hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|TX,"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Val Verde Regional Medical Center,2/28/2025,2.0.0,Val Verde Regional Medical Center,"801 N Bedell Ave, Del Rio, TX 78840",1891124640,TRUE,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
SERVICE DESCRIPTION,CATEGORY,BILLING MSDRG | CPT | HCPCS,ITEM/SERVICE DESCRIPTION,BILLING REVENUE CODE,GROSS CHARGES,90 DEGREES PLAN,REIMBURSEMENT METHOD,AETNA PLAN,REIMBURSEMENT METHOD,AETNA MEDICARE PLAN,REIMBURSEMENT METHOD,BCBC OF DEL RIO PLAN,REIMBURSEMENT METHOD,BCBS PLAN,REIMBURSEMENT METHOD,BCBS MEDICARE PLAN,REIMBURSEMENT METHOD,BCBS PPO PLAN,REIMBURSEMENT METHOD,BLUE ADV. HMO PLAN,REIMBURSEMENT METHOD,CIGNA PLAN,REIMBURSEMENT METHOD,FIRST CARE PLAN,REIMBURSEMENT METHOD,HUMANA PLAN,REIMBURSEMENT METHOD,HUMANA MEDICARE PLAN,REIMBURSEMENT METHOD,HUMANA MILITARY PLAN,REIMBURSEMENT METHOD,MEDICARE PLAN,REIMBURSEMENT METHOD,SAN FELIPE DEL RIO PLAN,REIMBURSEMENT METHOD,TEXAS MEDICAID PLAN,REIMBURSEMENT METHOD,TML PLAN,REIMBURSEMENT METHOD,TRICARE PLAN,REIMBURSEMENT METHOD,UHC PLAN,REIMBURSEMENT METHOD,UHC HMO PLAN,REIMBURSEMENT METHOD,UHC MEDICARE PLAN,REIMBURSEMENT METHOD,UNICARE PLAN,REIMBURSEMENT METHOD,UNICARE MEDICARE PLAN,REIMBURSEMENT METHOD,AETNA MEDICARE PLAN,REIMBURSEMENT METHOD,AMBETTER COMMERCIAL EXCHANGE PLAN,REIMBURSEMENT METHOD,AMBETTER MEDICARE PLAN,REIMBURSEMENT METHOD,AMBETTER PERINATE PLAN,REIMBURSEMENT METHOD,UHC MEDICARE PLAN,REIMBURSEMENT METHOD,UNICARE MEDICARE PLAN,REIMBURSEMENT METHOD,AMBETTER COMMERCIAL EXCHANGE PLAN,REIMBURSEMENT METHOD,AMBETTER MEDICARE PLAN,REIMBURSEMENT METHOD,AMBETTER PERINATE PLAN,REIMBURSEMENT METHOD,AMBETTER CHIP PLAN,REIMBURSEMENT METHOD,AMBETTER FOSTER CARE PLAN,REIMBURSEMENT METHOD,AMBETTER STAR PLAN,REIMBURSEMENT METHOD,AMBETTER STAR PLUS PLAN,REIMBURSEMENT METHOD,UHC CHIP PLAN,REIMBURSEMENT METHOD,UHC STAR KIDS PLAN,REIMBURSEMENT METHOD,UHC STAR PLAN,REIMBURSEMENT METHOD,UHC STAR PLUS FAN,REIMBURSEMENT METHOD,UHC TX CHIP PLAN,REIMBURSEMENT METHOD,De-Identified Minimum Negotiated Rate,De-Identified Maximum Negotiated Rate,DISCOUNTED CASH PRICE 
Inpatient Medical Services,IP MS DRG,743,Uterine and adnexa procedures for non-malignancy without comorbid conditions (CC) or major comorbid conditions or complications (MCC),100,"$13,922.78 ","$17,403.45 ",125% CMS MS-DRG rate,"$10,581.31 ",76% of total billed charges for inpatient setting,"$13,922.76 ",100% CMS MS-DRG rate,"$5,460.10 ",100% BCBSTX Medicaid DRG rate,"$5,460.10 ",100% BCBSTX Medicaid DRG rate,"$13,922.76 ",100% CMS MS-DRG rate,"$5,460.10 ",100% BCBSTX Medicaid DRG rate,"$4,852.92 ",100% BCBSTX Medicaid DRG rate,"$12,530.50 ",90% of total billed charges for inpatient setting,"$3,898.38 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$12,530.50 ",90% of total billed charges for inpatient setting,"$8,961.01 ",100% CMS MS-DRG rate,"$8,483.50 ",100% Humana Tricare DRG rate,"$13,922.76 ",100% CMS MS-DRG rate,"$9,049.81 ",65% of total billed charges for inpatient setting,"$3,759.15 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$13,226.64 ",95% of total billed charges for inpatient setting,"$3,126.36 ",100% Tricare DRG rate,"$12,252.05 ",88% of total billed charges for inpatient setting,"$12,252.05 ",88% of total billed charges for inpatient setting,"$13,922.76 ",100% CMS MS-DRG rate,"$12,530.50 ",90% of total billed charges for inpatient setting,"$13,922.76 ",100% CMS MS-DRG rate,"$13,922.76 ",100% CMS MS-DRG rate,"$13,922.76 ",100% CMS MS-DRG rate,"$13,922.76 ",100% CMS MS-DRG rate,"$13,922.76 ",100% CMS MS-DRG rate,"$13,922.76 ",100% CMS MS-DRG rate,"$13,922.76 ",100% CMS MS-DRG rate,"$13,922.76 ",100% CMS MS-DRG rate,"$13,922.76 ",100% CMS MS-DRG rate,"$13,922.76 ",100% CMS MS-DRG rate,"$3,898.38 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,898.38 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,898.38 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,898.38 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,898.38 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,898.38 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,898.38 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,898.38 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,898.38 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,126.36 ","$17,403.45 ","$9,049.81 "
Inpatient Medical Services,IP MS DRG,795,NORMAL NEWBORN,100,"$6,613.19 ","$8,266.49 ",125% CMS MS-DRG rate,"$5,026.02 ",76% of total billed charges for inpatient setting,"$6,613.19 ",100% CMS MS-DRG rate,$919.17 ,100% BCBSTX Medicaid DRG rate,$919.17 ,100% BCBSTX Medicaid DRG rate,"$6,613.19 ",100% CMS MS-DRG rate,$919.17 ,100% BCBSTX Medicaid DRG rate,$816.96 ,100% BCBSTX Medicaid DRG rate,"$5,951.87 ",90% of total billed charges for inpatient setting,"$1,851.69 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$5,951.87 ",90% of total billed charges for inpatient setting,"$1,555.45 ",100% CMS MS-DRG rate,$850.84 ,100% Humana Tricare DRG rate,"$6,613.19 ",100% CMS MS-DRG rate,"$4,298.57 ",65% of total billed charges for inpatient setting,"$1,785.56 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$6,282.53 ",95% of total billed charges for inpatient setting,"$1,930.49 ",100% Tricare DRG rate,"$5,819.61 ",88% of total billed charges for inpatient setting,"$5,819.61 ",88% of total billed charges for inpatient setting,"$6,613.19 ",100% CMS MS-DRG rate,"$5,951.87 ",90% of total billed charges for inpatient setting,"$6,613.19 ",100% CMS MS-DRG rate,"$6,613.19 ",100% CMS MS-DRG rate,"$6,613.19 ",100% CMS MS-DRG rate,"$6,613.19 ",100% CMS MS-DRG rate,"$6,613.19 ",100% CMS MS-DRG rate,"$6,613.19 ",100% CMS MS-DRG rate,"$6,613.19 ",100% CMS MS-DRG rate,"$6,613.19 ",100% CMS MS-DRG rate,"$6,613.19 ",100% CMS MS-DRG rate,"$6,613.19 ",100% CMS MS-DRG rate,"$1,851.69 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$1,851.69 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$1,851.69 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$1,851.69 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$1,851.69 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$1,851.69 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$1,851.69 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$1,851.69 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$1,851.69 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure",$816.96 ,"$8,266.49 ","$4,298.57 "
Inpatient Medical Services,IP MS DRG,807,VAGINAL DELIVERY WITHOUT STERILIZATION OR DANDC WITHOUT CC/MCC,100,"$10,058.27 ","$12,572.84 ",125% CMS MS-DRG rate,"$7,644.29 ",76% of total billed charges for inpatient setting,"$10,058.27 ",100% CMS MS-DRG rate,"$3,095.89 ",100% BCBSTX Medicaid DRG rate,"$3,095.89 ",100% BCBSTX Medicaid DRG rate,"$10,058.27 ",100% CMS MS-DRG rate,"$3,095.89 ",100% BCBSTX Medicaid DRG rate,"$2,751.61 ",100% BCBSTX Medicaid DRG rate,"$9,052.44 ",90% of total billed charges for inpatient setting,"$2,816.32 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$9,052.44 ",90% of total billed charges for inpatient setting,"$5,045.78 ",100% CMS MS-DRG rate,"$2,893.43 ",100% Humana Tricare DRG rate,"$10,058.27 ",100% CMS MS-DRG rate,"$6,537.88 ",65% of total billed charges for inpatient setting,"$2,715.73 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$9,555.36 ",95% of total billed charges for inpatient setting,"$2,936.16 ",100% Tricare DRG rate,"$8,851.28 ",88% of total billed charges for inpatient setting,"$8,851.28 ",88% of total billed charges for inpatient setting,"$10,058.27 ",100% CMS MS-DRG rate,"$9,052.44 ",90% of total billed charges for inpatient setting,"$10,058.27 ",100% CMS MS-DRG rate,"$10,058.27 ",100% CMS MS-DRG rate,"$10,058.27 ",100% CMS MS-DRG rate,"$10,058.27 ",100% CMS MS-DRG rate,"$10,058.27 ",100% CMS MS-DRG rate,"$10,058.27 ",100% CMS MS-DRG rate,"$10,058.27 ",100% CMS MS-DRG rate,"$10,058.27 ",100% CMS MS-DRG rate,"$10,058.27 ",100% CMS MS-DRG rate,"$10,058.27 ",100% CMS MS-DRG rate,"$2,816.32 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$2,816.32 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$2,816.32 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$2,816.32 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$2,816.32 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$2,816.32 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$2,816.32 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$2,816.32 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$2,816.32 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$2,715.73 ","$12,572.84 ","$6,537.88 "
Inpatient Medical Services,IP MS DRG,788,CESAREAN SECTION WITHOUT STERILIZATION WITHOU CC/MCC,100,"$11,585.95 ","$14,482.43 ",125% CMS MS-DRG rate,"$8,805.32 ",76% of total billed charges for inpatient setting,"$11,585.94 ",100% CMS MS-DRG rate,"$4,277.27 ",100% BCBSTX Medicaid DRG rate,"$4,277.27 ",100% BCBSTX Medicaid DRG rate,"$11,585.94 ",100% CMS MS-DRG rate,"$4,277.27 ",100% BCBSTX Medicaid DRG rate,"$3,801.62 ",100% BCBSTX Medicaid DRG rate,"$10,427.36 ",90% of total billed charges for inpatient setting,"$3,244.07 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$10,427.36 ",90% of total billed charges for inpatient setting,"$6,593.52 ",100% CMS MS-DRG rate,"$6,237.91 ",100% Humana Tricare DRG rate,"$11,585.94 ",100% CMS MS-DRG rate,"$7,530.87 ",65% of total billed charges for inpatient setting,"$3,128.21 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$11,006.65 ",95% of total billed charges for inpatient setting,"$3,382.11 ",100% Tricare DRG rate,"$10,195.64 ",88% of total billed charges for inpatient setting,"$10,195.64 ",88% of total billed charges for inpatient setting,"$11,585.94 ",100% CMS MS-DRG rate,"$10,427.36 ",90% of total billed charges for inpatient setting,"$11,585.94 ",100% CMS MS-DRG rate,"$11,585.94 ",100% CMS MS-DRG rate,"$11,585.94 ",100% CMS MS-DRG rate,"$11,585.94 ",100% CMS MS-DRG rate,"$11,585.94 ",100% CMS MS-DRG rate,"$11,585.94 ",100% CMS MS-DRG rate,"$11,585.94 ",100% CMS MS-DRG rate,"$11,585.94 ",100% CMS MS-DRG rate,"$11,585.94 ",100% CMS MS-DRG rate,"$11,585.94 ",100% CMS MS-DRG rate,"$3,244.07 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,244.07 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,244.07 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,244.07 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,244.07 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,244.07 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,244.07 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,244.07 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,244.07 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$3,128.21 ","$14,482.43 ","$7,530.87 "
Inpatient Medical Services,IP MS DRG,871,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV>96 HOURS WITHOUT MCC,100,"$20,168.95 ","$25,551.55 ",125% CMS MS-DRG rate,"$15,328.40 ",76% of total billed charges for inpatient setting,"$20,441.24 ",100% CMS MS-DRG rate,"$9,024.00 ",100% BCBSTX Medicaid DRG rate,"$9,024.00 ",100% BCBSTX Medicaid DRG rate,"$20,441.24 ",100% CMS MS-DRG rate,"$9,024.00 ",100% BCBSTX Medicaid DRG rate,"$8,020.50 ",100% BCBSTX Medicaid DRG rate,"$18,152.06 ",90% of total billed charges for inpatient setting,"$5,647.31 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$18,152.06 ",90% of total billed charges for inpatient setting,"$15,289.26 ",100% CMS MS-DRG rate,"$12,531.94 ",100% Humana Tricare DRG rate,"$20,441.24 ",100% CMS MS-DRG rate,"$13,109.82 ",65% of total billed charges for inpatient setting,"$5,445.62 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$19,160.50 ",95% of total billed charges for inpatient setting,"$4,528.94 ",100% Tricare DRG rate,"$17,748.68 ",88% of total billed charges for inpatient setting,"$17,748.68 ",88% of total billed charges for inpatient setting,"$20,441.24 ",100% CMS MS-DRG rate,"$18,152.06 ",90% of total billed charges for inpatient setting,"$20,441.24 ",100% CMS MS-DRG rate,"$20,441.24 ",100% CMS MS-DRG rate,"$20,441.24 ",100% CMS MS-DRG rate,"$20,441.24 ",100% CMS MS-DRG rate,"$20,441.24 ",100% CMS MS-DRG rate,"$20,441.24 ",100% CMS MS-DRG rate,"$20,441.24 ",100% CMS MS-DRG rate,"$20,441.24 ",100% CMS MS-DRG rate,"$20,441.24 ",100% CMS MS-DRG rate,"$20,441.24 ",100% CMS MS-DRG rate,"$5,647.31 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$5,647.31 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$5,647.31 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$5,647.31 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$5,647.31 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$5,647.31 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$5,647.31 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$5,647.31 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$5,647.31 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$4,528.94 ","$25,551.55 ","$13,109.82 "
Inpatient Medical Services,IP MS DRG,794,NEONATE WITH OTHER SIGNIFICANT PROBLEMS,100,"$16,418.66 ","$20,523.31 ",125% CMS MS-DRG rate,"$12,478.18 ",76% of total billed charges for inpatient setting,"$16,418.65 ",100% CMS MS-DRG rate,"$6,788.49 ",100% BCBSTX Medicaid DRG rate,"$6,788.49 ",100% BCBSTX Medicaid DRG rate,"$16,418.65 ",100% CMS MS-DRG rate,"$6,788.49 ",100% BCBSTX Medicaid DRG rate,"$6,033.59 ",100% BCBSTX Medicaid DRG rate,"$14,776.79 ",90% of total billed charges for inpatient setting,"$4,597.22 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$14,776.79 ",90% of total billed charges for inpatient setting,"$11,489.69 ",100% CMS MS-DRG rate,"$29,036.10 ",100% Humana Tricare DRG rate,"$16,418.65 ",100% CMS MS-DRG rate,"$10,672.13 ",65% of total billed charges for inpatient setting,"$4,433.04 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$15,597.73 ",95% of total billed charges for inpatient setting,"$4,792.85 ",100% Tricare DRG rate,"$14,448.42 ",88% of total billed charges for inpatient setting,"$14,448.42 ",88% of total billed charges for inpatient setting,"$16,418.65 ",100% CMS MS-DRG rate,"$14,776.79 ",90% of total billed charges for inpatient setting,"$16,418.65 ",100% CMS MS-DRG rate,"$16,418.65 ",100% CMS MS-DRG rate,"$16,418.65 ",100% CMS MS-DRG rate,"$16,418.65 ",100% CMS MS-DRG rate,"$16,418.65 ",100% CMS MS-DRG rate,"$16,418.65 ",100% CMS MS-DRG rate,"$16,418.65 ",100% CMS MS-DRG rate,"$16,418.65 ",100% CMS MS-DRG rate,"$16,418.65 ",100% CMS MS-DRG rate,"$16,418.65 ",100% CMS MS-DRG rate,"$4,597.22 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$4,597.22 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$4,597.22 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$4,597.22 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$4,597.22 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$4,597.22 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$4,597.22 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$4,597.22 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$4,597.22 ","28% of total billed charges for inpatient setting, which is 100% of the Medicaid inpatient CCR rate. This could also pay at TX Medicaid APR-DRG depending on the procedure","$4,433.04 ","$29,036.10 ","$10,672.13 "
