How much does a lower back X-ray cost in Austin?

14 hospitals in Austin list a self-pay price of $132–$475 for a lower back X-ray (2–3 views) (CPT 72100). The typical commercial rate in the same files is $350.

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

Published cash price

$132–$475

what 14 hospitals list for a self-pay lower back X-ray

Typical insured rate

$350

median of every commercial plan rate in the files

Lowest insured rate

$33.08

SUPERIOR AMBETTER (3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901), Ascension Seton Cedar Park

Lower back X-ray 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 72100; Medicaid and Medicare Advantage are shown separately below.

Lower back X-ray (2–3 views) (CPT 72100) — Austin
Hospital	Published cash price	Typical insured rate	Lowest insured rate
Ascension Seton Cedar ParkAscension Seton · file Jan 2026	$132–$314Cash ÷ typical 0.6×	$21718 plans	$33.08
Ascension Seton SmithvilleAscension Seton · file Jan 2026	$183–$347Cash ÷ typical 0.9×	$21219 plans	$33.08
Ascension Seton HaysAscension Seton · file Jan 2026	$183–$347Cash ÷ typical 0.9×	$19924 plans	$33.08
Ascension Seton Edgar B. DavisAscension Seton · file Jan 2026	$244–$261Cash ÷ typical 1.1×	$21718 plans	$33.08
Dell Seton Medical Center at The University of TexasAscension Seton · file Jan 2026	$347Cash ÷ typical 1.6×	$21718 plans	$33.08
Ascension Seton NorthwestAscension Seton · file Jan 2026	$347Cash ÷ typical 1.7×	$19924 plans	$33.08
Ascension Seton Medical Center AustinAscension Seton · file Jan 2026	$347Cash ÷ typical 1.9×	$18526 plans	$33.08
Ascension Seton SouthwestAscension Seton · file Jan 2026	$347Cash ÷ typical 1.7×	$19924 plans	$33.08
Baylor Scott & White Medical Center – LakewayBaylor Scott & White Health · file Jun 2026	$475Cash ÷ typical 1.1×	$43626 plans	$126
Baylor Scott & White Medical Center – Round RockBaylor Scott & White Health · file Jun 2026	$475Cash ÷ typical 1.0×	$45827 plans	$126
Baylor Scott & White Medical Center – TaylorBaylor Scott & White Health · file Jun 2026	$475Cash ÷ typical 1.0×	$45827 plans	$190
Baylor Scott & White Medical Center – AustinBaylor Scott & White Health · file Jun 2026	$475Cash ÷ typical 1.1×	$43522 plans	$126
Baylor Scott & White Medical Center – BudaBaylor Scott & White Health · file Jun 2026	$475Cash ÷ typical 1.1×	$43522 plans	$126
Baylor Scott & White Medical Center – PflugervilleBaylor Scott & White Health · file Jun 2026	$475Cash ÷ typical 1.1×	$43626 plans	$126
Dell Children's Medical CenterAscension Seton · children's hospital (not in the summary above) · file Jan 2026	$355–$674Cash ÷ typical 1.6×	$21718 plans	$33.08

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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.

Negotiated rates by insurer
Hospital	Blue Cross Blue Shield	Aetna	Cigna	UnitedHealthcare	Humana	Ambetter	Medicaid / CHIP	Medicare Advantage
Ascension Seton Cedar Park	$112–$454	$144–$278	$350	—	—	$33.08–$40.10	$33–$392	—
Ascension Seton Smithville	$112–$454	$144–$278	$350	—	—	$33.08–$40.10	$33–$433	—
Ascension Seton Hays	$112–$454	$144–$278	$350	—	—	$33–$185	$33–$433	$101–$108
Ascension Seton Edgar B. Davis	$112–$454	$144–$278	$350	—	—	$33.08–$40.10	$33–$306	—
Dell Seton Medical Center at The University of Texas	$112–$454	$144–$278	$350	—	—	$33.08–$40.10	$33–$433	—
Ascension Seton Northwest	$112–$454	$144–$278	$350	—	—	$33–$185	$33–$433	$101–$108
Ascension Seton Medical Center Austin	$112–$454	$144–$278	$350	$103	—	$33–$185	$33–$433	$101–$108
Ascension Seton Southwest	$112–$454	$144–$278	$350	—	—	$33–$185	$33–$433	$101–$108
Baylor Scott & White Medical Center – Lakeway	$377–$458	$435	$367–$429	$547	$514–$554	—	$40.10–$42.91	$100–$118
Baylor Scott & White Medical Center – Round Rock	$377–$458	$435	$397–$467	$547	$514–$554	—	$40.10–$42.91	$100–$118
Baylor Scott & White Medical Center – Taylor	$377–$458	$435	$397–$467	$547	$514–$554	—	$141	$150–$174
Baylor Scott & White Medical Center – Austin	$377–$458	$435	$367–$429	$547	$514–$554	—	$40.10–$42.91	$100–$118
Baylor Scott & White Medical Center – Buda	$377–$458	$435	$367–$429	$547	$514–$554	—	$40.10–$42.91	$100–$118
Baylor Scott & White Medical Center – Pflugerville	$377–$458	$435	$367–$429	$547	$514–$554	—	$40.10–$42.91	$100–$118
Dell Children's Medical Center	$112–$454	$144–$278	$350	—	—	$33.08–$40.10	$33–$433	—

