3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901 | Commercial | $119 | FEE SCHEDULE |
| UHC STAR | 4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR KIDS | 4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| UHC STAR PLUS | 4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT CHIP/CHIP PERINATE | 4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR | 4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| WELLPOINT STAR PLUS | 4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $119 | FEE SCHEDULE |
| TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | Military / VA | $148 | FEE SCHEDULE |
| HUMANA HMO | 2668_HUMANA HMO 20230701 | Commercial | $162 | OTHER |
| BCBS HPN | 4440_BLUE CROSS BLUE SHIELD HPN 20250501 | Commercial | $293 | FEE SCHEDULE |
| BCBS HPN | 4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501 | Commercial | $293 | FEE SCHEDULE |
| SUPERIOR STAR | 4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR FOSTER | 4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4888_SUPERIOR STAR KIDS OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR KIDS | 4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR | 3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| SUPERIOR STAR PLUS | 4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901 | Medicaid / CHIP | $295 | FEE SCHEDULE |
| BCBS HMO ESSENTIALS | 4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101 | Commercial | $324 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 4190_SUPERIOR CHIP OUTPATIENT 20241201 | Medicaid / CHIP | $332 | FEE SCHEDULE |
| SUPERIOR CHIP/CHIP PERINATE | 3619_SUPERIOR CHIP INPATIENT 20240901 | Medicaid / CHIP | $332 | FEE SCHEDULE |
| CIGNA HMO | 4476_CIGNA HMO (WIL,DEL) 20250701 | Commercial | $350 | FEE SCHEDULE |
| CIGNA HMO | 4475_CIGNA HMO (AUS,NW,SW,HAY) 20250701 | Commercial | $350 | FEE SCHEDULE |
| BCBS PPO | 4094_BLUE CROSS BLUE SHIELD PPO 20250101 | Commercial | $358 | FEE SCHEDULE |
| AETNA ACO HMO | 4489_AETNA ACO HMO 20250801 | Commercial | $541 | FEE SCHEDULE |
| AETNA MULTI-TIER WHOLE HEALTH SHA | 4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801 | Commercial | $541 | FEE SCHEDULE |
| AETNA SHA AISD | 4335_AETNA SHA AISD 20250101 | Commercial | $706 | OTHER |
| AETNA HMO EXCHANGE | 1377_AETNA HMO EXCHANGE 20200101 | Commercial | $846 | FEE SCHEDULE |
| AETNA CHOICE | 236_AETNA ELECT CHOICE 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA POS 20140601 | 235_AETNA POS 20140601 | Commercial | $846 | FEE SCHEDULE |
| AETNA HMO | 4486_AETNA HMO 20250801 | Commercial | $883 | OTHER |
| COVENANT HEALTH | 4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801 | Commercial | $883 | OTHER |
What this price covers
These are hospital charges for CPT code 76830 (Transvaginal ultrasound). 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.