Outpatient Medical Services,LAB,87635,SARS-COV-2 COVID 19 LAB,309,$497.50 ,$64.13 ,125% CMS Medicare OPPS fee schedule,$378.10 ,76%  of total billed charges for outpatient setting,$51.31 ,100% CMS Medicare OPPS fee schedule,$205.32 ,400% of BCBSTX fee schedule,$205.32 ,400% of BCBSTX fee schedule,$51.31 ,100% CMS Medicare OPPS fee schedule,$205.32 ,400% of BCBSTX fee schedule,$51.33 ,100% of BCBSTX fee schedule,$447.75 ,90% of total billed charges for oupatient setting,$223.88 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$447.75 ,90% of total billed charges for oupatient setting,$51.31 ,100% CMS Medicare OPPS fee schedule,$51.31 ,100% CMS Medicare OPPS fee schedule,$51.31 ,100% CMS Medicare OPPS fee schedule,$33.35 ,65% CMS Medicare OPPS fee schedule,$219.40 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$472.63 ,95% of total billed charges for outpatient setting,$38.48 ,75% CMS Medicare OPPS fee schedule,$437.80 ,88% of total billed charges for outpatient setting,$437.80 ,88% of total billed charges for outpatient setting,$51.31 ,100% CMS Medicare OPPS fee schedule,$46.17 ,90% CMS Medicare OPPS fee schedule,$51.31 ,100% CMS Medicare OPPS fee schedule,$51.31 ,100% CMS Medicare OPPS fee schedule,$51.31 ,100% CMS Medicare OPPS fee schedule,$51.31 ,100% CMS Medicare OPPS fee schedule,$51.31 ,100% CMS Medicare OPPS fee schedule,$51.31 ,100% CMS Medicare OPPS fee schedule,$51.31 ,100% CMS Medicare OPPS fee schedule,$51.31 ,100% CMS Medicare OPPS fee schedule,$51.31 ,100% CMS Medicare OPPS fee schedule,$51.31 ,100% CMS Medicare OPPS fee schedule,$223.88 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$223.88 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$223.88 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$223.88 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$223.88 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$223.88 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$223.88 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$223.88 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$223.88 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$33.35 ,$472.63 ,$323.38 
Outpatient Medical Services,LAB,83520,TRYPTASE,309,$577.71 ,$21.58 ,125% CMS Medicare OPPS fee schedule,$439.06 ,76%  of total billed charges for outpatient setting,$17.27 ,100% CMS Medicare OPPS fee schedule,$69.08 ,400% of BCBSTX fee schedule,$69.08 ,400% of BCBSTX fee schedule,$17.27 ,100% CMS Medicare OPPS fee schedule,$69.08 ,400% of BCBSTX fee schedule,$17.27 ,100% of BCBSTX fee schedule,$519.94 ,90% of total billed charges for oupatient setting,$14.51 ,100% of TX Medicaid OPPS fee schedule,$519.94 ,90% of total billed charges for oupatient setting,$17.27 ,100% CMS Medicare OPPS fee schedule,$17.27 ,100% CMS Medicare OPPS fee schedule,$17.27 ,100% CMS Medicare OPPS fee schedule,$11.23 ,65% CMS Medicare OPPS fee schedule,$14.22 ,98% of TX Medicaid OPPS fee schedule,$548.82 ,95% of total billed charges for outpatient setting,$12.95 ,75% CMS Medicare OPPS fee schedule,$508.38 ,88% of total billed charges for outpatient setting,$508.38 ,88% of total billed charges for outpatient setting,$17.27 ,100% CMS Medicare OPPS fee schedule,$15.54 ,90% CMS Medicare OPPS fee schedule,$17.27 ,100% CMS Medicare OPPS fee schedule,$17.27 ,100% CMS Medicare OPPS fee schedule,$17.27 ,100% CMS Medicare OPPS fee schedule,$17.27 ,100% CMS Medicare OPPS fee schedule,$17.27 ,100% CMS Medicare OPPS fee schedule,$17.27 ,100% CMS Medicare OPPS fee schedule,$17.27 ,100% CMS Medicare OPPS fee schedule,$17.27 ,100% CMS Medicare OPPS fee schedule,$17.27 ,100% CMS Medicare OPPS fee schedule,$17.27 ,100% CMS Medicare OPPS fee schedule,$14.51 ,100% of TX Medicaid OPPS fee schedule,$14.51 ,100% of TX Medicaid OPPS fee schedule,$14.51 ,100% of TX Medicaid OPPS fee schedule,$14.51 ,100% of TX Medicaid OPPS fee schedule,$14.51 ,100% of TX Medicaid OPPS fee schedule,$14.51 ,100% of TX Medicaid OPPS fee schedule,$14.51 ,100% of TX Medicaid OPPS fee schedule,$14.51 ,100% of TX Medicaid OPPS fee schedule,$14.51 ,100% of TX Medicaid OPPS fee schedule,$11.23 ,$548.82 ,$375.51 
Outpatient Medical Services,LAB,81001,URINALYSIS,307,$76.07 ,$3.96 ,125% CMS Medicare OPPS fee schedule,$57.81 ,76%  of total billed charges for outpatient setting,$3.17 ,100% CMS Medicare OPPS fee schedule,$15.68 ,400% of BCBSTX fee schedule,$15.68 ,400% of BCBSTX fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$15.68 ,400% of BCBSTX fee schedule,$3.92 ,100% of BCBSTX fee schedule,$68.46 ,90% of total billed charges for oupatient setting,$2.66 ,100% of TX Medicaid OPPS fee schedule,$68.46 ,90% of total billed charges for oupatient setting,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$2.06 ,65% CMS Medicare OPPS fee schedule,$2.61 ,98% of TX Medicaid OPPS fee schedule,$72.27 ,95% of total billed charges for outpatient setting,$2.37 ,75% CMS Medicare OPPS fee schedule,$66.94 ,88% of total billed charges for outpatient setting,$66.94 ,88% of total billed charges for outpatient setting,$3.17 ,100% CMS Medicare OPPS fee schedule,$2.85 ,90% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.06 ,$72.27 ,$49.45 
Outpatient Medical Services,LAB,87880,STREP SCREEN A SWAB,306,$170.00 ,$20.66 ,125% CMS Medicare OPPS fee schedule,$129.20 ,76%  of total billed charges for outpatient setting,$16.53 ,100% CMS Medicare OPPS fee schedule,$66.12 ,400% of BCBSTX fee schedule,$66.12 ,400% of BCBSTX fee schedule,$16.53 ,100% CMS Medicare OPPS fee schedule,$66.12 ,400% of BCBSTX fee schedule,$16.53 ,100% of BCBSTX fee schedule,$153.00 ,90% of total billed charges for oupatient setting,$13.89 ,100% of TX Medicaid OPPS fee schedule,$153.00 ,90% of total billed charges for oupatient setting,$16.53 ,100% CMS Medicare OPPS fee schedule,$16.53 ,100% CMS Medicare OPPS fee schedule,$16.53 ,100% CMS Medicare OPPS fee schedule,$10.74 ,65% CMS Medicare OPPS fee schedule,$13.61 ,98% of TX Medicaid OPPS fee schedule,$161.50 ,95% of total billed charges for outpatient setting,$12.39 ,75% CMS Medicare OPPS fee schedule,$149.60 ,88% of total billed charges for outpatient setting,$149.60 ,88% of total billed charges for outpatient setting,$16.53 ,100% CMS Medicare OPPS fee schedule,$14.87 ,90% CMS Medicare OPPS fee schedule,$16.53 ,100% CMS Medicare OPPS fee schedule,$16.53 ,100% CMS Medicare OPPS fee schedule,$16.53 ,100% CMS Medicare OPPS fee schedule,$16.53 ,100% CMS Medicare OPPS fee schedule,$16.53 ,100% CMS Medicare OPPS fee schedule,$16.53 ,100% CMS Medicare OPPS fee schedule,$16.53 ,100% CMS Medicare OPPS fee schedule,$16.53 ,100% CMS Medicare OPPS fee schedule,$16.53 ,100% CMS Medicare OPPS fee schedule,$16.53 ,100% CMS Medicare OPPS fee schedule,$13.89 ,100% of TX Medicaid OPPS fee schedule,$13.89 ,100% of TX Medicaid OPPS fee schedule,$13.89 ,100% of TX Medicaid OPPS fee schedule,$13.89 ,100% of TX Medicaid OPPS fee schedule,$13.89 ,100% of TX Medicaid OPPS fee schedule,$13.89 ,100% of TX Medicaid OPPS fee schedule,$13.89 ,100% of TX Medicaid OPPS fee schedule,$13.89 ,100% of TX Medicaid OPPS fee schedule,$13.89 ,100% of TX Medicaid OPPS fee schedule,$10.74 ,$161.50 ,$110.50 
Outpatient Medical Services,LAB,87804,INFLUENZA A&B ANTIGE,306,$93.71 ,$20.68 ,125% CMS Medicare OPPS fee schedule,$71.22 ,76%  of total billed charges for outpatient setting,$16.55 ,100% CMS Medicare OPPS fee schedule,$66.20 ,400% of BCBSTX fee schedule,$66.20 ,400% of BCBSTX fee schedule,$16.55 ,100% CMS Medicare OPPS fee schedule,$66.20 ,400% of BCBSTX fee schedule,$16.55 ,100% of BCBSTX fee schedule,$84.34 ,90% of total billed charges for oupatient setting,$13.90 ,100% of TX Medicaid OPPS fee schedule,$84.34 ,90% of total billed charges for oupatient setting,$16.55 ,100% CMS Medicare OPPS fee schedule,$16.55 ,100% CMS Medicare OPPS fee schedule,$16.55 ,100% CMS Medicare OPPS fee schedule,$10.76 ,65% CMS Medicare OPPS fee schedule,$13.62 ,98% of TX Medicaid OPPS fee schedule,$89.02 ,95% of total billed charges for outpatient setting,$12.41 ,75% CMS Medicare OPPS fee schedule,$82.46 ,88% of total billed charges for outpatient setting,$82.46 ,88% of total billed charges for outpatient setting,$16.55 ,100% CMS Medicare OPPS fee schedule,$14.89 ,90% CMS Medicare OPPS fee schedule,$16.55 ,100% CMS Medicare OPPS fee schedule,$16.55 ,100% CMS Medicare OPPS fee schedule,$16.55 ,100% CMS Medicare OPPS fee schedule,$16.55 ,100% CMS Medicare OPPS fee schedule,$16.55 ,100% CMS Medicare OPPS fee schedule,$16.55 ,100% CMS Medicare OPPS fee schedule,$16.55 ,100% CMS Medicare OPPS fee schedule,$16.55 ,100% CMS Medicare OPPS fee schedule,$16.55 ,100% CMS Medicare OPPS fee schedule,$16.55 ,100% CMS Medicare OPPS fee schedule,$13.90 ,100% of TX Medicaid OPPS fee schedule,$13.90 ,100% of TX Medicaid OPPS fee schedule,$13.90 ,100% of TX Medicaid OPPS fee schedule,$13.90 ,100% of TX Medicaid OPPS fee schedule,$13.90 ,100% of TX Medicaid OPPS fee schedule,$13.90 ,100% of TX Medicaid OPPS fee schedule,$13.90 ,100% of TX Medicaid OPPS fee schedule,$13.90 ,100% of TX Medicaid OPPS fee schedule,$13.90 ,100% of TX Medicaid OPPS fee schedule,$10.76 ,$89.02 ,$60.91 
Outpatient Medical Services,LAB,87280,RSV ANTIGEN TEST,306,$123.48 ,$16.77 ,125% CMS Medicare OPPS fee schedule,$93.84 ,76%  of total billed charges for outpatient setting,$13.42 ,100% CMS Medicare OPPS fee schedule,$59.20 ,400% of BCBSTX fee schedule,$59.20 ,400% of BCBSTX fee schedule,$13.42 ,100% CMS Medicare OPPS fee schedule,$59.20 ,400% of BCBSTX fee schedule,$14.80 ,100% of BCBSTX fee schedule,$111.13 ,90% of total billed charges for oupatient setting,$11.27 ,100% of TX Medicaid OPPS fee schedule,$111.13 ,90% of total billed charges for oupatient setting,$13.42 ,100% CMS Medicare OPPS fee schedule,$13.42 ,100% CMS Medicare OPPS fee schedule,$13.42 ,100% CMS Medicare OPPS fee schedule,$8.72 ,65% CMS Medicare OPPS fee schedule,$11.04 ,98% of TX Medicaid OPPS fee schedule,$117.31 ,95% of total billed charges for outpatient setting,$10.06 ,75% CMS Medicare OPPS fee schedule,$108.66 ,88% of total billed charges for outpatient setting,$108.66 ,88% of total billed charges for outpatient setting,$13.42 ,100% CMS Medicare OPPS fee schedule,$12.07 ,90% CMS Medicare OPPS fee schedule,$13.42 ,100% CMS Medicare OPPS fee schedule,$13.42 ,100% CMS Medicare OPPS fee schedule,$13.42 ,100% CMS Medicare OPPS fee schedule,$13.42 ,100% CMS Medicare OPPS fee schedule,$13.42 ,100% CMS Medicare OPPS fee schedule,$13.42 ,100% CMS Medicare OPPS fee schedule,$13.42 ,100% CMS Medicare OPPS fee schedule,$13.42 ,100% CMS Medicare OPPS fee schedule,$13.42 ,100% CMS Medicare OPPS fee schedule,$13.42 ,100% CMS Medicare OPPS fee schedule,$11.27 ,100% of TX Medicaid OPPS fee schedule,$11.27 ,100% of TX Medicaid OPPS fee schedule,$11.27 ,100% of TX Medicaid OPPS fee schedule,$11.27 ,100% of TX Medicaid OPPS fee schedule,$11.27 ,100% of TX Medicaid OPPS fee schedule,$11.27 ,100% of TX Medicaid OPPS fee schedule,$11.27 ,100% of TX Medicaid OPPS fee schedule,$11.27 ,100% of TX Medicaid OPPS fee schedule,$11.27 ,100% of TX Medicaid OPPS fee schedule,$8.72 ,$117.31 ,$80.26 
Outpatient Medical Services,LAB,87186,SENSITIVITY/ORGANISM,306,$240.61 ,$10.81 ,125% CMS Medicare OPPS fee schedule,$182.86 ,76%  of total billed charges for outpatient setting,$8.65 ,100% CMS Medicare OPPS fee schedule,$42.68 ,400% of BCBSTX fee schedule,$42.68 ,400% of BCBSTX fee schedule,$8.65 ,100% CMS Medicare OPPS fee schedule,$42.68 ,400% of BCBSTX fee schedule,$10.67 ,100% of BCBSTX fee schedule,$216.55 ,90% of total billed charges for oupatient setting,$7.27 ,100% of TX Medicaid OPPS fee schedule,$216.55 ,90% of total billed charges for oupatient setting,$8.65 ,100% CMS Medicare OPPS fee schedule,$8.65 ,100% CMS Medicare OPPS fee schedule,$8.65 ,100% CMS Medicare OPPS fee schedule,$5.62 ,65% CMS Medicare OPPS fee schedule,$7.12 ,98% of TX Medicaid OPPS fee schedule,$228.58 ,95% of total billed charges for outpatient setting,$6.48 ,75% CMS Medicare OPPS fee schedule,$211.74 ,88% of total billed charges for outpatient setting,$211.74 ,88% of total billed charges for outpatient setting,$8.65 ,100% CMS Medicare OPPS fee schedule,$7.78 ,90% CMS Medicare OPPS fee schedule,$8.65 ,100% CMS Medicare OPPS fee schedule,$8.65 ,100% CMS Medicare OPPS fee schedule,$8.65 ,100% CMS Medicare OPPS fee schedule,$8.65 ,100% CMS Medicare OPPS fee schedule,$8.65 ,100% CMS Medicare OPPS fee schedule,$8.65 ,100% CMS Medicare OPPS fee schedule,$8.65 ,100% CMS Medicare OPPS fee schedule,$8.65 ,100% CMS Medicare OPPS fee schedule,$8.65 ,100% CMS Medicare OPPS fee schedule,$8.65 ,100% CMS Medicare OPPS fee schedule,$7.27 ,100% of TX Medicaid OPPS fee schedule,$7.27 ,100% of TX Medicaid OPPS fee schedule,$7.27 ,100% of TX Medicaid OPPS fee schedule,$7.27 ,100% of TX Medicaid OPPS fee schedule,$7.27 ,100% of TX Medicaid OPPS fee schedule,$7.27 ,100% of TX Medicaid OPPS fee schedule,$7.27 ,100% of TX Medicaid OPPS fee schedule,$7.27 ,100% of TX Medicaid OPPS fee schedule,$7.27 ,100% of TX Medicaid OPPS fee schedule,$5.62 ,$228.58 ,$156.40 
Outpatient Medical Services,LAB,87088,CULTURE URINE,306,$111.35 ,$10.11 ,125% CMS Medicare OPPS fee schedule,$84.63 ,76%  of total billed charges for outpatient setting,$8.09 ,100% CMS Medicare OPPS fee schedule,$39.96 ,400% of BCBSTX fee schedule,$39.96 ,400% of BCBSTX fee schedule,$8.09 ,100% CMS Medicare OPPS fee schedule,$39.96 ,400% of BCBSTX fee schedule,$9.99 ,100% of BCBSTX fee schedule,$100.22 ,90% of total billed charges for oupatient setting,$6.80 ,100% of TX Medicaid OPPS fee schedule,$100.22 ,90% of total billed charges for oupatient setting,$8.09 ,100% CMS Medicare OPPS fee schedule,$8.09 ,100% CMS Medicare OPPS fee schedule,$8.09 ,100% CMS Medicare OPPS fee schedule,$5.26 ,65% CMS Medicare OPPS fee schedule,$6.66 ,98% of TX Medicaid OPPS fee schedule,$105.78 ,95% of total billed charges for outpatient setting,$6.06 ,75% CMS Medicare OPPS fee schedule,$97.99 ,88% of total billed charges for outpatient setting,$97.99 ,88% of total billed charges for outpatient setting,$8.09 ,100% CMS Medicare OPPS fee schedule,$7.28 ,90% CMS Medicare OPPS fee schedule,$8.09 ,100% CMS Medicare OPPS fee schedule,$8.09 ,100% CMS Medicare OPPS fee schedule,$8.09 ,100% CMS Medicare OPPS fee schedule,$8.09 ,100% CMS Medicare OPPS fee schedule,$8.09 ,100% CMS Medicare OPPS fee schedule,$8.09 ,100% CMS Medicare OPPS fee schedule,$8.09 ,100% CMS Medicare OPPS fee schedule,$8.09 ,100% CMS Medicare OPPS fee schedule,$8.09 ,100% CMS Medicare OPPS fee schedule,$8.09 ,100% CMS Medicare OPPS fee schedule,$6.80 ,100% of TX Medicaid OPPS fee schedule,$6.80 ,100% of TX Medicaid OPPS fee schedule,$6.80 ,100% of TX Medicaid OPPS fee schedule,$6.80 ,100% of TX Medicaid OPPS fee schedule,$6.80 ,100% of TX Medicaid OPPS fee schedule,$6.80 ,100% of TX Medicaid OPPS fee schedule,$6.80 ,100% of TX Medicaid OPPS fee schedule,$6.80 ,100% of TX Medicaid OPPS fee schedule,$6.80 ,100% of TX Medicaid OPPS fee schedule,$5.26 ,$105.78 ,$72.38 
Outpatient Medical Services,LAB,87073,CULTURE ANAROBIC W/,306,$137.81 ,$12.07 ,125% CMS Medicare OPPS fee schedule,$104.74 ,76%  of total billed charges for outpatient setting,$9.66 ,100% CMS Medicare OPPS fee schedule,$46.64 ,400% of BCBSTX fee schedule,$46.64 ,400% of BCBSTX fee schedule,$9.66 ,100% CMS Medicare OPPS fee schedule,$46.64 ,400% of BCBSTX fee schedule,$11.66 ,100% of BCBSTX fee schedule,$124.03 ,90% of total billed charges for oupatient setting,$8.11 ,100% of TX Medicaid OPPS fee schedule,$124.03 ,90% of total billed charges for oupatient setting,$9.66 ,100% CMS Medicare OPPS fee schedule,$9.66 ,100% CMS Medicare OPPS fee schedule,$9.66 ,100% CMS Medicare OPPS fee schedule,$6.28 ,65% CMS Medicare OPPS fee schedule,$7.95 ,98% of TX Medicaid OPPS fee schedule,$130.92 ,95% of total billed charges for outpatient setting,$7.24 ,75% CMS Medicare OPPS fee schedule,$121.27 ,88% of total billed charges for outpatient setting,$121.27 ,88% of total billed charges for outpatient setting,$9.66 ,100% CMS Medicare OPPS fee schedule,$8.69 ,90% CMS Medicare OPPS fee schedule,$9.66 ,100% CMS Medicare OPPS fee schedule,$9.66 ,100% CMS Medicare OPPS fee schedule,$9.66 ,100% CMS Medicare OPPS fee schedule,$9.66 ,100% CMS Medicare OPPS fee schedule,$9.66 ,100% CMS Medicare OPPS fee schedule,$9.66 ,100% CMS Medicare OPPS fee schedule,$9.66 ,100% CMS Medicare OPPS fee schedule,$9.66 ,100% CMS Medicare OPPS fee schedule,$9.66 ,100% CMS Medicare OPPS fee schedule,$9.66 ,100% CMS Medicare OPPS fee schedule,$8.11 ,100% of TX Medicaid OPPS fee schedule,$8.11 ,100% of TX Medicaid OPPS fee schedule,$8.11 ,100% of TX Medicaid OPPS fee schedule,$8.11 ,100% of TX Medicaid OPPS fee schedule,$8.11 ,100% of TX Medicaid OPPS fee schedule,$8.11 ,100% of TX Medicaid OPPS fee schedule,$8.11 ,100% of TX Medicaid OPPS fee schedule,$8.11 ,100% of TX Medicaid OPPS fee schedule,$8.11 ,100% of TX Medicaid OPPS fee schedule,$6.28 ,$130.92 ,$89.58 