Ascension Seton Cedar Park: all 56 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$24.52	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$33.08	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$33.74	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$50.92	OTHER
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$97.29	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$112	FEE SCHEDULE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$144	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$144	FEE SCHEDULE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$212	FEE SCHEDULE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$212	FEE SCHEDULE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$212	FEE SCHEDULE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$222	OTHER
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$278	OTHER
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$278	OTHER
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$349	FEE SCHEDULE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$349	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$349	FEE SCHEDULE
SUPERIOR STAR FOSTER	4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201	Medicaid / CHIP	$349	FEE SCHEDULE
SUPERIOR STAR FOSTER	4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$349	FEE SCHEDULE
SUPERIOR STAR KIDS	4888_SUPERIOR STAR KIDS OUTPATIENT 20241201	Medicaid / CHIP	$349	FEE SCHEDULE
SUPERIOR STAR KIDS	4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$349	FEE SCHEDULE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$349	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 HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$372	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$372	FEE SCHEDULE
SUPERIOR CHIP/CHIP PERINATE	3619_SUPERIOR CHIP INPATIENT 20240901	Medicaid / CHIP	$392	FEE SCHEDULE
SUPERIOR CHIP/CHIP PERINATE	4190_SUPERIOR CHIP OUTPATIENT 20241201	Medicaid / CHIP	$392	FEE SCHEDULE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$411	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$454	FEE SCHEDULE

Ascension Seton Smithville: all 87 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$24.52	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3600_BLUE CROSS CHIP/STAR KIDS (SMV) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4174_BLUE CROSS CHIP/STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	3699_CHIRP BLUE CROSS STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	4225_CHIRP BLUE CROSS STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3611_DELL CHIP/STAR KIDS (SMV) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	3710_CHIRP DELL STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$33.08	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	3743_CHIRP UHC STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4328_UHC STAR KIDS (SMV) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	3754_CHIRP UHC STAR PLUS (SMV) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	3589_WELLPOINT CHIP/STAR KIDS (SMV) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	3677_CHIRP WELLPOINT/AMERIGROUP STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	3688_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SMV) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$33.74	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4174_BLUE CROSS CHIP (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS STAR KIDS	5015_BLUE CROSS STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4185_DELL CHIP/STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
DELL STAR	4236_CHIRP DELL STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$40.10	FEE SCHEDULE
UHC STAR	4259_CHIRP UHC STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
UHC STAR KIDS	4317_UHC STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
UHC STAR PLUS	4270_CHIRP UHC STAR PLUS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4163_AMERIGROUP CHIP/STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4163_WELLPOINT/AMERIGROUP CHIP (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR	4203_CHIRP AMERIGROUP STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR	4203_CHIRP WELLPOINT/AMERIGROUP STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR KIDS	4982_WELLPOINT/AMERIGROUP STAR KIDS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR PLUS	4214_CHIRP AMERIGROUP STAR PLUS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR PLUS	4214_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$50.92	OTHER
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$97.29	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$112	FEE SCHEDULE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$144	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$144	FEE SCHEDULE
SENDERO IDEALCARE	1571_SENDERO IDEALCARE OP 20200101	Commercial	$180	OTHER
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$212	FEE SCHEDULE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$212	FEE SCHEDULE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$212	FEE SCHEDULE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$222	OTHER
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$278	OTHER
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$278	OTHER
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 HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$372	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$372	FEE SCHEDULE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR	3515_CHIRP SUPERIOR STAR (SMV) INPATIENT 20240901	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4381_CHIRP SUPERIOR STAR PLUS (SMV) INPATIENT 20240901	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR	4247_CHIRP SUPERIOR STAR (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR FOSTER	4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR FOSTER	4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR KIDS	4888_SUPERIOR STAR KIDS OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR KIDS	4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4401_CHIRP SUPERIOR STAR PLUS (SMV) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$411	FEE SCHEDULE
SUPERIOR CHIP/CHIP PERINATE	3619_SUPERIOR CHIP INPATIENT 20240901	Medicaid / CHIP	$433	FEE SCHEDULE
SUPERIOR CHIP/CHIP PERINATE	4190_SUPERIOR CHIP OUTPATIENT 20241201	Medicaid / CHIP	$433	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$454	FEE SCHEDULE