Outpatient Medical Services,LAB,87071,MRSA SCREEN,306,$109.15 ,$12.36 ,125% CMS Medicare OPPS fee schedule,$82.95 ,76%  of total billed charges for outpatient setting,$9.89 ,100% CMS Medicare OPPS fee schedule,$46.64 ,400% of BCBSTX fee schedule,$46.64 ,400% of BCBSTX fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$46.64 ,400% of BCBSTX fee schedule,$11.66 ,100% of BCBSTX fee schedule,$98.24 ,90% of total billed charges for oupatient setting,$8.31 ,100% of TX Medicaid OPPS fee schedule,$98.24 ,90% of total billed charges for oupatient setting,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$6.43 ,65% CMS Medicare OPPS fee schedule,$8.14 ,98% of TX Medicaid OPPS fee schedule,$103.69 ,95% of total billed charges for outpatient setting,$7.41 ,75% CMS Medicare OPPS fee schedule,$96.05 ,88% of total billed charges for outpatient setting,$96.05 ,88% of total billed charges for outpatient setting,$9.89 ,100% CMS Medicare OPPS fee schedule,$8.90 ,90% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$6.43 ,$103.69 ,$70.95 
Outpatient Medical Services,LAB,87071,CULTURE AEROBIC,306,$109.15 ,$12.36 ,125% CMS Medicare OPPS fee schedule,$82.95 ,76%  of total billed charges for outpatient setting,$9.89 ,100% CMS Medicare OPPS fee schedule,$46.64 ,400% of BCBSTX fee schedule,$46.64 ,400% of BCBSTX fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$46.64 ,400% of BCBSTX fee schedule,$11.66 ,100% of BCBSTX fee schedule,$98.24 ,90% of total billed charges for oupatient setting,$8.31 ,100% of TX Medicaid OPPS fee schedule,$98.24 ,90% of total billed charges for oupatient setting,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$6.43 ,65% CMS Medicare OPPS fee schedule,$8.14 ,98% of TX Medicaid OPPS fee schedule,$103.69 ,95% of total billed charges for outpatient setting,$7.41 ,75% CMS Medicare OPPS fee schedule,$96.05 ,88% of total billed charges for outpatient setting,$96.05 ,88% of total billed charges for outpatient setting,$9.89 ,100% CMS Medicare OPPS fee schedule,$8.90 ,90% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$9.89 ,100% CMS Medicare OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$8.31 ,100% of TX Medicaid OPPS fee schedule,$6.43 ,$103.69 ,$70.95 
Outpatient Medical Services,LAB,87040,BLOOD CULTURE,306,$245.77 ,$12.90 ,125% CMS Medicare OPPS fee schedule,$186.79 ,76%  of total billed charges for outpatient setting,$10.32 ,100% CMS Medicare OPPS fee schedule,$50.96 ,400% of BCBSTX fee schedule,$50.96 ,400% of BCBSTX fee schedule,$10.32 ,100% CMS Medicare OPPS fee schedule,$50.96 ,400% of BCBSTX fee schedule,$12.74 ,100% of BCBSTX fee schedule,$221.19 ,90% of total billed charges for oupatient setting,$8.67 ,100% of TX Medicaid OPPS fee schedule,$221.19 ,90% of total billed charges for oupatient setting,$10.32 ,100% CMS Medicare OPPS fee schedule,$10.32 ,100% CMS Medicare OPPS fee schedule,$10.32 ,100% CMS Medicare OPPS fee schedule,$6.71 ,65% CMS Medicare OPPS fee schedule,$8.50 ,98% of TX Medicaid OPPS fee schedule,$233.48 ,95% of total billed charges for outpatient setting,$7.74 ,75% CMS Medicare OPPS fee schedule,$216.28 ,88% of total billed charges for outpatient setting,$216.28 ,88% of total billed charges for outpatient setting,$10.32 ,100% CMS Medicare OPPS fee schedule,$9.28 ,90% CMS Medicare OPPS fee schedule,$10.32 ,100% CMS Medicare OPPS fee schedule,$10.32 ,100% CMS Medicare OPPS fee schedule,$10.32 ,100% CMS Medicare OPPS fee schedule,$10.32 ,100% CMS Medicare OPPS fee schedule,$10.32 ,100% CMS Medicare OPPS fee schedule,$10.32 ,100% CMS Medicare OPPS fee schedule,$10.32 ,100% CMS Medicare OPPS fee schedule,$10.32 ,100% CMS Medicare OPPS fee schedule,$10.32 ,100% CMS Medicare OPPS fee schedule,$10.32 ,100% CMS Medicare OPPS fee schedule,$8.67 ,100% of TX Medicaid OPPS fee schedule,$8.67 ,100% of TX Medicaid OPPS fee schedule,$8.67 ,100% of TX Medicaid OPPS fee schedule,$8.67 ,100% of TX Medicaid OPPS fee schedule,$8.67 ,100% of TX Medicaid OPPS fee schedule,$8.67 ,100% of TX Medicaid OPPS fee schedule,$8.67 ,100% of TX Medicaid OPPS fee schedule,$8.67 ,100% of TX Medicaid OPPS fee schedule,$8.67 ,100% of TX Medicaid OPPS fee schedule,$6.71 ,$233.48 ,$159.75 
Outpatient Medical Services,LAB,85730,PTT,305,$73.87 ,$7.51 ,125% CMS Medicare OPPS fee schedule,$56.14 ,76%  of total billed charges for outpatient setting,$6.01 ,100% CMS Medicare OPPS fee schedule,$29.68 ,400% of BCBSTX fee schedule,$29.68 ,400% of BCBSTX fee schedule,$6.01 ,100% CMS Medicare OPPS fee schedule,$29.68 ,400% of BCBSTX fee schedule,$7.42 ,100% of BCBSTX fee schedule,$66.48 ,90% of total billed charges for oupatient setting,$5.05 ,100% of TX Medicaid OPPS fee schedule,$66.48 ,90% of total billed charges for oupatient setting,$6.01 ,100% CMS Medicare OPPS fee schedule,$6.01 ,100% CMS Medicare OPPS fee schedule,$6.01 ,100% CMS Medicare OPPS fee schedule,$3.91 ,65% CMS Medicare OPPS fee schedule,$4.95 ,98% of TX Medicaid OPPS fee schedule,$70.18 ,95% of total billed charges for outpatient setting,$4.50 ,75% CMS Medicare OPPS fee schedule,$65.01 ,88% of total billed charges for outpatient setting,$65.01 ,88% of total billed charges for outpatient setting,$6.01 ,100% CMS Medicare OPPS fee schedule,$5.40 ,90% CMS Medicare OPPS fee schedule,$6.01 ,100% CMS Medicare OPPS fee schedule,$6.01 ,100% CMS Medicare OPPS fee schedule,$6.01 ,100% CMS Medicare OPPS fee schedule,$6.01 ,100% CMS Medicare OPPS fee schedule,$6.01 ,100% CMS Medicare OPPS fee schedule,$6.01 ,100% CMS Medicare OPPS fee schedule,$6.01 ,100% CMS Medicare OPPS fee schedule,$6.01 ,100% CMS Medicare OPPS fee schedule,$6.01 ,100% CMS Medicare OPPS fee schedule,$6.01 ,100% CMS Medicare OPPS fee schedule,$5.05 ,100% of TX Medicaid OPPS fee schedule,$5.05 ,100% of TX Medicaid OPPS fee schedule,$5.05 ,100% of TX Medicaid OPPS fee schedule,$5.05 ,100% of TX Medicaid OPPS fee schedule,$5.05 ,100% of TX Medicaid OPPS fee schedule,$5.05 ,100% of TX Medicaid OPPS fee schedule,$5.05 ,100% of TX Medicaid OPPS fee schedule,$5.05 ,100% of TX Medicaid OPPS fee schedule,$5.05 ,100% of TX Medicaid OPPS fee schedule,$3.91 ,$70.18 ,$48.02 
Outpatient Medical Services,LAB,85660,SICKLE CELL STUDY,305,$17.64 ,$6.88 ,125% CMS Medicare OPPS fee schedule,$13.41 ,76%  of total billed charges for outpatient setting,$5.51 ,100% CMS Medicare OPPS fee schedule,$27.20 ,400% of BCBSTX fee schedule,$27.20 ,400% of BCBSTX fee schedule,$5.51 ,100% CMS Medicare OPPS fee schedule,$27.20 ,400% of BCBSTX fee schedule,$6.80 ,100% of BCBSTX fee schedule,$15.88 ,90% of total billed charges for oupatient setting,$4.63 ,100% of TX Medicaid OPPS fee schedule,$15.88 ,90% of total billed charges for oupatient setting,$5.51 ,100% CMS Medicare OPPS fee schedule,$5.51 ,100% CMS Medicare OPPS fee schedule,$5.51 ,100% CMS Medicare OPPS fee schedule,$3.58 ,65% CMS Medicare OPPS fee schedule,$4.54 ,98% of TX Medicaid OPPS fee schedule,$16.76 ,95% of total billed charges for outpatient setting,$4.13 ,75% CMS Medicare OPPS fee schedule,$15.52 ,88% of total billed charges for outpatient setting,$15.52 ,88% of total billed charges for outpatient setting,$5.51 ,100% CMS Medicare OPPS fee schedule,$4.95 ,90% CMS Medicare OPPS fee schedule,$5.51 ,100% CMS Medicare OPPS fee schedule,$5.51 ,100% CMS Medicare OPPS fee schedule,$5.51 ,100% CMS Medicare OPPS fee schedule,$5.51 ,100% CMS Medicare OPPS fee schedule,$5.51 ,100% CMS Medicare OPPS fee schedule,$5.51 ,100% CMS Medicare OPPS fee schedule,$5.51 ,100% CMS Medicare OPPS fee schedule,$5.51 ,100% CMS Medicare OPPS fee schedule,$5.51 ,100% CMS Medicare OPPS fee schedule,$5.51 ,100% CMS Medicare OPPS fee schedule,$4.63 ,100% of TX Medicaid OPPS fee schedule,$4.63 ,100% of TX Medicaid OPPS fee schedule,$4.63 ,100% of TX Medicaid OPPS fee schedule,$4.63 ,100% of TX Medicaid OPPS fee schedule,$4.63 ,100% of TX Medicaid OPPS fee schedule,$4.63 ,100% of TX Medicaid OPPS fee schedule,$4.63 ,100% of TX Medicaid OPPS fee schedule,$4.63 ,100% of TX Medicaid OPPS fee schedule,$4.63 ,100% of TX Medicaid OPPS fee schedule,$3.58 ,$27.20 ,$11.47 
Outpatient Medical Services,LAB,85651,SEDIMENTATION RATE,305,$115.76 ,$5.33 ,125% CMS Medicare OPPS fee schedule,$87.98 ,76%  of total billed charges for outpatient setting,$4.26 ,100% CMS Medicare OPPS fee schedule,$17.52 ,400% of BCBSTX fee schedule,$17.52 ,400% of BCBSTX fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$17.52 ,400% of BCBSTX fee schedule,$4.38 ,100% of BCBSTX fee schedule,$104.18 ,90% of total billed charges for oupatient setting,$3.59 ,100% of TX Medicaid OPPS fee schedule,$104.18 ,90% of total billed charges for oupatient setting,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$2.77 ,65% CMS Medicare OPPS fee schedule,$3.52 ,98% of TX Medicaid OPPS fee schedule,$109.97 ,95% of total billed charges for outpatient setting,$3.20 ,75% CMS Medicare OPPS fee schedule,$101.87 ,88% of total billed charges for outpatient setting,$101.87 ,88% of total billed charges for outpatient setting,$4.26 ,100% CMS Medicare OPPS fee schedule,$3.84 ,90% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$2.77 ,$109.97 ,$75.24 
Outpatient Medical Services,LAB,85610,PROTHROMBIN TIME,305,$56.23 ,$5.36 ,125% CMS Medicare OPPS fee schedule,$42.73 ,76%  of total billed charges for outpatient setting,$4.29 ,100% CMS Medicare OPPS fee schedule,$19.40 ,400% of BCBSTX fee schedule,$19.40 ,400% of BCBSTX fee schedule,$4.29 ,100% CMS Medicare OPPS fee schedule,$19.40 ,400% of BCBSTX fee schedule,$4.85 ,100% of BCBSTX fee schedule,$50.61 ,90% of total billed charges for oupatient setting,$3.60 ,100% of TX Medicaid OPPS fee schedule,$50.61 ,90% of total billed charges for oupatient setting,$4.29 ,100% CMS Medicare OPPS fee schedule,$4.29 ,100% CMS Medicare OPPS fee schedule,$4.29 ,100% CMS Medicare OPPS fee schedule,$2.79 ,65% CMS Medicare OPPS fee schedule,$3.53 ,98% of TX Medicaid OPPS fee schedule,$53.42 ,95% of total billed charges for outpatient setting,$3.21 ,75% CMS Medicare OPPS fee schedule,$49.48 ,88% of total billed charges for outpatient setting,$49.48 ,88% of total billed charges for outpatient setting,$4.29 ,100% CMS Medicare OPPS fee schedule,$3.86 ,90% CMS Medicare OPPS fee schedule,$4.29 ,100% CMS Medicare OPPS fee schedule,$4.29 ,100% CMS Medicare OPPS fee schedule,$4.29 ,100% CMS Medicare OPPS fee schedule,$4.29 ,100% CMS Medicare OPPS fee schedule,$4.29 ,100% CMS Medicare OPPS fee schedule,$4.29 ,100% CMS Medicare OPPS fee schedule,$4.29 ,100% CMS Medicare OPPS fee schedule,$4.29 ,100% CMS Medicare OPPS fee schedule,$4.29 ,100% CMS Medicare OPPS fee schedule,$4.29 ,100% CMS Medicare OPPS fee schedule,$3.60 ,100% of TX Medicaid OPPS fee schedule,$3.60 ,100% of TX Medicaid OPPS fee schedule,$3.60 ,100% of TX Medicaid OPPS fee schedule,$3.60 ,100% of TX Medicaid OPPS fee schedule,$3.60 ,100% of TX Medicaid OPPS fee schedule,$3.60 ,100% of TX Medicaid OPPS fee schedule,$3.60 ,100% of TX Medicaid OPPS fee schedule,$3.60 ,100% of TX Medicaid OPPS fee schedule,$3.60 ,100% of TX Medicaid OPPS fee schedule,$2.79 ,$53.42 ,$36.55 
Outpatient Medical Services,LAB,85379,DDIMER (QUANT),305,$115.76 ,$12.72 ,125% CMS Medicare OPPS fee schedule,$87.98 ,76%  of total billed charges for outpatient setting,$10.18 ,100% CMS Medicare OPPS fee schedule,$50.24 ,400% of BCBSTX fee schedule,$50.24 ,400% of BCBSTX fee schedule,$10.18 ,100% CMS Medicare OPPS fee schedule,$50.24 ,400% of BCBSTX fee schedule,$12.56 ,100% of BCBSTX fee schedule,$104.18 ,90% of total billed charges for oupatient setting,$8.55 ,100% of TX Medicaid OPPS fee schedule,$104.18 ,90% of total billed charges for oupatient setting,$10.18 ,100% CMS Medicare OPPS fee schedule,$10.18 ,100% CMS Medicare OPPS fee schedule,$10.18 ,100% CMS Medicare OPPS fee schedule,$6.62 ,65% CMS Medicare OPPS fee schedule,$8.38 ,98% of TX Medicaid OPPS fee schedule,$109.97 ,95% of total billed charges for outpatient setting,$7.63 ,75% CMS Medicare OPPS fee schedule,$101.87 ,88% of total billed charges for outpatient setting,$101.87 ,88% of total billed charges for outpatient setting,$10.18 ,100% CMS Medicare OPPS fee schedule,$9.16 ,90% CMS Medicare OPPS fee schedule,$10.18 ,100% CMS Medicare OPPS fee schedule,$10.18 ,100% CMS Medicare OPPS fee schedule,$10.18 ,100% CMS Medicare OPPS fee schedule,$10.18 ,100% CMS Medicare OPPS fee schedule,$10.18 ,100% CMS Medicare OPPS fee schedule,$10.18 ,100% CMS Medicare OPPS fee schedule,$10.18 ,100% CMS Medicare OPPS fee schedule,$10.18 ,100% CMS Medicare OPPS fee schedule,$10.18 ,100% CMS Medicare OPPS fee schedule,$10.18 ,100% CMS Medicare OPPS fee schedule,$8.55 ,100% of TX Medicaid OPPS fee schedule,$8.55 ,100% of TX Medicaid OPPS fee schedule,$8.55 ,100% of TX Medicaid OPPS fee schedule,$8.55 ,100% of TX Medicaid OPPS fee schedule,$8.55 ,100% of TX Medicaid OPPS fee schedule,$8.55 ,100% of TX Medicaid OPPS fee schedule,$8.55 ,100% of TX Medicaid OPPS fee schedule,$8.55 ,100% of TX Medicaid OPPS fee schedule,$8.55 ,100% of TX Medicaid OPPS fee schedule,$6.62 ,$109.97 ,$75.24 
Outpatient Medical Services,LAB,85027,CBC,305,$92.61 ,$8.08 ,125% CMS Medicare OPPS fee schedule,$70.38 ,76%  of total billed charges for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule,$31.92 ,400% of BCBSTX fee schedule,$31.92 ,400% of BCBSTX fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$31.92 ,400% of BCBSTX fee schedule,$7.98 ,100% of BCBSTX fee schedule,$83.35 ,90% of total billed charges for oupatient setting,$5.43 ,100% of TX Medicaid OPPS fee schedule,$83.35 ,90% of total billed charges for oupatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$4.21 ,65% CMS Medicare OPPS fee schedule,$5.32 ,98% of TX Medicaid OPPS fee schedule,$87.98 ,95% of total billed charges for outpatient setting,$4.85 ,75% CMS Medicare OPPS fee schedule,$81.50 ,88% of total billed charges for outpatient setting,$81.50 ,88% of total billed charges for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule,$5.82 ,90% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$4.21 ,$87.98 ,$60.20 
Outpatient Medical Services,LAB,85025,CBC & AUTO DIFF,305,$164.54 ,$9.71 ,125% CMS Medicare OPPS fee schedule,$125.05 ,76%  of total billed charges for outpatient setting,$7.77 ,100% CMS Medicare OPPS fee schedule,$38.36 ,400% of BCBSTX fee schedule,$38.36 ,400% of BCBSTX fee schedule,$7.77 ,100% CMS Medicare OPPS fee schedule,$38.36 ,400% of BCBSTX fee schedule,$9.59 ,100% of BCBSTX fee schedule,$148.09 ,90% of total billed charges for oupatient setting,$6.53 ,100% of TX Medicaid OPPS fee schedule,$148.09 ,90% of total billed charges for oupatient setting,$7.77 ,100% CMS Medicare OPPS fee schedule,$7.77 ,100% CMS Medicare OPPS fee schedule,$7.77 ,100% CMS Medicare OPPS fee schedule,$5.05 ,65% CMS Medicare OPPS fee schedule,$6.40 ,98% of TX Medicaid OPPS fee schedule,$156.31 ,95% of total billed charges for outpatient setting,$5.82 ,75% CMS Medicare OPPS fee schedule,$144.80 ,88% of total billed charges for outpatient setting,$144.80 ,88% of total billed charges for outpatient setting,$7.77 ,100% CMS Medicare OPPS fee schedule,$6.99 ,90% CMS Medicare OPPS fee schedule,$7.77 ,100% CMS Medicare OPPS fee schedule,$7.77 ,100% CMS Medicare OPPS fee schedule,$7.77 ,100% CMS Medicare OPPS fee schedule,$7.77 ,100% CMS Medicare OPPS fee schedule,$7.77 ,100% CMS Medicare OPPS fee schedule,$7.77 ,100% CMS Medicare OPPS fee schedule,$7.77 ,100% CMS Medicare OPPS fee schedule,$7.77 ,100% CMS Medicare OPPS fee schedule,$7.77 ,100% CMS Medicare OPPS fee schedule,$7.77 ,100% CMS Medicare OPPS fee schedule,$6.53 ,100% of TX Medicaid OPPS fee schedule,$6.53 ,100% of TX Medicaid OPPS fee schedule,$6.53 ,100% of TX Medicaid OPPS fee schedule,$6.53 ,100% of TX Medicaid OPPS fee schedule,$6.53 ,100% of TX Medicaid OPPS fee schedule,$6.53 ,100% of TX Medicaid OPPS fee schedule,$6.53 ,100% of TX Medicaid OPPS fee schedule,$6.53 ,100% of TX Medicaid OPPS fee schedule,$6.53 ,100% of TX Medicaid OPPS fee schedule,$5.05 ,$156.31 ,$106.95 