Ascension Seton Hays: all 126 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$24.52	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3597_BLUE CROSS CHIP/STAR KIDS (HAY) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	3696_CHIRP BLUE CROSS STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	4222_CHIRP BLUE CROSS STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3608_DELL CHIP/STAR KIDS (HAY) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	3707_CHIRP DELL STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	4233_CHIRP DELL STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$33.08	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	3740_CHIRP UHC STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	4256_CHIRP UHC STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4314_UHC STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4325_UHC STAR KIDS (HAY) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	3751_CHIRP UHC STAR PLUS (HAY) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	4267_CHIRP UHC STAR PLUS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	3674_CHIRP WELLPOINT/AMERIGROUP STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4200_CHIRP AMERIGROUP STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4200_CHIRP WELLPOINT/AMERIGROUP STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	3685_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (HAY) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	4211_CHIRP AMERIGROUP STAR PLUS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$33.74	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4171_BLUE CROSS CHIP (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4171_BLUE CROSS CHIP/STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS STAR KIDS	5009_BLUE CROSS STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4182_DELL CHIP/STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4160_AMERIGROUP CHIP/STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4160_WELLPOINT/AMERIGROUP CHIP (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR KIDS	4976_WELLPOINT/AMERIGROUP STAR KIDS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR PLUS	4211_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$50.92	OTHER
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$97.29	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
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 BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$112	FEE SCHEDULE
OCCUNET	4674_OCCUNET IP 20251001	Workers' comp	$144	OTHER
OCCUNET	4123_OCCUNET OP 20250101	Workers' comp	$144	OTHER
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$144	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$144	FEE SCHEDULE
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
SUPERIOR STAR	3512_CHIRP SUPERIOR STAR (HAY) INPATIENT 20240901	Medicaid / CHIP	$200	FEE SCHEDULE
SUPERIOR STAR PLUS	4378_CHIRP SUPERIOR STAR PLUS (HAY) INPATIENT 20240901	Medicaid / CHIP	$200	FEE SCHEDULE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$212	FEE SCHEDULE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$212	FEE SCHEDULE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$212	FEE SCHEDULE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$222	OTHER
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$278	OTHER
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$278	OTHER
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 HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$372	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$372	FEE SCHEDULE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR	4244_CHIRP SUPERIOR STAR (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR FOSTER	4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR FOSTER	4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR KIDS	4888_SUPERIOR STAR KIDS OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR KIDS	4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4395_CHIRP SUPERIOR STAR PLUS (HAY) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$411	FEE SCHEDULE
SUPERIOR CHIP/CHIP PERINATE	3619_SUPERIOR CHIP INPATIENT 20240901	Medicaid / CHIP	$433	FEE SCHEDULE
SUPERIOR CHIP/CHIP PERINATE	4190_SUPERIOR CHIP OUTPATIENT 20241201	Medicaid / CHIP	$433	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$454	FEE SCHEDULE

Ascension Seton Edgar B. Davis: all 85 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$24.52	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$33.08	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$33.74	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$50.92	OTHER
BCBS STAR	4221_CHIRP BLUE CROSS STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$64.64	FEE SCHEDULE
DELL STAR	4232_CHIRP DELL STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$64.64	FEE SCHEDULE
UHC STAR	4255_CHIRP UHC STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$64.64	FEE SCHEDULE
UHC STAR KIDS	4313_UHC STAR KIDS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$64.64	FEE SCHEDULE
UHC STAR PLUS	4266_CHIRP UHC STAR PLUS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$64.64	FEE SCHEDULE
WELLPOINT STAR	4199_CHIRP AMERIGROUP STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$64.64	FEE SCHEDULE
WELLPOINT STAR	4199_CHIRP WELLPOINT/AMERIGROUP STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$64.64	FEE SCHEDULE
WELLPOINT STAR PLUS	4210_CHIRP AMERIGROUP STAR PLUS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$64.64	FEE SCHEDULE
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$97.29	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$112	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
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$144	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$144	FEE SCHEDULE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$212	FEE SCHEDULE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$212	FEE SCHEDULE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$212	FEE SCHEDULE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$222	OTHER
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$272	FEE SCHEDULE
SUPERIOR STAR	3511_CHIRP SUPERIOR STAR (EBD) INPATIENT 20240901	Medicaid / CHIP	$272	FEE SCHEDULE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$272	FEE SCHEDULE
SUPERIOR STAR PLUS	4377_CHIRP SUPERIOR STAR PLUS (EBD) INPATIENT 20240901	Medicaid / CHIP	$272	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$272	FEE SCHEDULE
SUPERIOR STAR	4243_CHIRP SUPERIOR STAR (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$272	FEE SCHEDULE
SUPERIOR STAR FOSTER	4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201	Medicaid / CHIP	$272	FEE SCHEDULE
SUPERIOR STAR FOSTER	4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$272	FEE SCHEDULE
SUPERIOR STAR KIDS	4888_SUPERIOR STAR KIDS OUTPATIENT 20241201	Medicaid / CHIP	$272	FEE SCHEDULE
SUPERIOR STAR KIDS	4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$272	FEE SCHEDULE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$272	FEE SCHEDULE
SUPERIOR STAR PLUS	4393_CHIRP SUPERIOR STAR PLUS (EBD) OUTPATIENT 20241201	Medicaid / CHIP	$272	FEE SCHEDULE
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$278	OTHER
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$278	OTHER
SUPERIOR CHIP/CHIP PERINATE	3619_SUPERIOR CHIP INPATIENT 20240901	Medicaid / CHIP	$306	FEE SCHEDULE
SUPERIOR CHIP/CHIP PERINATE	4190_SUPERIOR CHIP OUTPATIENT 20241201	Medicaid / CHIP	$306	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 HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$372	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$372	FEE SCHEDULE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$411	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$454	FEE SCHEDULE

Dell Seton Medical Center at The University of Texas: all 83 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$24.52	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3595_BLUE CROSS CHIP/STAR KIDS (DEL) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	3694_CHIRP BLUE CROSS STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	4220_CHIRP BLUE CROSS STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3606_DELL CHIP/STAR KIDS (DEL) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	3705_CHIRP DELL STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	4231_CHIRP DELL STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$33.08	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	3738_CHIRP UHC STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	4254_CHIRP UHC STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4312_UHC STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4323_UHC STAR KIDS (DEL) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	3749_CHIRP UHC STAR PLUS (DEL) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	4265_CHIRP UHC STAR PLUS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	3672_CHIRP WELLPOINT/AMERIGROUP STAR (DEL) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4198_CHIRP AMERIGROUP STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4198_CHIRP WELLPOINT/AMERIGROUP STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	3683_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (DEL) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	4209_CHIRP AMERIGROUP STAR PLUS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$33.74	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4169_BLUE CROSS CHIP (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4169_BLUE CROSS CHIP/STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS STAR KIDS	5005_BLUE CROSS STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4180_DELL CHIP/STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4158_AMERIGROUP CHIP/STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4158_WELLPOINT/AMERIGROUP CHIP (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR KIDS	4972_WELLPOINT/AMERIGROUP STAR KIDS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR PLUS	4209_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$50.92	OTHER
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$97.29	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$112	FEE SCHEDULE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$144	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$144	FEE SCHEDULE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$212	FEE SCHEDULE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$212	FEE SCHEDULE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$212	FEE SCHEDULE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$222	OTHER
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$278	OTHER
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$278	OTHER
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 HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$372	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$372	FEE SCHEDULE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR	4242_CHIRP SUPERIOR STAR (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR FOSTER	4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR FOSTER	4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR KIDS	4888_SUPERIOR STAR KIDS OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR KIDS	4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4391_CHIRP SUPERIOR STAR PLUS (DEL) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$411	FEE SCHEDULE
SUPERIOR CHIP/CHIP PERINATE	3619_SUPERIOR CHIP INPATIENT 20240901	Medicaid / CHIP	$433	FEE SCHEDULE
SUPERIOR CHIP/CHIP PERINATE	4190_SUPERIOR CHIP OUTPATIENT 20241201	Medicaid / CHIP	$433	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$454	FEE SCHEDULE

Ascension Seton Northwest: all 123 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$24.52	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3598_BLUE CROSS CHIP/STAR KIDS (NW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	3697_CHIRP BLUE CROSS STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	4223_CHIRP BLUE CROSS STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3609_DELL CHIP/STAR KIDS (NW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4183_DELL CHIP/STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	3708_CHIRP DELL STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	4234_CHIRP DELL STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$33.08	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	3741_CHIRP UHC STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	4257_CHIRP UHC STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4315_UHC STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4326_UHC STAR KIDS (NW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	3752_CHIRP UHC STAR PLUS (NW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	4268_CHIRP UHC STAR PLUS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4161_AMERIGROUP CHIP/STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	3675_CHIRP WELLPOINT/AMERIGROUP STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4201_CHIRP AMERIGROUP STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4201_CHIRP WELLPOINT/AMERIGROUP STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	3686_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (NW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	4212_CHIRP AMERIGROUP STAR PLUS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$33.74	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4172_BLUE CROSS CHIP (NW) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4172_BLUE CROSS CHIP/STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS STAR KIDS	5011_BLUE CROSS STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4161_WELLPOINT/AMERIGROUP CHIP (NW) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR KIDS	4978_WELLPOINT/AMERIGROUP STAR KIDS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR PLUS	4212_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$50.92	OTHER
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$97.29	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
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 BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$112	FEE SCHEDULE
OCCUNET	4674_OCCUNET IP 20251001	Workers' comp	$144	OTHER
OCCUNET	4123_OCCUNET OP 20250101	Workers' comp	$144	OTHER
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$144	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$144	FEE SCHEDULE
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
SUPERIOR STAR	3513_CHIRP SUPERIOR STAR (NW) INPATIENT 20240901	Medicaid / CHIP	$200	FEE SCHEDULE
SUPERIOR STAR PLUS	4379_CHIRP SUPERIOR STAR PLUS (NW) INPATIENT 20240901	Medicaid / CHIP	$200	FEE SCHEDULE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$212	FEE SCHEDULE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$212	FEE SCHEDULE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$212	FEE SCHEDULE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$222	OTHER
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$278	OTHER
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$278	OTHER
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 HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$372	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$372	FEE SCHEDULE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR	4245_CHIRP SUPERIOR STAR (NW) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR FOSTER	4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR FOSTER	4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR KIDS	4888_SUPERIOR STAR KIDS OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR KIDS	4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4397_CHIRP SUPERIOR STAR PLUS (NW) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$411	FEE SCHEDULE
SUPERIOR CHIP/CHIP PERINATE	3619_SUPERIOR CHIP INPATIENT 20240901	Medicaid / CHIP	$433	FEE SCHEDULE
SUPERIOR CHIP/CHIP PERINATE	4190_SUPERIOR CHIP OUTPATIENT 20241201	Medicaid / CHIP	$433	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$454	FEE SCHEDULE