Outpatient Medical Services,LAB,85018,HEMOGLOBIN,305,$58.43 ,$2.96 ,125% CMS Medicare OPPS fee schedule,$44.41 ,76%  of total billed charges for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule,$11.72 ,400% of BCBSTX fee schedule,$11.72 ,400% of BCBSTX fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$11.72 ,400% of BCBSTX fee schedule,$2.93 ,100% of BCBSTX fee schedule,$52.59 ,90% of total billed charges for oupatient setting,$1.99 ,100% of TX Medicaid OPPS fee schedule,$52.59 ,90% of total billed charges for oupatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$1.54 ,65% CMS Medicare OPPS fee schedule,$1.95 ,98% of TX Medicaid OPPS fee schedule,$55.51 ,95% of total billed charges for outpatient setting,$1.77 ,75% CMS Medicare OPPS fee schedule,$51.42 ,88% of total billed charges for outpatient setting,$51.42 ,88% of total billed charges for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.13 ,90% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.54 ,$55.51 ,$37.98 
Outpatient Medical Services,LAB,85014,HEMATOCRIT,305,$58.43 ,$2.96 ,125% CMS Medicare OPPS fee schedule,$44.41 ,76%  of total billed charges for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule,$11.72 ,400% of BCBSTX fee schedule,$11.72 ,400% of BCBSTX fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$11.72 ,400% of BCBSTX fee schedule,$2.93 ,100% of BCBSTX fee schedule,$52.59 ,90% of total billed charges for oupatient setting,$1.99 ,100% of TX Medicaid OPPS fee schedule,$52.59 ,90% of total billed charges for oupatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$1.54 ,65% CMS Medicare OPPS fee schedule,$1.95 ,98% of TX Medicaid OPPS fee schedule,$55.51 ,95% of total billed charges for outpatient setting,$1.77 ,75% CMS Medicare OPPS fee schedule,$51.42 ,88% of total billed charges for outpatient setting,$51.42 ,88% of total billed charges for outpatient setting,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.13 ,90% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$2.37 ,100% CMS Medicare OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.99 ,100% of TX Medicaid OPPS fee schedule,$1.54 ,$55.51 ,$37.98 
Outpatient Medical Services,LAB,86706,HEPATITIS B SURF AB,302,$248.06 ,$13.42 ,125% CMS Medicare OPPS fee schedule,$188.53 ,76%  of total billed charges for outpatient setting,$10.74 ,100% CMS Medicare OPPS fee schedule,$53.04 ,400% of BCBSTX fee schedule,$53.04 ,400% of BCBSTX fee schedule,$10.74 ,100% CMS Medicare OPPS fee schedule,$53.04 ,400% of BCBSTX fee schedule,$13.26 ,100% of BCBSTX fee schedule,$223.25 ,90% of total billed charges for oupatient setting,$9.02 ,100% of TX Medicaid OPPS fee schedule,$223.25 ,90% of total billed charges for oupatient setting,$10.74 ,100% CMS Medicare OPPS fee schedule,$10.74 ,100% CMS Medicare OPPS fee schedule,$10.74 ,100% CMS Medicare OPPS fee schedule,$6.98 ,65% CMS Medicare OPPS fee schedule,$8.84 ,98% of TX Medicaid OPPS fee schedule,$235.66 ,95% of total billed charges for outpatient setting,$8.05 ,75% CMS Medicare OPPS fee schedule,$218.29 ,88% of total billed charges for outpatient setting,$218.29 ,88% of total billed charges for outpatient setting,$10.74 ,100% CMS Medicare OPPS fee schedule,$9.66 ,90% CMS Medicare OPPS fee schedule,$10.74 ,100% CMS Medicare OPPS fee schedule,$10.74 ,100% CMS Medicare OPPS fee schedule,$10.74 ,100% CMS Medicare OPPS fee schedule,$10.74 ,100% CMS Medicare OPPS fee schedule,$10.74 ,100% CMS Medicare OPPS fee schedule,$10.74 ,100% CMS Medicare OPPS fee schedule,$10.74 ,100% CMS Medicare OPPS fee schedule,$10.74 ,100% CMS Medicare OPPS fee schedule,$10.74 ,100% CMS Medicare OPPS fee schedule,$10.74 ,100% CMS Medicare OPPS fee schedule,$9.02 ,100% of TX Medicaid OPPS fee schedule,$9.02 ,100% of TX Medicaid OPPS fee schedule,$9.02 ,100% of TX Medicaid OPPS fee schedule,$9.02 ,100% of TX Medicaid OPPS fee schedule,$9.02 ,100% of TX Medicaid OPPS fee schedule,$9.02 ,100% of TX Medicaid OPPS fee schedule,$9.02 ,100% of TX Medicaid OPPS fee schedule,$9.02 ,100% of TX Medicaid OPPS fee schedule,$9.02 ,100% of TX Medicaid OPPS fee schedule,$6.98 ,$235.66 ,$161.24 
Outpatient Medical Services,LAB,86703,HIV1 AND HIV2 ANTI,302,$135.61 ,$17.13 ,125% CMS Medicare OPPS fee schedule,$103.06 ,76%  of total billed charges for outpatient setting,$13.71 ,100% CMS Medicare OPPS fee schedule,$67.68 ,400% of BCBSTX fee schedule,$67.68 ,400% of BCBSTX fee schedule,$13.71 ,100% CMS Medicare OPPS fee schedule,$67.68 ,400% of BCBSTX fee schedule,$16.92 ,100% of BCBSTX fee schedule,$122.05 ,90% of total billed charges for oupatient setting,$11.52 ,100% of TX Medicaid OPPS fee schedule,$122.05 ,90% of total billed charges for oupatient setting,$13.71 ,100% CMS Medicare OPPS fee schedule,$13.71 ,100% CMS Medicare OPPS fee schedule,$13.71 ,100% CMS Medicare OPPS fee schedule,$8.91 ,65% CMS Medicare OPPS fee schedule,$11.29 ,98% of TX Medicaid OPPS fee schedule,$128.83 ,95% of total billed charges for outpatient setting,$10.28 ,75% CMS Medicare OPPS fee schedule,$119.34 ,88% of total billed charges for outpatient setting,$119.34 ,88% of total billed charges for outpatient setting,$13.71 ,100% CMS Medicare OPPS fee schedule,$12.33 ,90% CMS Medicare OPPS fee schedule,$13.71 ,100% CMS Medicare OPPS fee schedule,$13.71 ,100% CMS Medicare OPPS fee schedule,$13.71 ,100% CMS Medicare OPPS fee schedule,$13.71 ,100% CMS Medicare OPPS fee schedule,$13.71 ,100% CMS Medicare OPPS fee schedule,$13.71 ,100% CMS Medicare OPPS fee schedule,$13.71 ,100% CMS Medicare OPPS fee schedule,$13.71 ,100% CMS Medicare OPPS fee schedule,$13.71 ,100% CMS Medicare OPPS fee schedule,$13.71 ,100% CMS Medicare OPPS fee schedule,$11.52 ,100% of TX Medicaid OPPS fee schedule,$11.52 ,100% of TX Medicaid OPPS fee schedule,$11.52 ,100% of TX Medicaid OPPS fee schedule,$11.52 ,100% of TX Medicaid OPPS fee schedule,$11.52 ,100% of TX Medicaid OPPS fee schedule,$11.52 ,100% of TX Medicaid OPPS fee schedule,$11.52 ,100% of TX Medicaid OPPS fee schedule,$11.52 ,100% of TX Medicaid OPPS fee schedule,$11.52 ,100% of TX Medicaid OPPS fee schedule,$8.91 ,$128.83 ,$88.15 
Outpatient Medical Services,LAB,86592,RPR,302,$163.17 ,$5.33 ,125% CMS Medicare OPPS fee schedule,$124.01 ,76%  of total billed charges for outpatient setting,$4.26 ,100% CMS Medicare OPPS fee schedule,$21.08 ,400% of BCBSTX fee schedule,$21.08 ,400% of BCBSTX fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$21.08 ,400% of BCBSTX fee schedule,$5.27 ,100% of BCBSTX fee schedule,$146.85 ,90% of total billed charges for oupatient setting,$3.59 ,100% of TX Medicaid OPPS fee schedule,$146.85 ,90% of total billed charges for oupatient setting,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$2.77 ,65% CMS Medicare OPPS fee schedule,$3.52 ,98% of TX Medicaid OPPS fee schedule,$155.01 ,95% of total billed charges for outpatient setting,$3.20 ,75% CMS Medicare OPPS fee schedule,$143.59 ,88% of total billed charges for outpatient setting,$143.59 ,88% of total billed charges for outpatient setting,$4.26 ,100% CMS Medicare OPPS fee schedule,$3.84 ,90% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$4.26 ,100% CMS Medicare OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$3.59 ,100% of TX Medicaid OPPS fee schedule,$2.77 ,$155.01 ,$106.06 
Outpatient Medical Services,LAB,86141,CARDIO IQ HS CRP,302,$125.69 ,$16.18 ,125% CMS Medicare OPPS fee schedule,$95.52 ,76%  of total billed charges for outpatient setting,$12.95 ,100% CMS Medicare OPPS fee schedule,$63.92 ,400% of BCBSTX fee schedule,$63.92 ,400% of BCBSTX fee schedule,$12.95 ,100% CMS Medicare OPPS fee schedule,$63.92 ,400% of BCBSTX fee schedule,$15.98 ,100% of BCBSTX fee schedule,$113.12 ,90% of total billed charges for oupatient setting,$10.88 ,100% of TX Medicaid OPPS fee schedule,$113.12 ,90% of total billed charges for oupatient setting,$12.95 ,100% CMS Medicare OPPS fee schedule,$12.95 ,100% CMS Medicare OPPS fee schedule,$12.95 ,100% CMS Medicare OPPS fee schedule,$8.42 ,65% CMS Medicare OPPS fee schedule,$10.66 ,98% of TX Medicaid OPPS fee schedule,$119.41 ,95% of total billed charges for outpatient setting,$9.71 ,75% CMS Medicare OPPS fee schedule,$110.61 ,88% of total billed charges for outpatient setting,$110.61 ,88% of total billed charges for outpatient setting,$12.95 ,100% CMS Medicare OPPS fee schedule,$11.65 ,90% CMS Medicare OPPS fee schedule,$12.95 ,100% CMS Medicare OPPS fee schedule,$12.95 ,100% CMS Medicare OPPS fee schedule,$12.95 ,100% CMS Medicare OPPS fee schedule,$12.95 ,100% CMS Medicare OPPS fee schedule,$12.95 ,100% CMS Medicare OPPS fee schedule,$12.95 ,100% CMS Medicare OPPS fee schedule,$12.95 ,100% CMS Medicare OPPS fee schedule,$12.95 ,100% CMS Medicare OPPS fee schedule,$12.95 ,100% CMS Medicare OPPS fee schedule,$12.95 ,100% CMS Medicare OPPS fee schedule,$10.88 ,100% of TX Medicaid OPPS fee schedule,$10.88 ,100% of TX Medicaid OPPS fee schedule,$10.88 ,100% of TX Medicaid OPPS fee schedule,$10.88 ,100% of TX Medicaid OPPS fee schedule,$10.88 ,100% of TX Medicaid OPPS fee schedule,$10.88 ,100% of TX Medicaid OPPS fee schedule,$10.88 ,100% of TX Medicaid OPPS fee schedule,$10.88 ,100% of TX Medicaid OPPS fee schedule,$10.88 ,100% of TX Medicaid OPPS fee schedule,$8.42 ,$119.41 ,$81.70 
Outpatient Medical Services,LAB,86140,CRP,302,$51.82 ,$6.47 ,125% CMS Medicare OPPS fee schedule,$39.38 ,76%  of total billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule,$25.56 ,400% of BCBSTX fee schedule,$25.56 ,400% of BCBSTX fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$25.56 ,400% of BCBSTX fee schedule,$6.39 ,100% of BCBSTX fee schedule,$46.64 ,90% of total billed charges for oupatient setting,$4.35 ,100% of TX Medicaid OPPS fee schedule,$46.64 ,90% of total billed charges for oupatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$3.37 ,65% CMS Medicare OPPS fee schedule,$4.26 ,98% of TX Medicaid OPPS fee schedule,$49.23 ,95% of total billed charges for outpatient setting,$3.88 ,75% CMS Medicare OPPS fee schedule,$45.60 ,88% of total billed charges for outpatient setting,$45.60 ,88% of total billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule,$4.66 ,90% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$3.37 ,$49.23 ,$33.68 
Outpatient Medical Services,LAB,87426,Sars Cov 2 Rapid Antigen,301,$102.50 ,$44.16 ,125% CMS Medicare OPPS fee schedule,$77.90 ,76%  of total billed charges for outpatient setting,$35.33 ,100% CMS Medicare OPPS fee schedule,$205.24 ,400% of BCBSTX fee schedule,$205.24 ,400% of BCBSTX fee schedule,$35.33 ,100% CMS Medicare OPPS fee schedule,$205.24 ,400% of BCBSTX fee schedule,$51.31 ,100% of BCBSTX fee schedule,$92.25 ,90% of total billed charges for oupatient setting,$46.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$92.25 ,90% of total billed charges for oupatient setting,$35.33 ,100% CMS Medicare OPPS fee schedule,$35.33 ,100% CMS Medicare OPPS fee schedule,$35.33 ,100% CMS Medicare OPPS fee schedule,$22.96 ,65% CMS Medicare OPPS fee schedule,$45.20 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$97.38 ,95% of total billed charges for outpatient setting,$26.49 ,75% CMS Medicare OPPS fee schedule,$90.20 ,88% of total billed charges for outpatient setting,$90.20 ,88% of total billed charges for outpatient setting,$35.33 ,100% CMS Medicare OPPS fee schedule,$31.79 ,90% CMS Medicare OPPS fee schedule,$35.33 ,100% CMS Medicare OPPS fee schedule,$35.33 ,100% CMS Medicare OPPS fee schedule,$35.33 ,100% CMS Medicare OPPS fee schedule,$35.33 ,100% CMS Medicare OPPS fee schedule,$35.33 ,100% CMS Medicare OPPS fee schedule,$35.33 ,100% CMS Medicare OPPS fee schedule,$35.33 ,100% CMS Medicare OPPS fee schedule,$35.33 ,100% CMS Medicare OPPS fee schedule,$35.33 ,100% CMS Medicare OPPS fee schedule,$35.33 ,100% CMS Medicare OPPS fee schedule,$46.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$46.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$46.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$46.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$46.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$46.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$46.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$46.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$46.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$22.96 ,$205.24 ,$66.63 
Outpatient Medical Services,LAB,84703,HCGQUAL,301,$192.94 ,$9.40 ,125% CMS Medicare OPPS fee schedule,$146.63 ,76%  of total billed charges for outpatient setting,$7.52 ,100% CMS Medicare OPPS fee schedule,$37.16 ,400% of BCBSTX fee schedule,$37.16 ,400% of BCBSTX fee schedule,$7.52 ,100% CMS Medicare OPPS fee schedule,$37.16 ,400% of BCBSTX fee schedule,$9.29 ,100% of BCBSTX fee schedule,$173.65 ,90% of total billed charges for oupatient setting,$6.32 ,100% of TX Medicaid OPPS fee schedule,$173.65 ,90% of total billed charges for oupatient setting,$7.52 ,100% CMS Medicare OPPS fee schedule,$7.52 ,100% CMS Medicare OPPS fee schedule,$7.52 ,100% CMS Medicare OPPS fee schedule,$4.89 ,65% CMS Medicare OPPS fee schedule,$6.19 ,98% of TX Medicaid OPPS fee schedule,$183.29 ,95% of total billed charges for outpatient setting,$5.64 ,75% CMS Medicare OPPS fee schedule,$169.79 ,88% of total billed charges for outpatient setting,$169.79 ,88% of total billed charges for outpatient setting,$7.52 ,100% CMS Medicare OPPS fee schedule,$6.76 ,90% CMS Medicare OPPS fee schedule,$7.52 ,100% CMS Medicare OPPS fee schedule,$7.52 ,100% CMS Medicare OPPS fee schedule,$7.52 ,100% CMS Medicare OPPS fee schedule,$7.52 ,100% CMS Medicare OPPS fee schedule,$7.52 ,100% CMS Medicare OPPS fee schedule,$7.52 ,100% CMS Medicare OPPS fee schedule,$7.52 ,100% CMS Medicare OPPS fee schedule,$7.52 ,100% CMS Medicare OPPS fee schedule,$7.52 ,100% CMS Medicare OPPS fee schedule,$7.52 ,100% CMS Medicare OPPS fee schedule,$6.32 ,100% of TX Medicaid OPPS fee schedule,$6.32 ,100% of TX Medicaid OPPS fee schedule,$6.32 ,100% of TX Medicaid OPPS fee schedule,$6.32 ,100% of TX Medicaid OPPS fee schedule,$6.32 ,100% of TX Medicaid OPPS fee schedule,$6.32 ,100% of TX Medicaid OPPS fee schedule,$6.32 ,100% of TX Medicaid OPPS fee schedule,$6.32 ,100% of TX Medicaid OPPS fee schedule,$6.32 ,100% of TX Medicaid OPPS fee schedule,$4.89 ,$183.29 ,$125.41 
Outpatient Medical Services,LAB,84702,HCG QUANTITATIVE,301,$206.17 ,$18.81 ,125% CMS Medicare OPPS fee schedule,$156.69 ,76%  of total billed charges for outpatient setting,$15.05 ,100% CMS Medicare OPPS fee schedule,$74.36 ,400% of BCBSTX fee schedule,$74.36 ,400% of BCBSTX fee schedule,$15.05 ,100% CMS Medicare OPPS fee schedule,$74.36 ,400% of BCBSTX fee schedule,$18.59 ,100% of BCBSTX fee schedule,$185.55 ,90% of total billed charges for oupatient setting,$12.64 ,100% of TX Medicaid OPPS fee schedule,$185.55 ,90% of total billed charges for oupatient setting,$15.05 ,100% CMS Medicare OPPS fee schedule,$15.05 ,100% CMS Medicare OPPS fee schedule,$15.05 ,100% CMS Medicare OPPS fee schedule,$9.78 ,65% CMS Medicare OPPS fee schedule,$12.39 ,98% of TX Medicaid OPPS fee schedule,$195.86 ,95% of total billed charges for outpatient setting,$11.28 ,75% CMS Medicare OPPS fee schedule,$181.43 ,88% of total billed charges for outpatient setting,$181.43 ,88% of total billed charges for outpatient setting,$15.05 ,100% CMS Medicare OPPS fee schedule,$13.54 ,90% CMS Medicare OPPS fee schedule,$15.05 ,100% CMS Medicare OPPS fee schedule,$15.05 ,100% CMS Medicare OPPS fee schedule,$15.05 ,100% CMS Medicare OPPS fee schedule,$15.05 ,100% CMS Medicare OPPS fee schedule,$15.05 ,100% CMS Medicare OPPS fee schedule,$15.05 ,100% CMS Medicare OPPS fee schedule,$15.05 ,100% CMS Medicare OPPS fee schedule,$15.05 ,100% CMS Medicare OPPS fee schedule,$15.05 ,100% CMS Medicare OPPS fee schedule,$15.05 ,100% CMS Medicare OPPS fee schedule,$12.64 ,100% of TX Medicaid OPPS fee schedule,$12.64 ,100% of TX Medicaid OPPS fee schedule,$12.64 ,100% of TX Medicaid OPPS fee schedule,$12.64 ,100% of TX Medicaid OPPS fee schedule,$12.64 ,100% of TX Medicaid OPPS fee schedule,$12.64 ,100% of TX Medicaid OPPS fee schedule,$12.64 ,100% of TX Medicaid OPPS fee schedule,$12.64 ,100% of TX Medicaid OPPS fee schedule,$12.64 ,100% of TX Medicaid OPPS fee schedule,$9.78 ,$195.86 ,$134.01 