Ascension Seton Medical Center Austin: all 126 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$24.52	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3592_BLUE CROSS CHIP/STAR KIDS (AUS) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	3691_CHIRP BLUE CROSS STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	4217_CHIRP BLUE CROSS STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3603_DELL CHIP/STAR KIDS (AUS) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	3702_CHIRP DELL STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	4228_CHIRP DELL STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$33.08	FEE SCHEDULE
UHC STAR	3735_CHIRP UHC STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	4251_CHIRP UHC STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4309_UHC STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4320_UHC STAR KIDS (AUS) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	3746_CHIRP UHC STAR PLUS (AUS) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	4262_CHIRP UHC STAR PLUS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	3669_CHIRP WELLPOINT/AMERIGROUP STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4195_CHIRP AMERIGROUP STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4195_CHIRP WELLPOINT/AMERIGROUP STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	3680_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (AUS) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	4206_CHIRP AMERIGROUP STAR PLUS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$33.74	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4166_BLUE CROSS CHIP (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4166_BLUE CROSS CHIP/STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS STAR KIDS	4999_BLUE CROSS STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4177_DELL CHIP/STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4155_AMERIGROUP CHIP/STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4155_WELLPOINT/AMERIGROUP CHIP (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR KIDS	4966_WELLPOINT/AMERIGROUP STAR KIDS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR PLUS	4206_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$50.92	OTHER
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$97.29	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
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 BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$112	FEE SCHEDULE
OCCUNET	4674_OCCUNET IP 20251001	Workers' comp	$144	OTHER
OCCUNET	4123_OCCUNET OP 20250101	Workers' comp	$144	OTHER
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$144	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$144	FEE SCHEDULE
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
SUPERIOR STAR	3507_CHIRP SUPERIOR STAR (AUS) INPATIENT 20240901	Medicaid / CHIP	$200	FEE SCHEDULE
SUPERIOR STAR PLUS	4373_CHIRP SUPERIOR STAR PLUS (AUS) INPATIENT 20240901	Medicaid / CHIP	$200	FEE SCHEDULE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$212	FEE SCHEDULE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$212	FEE SCHEDULE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$212	FEE SCHEDULE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$222	OTHER
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$278	OTHER
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$278	OTHER
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 HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$372	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$372	FEE SCHEDULE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR	4239_CHIRP SUPERIOR STAR (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR FOSTER	4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR FOSTER	4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR KIDS	4888_SUPERIOR STAR KIDS OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR KIDS	4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4385_CHIRP SUPERIOR STAR PLUS (AUS) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$411	FEE SCHEDULE
SUPERIOR CHIP/CHIP PERINATE	3619_SUPERIOR CHIP INPATIENT 20240901	Medicaid / CHIP	$433	FEE SCHEDULE
SUPERIOR CHIP/CHIP PERINATE	4190_SUPERIOR CHIP OUTPATIENT 20241201	Medicaid / CHIP	$433	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$454	FEE SCHEDULE

Ascension Seton Southwest: all 124 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$24.52	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3601_BLUE CROSS CHIP/STAR KIDS (SW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4175_BLUE CROSS CHIP/STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	3700_CHIRP BLUE CROSS STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	4226_CHIRP BLUE CROSS STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3612_DELL CHIP/STAR KIDS (SW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4186_DELL CHIP/STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	3711_CHIRP DELL STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	4237_CHIRP DELL STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$33.08	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	3744_CHIRP UHC STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	4260_CHIRP UHC STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4318_UHC STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4329_UHC STAR KIDS (SW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	3755_CHIRP UHC STAR PLUS (SW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	4271_CHIRP UHC STAR PLUS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4164_AMERIGROUP CHIP/STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	3678_CHIRP WELLPOINT/AMERIGROUP STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4204_CHIRP AMERIGROUP STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4204_CHIRP WELLPOINT/AMERIGROUP STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	3689_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SW) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	4215_CHIRP AMERIGROUP STAR PLUS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$33.74	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4175_BLUE CROSS CHIP (SW) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS STAR KIDS	5017_BLUE CROSS STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4164_WELLPOINT/AMERIGROUP CHIP (SW) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR KIDS	4984_WELLPOINT/AMERIGROUP STAR KIDS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR PLUS	4215_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$50.92	OTHER
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$97.29	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
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 BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$112	FEE SCHEDULE
OCCUNET	4674_OCCUNET IP 20251001	Workers' comp	$144	OTHER
OCCUNET	4123_OCCUNET OP 20250101	Workers' comp	$144	OTHER
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$144	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$144	FEE SCHEDULE
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
SUPERIOR STAR	3516_CHIRP SUPERIOR STAR (SW) INPATIENT 20240901	Medicaid / CHIP	$200	FEE SCHEDULE
SUPERIOR STAR PLUS	4382_CHIRP SUPERIOR STAR PLUS (SW) INPATIENT 20240901	Medicaid / CHIP	$200	FEE SCHEDULE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$212	FEE SCHEDULE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$212	FEE SCHEDULE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$212	FEE SCHEDULE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$222	OTHER
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$278	OTHER
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$278	OTHER
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 HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$372	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$372	FEE SCHEDULE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR	4248_CHIRP SUPERIOR STAR (SW) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR FOSTER	4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR FOSTER	4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR KIDS	4888_SUPERIOR STAR KIDS OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR KIDS	4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4403_CHIRP SUPERIOR STAR PLUS (SW) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$411	FEE SCHEDULE
SUPERIOR CHIP/CHIP PERINATE	3619_SUPERIOR CHIP INPATIENT 20240901	Medicaid / CHIP	$433	FEE SCHEDULE
SUPERIOR CHIP/CHIP PERINATE	4190_SUPERIOR CHIP OUTPATIENT 20241201	Medicaid / CHIP	$433	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$454	FEE SCHEDULE

Baylor Scott & White Medical Center – Lakeway: all 40 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Superior Health Plan	Medicaid	Medicaid / CHIP	$40.10	fee schedule
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$42.91	fee schedule
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$99.77	fee schedule
CORVEL	Worker's Compensation	Workers' comp	$102	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	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
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$288	percent of total billed charges
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$339	percent of total billed charges
Cigna	Local Plus	Commercial	$367	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$377	fee schedule
Blue Cross Blue Shield	Blue Advantage	Commercial	$381	fee schedule
Cigna	HMO/PPO	Commercial	$429	percent of total billed charges
Aetna	Commercial	Commercial	$435	percent of total billed charges
QuikTrip	Employee Benefit Plan	Commercial	$435	percent of total billed charges
MidCoast	Commercial	Commercial	$435	percent of total billed charges
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$436	fee schedule
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$458	fee schedule
University of Mary Hardin-Baylor	Commercial	Commercial	$459	percent of total billed charges
Independent Medical System	Commercial PPO	Commercial	$475	percent of total billed charges
Curative	Commercial	Commercial	$514	percent of total billed charges
Humana	Commercial HMO	Commercial	$514	percent of total billed charges
United Healthcare	Commercial	Commercial	$547	percent of total billed charges
First Health	PPO	Commercial	$554	percent of total billed charges
HealthSmart	Accel Network	Commercial	$554	percent of total billed charges
Humana	Commercial PPO	Commercial	$554	percent of total billed charges
HealthSmart	Preferred Network	Commercial	$593	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$593	percent of total billed charges
Three Rivers	Three Rivers Provider Network	Commercial	$712	percent of total billed charges

Baylor Scott & White Medical Center – Round Rock: all 43 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Superior Health Plan	Medicaid	Medicaid / CHIP	$40.10	fee schedule
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$42.91	fee schedule
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$99.77	fee schedule
CORVEL	Worker's Compensation	Workers' comp	$102	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	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
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$288	percent of total billed charges
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$339	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$377	fee schedule
Blue Cross Blue Shield	Blue Advantage	Commercial	$381	fee schedule
Cigna	Local Plus	Commercial	$397	percent of total billed charges
Aetna	Commercial	Commercial	$435	percent of total billed charges
QuikTrip	Employee Benefit Plan	Commercial	$435	percent of total billed charges
MidCoast	Commercial	Commercial	$435	percent of total billed charges
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$436	fee schedule
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$458	fee schedule
University of Mary Hardin-Baylor	Commercial	Commercial	$459	percent of total billed charges
Cigna	HMO/PPO	Commercial	$467	percent of total billed charges
Independent Medical System	Commercial PPO	Commercial	$475	percent of total billed charges
Curative	Commercial	Commercial	$514	percent of total billed charges
Humana	Commercial HMO	Commercial	$514	percent of total billed charges
United Healthcare	Commercial	Commercial	$547	percent of total billed charges
First Health	PPO	Commercial	$554	percent of total billed charges
HealthSmart	Accel Network	Commercial	$554	percent of total billed charges
Humana	Commercial PPO	Commercial	$554	percent of total billed charges
BlueBell Creameries	Self Insured	Commercial	$593	percent of total billed charges
HealthSmart	Preferred Network	Commercial	$593	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$593	percent of total billed charges
Three Rivers	Three Rivers Provider Network	Commercial	$712	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	$150	percent of total billed charges
American Health Plan	Medicare Advantage	Medicare Advantage	$158	percent of total billed charges
TriWest	Community Care Network	Military / VA	$158	percent of total billed charges
CORVEL	Worker's Compensation	Workers' comp	$166	percent of total billed charges
Prime Health Services	Worker's Compensation	Workers' comp	$166	percent of total billed charges
Blue Cross Blue Shield	Medicare Advantage	Medicare Advantage	$166	percent of total billed charges
HealthSpring	Medicare Advantage	Medicare Advantage	$166	percent of total billed charges
ProCare Advantage	Medicare Advantage	Medicare Advantage	$166	percent of total billed charges
Superior Health Plan	Medicare HMO/Medicare PPO	Medicare Advantage	$174	percent of total billed charges
Baylor Scott & White Health Plan	BSW Premier - Small Group	Commercial	$190	percent of total billed charges
CareWorks fka Rockport	Worker's Compensation	Workers' comp	$197	percent of total billed charges
Injury Management Organization	Med Select Network	Workers' comp	$197	percent of total billed charges
Sedgwick	Preferred Network	Workers' comp	$197	percent of total billed charges
Baylor Scott & White Health Plan	BSW Premier - Individual	Commercial	$199	percent of total billed charges
Mark Cuban	Commercial	Commercial	$272	fee schedule
Baylor Scott & White Health Plan	BSW Plus - Small Group	Commercial	$285	percent of total billed charges
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$288	percent of total billed charges
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$339	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$377	fee schedule
Blue Cross Blue Shield	Blue Advantage	Commercial	$381	fee schedule
Cigna	Local Plus	Commercial	$397	percent of total billed charges
Aetna	Commercial	Commercial	$435	percent of total billed charges
QuikTrip	Employee Benefit Plan	Commercial	$435	percent of total billed charges
MidCoast	Commercial	Commercial	$435	percent of total billed charges
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$436	fee schedule
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$458	fee schedule
University of Mary Hardin-Baylor	Commercial	Commercial	$459	percent of total billed charges
Cigna	HMO/PPO	Commercial	$467	percent of total billed charges
Independent Medical System	Commercial PPO	Commercial	$475	percent of total billed charges
Curative	Commercial	Commercial	$514	percent of total billed charges
Humana	Commercial HMO	Commercial	$514	percent of total billed charges
United Healthcare	Commercial	Commercial	$547	percent of total billed charges
First Health	PPO	Commercial	$554	percent of total billed charges
HealthSmart	Accel Network	Commercial	$554	percent of total billed charges
Humana	Commercial PPO	Commercial	$554	percent of total billed charges
HealthSmart	Preferred Network	Commercial	$593	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$593	percent of total billed charges
BlueBell Creameries	Self Insured	Commercial	$633	percent of total billed charges
Three Rivers	Three Rivers Provider Network	Commercial	$633	percent of total billed charges