Outpatient Medical Services,LAB,84550,URIC ACID BLOOD,301,$73.87 ,$5.65 ,125% CMS Medicare OPPS fee schedule,$56.14 ,76%  of total billed charges for outpatient setting,$4.51 ,100% CMS Medicare OPPS fee schedule,$22.32 ,400% of BCBSTX fee schedule,$22.32 ,400% of BCBSTX fee schedule,$4.51 ,100% CMS Medicare OPPS fee schedule,$22.32 ,400% of BCBSTX fee schedule,$5.58 ,100% of BCBSTX fee schedule,$66.48 ,90% of total billed charges for oupatient setting,$3.80 ,100% of TX Medicaid OPPS fee schedule,$66.48 ,90% of total billed charges for oupatient setting,$4.51 ,100% CMS Medicare OPPS fee schedule,$4.51 ,100% CMS Medicare OPPS fee schedule,$4.51 ,100% CMS Medicare OPPS fee schedule,$2.93 ,65% CMS Medicare OPPS fee schedule,$3.72 ,98% of TX Medicaid OPPS fee schedule,$70.18 ,95% of total billed charges for outpatient setting,$3.38 ,75% CMS Medicare OPPS fee schedule,$65.01 ,88% of total billed charges for outpatient setting,$65.01 ,88% of total billed charges for outpatient setting,$4.51 ,100% CMS Medicare OPPS fee schedule,$4.06 ,90% CMS Medicare OPPS fee schedule,$4.51 ,100% CMS Medicare OPPS fee schedule,$4.51 ,100% CMS Medicare OPPS fee schedule,$4.51 ,100% CMS Medicare OPPS fee schedule,$4.51 ,100% CMS Medicare OPPS fee schedule,$4.51 ,100% CMS Medicare OPPS fee schedule,$4.51 ,100% CMS Medicare OPPS fee schedule,$4.51 ,100% CMS Medicare OPPS fee schedule,$4.51 ,100% CMS Medicare OPPS fee schedule,$4.51 ,100% CMS Medicare OPPS fee schedule,$4.51 ,100% CMS Medicare OPPS fee schedule,$3.80 ,100% of TX Medicaid OPPS fee schedule,$3.80 ,100% of TX Medicaid OPPS fee schedule,$3.80 ,100% of TX Medicaid OPPS fee schedule,$3.80 ,100% of TX Medicaid OPPS fee schedule,$3.80 ,100% of TX Medicaid OPPS fee schedule,$3.80 ,100% of TX Medicaid OPPS fee schedule,$3.80 ,100% of TX Medicaid OPPS fee schedule,$3.80 ,100% of TX Medicaid OPPS fee schedule,$3.80 ,100% of TX Medicaid OPPS fee schedule,$2.93 ,$70.18 ,$48.02 
Outpatient Medical Services,LAB,84484,TROPONIN,301,$166.48 ,$15.58 ,125% CMS Medicare OPPS fee schedule,$126.52 ,76%  of total billed charges for outpatient setting,$12.47 ,100% CMS Medicare OPPS fee schedule,$49.88 ,400% of BCBSTX fee schedule,$49.88 ,400% of BCBSTX fee schedule,$12.47 ,100% CMS Medicare OPPS fee schedule,$49.88 ,400% of BCBSTX fee schedule,$12.47 ,100% of BCBSTX fee schedule,$149.83 ,90% of total billed charges for oupatient setting,$10.47 ,100% of TX Medicaid OPPS fee schedule,$149.83 ,90% of total billed charges for oupatient setting,$12.47 ,100% CMS Medicare OPPS fee schedule,$12.47 ,100% CMS Medicare OPPS fee schedule,$12.47 ,100% CMS Medicare OPPS fee schedule,$8.11 ,65% CMS Medicare OPPS fee schedule,$10.26 ,98% of TX Medicaid OPPS fee schedule,$158.16 ,95% of total billed charges for outpatient setting,$9.35 ,75% CMS Medicare OPPS fee schedule,$146.50 ,88% of total billed charges for outpatient setting,$146.50 ,88% of total billed charges for outpatient setting,$12.47 ,100% CMS Medicare OPPS fee schedule,$11.22 ,90% CMS Medicare OPPS fee schedule,$12.47 ,100% CMS Medicare OPPS fee schedule,$12.47 ,100% CMS Medicare OPPS fee schedule,$12.47 ,100% CMS Medicare OPPS fee schedule,$12.47 ,100% CMS Medicare OPPS fee schedule,$12.47 ,100% CMS Medicare OPPS fee schedule,$12.47 ,100% CMS Medicare OPPS fee schedule,$12.47 ,100% CMS Medicare OPPS fee schedule,$12.47 ,100% CMS Medicare OPPS fee schedule,$12.47 ,100% CMS Medicare OPPS fee schedule,$12.47 ,100% CMS Medicare OPPS fee schedule,$10.47 ,100% of TX Medicaid OPPS fee schedule,$10.47 ,100% of TX Medicaid OPPS fee schedule,$10.47 ,100% of TX Medicaid OPPS fee schedule,$10.47 ,100% of TX Medicaid OPPS fee schedule,$10.47 ,100% of TX Medicaid OPPS fee schedule,$10.47 ,100% of TX Medicaid OPPS fee schedule,$10.47 ,100% of TX Medicaid OPPS fee schedule,$10.47 ,100% of TX Medicaid OPPS fee schedule,$10.47 ,100% of TX Medicaid OPPS fee schedule,$8.11 ,$158.16 ,$108.21 
Outpatient Medical Services,LAB,84466,TRANSFERRIN,301,$103.64 ,$15.95 ,125% CMS Medicare OPPS fee schedule,$78.77 ,76%  of total billed charges for outpatient setting,$12.76 ,100% CMS Medicare OPPS fee schedule,$63.04 ,400% of BCBSTX fee schedule,$63.04 ,400% of BCBSTX fee schedule,$12.76 ,100% CMS Medicare OPPS fee schedule,$63.04 ,400% of BCBSTX fee schedule,$15.76 ,100% of BCBSTX fee schedule,$93.28 ,90% of total billed charges for oupatient setting,$10.72 ,100% of TX Medicaid OPPS fee schedule,$93.28 ,90% of total billed charges for oupatient setting,$12.76 ,100% CMS Medicare OPPS fee schedule,$12.76 ,100% CMS Medicare OPPS fee schedule,$12.76 ,100% CMS Medicare OPPS fee schedule,$8.29 ,65% CMS Medicare OPPS fee schedule,$10.51 ,98% of TX Medicaid OPPS fee schedule,$98.46 ,95% of total billed charges for outpatient setting,$9.57 ,75% CMS Medicare OPPS fee schedule,$91.20 ,88% of total billed charges for outpatient setting,$91.20 ,88% of total billed charges for outpatient setting,$12.76 ,100% CMS Medicare OPPS fee schedule,$11.48 ,90% CMS Medicare OPPS fee schedule,$12.76 ,100% CMS Medicare OPPS fee schedule,$12.76 ,100% CMS Medicare OPPS fee schedule,$12.76 ,100% CMS Medicare OPPS fee schedule,$12.76 ,100% CMS Medicare OPPS fee schedule,$12.76 ,100% CMS Medicare OPPS fee schedule,$12.76 ,100% CMS Medicare OPPS fee schedule,$12.76 ,100% CMS Medicare OPPS fee schedule,$12.76 ,100% CMS Medicare OPPS fee schedule,$12.76 ,100% CMS Medicare OPPS fee schedule,$12.76 ,100% CMS Medicare OPPS fee schedule,$10.72 ,100% of TX Medicaid OPPS fee schedule,$10.72 ,100% of TX Medicaid OPPS fee schedule,$10.72 ,100% of TX Medicaid OPPS fee schedule,$10.72 ,100% of TX Medicaid OPPS fee schedule,$10.72 ,100% of TX Medicaid OPPS fee schedule,$10.72 ,100% of TX Medicaid OPPS fee schedule,$10.72 ,100% of TX Medicaid OPPS fee schedule,$10.72 ,100% of TX Medicaid OPPS fee schedule,$10.72 ,100% of TX Medicaid OPPS fee schedule,$8.29 ,$98.46 ,$67.37 
Outpatient Medical Services,LAB,84443,THYROID STIM HORMONE,301,$299.88 ,$21.00 ,125% CMS Medicare OPPS fee schedule,$227.91 ,76%  of total billed charges for outpatient setting,$16.80 ,100% CMS Medicare OPPS fee schedule,$83.00 ,400% of BCBSTX fee schedule,$83.00 ,400% of BCBSTX fee schedule,$16.80 ,100% CMS Medicare OPPS fee schedule,$83.00 ,400% of BCBSTX fee schedule,$20.75 ,100% of BCBSTX fee schedule,$269.89 ,90% of total billed charges for oupatient setting,$14.11 ,100% of TX Medicaid OPPS fee schedule,$269.89 ,90% of total billed charges for oupatient setting,$16.80 ,100% CMS Medicare OPPS fee schedule,$16.80 ,100% CMS Medicare OPPS fee schedule,$16.80 ,100% CMS Medicare OPPS fee schedule,$10.92 ,65% CMS Medicare OPPS fee schedule,$13.83 ,98% of TX Medicaid OPPS fee schedule,$284.89 ,95% of total billed charges for outpatient setting,$12.60 ,75% CMS Medicare OPPS fee schedule,$263.89 ,88% of total billed charges for outpatient setting,$263.89 ,88% of total billed charges for outpatient setting,$16.80 ,100% CMS Medicare OPPS fee schedule,$15.12 ,90% CMS Medicare OPPS fee schedule,$16.80 ,100% CMS Medicare OPPS fee schedule,$16.80 ,100% CMS Medicare OPPS fee schedule,$16.80 ,100% CMS Medicare OPPS fee schedule,$16.80 ,100% CMS Medicare OPPS fee schedule,$16.80 ,100% CMS Medicare OPPS fee schedule,$16.80 ,100% CMS Medicare OPPS fee schedule,$16.80 ,100% CMS Medicare OPPS fee schedule,$16.80 ,100% CMS Medicare OPPS fee schedule,$16.80 ,100% CMS Medicare OPPS fee schedule,$16.80 ,100% CMS Medicare OPPS fee schedule,$14.11 ,100% of TX Medicaid OPPS fee schedule,$14.11 ,100% of TX Medicaid OPPS fee schedule,$14.11 ,100% of TX Medicaid OPPS fee schedule,$14.11 ,100% of TX Medicaid OPPS fee schedule,$14.11 ,100% of TX Medicaid OPPS fee schedule,$14.11 ,100% of TX Medicaid OPPS fee schedule,$14.11 ,100% of TX Medicaid OPPS fee schedule,$14.11 ,100% of TX Medicaid OPPS fee schedule,$14.11 ,100% of TX Medicaid OPPS fee schedule,$10.92 ,$284.89 ,$194.92 
Outpatient Medical Services,LAB,84439,FREE T4,301,$226.01 ,$11.27 ,125% CMS Medicare OPPS fee schedule,$171.77 ,76%  of total billed charges for outpatient setting,$9.02 ,100% CMS Medicare OPPS fee schedule,$44.52 ,400% of BCBSTX fee schedule,$44.52 ,400% of BCBSTX fee schedule,$9.02 ,100% CMS Medicare OPPS fee schedule,$44.52 ,400% of BCBSTX fee schedule,$11.13 ,100% of BCBSTX fee schedule,$203.41 ,90% of total billed charges for oupatient setting,$7.58 ,100% of TX Medicaid OPPS fee schedule,$203.41 ,90% of total billed charges for oupatient setting,$9.02 ,100% CMS Medicare OPPS fee schedule,$9.02 ,100% CMS Medicare OPPS fee schedule,$9.02 ,100% CMS Medicare OPPS fee schedule,$5.86 ,65% CMS Medicare OPPS fee schedule,$7.43 ,98% of TX Medicaid OPPS fee schedule,$214.71 ,95% of total billed charges for outpatient setting,$6.76 ,75% CMS Medicare OPPS fee schedule,$198.89 ,88% of total billed charges for outpatient setting,$198.89 ,88% of total billed charges for outpatient setting,$9.02 ,100% CMS Medicare OPPS fee schedule,$8.11 ,90% CMS Medicare OPPS fee schedule,$9.02 ,100% CMS Medicare OPPS fee schedule,$9.02 ,100% CMS Medicare OPPS fee schedule,$9.02 ,100% CMS Medicare OPPS fee schedule,$9.02 ,100% CMS Medicare OPPS fee schedule,$9.02 ,100% CMS Medicare OPPS fee schedule,$9.02 ,100% CMS Medicare OPPS fee schedule,$9.02 ,100% CMS Medicare OPPS fee schedule,$9.02 ,100% CMS Medicare OPPS fee schedule,$9.02 ,100% CMS Medicare OPPS fee schedule,$9.02 ,100% CMS Medicare OPPS fee schedule,$7.58 ,100% of TX Medicaid OPPS fee schedule,$7.58 ,100% of TX Medicaid OPPS fee schedule,$7.58 ,100% of TX Medicaid OPPS fee schedule,$7.58 ,100% of TX Medicaid OPPS fee schedule,$7.58 ,100% of TX Medicaid OPPS fee schedule,$7.58 ,100% of TX Medicaid OPPS fee schedule,$7.58 ,100% of TX Medicaid OPPS fee schedule,$7.58 ,100% of TX Medicaid OPPS fee schedule,$7.58 ,100% of TX Medicaid OPPS fee schedule,$5.86 ,$214.71 ,$146.91 
Outpatient Medical Services,LAB,84156,PROTEIN URINE,301,$88.20 ,$4.58 ,125% CMS Medicare OPPS fee schedule,$67.03 ,76%  of total billed charges for outpatient setting,$3.67 ,100% CMS Medicare OPPS fee schedule,$18.12 ,400% of BCBSTX fee schedule,$18.12 ,400% of BCBSTX fee schedule,$3.67 ,100% CMS Medicare OPPS fee schedule,$18.12 ,400% of BCBSTX fee schedule,$4.53 ,100% of BCBSTX fee schedule,$79.38 ,90% of total billed charges for oupatient setting,$3.08 ,100% of TX Medicaid OPPS fee schedule,$79.38 ,90% of total billed charges for oupatient setting,$3.67 ,100% CMS Medicare OPPS fee schedule,$3.67 ,100% CMS Medicare OPPS fee schedule,$3.67 ,100% CMS Medicare OPPS fee schedule,$2.39 ,65% CMS Medicare OPPS fee schedule,$3.02 ,98% of TX Medicaid OPPS fee schedule,$83.79 ,95% of total billed charges for outpatient setting,$2.75 ,75% CMS Medicare OPPS fee schedule,$77.62 ,88% of total billed charges for outpatient setting,$77.62 ,88% of total billed charges for outpatient setting,$3.67 ,100% CMS Medicare OPPS fee schedule,$3.30 ,90% CMS Medicare OPPS fee schedule,$3.67 ,100% CMS Medicare OPPS fee schedule,$3.67 ,100% CMS Medicare OPPS fee schedule,$3.67 ,100% CMS Medicare OPPS fee schedule,$3.67 ,100% CMS Medicare OPPS fee schedule,$3.67 ,100% CMS Medicare OPPS fee schedule,$3.67 ,100% CMS Medicare OPPS fee schedule,$3.67 ,100% CMS Medicare OPPS fee schedule,$3.67 ,100% CMS Medicare OPPS fee schedule,$3.67 ,100% CMS Medicare OPPS fee schedule,$3.67 ,100% CMS Medicare OPPS fee schedule,$3.08 ,100% of TX Medicaid OPPS fee schedule,$3.08 ,100% of TX Medicaid OPPS fee schedule,$3.08 ,100% of TX Medicaid OPPS fee schedule,$3.08 ,100% of TX Medicaid OPPS fee schedule,$3.08 ,100% of TX Medicaid OPPS fee schedule,$3.08 ,100% of TX Medicaid OPPS fee schedule,$3.08 ,100% of TX Medicaid OPPS fee schedule,$3.08 ,100% of TX Medicaid OPPS fee schedule,$3.08 ,100% of TX Medicaid OPPS fee schedule,$2.39 ,$83.79 ,$57.33 
Outpatient Medical Services,LAB,84153,PSA TOTAL,301,$291.06 ,$22.98 ,125% CMS Medicare OPPS fee schedule,$221.21 ,76%  of total billed charges for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule,$90.84 ,400% of BCBSTX fee schedule,$90.84 ,400% of BCBSTX fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$90.84 ,400% of BCBSTX fee schedule,$22.71 ,100% of BCBSTX fee schedule,$261.95 ,90% of total billed charges for oupatient setting,$15.45 ,100% of TX Medicaid OPPS fee schedule,$261.95 ,90% of total billed charges for oupatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$11.95 ,65% CMS Medicare OPPS fee schedule,$15.14 ,98% of TX Medicaid OPPS fee schedule,$276.51 ,95% of total billed charges for outpatient setting,$13.79 ,75% CMS Medicare OPPS fee schedule,$256.13 ,88% of total billed charges for outpatient setting,$256.13 ,88% of total billed charges for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule,$16.55 ,90% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$11.95 ,$276.51 ,$189.19 
Outpatient Medical Services,LAB,84100,PHOSPHOROUS,301,$59.54 ,$5.92 ,125% CMS Medicare OPPS fee schedule,$45.25 ,76%  of total billed charges for outpatient setting,$4.74 ,100% CMS Medicare OPPS fee schedule,$23.40 ,400% of BCBSTX fee schedule,$23.40 ,400% of BCBSTX fee schedule,$4.74 ,100% CMS Medicare OPPS fee schedule,$23.40 ,400% of BCBSTX fee schedule,$5.85 ,100% of BCBSTX fee schedule,$53.59 ,90% of total billed charges for oupatient setting,$3.98 ,100% of TX Medicaid OPPS fee schedule,$53.59 ,90% of total billed charges for oupatient setting,$4.74 ,100% CMS Medicare OPPS fee schedule,$4.74 ,100% CMS Medicare OPPS fee schedule,$4.74 ,100% CMS Medicare OPPS fee schedule,$3.08 ,65% CMS Medicare OPPS fee schedule,$3.90 ,98% of TX Medicaid OPPS fee schedule,$56.56 ,95% of total billed charges for outpatient setting,$3.55 ,75% CMS Medicare OPPS fee schedule,$52.40 ,88% of total billed charges for outpatient setting,$52.40 ,88% of total billed charges for outpatient setting,$4.74 ,100% CMS Medicare OPPS fee schedule,$4.26 ,90% CMS Medicare OPPS fee schedule,$4.74 ,100% CMS Medicare OPPS fee schedule,$4.74 ,100% CMS Medicare OPPS fee schedule,$4.74 ,100% CMS Medicare OPPS fee schedule,$4.74 ,100% CMS Medicare OPPS fee schedule,$4.74 ,100% CMS Medicare OPPS fee schedule,$4.74 ,100% CMS Medicare OPPS fee schedule,$4.74 ,100% CMS Medicare OPPS fee schedule,$4.74 ,100% CMS Medicare OPPS fee schedule,$4.74 ,100% CMS Medicare OPPS fee schedule,$4.74 ,100% CMS Medicare OPPS fee schedule,$3.98 ,100% of TX Medicaid OPPS fee schedule,$3.98 ,100% of TX Medicaid OPPS fee schedule,$3.98 ,100% of TX Medicaid OPPS fee schedule,$3.98 ,100% of TX Medicaid OPPS fee schedule,$3.98 ,100% of TX Medicaid OPPS fee schedule,$3.98 ,100% of TX Medicaid OPPS fee schedule,$3.98 ,100% of TX Medicaid OPPS fee schedule,$3.98 ,100% of TX Medicaid OPPS fee schedule,$3.98 ,100% of TX Medicaid OPPS fee schedule,$3.08 ,$56.56 ,$38.70 
Outpatient Medical Services,LAB,84030,NEWBORN SCREENS,301,$72.77 ,$6.87 ,125% CMS Medicare OPPS fee schedule,$55.31 ,76%  of total billed charges for outpatient setting,$5.50 ,100% CMS Medicare OPPS fee schedule,$27.16 ,400% of BCBSTX fee schedule,$27.16 ,400% of BCBSTX fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$27.16 ,400% of BCBSTX fee schedule,$6.79 ,100% of BCBSTX fee schedule,$65.49 ,90% of total billed charges for oupatient setting,$4.62 ,100% of TX Medicaid OPPS fee schedule,$65.49 ,90% of total billed charges for oupatient setting,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$3.58 ,65% CMS Medicare OPPS fee schedule,$4.53 ,98% of TX Medicaid OPPS fee schedule,$69.13 ,95% of total billed charges for outpatient setting,$4.12 ,75% CMS Medicare OPPS fee schedule,$64.04 ,88% of total billed charges for outpatient setting,$64.04 ,88% of total billed charges for outpatient setting,$5.50 ,100% CMS Medicare OPPS fee schedule,$4.95 ,90% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$4.62 ,100% of TX Medicaid OPPS fee schedule,$4.62 ,100% of TX Medicaid OPPS fee schedule,$4.62 ,100% of TX Medicaid OPPS fee schedule,$4.62 ,100% of TX Medicaid OPPS fee schedule,$4.62 ,100% of TX Medicaid OPPS fee schedule,$4.62 ,100% of TX Medicaid OPPS fee schedule,$4.62 ,100% of TX Medicaid OPPS fee schedule,$4.62 ,100% of TX Medicaid OPPS fee schedule,$4.62 ,100% of TX Medicaid OPPS fee schedule,$3.58 ,$69.13 ,$47.30 
Outpatient Medical Services,LAB,83880,TRIAGE BNP,301,$277.14 ,$49.07 ,125% CMS Medicare OPPS fee schedule,$210.63 ,76%  of total billed charges for outpatient setting,$39.26 ,100% CMS Medicare OPPS fee schedule,$167.60 ,400% of BCBSTX fee schedule,$167.60 ,400% of BCBSTX fee schedule,$39.26 ,100% CMS Medicare OPPS fee schedule,$167.60 ,400% of BCBSTX fee schedule,$41.90 ,100% of BCBSTX fee schedule,$249.43 ,90% of total billed charges for oupatient setting,$32.98 ,100% of TX Medicaid OPPS fee schedule,$249.43 ,90% of total billed charges for oupatient setting,$39.26 ,100% CMS Medicare OPPS fee schedule,$39.26 ,100% CMS Medicare OPPS fee schedule,$39.26 ,100% CMS Medicare OPPS fee schedule,$25.52 ,65% CMS Medicare OPPS fee schedule,$32.32 ,98% of TX Medicaid OPPS fee schedule,$263.28 ,95% of total billed charges for outpatient setting,$29.44 ,75% CMS Medicare OPPS fee schedule,$243.88 ,88% of total billed charges for outpatient setting,$243.88 ,88% of total billed charges for outpatient setting,$39.26 ,100% CMS Medicare OPPS fee schedule,$35.33 ,90% CMS Medicare OPPS fee schedule,$39.26 ,100% CMS Medicare OPPS fee schedule,$39.26 ,100% CMS Medicare OPPS fee schedule,$39.26 ,100% CMS Medicare OPPS fee schedule,$39.26 ,100% CMS Medicare OPPS fee schedule,$39.26 ,100% CMS Medicare OPPS fee schedule,$39.26 ,100% CMS Medicare OPPS fee schedule,$39.26 ,100% CMS Medicare OPPS fee schedule,$39.26 ,100% CMS Medicare OPPS fee schedule,$39.26 ,100% CMS Medicare OPPS fee schedule,$39.26 ,100% CMS Medicare OPPS fee schedule,$32.98 ,100% of TX Medicaid OPPS fee schedule,$32.98 ,100% of TX Medicaid OPPS fee schedule,$32.98 ,100% of TX Medicaid OPPS fee schedule,$32.98 ,100% of TX Medicaid OPPS fee schedule,$32.98 ,100% of TX Medicaid OPPS fee schedule,$32.98 ,100% of TX Medicaid OPPS fee schedule,$32.98 ,100% of TX Medicaid OPPS fee schedule,$32.98 ,100% of TX Medicaid OPPS fee schedule,$32.98 ,100% of TX Medicaid OPPS fee schedule,$25.52 ,$263.28 ,$180.14 
Outpatient Medical Services,LAB,83874,MYOGLOBIN,301,$295.47 ,$16.15 ,125% CMS Medicare OPPS fee schedule,$224.56 ,76%  of total billed charges for outpatient setting,$12.92 ,100% CMS Medicare OPPS fee schedule,$63.80 ,400% of BCBSTX fee schedule,$63.80 ,400% of BCBSTX fee schedule,$12.92 ,100% CMS Medicare OPPS fee schedule,$63.80 ,400% of BCBSTX fee schedule,$15.95 ,100% of BCBSTX fee schedule,$265.92 ,90% of total billed charges for oupatient setting,$10.85 ,100% of TX Medicaid OPPS fee schedule,$265.92 ,90% of total billed charges for oupatient setting,$12.92 ,100% CMS Medicare OPPS fee schedule,$12.92 ,100% CMS Medicare OPPS fee schedule,$12.92 ,100% CMS Medicare OPPS fee schedule,$8.40 ,65% CMS Medicare OPPS fee schedule,$10.63 ,98% of TX Medicaid OPPS fee schedule,$280.70 ,95% of total billed charges for outpatient setting,$9.69 ,75% CMS Medicare OPPS fee schedule,$260.01 ,88% of total billed charges for outpatient setting,$260.01 ,88% of total billed charges for outpatient setting,$12.92 ,100% CMS Medicare OPPS fee schedule,$11.62 ,90% CMS Medicare OPPS fee schedule,$12.92 ,100% CMS Medicare OPPS fee schedule,$12.92 ,100% CMS Medicare OPPS fee schedule,$12.92 ,100% CMS Medicare OPPS fee schedule,$12.92 ,100% CMS Medicare OPPS fee schedule,$12.92 ,100% CMS Medicare OPPS fee schedule,$12.92 ,100% CMS Medicare OPPS fee schedule,$12.92 ,100% CMS Medicare OPPS fee schedule,$12.92 ,100% CMS Medicare OPPS fee schedule,$12.92 ,100% CMS Medicare OPPS fee schedule,$12.92 ,100% CMS Medicare OPPS fee schedule,$10.85 ,100% of TX Medicaid OPPS fee schedule,$10.85 ,100% of TX Medicaid OPPS fee schedule,$10.85 ,100% of TX Medicaid OPPS fee schedule,$10.85 ,100% of TX Medicaid OPPS fee schedule,$10.85 ,100% of TX Medicaid OPPS fee schedule,$10.85 ,100% of TX Medicaid OPPS fee schedule,$10.85 ,100% of TX Medicaid OPPS fee schedule,$10.85 ,100% of TX Medicaid OPPS fee schedule,$10.85 ,100% of TX Medicaid OPPS fee schedule,$8.40 ,$280.70 ,$192.06 
Outpatient Medical Services,LAB,83735,MAGNESIUM SERUM,301,$145.86 ,$8.37 ,125% CMS Medicare OPPS fee schedule,$110.85 ,76%  of total billed charges for outpatient setting,$6.70 ,100% CMS Medicare OPPS fee schedule,$33.08 ,400% of BCBSTX fee schedule,$33.08 ,400% of BCBSTX fee schedule,$6.70 ,100% CMS Medicare OPPS fee schedule,$33.08 ,400% of BCBSTX fee schedule,$8.27 ,100% of BCBSTX fee schedule,$131.27 ,90% of total billed charges for oupatient setting,$5.63 ,100% of TX Medicaid OPPS fee schedule,$131.27 ,90% of total billed charges for oupatient setting,$6.70 ,100% CMS Medicare OPPS fee schedule,$6.70 ,100% CMS Medicare OPPS fee schedule,$6.70 ,100% CMS Medicare OPPS fee schedule,$4.36 ,65% CMS Medicare OPPS fee schedule,$5.52 ,98% of TX Medicaid OPPS fee schedule,$138.57 ,95% of total billed charges for outpatient setting,$5.02 ,75% CMS Medicare OPPS fee schedule,$128.36 ,88% of total billed charges for outpatient setting,$128.36 ,88% of total billed charges for outpatient setting,$6.70 ,100% CMS Medicare OPPS fee schedule,$6.03 ,90% CMS Medicare OPPS fee schedule,$6.70 ,100% CMS Medicare OPPS fee schedule,$6.70 ,100% CMS Medicare OPPS fee schedule,$6.70 ,100% CMS Medicare OPPS fee schedule,$6.70 ,100% CMS Medicare OPPS fee schedule,$6.70 ,100% CMS Medicare OPPS fee schedule,$6.70 ,100% CMS Medicare OPPS fee schedule,$6.70 ,100% CMS Medicare OPPS fee schedule,$6.70 ,100% CMS Medicare OPPS fee schedule,$6.70 ,100% CMS Medicare OPPS fee schedule,$6.70 ,100% CMS Medicare OPPS fee schedule,$5.63 ,100% of TX Medicaid OPPS fee schedule,$5.63 ,100% of TX Medicaid OPPS fee schedule,$5.63 ,100% of TX Medicaid OPPS fee schedule,$5.63 ,100% of TX Medicaid OPPS fee schedule,$5.63 ,100% of TX Medicaid OPPS fee schedule,$5.63 ,100% of TX Medicaid OPPS fee schedule,$5.63 ,100% of TX Medicaid OPPS fee schedule,$5.63 ,100% of TX Medicaid OPPS fee schedule,$5.63 ,100% of TX Medicaid OPPS fee schedule,$4.36 ,$138.57 ,$94.81 
Outpatient Medical Services,LAB,83690,LIPASE,301,$235.94 ,$8.61 ,125% CMS Medicare OPPS fee schedule,$179.31 ,76%  of total billed charges for outpatient setting,$6.89 ,100% CMS Medicare OPPS fee schedule,$34.04 ,400% of BCBSTX fee schedule,$34.04 ,400% of BCBSTX fee schedule,$6.89 ,100% CMS Medicare OPPS fee schedule,$34.04 ,400% of BCBSTX fee schedule,$8.51 ,100% of BCBSTX fee schedule,$212.35 ,90% of total billed charges for oupatient setting,$5.79 ,100% of TX Medicaid OPPS fee schedule,$212.35 ,90% of total billed charges for oupatient setting,$6.89 ,100% CMS Medicare OPPS fee schedule,$6.89 ,100% CMS Medicare OPPS fee schedule,$6.89 ,100% CMS Medicare OPPS fee schedule,$4.48 ,65% CMS Medicare OPPS fee schedule,$5.67 ,98% of TX Medicaid OPPS fee schedule,$224.14 ,95% of total billed charges for outpatient setting,$5.16 ,75% CMS Medicare OPPS fee schedule,$207.63 ,88% of total billed charges for outpatient setting,$207.63 ,88% of total billed charges for outpatient setting,$6.89 ,100% CMS Medicare OPPS fee schedule,$6.20 ,90% CMS Medicare OPPS fee schedule,$6.89 ,100% CMS Medicare OPPS fee schedule,$6.89 ,100% CMS Medicare OPPS fee schedule,$6.89 ,100% CMS Medicare OPPS fee schedule,$6.89 ,100% CMS Medicare OPPS fee schedule,$6.89 ,100% CMS Medicare OPPS fee schedule,$6.89 ,100% CMS Medicare OPPS fee schedule,$6.89 ,100% CMS Medicare OPPS fee schedule,$6.89 ,100% CMS Medicare OPPS fee schedule,$6.89 ,100% CMS Medicare OPPS fee schedule,$6.89 ,100% CMS Medicare OPPS fee schedule,$5.79 ,100% of TX Medicaid OPPS fee schedule,$5.79 ,100% of TX Medicaid OPPS fee schedule,$5.79 ,100% of TX Medicaid OPPS fee schedule,$5.79 ,100% of TX Medicaid OPPS fee schedule,$5.79 ,100% of TX Medicaid OPPS fee schedule,$5.79 ,100% of TX Medicaid OPPS fee schedule,$5.79 ,100% of TX Medicaid OPPS fee schedule,$5.79 ,100% of TX Medicaid OPPS fee schedule,$5.79 ,100% of TX Medicaid OPPS fee schedule,$4.48 ,$224.14 ,$153.36 
Outpatient Medical Services,LAB,83605,LACTATE ACID (LACTIC,301,$119.07 ,$14.46 ,125% CMS Medicare OPPS fee schedule,$90.49 ,76%  of total billed charges for outpatient setting,$11.57 ,100% CMS Medicare OPPS fee schedule,$52.76 ,400% of BCBSTX fee schedule,$52.76 ,400% of BCBSTX fee schedule,$11.57 ,100% CMS Medicare OPPS fee schedule,$52.76 ,400% of BCBSTX fee schedule,$13.19 ,100% of BCBSTX fee schedule,$107.16 ,90% of total billed charges for oupatient setting,$9.72 ,100% of TX Medicaid OPPS fee schedule,$107.16 ,90% of total billed charges for oupatient setting,$11.57 ,100% CMS Medicare OPPS fee schedule,$11.57 ,100% CMS Medicare OPPS fee schedule,$11.57 ,100% CMS Medicare OPPS fee schedule,$7.52 ,65% CMS Medicare OPPS fee schedule,$9.53 ,98% of TX Medicaid OPPS fee schedule,$113.12 ,95% of total billed charges for outpatient setting,$8.67 ,75% CMS Medicare OPPS fee schedule,$104.78 ,88% of total billed charges for outpatient setting,$104.78 ,88% of total billed charges for outpatient setting,$11.57 ,100% CMS Medicare OPPS fee schedule,$10.41 ,90% CMS Medicare OPPS fee schedule,$11.57 ,100% CMS Medicare OPPS fee schedule,$11.57 ,100% CMS Medicare OPPS fee schedule,$11.57 ,100% CMS Medicare OPPS fee schedule,$11.57 ,100% CMS Medicare OPPS fee schedule,$11.57 ,100% CMS Medicare OPPS fee schedule,$11.57 ,100% CMS Medicare OPPS fee schedule,$11.57 ,100% CMS Medicare OPPS fee schedule,$11.57 ,100% CMS Medicare OPPS fee schedule,$11.57 ,100% CMS Medicare OPPS fee schedule,$11.57 ,100% CMS Medicare OPPS fee schedule,$9.72 ,100% of TX Medicaid OPPS fee schedule,$9.72 ,100% of TX Medicaid OPPS fee schedule,$9.72 ,100% of TX Medicaid OPPS fee schedule,$9.72 ,100% of TX Medicaid OPPS fee schedule,$9.72 ,100% of TX Medicaid OPPS fee schedule,$9.72 ,100% of TX Medicaid OPPS fee schedule,$9.72 ,100% of TX Medicaid OPPS fee schedule,$9.72 ,100% of TX Medicaid OPPS fee schedule,$9.72 ,100% of TX Medicaid OPPS fee schedule,$7.52 ,$113.12 ,$77.40 
Outpatient Medical Services,LAB,83550,TIBC,301,$291.06 ,$10.92 ,125% CMS Medicare OPPS fee schedule,$221.21 ,76%  of total billed charges for outpatient setting,$8.74 ,100% CMS Medicare OPPS fee schedule,$43.16 ,400% of BCBSTX fee schedule,$43.16 ,400% of BCBSTX fee schedule,$8.74 ,100% CMS Medicare OPPS fee schedule,$43.16 ,400% of BCBSTX fee schedule,$10.79 ,100% of BCBSTX fee schedule,$261.95 ,90% of total billed charges for oupatient setting,$7.34 ,100% of TX Medicaid OPPS fee schedule,$261.95 ,90% of total billed charges for oupatient setting,$8.74 ,100% CMS Medicare OPPS fee schedule,$8.74 ,100% CMS Medicare OPPS fee schedule,$8.74 ,100% CMS Medicare OPPS fee schedule,$5.68 ,65% CMS Medicare OPPS fee schedule,$7.19 ,98% of TX Medicaid OPPS fee schedule,$276.51 ,95% of total billed charges for outpatient setting,$6.55 ,75% CMS Medicare OPPS fee schedule,$256.13 ,88% of total billed charges for outpatient setting,$256.13 ,88% of total billed charges for outpatient setting,$8.74 ,100% CMS Medicare OPPS fee schedule,$7.86 ,90% CMS Medicare OPPS fee schedule,$8.74 ,100% CMS Medicare OPPS fee schedule,$8.74 ,100% CMS Medicare OPPS fee schedule,$8.74 ,100% CMS Medicare OPPS fee schedule,$8.74 ,100% CMS Medicare OPPS fee schedule,$8.74 ,100% CMS Medicare OPPS fee schedule,$8.74 ,100% CMS Medicare OPPS fee schedule,$8.74 ,100% CMS Medicare OPPS fee schedule,$8.74 ,100% CMS Medicare OPPS fee schedule,$8.74 ,100% CMS Medicare OPPS fee schedule,$8.74 ,100% CMS Medicare OPPS fee schedule,$7.34 ,100% of TX Medicaid OPPS fee schedule,$7.34 ,100% of TX Medicaid OPPS fee schedule,$7.34 ,100% of TX Medicaid OPPS fee schedule,$7.34 ,100% of TX Medicaid OPPS fee schedule,$7.34 ,100% of TX Medicaid OPPS fee schedule,$7.34 ,100% of TX Medicaid OPPS fee schedule,$7.34 ,100% of TX Medicaid OPPS fee schedule,$7.34 ,100% of TX Medicaid OPPS fee schedule,$7.34 ,100% of TX Medicaid OPPS fee schedule,$5.68 ,$276.51 ,$189.19 
Outpatient Medical Services,LAB,83540,IRON SERUM,301,$89.30 ,$8.08 ,125% CMS Medicare OPPS fee schedule,$67.87 ,76%  of total billed charges for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule,$31.96 ,400% of BCBSTX fee schedule,$31.96 ,400% of BCBSTX fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$31.96 ,400% of BCBSTX fee schedule,$7.99 ,100% of BCBSTX fee schedule,$80.37 ,90% of total billed charges for oupatient setting,$5.43 ,100% of TX Medicaid OPPS fee schedule,$80.37 ,90% of total billed charges for oupatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$4.21 ,65% CMS Medicare OPPS fee schedule,$5.32 ,98% of TX Medicaid OPPS fee schedule,$84.84 ,95% of total billed charges for outpatient setting,$4.85 ,75% CMS Medicare OPPS fee schedule,$78.58 ,88% of total billed charges for outpatient setting,$78.58 ,88% of total billed charges for outpatient setting,$6.47 ,100% CMS Medicare OPPS fee schedule,$5.82 ,90% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$6.47 ,100% CMS Medicare OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$5.43 ,100% of TX Medicaid OPPS fee schedule,$4.21 ,$84.84 ,$58.05 
Outpatient Medical Services,LAB,83036,HAIC,301,$186.32 ,$12.13 ,125% CMS Medicare OPPS fee schedule,$141.60 ,76%  of total billed charges for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule,$47.96 ,400% of BCBSTX fee schedule,$47.96 ,400% of BCBSTX fee schedule,$9.71 ,100% CMS Medicare OPPS fee schedule,$47.96 ,400% of BCBSTX fee schedule,$11.99 ,100% of BCBSTX fee schedule,$167.69 ,90% of total billed charges for oupatient setting,$8.16 ,100% of TX Medicaid OPPS fee schedule,$167.69 ,90% of total billed charges for oupatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule,$9.71 ,100% CMS Medicare OPPS fee schedule,$9.71 ,100% CMS Medicare OPPS fee schedule,$6.31 ,65% CMS Medicare OPPS fee schedule,$8.00 ,98% of TX Medicaid OPPS fee schedule,$177.00 ,95% of total billed charges for outpatient setting,$7.28 ,75% CMS Medicare OPPS fee schedule,$163.96 ,88% of total billed charges for outpatient setting,$163.96 ,88% of total billed charges for outpatient setting,$9.71 ,100% CMS Medicare OPPS fee schedule,$8.73 ,90% CMS Medicare OPPS fee schedule,$9.71 ,100% CMS Medicare OPPS fee schedule,$9.71 ,100% CMS Medicare OPPS fee schedule,$9.71 ,100% CMS Medicare OPPS fee schedule,$9.71 ,100% CMS Medicare OPPS fee schedule,$9.71 ,100% CMS Medicare OPPS fee schedule,$9.71 ,100% CMS Medicare OPPS fee schedule,$9.71 ,100% CMS Medicare OPPS fee schedule,$9.71 ,100% CMS Medicare OPPS fee schedule,$9.71 ,100% CMS Medicare OPPS fee schedule,$9.71 ,100% CMS Medicare OPPS fee schedule,$8.16 ,100% of TX Medicaid OPPS fee schedule,$8.16 ,100% of TX Medicaid OPPS fee schedule,$8.16 ,100% of TX Medicaid OPPS fee schedule,$8.16 ,100% of TX Medicaid OPPS fee schedule,$8.16 ,100% of TX Medicaid OPPS fee schedule,$8.16 ,100% of TX Medicaid OPPS fee schedule,$8.16 ,100% of TX Medicaid OPPS fee schedule,$8.16 ,100% of TX Medicaid OPPS fee schedule,$8.16 ,100% of TX Medicaid OPPS fee schedule,$6.31 ,$177.00 ,$121.11 
Outpatient Medical Services,LAB,82977,GGT,301,$91.51 ,$9.00 ,125% CMS Medicare OPPS fee schedule,$69.55 ,76%  of total billed charges for outpatient setting,$7.20 ,100% CMS Medicare OPPS fee schedule,$35.56 ,400% of BCBSTX fee schedule,$35.56 ,400% of BCBSTX fee schedule,$7.20 ,100% CMS Medicare OPPS fee schedule,$35.56 ,400% of BCBSTX fee schedule,$8.89 ,100% of BCBSTX fee schedule,$82.36 ,90% of total billed charges for oupatient setting,$6.05 ,100% of TX Medicaid OPPS fee schedule,$82.36 ,90% of total billed charges for oupatient setting,$7.20 ,100% CMS Medicare OPPS fee schedule,$7.20 ,100% CMS Medicare OPPS fee schedule,$7.20 ,100% CMS Medicare OPPS fee schedule,$4.68 ,65% CMS Medicare OPPS fee schedule,$5.93 ,98% of TX Medicaid OPPS fee schedule,$86.93 ,95% of total billed charges for outpatient setting,$5.40 ,75% CMS Medicare OPPS fee schedule,$80.53 ,88% of total billed charges for outpatient setting,$80.53 ,88% of total billed charges for outpatient setting,$7.20 ,100% CMS Medicare OPPS fee schedule,$6.48 ,90% CMS Medicare OPPS fee schedule,$7.20 ,100% CMS Medicare OPPS fee schedule,$7.20 ,100% CMS Medicare OPPS fee schedule,$7.20 ,100% CMS Medicare OPPS fee schedule,$7.20 ,100% CMS Medicare OPPS fee schedule,$7.20 ,100% CMS Medicare OPPS fee schedule,$7.20 ,100% CMS Medicare OPPS fee schedule,$7.20 ,100% CMS Medicare OPPS fee schedule,$7.20 ,100% CMS Medicare OPPS fee schedule,$7.20 ,100% CMS Medicare OPPS fee schedule,$7.20 ,100% CMS Medicare OPPS fee schedule,$6.05 ,100% of TX Medicaid OPPS fee schedule,$6.05 ,100% of TX Medicaid OPPS fee schedule,$6.05 ,100% of TX Medicaid OPPS fee schedule,$6.05 ,100% of TX Medicaid OPPS fee schedule,$6.05 ,100% of TX Medicaid OPPS fee schedule,$6.05 ,100% of TX Medicaid OPPS fee schedule,$6.05 ,100% of TX Medicaid OPPS fee schedule,$6.05 ,100% of TX Medicaid OPPS fee schedule,$6.05 ,100% of TX Medicaid OPPS fee schedule,$4.68 ,$86.93 ,$59.48 