Baylor Scott & White Medical Center – Austin: all 32 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Superior Health Plan	Medicaid	Medicaid / CHIP	$40.10	fee schedule
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$42.91	fee schedule
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$99.77	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	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
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$288	percent of total billed charges
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$339	percent of total billed charges
Cigna	Local Plus	Commercial	$367	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$377	fee schedule
Blue Cross Blue Shield	Blue Advantage	Commercial	$381	fee schedule
Cigna	HMO/PPO	Commercial	$429	percent of total billed charges
Aetna	Commercial	Commercial	$435	percent of total billed charges
QuikTrip	Employee Benefit Plan	Commercial	$435	percent of total billed charges
MidCoast	Commercial	Commercial	$435	percent of total billed charges
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$436	fee schedule
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$458	fee schedule
University of Mary Hardin-Baylor	Commercial	Commercial	$459	percent of total billed charges
Curative	Commercial	Commercial	$514	percent of total billed charges
Humana	Commercial HMO	Commercial	$514	percent of total billed charges
United Healthcare	Commercial	Commercial	$547	percent of total billed charges
First Health	PPO	Commercial	$554	percent of total billed charges
Humana	Commercial PPO	Commercial	$554	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$593	percent of total billed charges

Baylor Scott & White Medical Center – Buda: all 33 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
Superior Health Plan	Medicaid	Medicaid / CHIP	$40.10	fee schedule
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$42.91	fee schedule
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$99.77	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	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
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$288	percent of total billed charges
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$339	percent of total billed charges
Cigna	Local Plus	Commercial	$367	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$377	fee schedule
Blue Cross Blue Shield	Blue Advantage	Commercial	$381	fee schedule
Cigna	HMO/PPO	Commercial	$429	percent of total billed charges
Aetna	Commercial	Commercial	$435	percent of total billed charges
QuikTrip	Employee Benefit Plan	Commercial	$435	percent of total billed charges
MidCoast	Commercial	Commercial	$435	percent of total billed charges
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$436	fee schedule
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$458	fee schedule
University of Mary Hardin-Baylor	Commercial	Commercial	$459	percent of total billed charges
Curative	Commercial	Commercial	$514	percent of total billed charges
Humana	Commercial HMO	Commercial	$514	percent of total billed charges
United Healthcare	Commercial	Commercial	$547	percent of total billed charges
First Health	PPO	Commercial	$554	percent of total billed charges
Humana	Commercial PPO	Commercial	$554	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$593	percent of total billed charges

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

Payer	Plan (as written in the file)	Type	Rate	Method
Superior Health Plan	Medicaid	Medicaid / CHIP	$40.10	fee schedule
United Healthcare	Medicaid/CHIP	Medicaid / CHIP	$42.91	fee schedule
Baylor Scott & White Health Plan	Medicare Advantage	Medicare Advantage	$99.77	fee schedule
CORVEL	Worker's Compensation	Workers' comp	$102	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	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
Baylor Scott & White Health Plan	BSW Premier - Large Group/BSW Premier Direct to Employer (Rate 1)/BSWH Employee	Commercial	$288	percent of total billed charges
Baylor Scott & White Health Plan	BSW Plus - Large Group/BSW Premier Direct to Employer (Rate 2)	Commercial	$339	percent of total billed charges
Cigna	Local Plus	Commercial	$367	percent of total billed charges
Blue Cross Blue Shield	Blue Premier/High Performance Network/My BlueHealth	Commercial	$377	fee schedule
Blue Cross Blue Shield	Blue Advantage	Commercial	$381	fee schedule
Cigna	HMO/PPO	Commercial	$429	percent of total billed charges
Aetna	Commercial	Commercial	$435	percent of total billed charges
QuikTrip	Employee Benefit Plan	Commercial	$435	percent of total billed charges
MidCoast	Commercial	Commercial	$435	percent of total billed charges
Blue Cross Blue Shield	Blue Essentials (HMO)	Commercial	$436	fee schedule
Blue Cross Blue Shield	BlueChoice (PPO)	Commercial	$458	fee schedule
University of Mary Hardin-Baylor	Commercial	Commercial	$459	percent of total billed charges
Independent Medical System	Commercial PPO	Commercial	$475	percent of total billed charges
Curative	Commercial	Commercial	$514	percent of total billed charges
Humana	Commercial HMO	Commercial	$514	percent of total billed charges
United Healthcare	Commercial	Commercial	$547	percent of total billed charges
First Health	PPO	Commercial	$554	percent of total billed charges
HealthSmart	Accel Network	Commercial	$554	percent of total billed charges
Humana	Commercial PPO	Commercial	$554	percent of total billed charges
HealthSmart	Preferred Network	Commercial	$593	percent of total billed charges
Private Health Care System	PHCS Network	Commercial	$593	percent of total billed charges
Three Rivers	Three Rivers Provider Network	Commercial	$712	percent of total billed charges