Outpatient Medical Services,LAB,82962,GLUCOSE (FS),301,$59.54 ,$4.10 ,125% CMS Medicare OPPS fee schedule,$45.25 ,76%  of total billed charges for outpatient setting,$3.28 ,100% CMS Medicare OPPS fee schedule,$13.12 ,400% of BCBSTX fee schedule,$13.12 ,400% of BCBSTX fee schedule,$3.28 ,100% CMS Medicare OPPS fee schedule,$13.12 ,400% of BCBSTX fee schedule,$3.28 ,100% of BCBSTX fee schedule,$53.59 ,90% of total billed charges for oupatient setting,$26.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$53.59 ,90% of total billed charges for oupatient setting,$3.28 ,100% CMS Medicare OPPS fee schedule,$3.28 ,100% CMS Medicare OPPS fee schedule,$3.28 ,100% CMS Medicare OPPS fee schedule,$2.13 ,65% CMS Medicare OPPS fee schedule,$26.26 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$56.56 ,95% of total billed charges for outpatient setting,$2.45 ,75% CMS Medicare OPPS fee schedule,$52.40 ,88% of total billed charges for outpatient setting,$52.40 ,88% of total billed charges for outpatient setting,$3.28 ,100% CMS Medicare OPPS fee schedule,$2.95 ,90% CMS Medicare OPPS fee schedule,$3.28 ,100% CMS Medicare OPPS fee schedule,$3.28 ,100% CMS Medicare OPPS fee schedule,$3.28 ,100% CMS Medicare OPPS fee schedule,$3.28 ,100% CMS Medicare OPPS fee schedule,$3.28 ,100% CMS Medicare OPPS fee schedule,$3.28 ,100% CMS Medicare OPPS fee schedule,$3.28 ,100% CMS Medicare OPPS fee schedule,$3.28 ,100% CMS Medicare OPPS fee schedule,$3.28 ,100% CMS Medicare OPPS fee schedule,$3.28 ,100% CMS Medicare OPPS fee schedule,$26.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$26.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$26.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$26.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$26.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$26.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$26.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$26.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$26.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$2.13 ,$56.56 ,$38.70 
Outpatient Medical Services,LAB,82728,FERRITIN,301,$253.58 ,$17.03 ,125% CMS Medicare OPPS fee schedule,$192.72 ,76%  of total billed charges for outpatient setting,$13.63 ,100% CMS Medicare OPPS fee schedule,$67.32 ,400% of BCBSTX fee schedule,$67.32 ,400% of BCBSTX fee schedule,$13.63 ,100% CMS Medicare OPPS fee schedule,$67.32 ,400% of BCBSTX fee schedule,$16.83 ,100% of BCBSTX fee schedule,$228.22 ,90% of total billed charges for oupatient setting,$11.45 ,100% of TX Medicaid OPPS fee schedule,$228.22 ,90% of total billed charges for oupatient setting,$13.63 ,100% CMS Medicare OPPS fee schedule,$13.63 ,100% CMS Medicare OPPS fee schedule,$13.63 ,100% CMS Medicare OPPS fee schedule,$8.86 ,65% CMS Medicare OPPS fee schedule,$11.22 ,98% of TX Medicaid OPPS fee schedule,$240.90 ,95% of total billed charges for outpatient setting,$10.22 ,75% CMS Medicare OPPS fee schedule,$223.15 ,88% of total billed charges for outpatient setting,$223.15 ,88% of total billed charges for outpatient setting,$13.63 ,100% CMS Medicare OPPS fee schedule,$12.26 ,90% CMS Medicare OPPS fee schedule,$13.63 ,100% CMS Medicare OPPS fee schedule,$13.63 ,100% CMS Medicare OPPS fee schedule,$13.63 ,100% CMS Medicare OPPS fee schedule,$13.63 ,100% CMS Medicare OPPS fee schedule,$13.63 ,100% CMS Medicare OPPS fee schedule,$13.63 ,100% CMS Medicare OPPS fee schedule,$13.63 ,100% CMS Medicare OPPS fee schedule,$13.63 ,100% CMS Medicare OPPS fee schedule,$13.63 ,100% CMS Medicare OPPS fee schedule,$13.63 ,100% CMS Medicare OPPS fee schedule,$11.45 ,100% of TX Medicaid OPPS fee schedule,$11.45 ,100% of TX Medicaid OPPS fee schedule,$11.45 ,100% of TX Medicaid OPPS fee schedule,$11.45 ,100% of TX Medicaid OPPS fee schedule,$11.45 ,100% of TX Medicaid OPPS fee schedule,$11.45 ,100% of TX Medicaid OPPS fee schedule,$11.45 ,100% of TX Medicaid OPPS fee schedule,$11.45 ,100% of TX Medicaid OPPS fee schedule,$11.45 ,100% of TX Medicaid OPPS fee schedule,$8.86 ,$240.90 ,$164.83 
Outpatient Medical Services,LAB,82607,VITAMIN B12,301,$78.28 ,$18.85 ,125% CMS Medicare OPPS fee schedule,$59.49 ,76%  of total billed charges for outpatient setting,$15.08 ,100% CMS Medicare OPPS fee schedule,$74.44 ,400% of BCBSTX fee schedule,$74.44 ,400% of BCBSTX fee schedule,$15.08 ,100% CMS Medicare OPPS fee schedule,$74.44 ,400% of BCBSTX fee schedule,$18.61 ,100% of BCBSTX fee schedule,$70.45 ,90% of total billed charges for oupatient setting,$12.67 ,100% of TX Medicaid OPPS fee schedule,$70.45 ,90% of total billed charges for oupatient setting,$15.08 ,100% CMS Medicare OPPS fee schedule,$15.08 ,100% CMS Medicare OPPS fee schedule,$15.08 ,100% CMS Medicare OPPS fee schedule,$9.80 ,65% CMS Medicare OPPS fee schedule,$12.42 ,98% of TX Medicaid OPPS fee schedule,$74.37 ,95% of total billed charges for outpatient setting,$11.31 ,75% CMS Medicare OPPS fee schedule,$68.89 ,88% of total billed charges for outpatient setting,$68.89 ,88% of total billed charges for outpatient setting,$15.08 ,100% CMS Medicare OPPS fee schedule,$13.57 ,90% CMS Medicare OPPS fee schedule,$15.08 ,100% CMS Medicare OPPS fee schedule,$15.08 ,100% CMS Medicare OPPS fee schedule,$15.08 ,100% CMS Medicare OPPS fee schedule,$15.08 ,100% CMS Medicare OPPS fee schedule,$15.08 ,100% CMS Medicare OPPS fee schedule,$15.08 ,100% CMS Medicare OPPS fee schedule,$15.08 ,100% CMS Medicare OPPS fee schedule,$15.08 ,100% CMS Medicare OPPS fee schedule,$15.08 ,100% CMS Medicare OPPS fee schedule,$15.08 ,100% CMS Medicare OPPS fee schedule,$12.67 ,100% of TX Medicaid OPPS fee schedule,$12.67 ,100% of TX Medicaid OPPS fee schedule,$12.67 ,100% of TX Medicaid OPPS fee schedule,$12.67 ,100% of TX Medicaid OPPS fee schedule,$12.67 ,100% of TX Medicaid OPPS fee schedule,$12.67 ,100% of TX Medicaid OPPS fee schedule,$12.67 ,100% of TX Medicaid OPPS fee schedule,$12.67 ,100% of TX Medicaid OPPS fee schedule,$12.67 ,100% of TX Medicaid OPPS fee schedule,$9.80 ,$74.44 ,$50.88 
Outpatient Medical Services,LAB,82570,CREATININE URINE,301,$149.94 ,$6.47 ,125% CMS Medicare OPPS fee schedule,$113.95 ,76%  of total billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule,$25.56 ,400% of BCBSTX fee schedule,$25.56 ,400% of BCBSTX fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$25.56 ,400% of BCBSTX fee schedule,$6.39 ,100% of BCBSTX fee schedule,$134.95 ,90% of total billed charges for oupatient setting,$4.35 ,100% of TX Medicaid OPPS fee schedule,$134.95 ,90% of total billed charges for oupatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$3.37 ,65% CMS Medicare OPPS fee schedule,$4.26 ,98% of TX Medicaid OPPS fee schedule,$142.44 ,95% of total billed charges for outpatient setting,$3.88 ,75% CMS Medicare OPPS fee schedule,$131.95 ,88% of total billed charges for outpatient setting,$131.95 ,88% of total billed charges for outpatient setting,$5.18 ,100% CMS Medicare OPPS fee schedule,$4.66 ,90% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$5.18 ,100% CMS Medicare OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$4.35 ,100% of TX Medicaid OPPS fee schedule,$3.37 ,$142.44 ,$97.46 
Outpatient Medical Services,LAB,82553,CKMB,301,$279.98 ,$14.43 ,125% CMS Medicare OPPS fee schedule,$212.78 ,76%  of total billed charges for outpatient setting,$11.55 ,100% CMS Medicare OPPS fee schedule,$57.04 ,400% of BCBSTX fee schedule,$57.04 ,400% of BCBSTX fee schedule,$11.55 ,100% CMS Medicare OPPS fee schedule,$57.04 ,400% of BCBSTX fee schedule,$14.26 ,100% of BCBSTX fee schedule,$251.98 ,90% of total billed charges for oupatient setting,$9.70 ,100% of TX Medicaid OPPS fee schedule,$251.98 ,90% of total billed charges for oupatient setting,$11.55 ,100% CMS Medicare OPPS fee schedule,$11.55 ,100% CMS Medicare OPPS fee schedule,$11.55 ,100% CMS Medicare OPPS fee schedule,$7.51 ,65% CMS Medicare OPPS fee schedule,$9.51 ,98% of TX Medicaid OPPS fee schedule,$265.98 ,95% of total billed charges for outpatient setting,$8.66 ,75% CMS Medicare OPPS fee schedule,$246.38 ,88% of total billed charges for outpatient setting,$246.38 ,88% of total billed charges for outpatient setting,$11.55 ,100% CMS Medicare OPPS fee schedule,$10.39 ,90% CMS Medicare OPPS fee schedule,$11.55 ,100% CMS Medicare OPPS fee schedule,$11.55 ,100% CMS Medicare OPPS fee schedule,$11.55 ,100% CMS Medicare OPPS fee schedule,$11.55 ,100% CMS Medicare OPPS fee schedule,$11.55 ,100% CMS Medicare OPPS fee schedule,$11.55 ,100% CMS Medicare OPPS fee schedule,$11.55 ,100% CMS Medicare OPPS fee schedule,$11.55 ,100% CMS Medicare OPPS fee schedule,$11.55 ,100% CMS Medicare OPPS fee schedule,$11.55 ,100% CMS Medicare OPPS fee schedule,$9.70 ,100% of TX Medicaid OPPS fee schedule,$9.70 ,100% of TX Medicaid OPPS fee schedule,$9.70 ,100% of TX Medicaid OPPS fee schedule,$9.70 ,100% of TX Medicaid OPPS fee schedule,$9.70 ,100% of TX Medicaid OPPS fee schedule,$9.70 ,100% of TX Medicaid OPPS fee schedule,$9.70 ,100% of TX Medicaid OPPS fee schedule,$9.70 ,100% of TX Medicaid OPPS fee schedule,$9.70 ,100% of TX Medicaid OPPS fee schedule,$7.51 ,$265.98 ,$181.99 
Outpatient Medical Services,LAB,82550,CPK (BLOOD) TOTAL,301,$183.68 ,$8.13 ,125% CMS Medicare OPPS fee schedule,$139.60 ,76%  of total billed charges for outpatient setting,$6.51 ,100% CMS Medicare OPPS fee schedule,$32.16 ,400% of BCBSTX fee schedule,$32.16 ,400% of BCBSTX fee schedule,$6.51 ,100% CMS Medicare OPPS fee schedule,$32.16 ,400% of BCBSTX fee schedule,$8.04 ,100% of BCBSTX fee schedule,$165.31 ,90% of total billed charges for oupatient setting,$5.47 ,100% of TX Medicaid OPPS fee schedule,$165.31 ,90% of total billed charges for oupatient setting,$6.51 ,100% CMS Medicare OPPS fee schedule,$6.51 ,100% CMS Medicare OPPS fee schedule,$6.51 ,100% CMS Medicare OPPS fee schedule,$4.23 ,65% CMS Medicare OPPS fee schedule,$5.36 ,98% of TX Medicaid OPPS fee schedule,$174.50 ,95% of total billed charges for outpatient setting,$4.88 ,75% CMS Medicare OPPS fee schedule,$161.64 ,88% of total billed charges for outpatient setting,$161.64 ,88% of total billed charges for outpatient setting,$6.51 ,100% CMS Medicare OPPS fee schedule,$5.85 ,90% CMS Medicare OPPS fee schedule,$6.51 ,100% CMS Medicare OPPS fee schedule,$6.51 ,100% CMS Medicare OPPS fee schedule,$6.51 ,100% CMS Medicare OPPS fee schedule,$6.51 ,100% CMS Medicare OPPS fee schedule,$6.51 ,100% CMS Medicare OPPS fee schedule,$6.51 ,100% CMS Medicare OPPS fee schedule,$6.51 ,100% CMS Medicare OPPS fee schedule,$6.51 ,100% CMS Medicare OPPS fee schedule,$6.51 ,100% CMS Medicare OPPS fee schedule,$6.51 ,100% CMS Medicare OPPS fee schedule,$5.47 ,100% of TX Medicaid OPPS fee schedule,$5.47 ,100% of TX Medicaid OPPS fee schedule,$5.47 ,100% of TX Medicaid OPPS fee schedule,$5.47 ,100% of TX Medicaid OPPS fee schedule,$5.47 ,100% of TX Medicaid OPPS fee schedule,$5.47 ,100% of TX Medicaid OPPS fee schedule,$5.47 ,100% of TX Medicaid OPPS fee schedule,$5.47 ,100% of TX Medicaid OPPS fee schedule,$5.47 ,100% of TX Medicaid OPPS fee schedule,$4.23 ,$174.50 ,$119.39 
Outpatient Medical Services,LAB,82272,OCCULT BLOOD  STOOL,301,$38.59 ,$5.28 ,125% CMS Medicare OPPS fee schedule,$29.33 ,76%  of total billed charges for outpatient setting,$4.23 ,100% CMS Medicare OPPS fee schedule,$16.92 ,400% of BCBSTX fee schedule,$16.92 ,400% of BCBSTX fee schedule,$4.23 ,100% CMS Medicare OPPS fee schedule,$16.92 ,400% of BCBSTX fee schedule,$4.23 ,100% of BCBSTX fee schedule,$34.73 ,90% of total billed charges for oupatient setting,$3.55 ,100% of TX Medicaid OPPS fee schedule,$34.73 ,90% of total billed charges for oupatient setting,$4.23 ,100% CMS Medicare OPPS fee schedule,$4.23 ,100% CMS Medicare OPPS fee schedule,$4.23 ,100% CMS Medicare OPPS fee schedule,$2.75 ,65% CMS Medicare OPPS fee schedule,$3.48 ,98% of TX Medicaid OPPS fee schedule,$36.66 ,95% of total billed charges for outpatient setting,$3.17 ,75% CMS Medicare OPPS fee schedule,$33.96 ,88% of total billed charges for outpatient setting,$33.96 ,88% of total billed charges for outpatient setting,$4.23 ,100% CMS Medicare OPPS fee schedule,$3.80 ,90% CMS Medicare OPPS fee schedule,$4.23 ,100% CMS Medicare OPPS fee schedule,$4.23 ,100% CMS Medicare OPPS fee schedule,$4.23 ,100% CMS Medicare OPPS fee schedule,$4.23 ,100% CMS Medicare OPPS fee schedule,$4.23 ,100% CMS Medicare OPPS fee schedule,$4.23 ,100% CMS Medicare OPPS fee schedule,$4.23 ,100% CMS Medicare OPPS fee schedule,$4.23 ,100% CMS Medicare OPPS fee schedule,$4.23 ,100% CMS Medicare OPPS fee schedule,$4.23 ,100% CMS Medicare OPPS fee schedule,$3.55 ,100% of TX Medicaid OPPS fee schedule,$3.55 ,100% of TX Medicaid OPPS fee schedule,$3.55 ,100% of TX Medicaid OPPS fee schedule,$3.55 ,100% of TX Medicaid OPPS fee schedule,$3.55 ,100% of TX Medicaid OPPS fee schedule,$3.55 ,100% of TX Medicaid OPPS fee schedule,$3.55 ,100% of TX Medicaid OPPS fee schedule,$3.55 ,100% of TX Medicaid OPPS fee schedule,$3.55 ,100% of TX Medicaid OPPS fee schedule,$2.75 ,$36.66 ,$25.08 
Outpatient Medical Services,LAB,82248,BILIRUBINDIRECT,301,$79.38 ,$6.27 ,125% CMS Medicare OPPS fee schedule,$60.33 ,76%  of total billed charges for outpatient setting,$5.01 ,100% CMS Medicare OPPS fee schedule,$24.76 ,400% of BCBSTX fee schedule,$24.76 ,400% of BCBSTX fee schedule,$5.01 ,100% CMS Medicare OPPS fee schedule,$24.76 ,400% of BCBSTX fee schedule,$6.19 ,100% of BCBSTX fee schedule,$71.44 ,90% of total billed charges for oupatient setting,$4.22 ,100% of TX Medicaid OPPS fee schedule,$71.44 ,90% of total billed charges for oupatient setting,$5.01 ,100% CMS Medicare OPPS fee schedule,$5.01 ,100% CMS Medicare OPPS fee schedule,$5.01 ,100% CMS Medicare OPPS fee schedule,$3.26 ,65% CMS Medicare OPPS fee schedule,$4.14 ,98% of TX Medicaid OPPS fee schedule,$75.41 ,95% of total billed charges for outpatient setting,$3.76 ,75% CMS Medicare OPPS fee schedule,$69.85 ,88% of total billed charges for outpatient setting,$69.85 ,88% of total billed charges for outpatient setting,$5.01 ,100% CMS Medicare OPPS fee schedule,$4.51 ,90% CMS Medicare OPPS fee schedule,$5.01 ,100% CMS Medicare OPPS fee schedule,$5.01 ,100% CMS Medicare OPPS fee schedule,$5.01 ,100% CMS Medicare OPPS fee schedule,$5.01 ,100% CMS Medicare OPPS fee schedule,$5.01 ,100% CMS Medicare OPPS fee schedule,$5.01 ,100% CMS Medicare OPPS fee schedule,$5.01 ,100% CMS Medicare OPPS fee schedule,$5.01 ,100% CMS Medicare OPPS fee schedule,$5.01 ,100% CMS Medicare OPPS fee schedule,$5.01 ,100% CMS Medicare OPPS fee schedule,$4.22 ,100% of TX Medicaid OPPS fee schedule,$4.22 ,100% of TX Medicaid OPPS fee schedule,$4.22 ,100% of TX Medicaid OPPS fee schedule,$4.22 ,100% of TX Medicaid OPPS fee schedule,$4.22 ,100% of TX Medicaid OPPS fee schedule,$4.22 ,100% of TX Medicaid OPPS fee schedule,$4.22 ,100% of TX Medicaid OPPS fee schedule,$4.22 ,100% of TX Medicaid OPPS fee schedule,$4.22 ,100% of TX Medicaid OPPS fee schedule,$3.26 ,$75.41 ,$51.60 