Dell Children's Medical Center: all 56 plan rates

Payer	Plan (as written in the file)	Type	Rate	Method
CHAMPVA	1136_CHAMPVA AUSTIN 20180301	Military / VA	$24.52	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	3594_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	3693_CHIRP BLUE CROSS STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
BCBS STAR	4219_CHIRP BLUE CROSS STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	3605_DELL CHIP/STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL CHIP/CHIP PERINATE	4179_DELL CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	3704_CHIRP DELL STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
DELL STAR	4230_CHIRP DELL STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
SUPERIOR AMBETTER	3879_SUPERIOR AMBETTER (CHI,DCN) INPATIENT 20240901	Commercial	$33.08	FEE SCHEDULE
UHC STAR	3737_CHIRP UHC STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR	4253_CHIRP UHC STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4311_UHC STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR KIDS	4322_UHC STAR KIDS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	3748_CHIRP UHC STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
UHC STAR PLUS	4264_CHIRP UHC STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_AMERIGROUP CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	3671_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR	4197_CHIRP WELLPOINT/AMERIGROUP STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	3682_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$33.08	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$33.08	FEE SCHEDULE
CHAMPVA	1135_CHAMPVA REST_TX 20180301	Military / VA	$33.74	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS CHIP/CHIP PERINATE	4168_BLUE CROSS CHIP/STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
BCBS STAR KIDS	5003_BLUE CROSS STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
SUPERIOR AMBETTER	3880_SUPERIOR AMBETTER (CHI,DCN) OUTPATIENT 20240901	Commercial	$40.10	FEE SCHEDULE
WELLPOINT CHIP/CHIP PERINATE	4157_WELLPOINT/AMERIGROUP CHIP (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR KIDS	4970_WELLPOINT/AMERIGROUP STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
WELLPOINT STAR PLUS	4208_CHIRP WELLPOINT/AMERIGROUP STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$40.10	FEE SCHEDULE
HUMANA HMO	2668_HUMANA HMO 20230701	Commercial	$50.92	OTHER
TRICARE	1229_TRICARE CAH OUTPATIENT 20170101	Military / VA	$97.29	FEE SCHEDULE
BCBS BAV EXCHANGE	4127_BLUE CROSS BLUE SHIELD BAV EXCHANGE 20250101	Commercial	$112	FEE SCHEDULE
AETNA ACO HMO	4489_AETNA ACO HMO 20250801	Commercial	$144	FEE SCHEDULE
AETNA MULTI-TIER WHOLE HEALTH SHA	4490_AETNA MULTI-TIER WHOLE HEALTH SHA 20250801	Commercial	$144	FEE SCHEDULE
AETNA HMO EXCHANGE	1377_AETNA HMO EXCHANGE 20200101	Commercial	$212	FEE SCHEDULE
AETNA CHOICE	236_AETNA ELECT CHOICE 20140601	Commercial	$212	FEE SCHEDULE
AETNA POS 20140601	235_AETNA POS 20140601	Commercial	$212	FEE SCHEDULE
AETNA SHA AISD	4335_AETNA SHA AISD 20250101	Commercial	$222	OTHER
AETNA HMO	4486_AETNA HMO 20250801	Commercial	$278	OTHER
COVENANT HEALTH	4491_COVENANT MANAGEMENT SOLUTIONS-AETNA 20250801	Commercial	$278	OTHER
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 HPN	4440_BLUE CROSS BLUE SHIELD HPN 20250501	Commercial	$372	FEE SCHEDULE
BCBS HPN	4497_BLUE CROSS BLUE SHIELD HPN (DELL, WILLIAMSON,HAYS) 20250501	Commercial	$372	FEE SCHEDULE
SUPERIOR STAR	3509_CHIRP SUPERIOR STAR (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4375_CHIRP SUPERIOR STAR PLUS (CHI,DCN) INPATIENT 20240901	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR	4241_CHIRP SUPERIOR STAR (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR FOSTER	4188_SUPERIOR STAR FOSTER OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR FOSTER	4189_SUPERIOR STAR FOSTER (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR KIDS	4888_SUPERIOR STAR KIDS OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR KIDS	4889_SUPERIOR STAR KIDS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
SUPERIOR STAR PLUS	4389_CHIRP SUPERIOR STAR PLUS (CHI,DCN) OUTPATIENT 20241201	Medicaid / CHIP	$385	FEE SCHEDULE
BCBS HMO ESSENTIALS	4095_BLUE CROSS BLUE SHIELD HMO ESSENTIALS 20250101	Commercial	$411	FEE SCHEDULE
SUPERIOR CHIP/CHIP PERINATE	3619_SUPERIOR CHIP INPATIENT 20240901	Medicaid / CHIP	$433	FEE SCHEDULE
SUPERIOR CHIP/CHIP PERINATE	4190_SUPERIOR CHIP OUTPATIENT 20241201	Medicaid / CHIP	$433	FEE SCHEDULE
BCBS PPO	4094_BLUE CROSS BLUE SHIELD PPO 20250101	Commercial	$454	FEE SCHEDULE

What this price covers

These are hospital charges for CPT code 72100 (Lower back X-ray (2–3 views)). 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.

Lower back X-ray in other cities

Compare Lower back X-ray prices across all cities →

Houston, TXCash $102–$3,837 Dallas–Fort Worth, TXCash $224–$524 Phoenix, AZCash $66–$1,080

Other X-ray prices in Austin

Chest X-rayCPT 71046 Knee X-rayCPT 73562 Shoulder X-rayCPT 73030