Outpatient Medical Services,LAB,82140,AMMONIA,301,$128.99 ,$18.21 ,125% CMS Medicare OPPS fee schedule,$98.03 ,76%  of total billed charges for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule,$71.96 ,400% of BCBSTX fee schedule,$71.96 ,400% of BCBSTX fee schedule,$14.57 ,100% CMS Medicare OPPS fee schedule,$71.96 ,400% of BCBSTX fee schedule,$17.99 ,100% of BCBSTX fee schedule,$116.09 ,90% of total billed charges for oupatient setting,$12.24 ,100% of TX Medicaid OPPS fee schedule,$116.09 ,90% of total billed charges for oupatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule,$14.57 ,100% CMS Medicare OPPS fee schedule,$14.57 ,100% CMS Medicare OPPS fee schedule,$9.47 ,65% CMS Medicare OPPS fee schedule,$12.00 ,98% of TX Medicaid OPPS fee schedule,$122.54 ,95% of total billed charges for outpatient setting,$10.92 ,75% CMS Medicare OPPS fee schedule,$113.51 ,88% of total billed charges for outpatient setting,$113.51 ,88% of total billed charges for outpatient setting,$14.57 ,100% CMS Medicare OPPS fee schedule,$13.11 ,90% CMS Medicare OPPS fee schedule,$14.57 ,100% CMS Medicare OPPS fee schedule,$14.57 ,100% CMS Medicare OPPS fee schedule,$14.57 ,100% CMS Medicare OPPS fee schedule,$14.57 ,100% CMS Medicare OPPS fee schedule,$14.57 ,100% CMS Medicare OPPS fee schedule,$14.57 ,100% CMS Medicare OPPS fee schedule,$14.57 ,100% CMS Medicare OPPS fee schedule,$14.57 ,100% CMS Medicare OPPS fee schedule,$14.57 ,100% CMS Medicare OPPS fee schedule,$14.57 ,100% CMS Medicare OPPS fee schedule,$12.24 ,100% of TX Medicaid OPPS fee schedule,$12.24 ,100% of TX Medicaid OPPS fee schedule,$12.24 ,100% of TX Medicaid OPPS fee schedule,$12.24 ,100% of TX Medicaid OPPS fee schedule,$12.24 ,100% of TX Medicaid OPPS fee schedule,$12.24 ,100% of TX Medicaid OPPS fee schedule,$12.24 ,100% of TX Medicaid OPPS fee schedule,$12.24 ,100% of TX Medicaid OPPS fee schedule,$12.24 ,100% of TX Medicaid OPPS fee schedule,$9.47 ,$122.54 ,$83.84 
Outpatient Medical Services,LAB,82043,MICROALBUMIN,301,$149.94 ,$7.22 ,125% CMS Medicare OPPS fee schedule,$113.95 ,76%  of total billed charges for outpatient setting,$5.78 ,100% CMS Medicare OPPS fee schedule,$28.56 ,400% of BCBSTX fee schedule,$28.56 ,400% of BCBSTX fee schedule,$5.78 ,100% CMS Medicare OPPS fee schedule,$28.56 ,400% of BCBSTX fee schedule,$7.14 ,100% of BCBSTX fee schedule,$134.95 ,90% of total billed charges for oupatient setting,$4.86 ,100% of TX Medicaid OPPS fee schedule,$134.95 ,90% of total billed charges for oupatient setting,$5.78 ,100% CMS Medicare OPPS fee schedule,$5.78 ,100% CMS Medicare OPPS fee schedule,$5.78 ,100% CMS Medicare OPPS fee schedule,$3.76 ,65% CMS Medicare OPPS fee schedule,$4.76 ,98% of TX Medicaid OPPS fee schedule,$142.44 ,95% of total billed charges for outpatient setting,$4.33 ,75% CMS Medicare OPPS fee schedule,$131.95 ,88% of total billed charges for outpatient setting,$131.95 ,88% of total billed charges for outpatient setting,$5.78 ,100% CMS Medicare OPPS fee schedule,$5.20 ,90% CMS Medicare OPPS fee schedule,$5.78 ,100% CMS Medicare OPPS fee schedule,$5.78 ,100% CMS Medicare OPPS fee schedule,$5.78 ,100% CMS Medicare OPPS fee schedule,$5.78 ,100% CMS Medicare OPPS fee schedule,$5.78 ,100% CMS Medicare OPPS fee schedule,$5.78 ,100% CMS Medicare OPPS fee schedule,$5.78 ,100% CMS Medicare OPPS fee schedule,$5.78 ,100% CMS Medicare OPPS fee schedule,$5.78 ,100% CMS Medicare OPPS fee schedule,$5.78 ,100% CMS Medicare OPPS fee schedule,$4.86 ,100% of TX Medicaid OPPS fee schedule,$4.86 ,100% of TX Medicaid OPPS fee schedule,$4.86 ,100% of TX Medicaid OPPS fee schedule,$4.86 ,100% of TX Medicaid OPPS fee schedule,$4.86 ,100% of TX Medicaid OPPS fee schedule,$4.86 ,100% of TX Medicaid OPPS fee schedule,$4.86 ,100% of TX Medicaid OPPS fee schedule,$4.86 ,100% of TX Medicaid OPPS fee schedule,$4.86 ,100% of TX Medicaid OPPS fee schedule,$3.76 ,$142.44 ,$97.46 
Outpatient Medical Services,LAB,80329,ACETAMINOPHEN,301,$224.91 ,,125% CMS Medicare OPPS fee schedule,$170.93 ,76%  of total billed charges for outpatient setting,,100% CMS Medicare OPPS fee schedule,,400% of BCBSTX fee schedule,,400% of BCBSTX fee schedule,,100% CMS Medicare OPPS fee schedule,,400% of BCBSTX fee schedule,,100% of BCBSTX fee schedule,$202.42 ,90% of total billed charges for oupatient setting,$9.63 ,100% of TX Medicaid OPPS fee schedule,$202.42 ,90% of total billed charges for oupatient setting,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,65% CMS Medicare OPPS fee schedule,$9.44 ,98% of TX Medicaid OPPS fee schedule,$213.66 ,95% of total billed charges for outpatient setting,,100% CMS Medicare OPPS fee schedule,$197.92 ,88% of total billed charges for outpatient setting,$197.92 ,88% of total billed charges for outpatient setting,,100% CMS Medicare OPPS fee schedule,,90% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,$9.63 ,100% of TX Medicaid OPPS fee schedule,$9.63 ,100% of TX Medicaid OPPS fee schedule,$9.63 ,100% of TX Medicaid OPPS fee schedule,$9.63 ,100% of TX Medicaid OPPS fee schedule,$9.63 ,100% of TX Medicaid OPPS fee schedule,$9.63 ,100% of TX Medicaid OPPS fee schedule,$9.63 ,100% of TX Medicaid OPPS fee schedule,$9.63 ,100% of TX Medicaid OPPS fee schedule,$9.63 ,100% of TX Medicaid OPPS fee schedule,,$213.66 ,$146.19 
Outpatient Medical Services,LAB,80320,ALCOHOL BLOOD,301,$173.09 ,,125% CMS Medicare OPPS fee schedule,$131.55 ,76%  of total billed charges for outpatient setting,,100% CMS Medicare OPPS fee schedule,,400% of BCBSTX fee schedule,,400% of BCBSTX fee schedule,,100% CMS Medicare OPPS fee schedule,,400% of BCBSTX fee schedule,,100% of BCBSTX fee schedule,$155.78 ,90% of total billed charges for oupatient setting,$9.42 ,100% of TX Medicaid OPPS fee schedule,$155.78 ,90% of total billed charges for oupatient setting,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,65% CMS Medicare OPPS fee schedule,$9.23 ,98% of TX Medicaid OPPS fee schedule,$164.44 ,95% of total billed charges for outpatient setting,,100% CMS Medicare OPPS fee schedule,$152.32 ,88% of total billed charges for outpatient setting,$152.32 ,88% of total billed charges for outpatient setting,,100% CMS Medicare OPPS fee schedule,,90% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,$9.42 ,100% of TX Medicaid OPPS fee schedule,$9.42 ,100% of TX Medicaid OPPS fee schedule,$9.42 ,100% of TX Medicaid OPPS fee schedule,$9.42 ,100% of TX Medicaid OPPS fee schedule,$9.42 ,100% of TX Medicaid OPPS fee schedule,$9.42 ,100% of TX Medicaid OPPS fee schedule,$9.42 ,100% of TX Medicaid OPPS fee schedule,$9.42 ,100% of TX Medicaid OPPS fee schedule,$9.42 ,100% of TX Medicaid OPPS fee schedule,,$164.44 ,$112.51 
Outpatient Medical Services,LAB,80307,DIAG URINE DRUG SCRN,301,$323.03 ,$77.67 ,125% CMS Medicare OPPS fee schedule,$245.50 ,76%  of total billed charges for outpatient setting,$62.14 ,100% CMS Medicare OPPS fee schedule,$287.32 ,400% of BCBSTX fee schedule,$287.32 ,400% of BCBSTX fee schedule,$62.14 ,100% CMS Medicare OPPS fee schedule,$287.32 ,400% of BCBSTX fee schedule,$71.83 ,100% of BCBSTX fee schedule,$290.73 ,90% of total billed charges for oupatient setting,$52.20 ,100% of TX Medicaid OPPS fee schedule,$290.73 ,90% of total billed charges for oupatient setting,$62.14 ,100% CMS Medicare OPPS fee schedule,$62.14 ,100% CMS Medicare OPPS fee schedule,$62.14 ,100% CMS Medicare OPPS fee schedule,$40.39 ,65% CMS Medicare OPPS fee schedule,$51.16 ,98% of TX Medicaid OPPS fee schedule,$306.88 ,95% of total billed charges for outpatient setting,$46.60 ,75% CMS Medicare OPPS fee schedule,$284.27 ,88% of total billed charges for outpatient setting,$284.27 ,88% of total billed charges for outpatient setting,$62.14 ,100% CMS Medicare OPPS fee schedule,$55.92 ,90% CMS Medicare OPPS fee schedule,$62.14 ,100% CMS Medicare OPPS fee schedule,$62.14 ,100% CMS Medicare OPPS fee schedule,$62.14 ,100% CMS Medicare OPPS fee schedule,$62.14 ,100% CMS Medicare OPPS fee schedule,$62.14 ,100% CMS Medicare OPPS fee schedule,$62.14 ,100% CMS Medicare OPPS fee schedule,$62.14 ,100% CMS Medicare OPPS fee schedule,$62.14 ,100% CMS Medicare OPPS fee schedule,$62.14 ,100% CMS Medicare OPPS fee schedule,$62.14 ,100% CMS Medicare OPPS fee schedule,$52.20 ,100% of TX Medicaid OPPS fee schedule,$52.20 ,100% of TX Medicaid OPPS fee schedule,$52.20 ,100% of TX Medicaid OPPS fee schedule,$52.20 ,100% of TX Medicaid OPPS fee schedule,$52.20 ,100% of TX Medicaid OPPS fee schedule,$52.20 ,100% of TX Medicaid OPPS fee schedule,$52.20 ,100% of TX Medicaid OPPS fee schedule,$52.20 ,100% of TX Medicaid OPPS fee schedule,$52.20 ,100% of TX Medicaid OPPS fee schedule,$40.39 ,$306.88 ,$209.97 
Outpatient Medical Services,LAB,80202,VANCOMYCIN LEVEL,301,$202.86 ,$16.92 ,125% CMS Medicare OPPS fee schedule,$154.17 ,76%  of total billed charges for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule,$66.88 ,400% of BCBSTX fee schedule,$66.88 ,400% of BCBSTX fee schedule,$13.54 ,100% CMS Medicare OPPS fee schedule,$66.88 ,400% of BCBSTX fee schedule,$16.72 ,100% of BCBSTX fee schedule,$182.57 ,90% of total billed charges for oupatient setting,$11.37 ,100% of TX Medicaid OPPS fee schedule,$182.57 ,90% of total billed charges for oupatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule,$13.54 ,100% CMS Medicare OPPS fee schedule,$13.54 ,100% CMS Medicare OPPS fee schedule,$8.80 ,65% CMS Medicare OPPS fee schedule,$11.14 ,98% of TX Medicaid OPPS fee schedule,$192.72 ,95% of total billed charges for outpatient setting,$10.15 ,75% CMS Medicare OPPS fee schedule,$178.52 ,88% of total billed charges for outpatient setting,$178.52 ,88% of total billed charges for outpatient setting,$13.54 ,100% CMS Medicare OPPS fee schedule,$12.18 ,90% CMS Medicare OPPS fee schedule,$13.54 ,100% CMS Medicare OPPS fee schedule,$13.54 ,100% CMS Medicare OPPS fee schedule,$13.54 ,100% CMS Medicare OPPS fee schedule,$13.54 ,100% CMS Medicare OPPS fee schedule,$13.54 ,100% CMS Medicare OPPS fee schedule,$13.54 ,100% CMS Medicare OPPS fee schedule,$13.54 ,100% CMS Medicare OPPS fee schedule,$13.54 ,100% CMS Medicare OPPS fee schedule,$13.54 ,100% CMS Medicare OPPS fee schedule,$13.54 ,100% CMS Medicare OPPS fee schedule,$11.37 ,100% of TX Medicaid OPPS fee schedule,$11.37 ,100% of TX Medicaid OPPS fee schedule,$11.37 ,100% of TX Medicaid OPPS fee schedule,$11.37 ,100% of TX Medicaid OPPS fee schedule,$11.37 ,100% of TX Medicaid OPPS fee schedule,$11.37 ,100% of TX Medicaid OPPS fee schedule,$11.37 ,100% of TX Medicaid OPPS fee schedule,$11.37 ,100% of TX Medicaid OPPS fee schedule,$11.37 ,100% of TX Medicaid OPPS fee schedule,$8.80 ,$192.72 ,$131.86 
Outpatient Medical Services,LAB,80076,HEPATIC FUNCTION PAN,301,$389.18 ,$10.21 ,125% CMS Medicare OPPS fee schedule,$295.78 ,76%  of total billed charges for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule,$40.36 ,400% of BCBSTX fee schedule,$40.36 ,400% of BCBSTX fee schedule,$8.17 ,100% CMS Medicare OPPS fee schedule,$40.36 ,400% of BCBSTX fee schedule,$10.09 ,100% of BCBSTX fee schedule,$350.26 ,90% of total billed charges for oupatient setting,$6.86 ,100% of TX Medicaid OPPS fee schedule,$350.26 ,90% of total billed charges for oupatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule,$8.17 ,100% CMS Medicare OPPS fee schedule,$8.17 ,100% CMS Medicare OPPS fee schedule,$5.31 ,65% CMS Medicare OPPS fee schedule,$6.72 ,98% of TX Medicaid OPPS fee schedule,$369.72 ,95% of total billed charges for outpatient setting,$6.12 ,75% CMS Medicare OPPS fee schedule,$342.48 ,88% of total billed charges for outpatient setting,$342.48 ,88% of total billed charges for outpatient setting,$8.17 ,100% CMS Medicare OPPS fee schedule,$7.35 ,90% CMS Medicare OPPS fee schedule,$8.17 ,100% CMS Medicare OPPS fee schedule,$8.17 ,100% CMS Medicare OPPS fee schedule,$8.17 ,100% CMS Medicare OPPS fee schedule,$8.17 ,100% CMS Medicare OPPS fee schedule,$8.17 ,100% CMS Medicare OPPS fee schedule,$8.17 ,100% CMS Medicare OPPS fee schedule,$8.17 ,100% CMS Medicare OPPS fee schedule,$8.17 ,100% CMS Medicare OPPS fee schedule,$8.17 ,100% CMS Medicare OPPS fee schedule,$8.17 ,100% CMS Medicare OPPS fee schedule,$6.86 ,100% of TX Medicaid OPPS fee schedule,$6.86 ,100% of TX Medicaid OPPS fee schedule,$6.86 ,100% of TX Medicaid OPPS fee schedule,$6.86 ,100% of TX Medicaid OPPS fee schedule,$6.86 ,100% of TX Medicaid OPPS fee schedule,$6.86 ,100% of TX Medicaid OPPS fee schedule,$6.86 ,100% of TX Medicaid OPPS fee schedule,$6.86 ,100% of TX Medicaid OPPS fee schedule,$6.86 ,100% of TX Medicaid OPPS fee schedule,$5.31 ,$369.72 ,$252.97 
Outpatient Medical Services,LAB,80074,HEP PANEL(A B NON A&,301,$723.24 ,$59.53 ,125% CMS Medicare OPPS fee schedule,$549.66 ,76%  of total billed charges for outpatient setting,$47.63 ,100% CMS Medicare OPPS fee schedule,$235.24 ,400% of BCBSTX fee schedule,$235.24 ,400% of BCBSTX fee schedule,$47.63 ,100% CMS Medicare OPPS fee schedule,$235.24 ,400% of BCBSTX fee schedule,$58.81 ,100% of BCBSTX fee schedule,$650.92 ,90% of total billed charges for oupatient setting,$40.01 ,100% of TX Medicaid OPPS fee schedule,$650.92 ,90% of total billed charges for oupatient setting,$47.63 ,100% CMS Medicare OPPS fee schedule,$47.63 ,100% CMS Medicare OPPS fee schedule,$47.63 ,100% CMS Medicare OPPS fee schedule,$30.96 ,65% CMS Medicare OPPS fee schedule,$39.21 ,98% of TX Medicaid OPPS fee schedule,$687.08 ,95% of total billed charges for outpatient setting,$35.72 ,75% CMS Medicare OPPS fee schedule,$636.45 ,88% of total billed charges for outpatient setting,$636.45 ,88% of total billed charges for outpatient setting,$47.63 ,100% CMS Medicare OPPS fee schedule,$42.86 ,90% CMS Medicare OPPS fee schedule,$47.63 ,100% CMS Medicare OPPS fee schedule,$47.63 ,100% CMS Medicare OPPS fee schedule,$47.63 ,100% CMS Medicare OPPS fee schedule,$47.63 ,100% CMS Medicare OPPS fee schedule,$47.63 ,100% CMS Medicare OPPS fee schedule,$47.63 ,100% CMS Medicare OPPS fee schedule,$47.63 ,100% CMS Medicare OPPS fee schedule,$47.63 ,100% CMS Medicare OPPS fee schedule,$47.63 ,100% CMS Medicare OPPS fee schedule,$47.63 ,100% CMS Medicare OPPS fee schedule,$40.01 ,100% of TX Medicaid OPPS fee schedule,$40.01 ,100% of TX Medicaid OPPS fee schedule,$40.01 ,100% of TX Medicaid OPPS fee schedule,$40.01 ,100% of TX Medicaid OPPS fee schedule,$40.01 ,100% of TX Medicaid OPPS fee schedule,$40.01 ,100% of TX Medicaid OPPS fee schedule,$40.01 ,100% of TX Medicaid OPPS fee schedule,$40.01 ,100% of TX Medicaid OPPS fee schedule,$40.01 ,100% of TX Medicaid OPPS fee schedule,$30.96 ,$687.08 ,$470.11 
Outpatient Medical Services,LAB,80069,RENAL FUNCTION PANEL,301,$249.17 ,$10.85 ,125% CMS Medicare OPPS fee schedule,$189.37 ,76%  of total billed charges for outpatient setting,$8.68 ,100% CMS Medicare OPPS fee schedule,$42.88 ,400% of BCBSTX fee schedule,$42.88 ,400% of BCBSTX fee schedule,$8.68 ,100% CMS Medicare OPPS fee schedule,$42.88 ,400% of BCBSTX fee schedule,$10.72 ,100% of BCBSTX fee schedule,$224.25 ,90% of total billed charges for oupatient setting,$7.29 ,100% of TX Medicaid OPPS fee schedule,$224.25 ,90% of total billed charges for oupatient setting,$8.68 ,100% CMS Medicare OPPS fee schedule,$8.68 ,100% CMS Medicare OPPS fee schedule,$8.68 ,100% CMS Medicare OPPS fee schedule,$5.64 ,65% CMS Medicare OPPS fee schedule,$7.14 ,98% of TX Medicaid OPPS fee schedule,$236.71 ,95% of total billed charges for outpatient setting,$6.51 ,75% CMS Medicare OPPS fee schedule,$219.27 ,88% of total billed charges for outpatient setting,$219.27 ,88% of total billed charges for outpatient setting,$8.68 ,100% CMS Medicare OPPS fee schedule,$7.81 ,90% CMS Medicare OPPS fee schedule,$8.68 ,100% CMS Medicare OPPS fee schedule,$8.68 ,100% CMS Medicare OPPS fee schedule,$8.68 ,100% CMS Medicare OPPS fee schedule,$8.68 ,100% CMS Medicare OPPS fee schedule,$8.68 ,100% CMS Medicare OPPS fee schedule,$8.68 ,100% CMS Medicare OPPS fee schedule,$8.68 ,100% CMS Medicare OPPS fee schedule,$8.68 ,100% CMS Medicare OPPS fee schedule,$8.68 ,100% CMS Medicare OPPS fee schedule,$8.68 ,100% CMS Medicare OPPS fee schedule,$7.29 ,100% of TX Medicaid OPPS fee schedule,$7.29 ,100% of TX Medicaid OPPS fee schedule,$7.29 ,100% of TX Medicaid OPPS fee schedule,$7.29 ,100% of TX Medicaid OPPS fee schedule,$7.29 ,100% of TX Medicaid OPPS fee schedule,$7.29 ,100% of TX Medicaid OPPS fee schedule,$7.29 ,100% of TX Medicaid OPPS fee schedule,$7.29 ,100% of TX Medicaid OPPS fee schedule,$7.29 ,100% of TX Medicaid OPPS fee schedule,$5.64 ,$236.71 ,$161.96 
Outpatient Medical Services,LAB,80061,LIPID PROFILE,301,$250.27 ,$16.73 ,125% CMS Medicare OPPS fee schedule,$190.21 ,76%  of total billed charges for outpatient setting,$13.39 ,100% CMS Medicare OPPS fee schedule,$66.12 ,400% of BCBSTX fee schedule,$66.12 ,400% of BCBSTX fee schedule,$13.39 ,100% CMS Medicare OPPS fee schedule,$66.12 ,400% of BCBSTX fee schedule,$16.53 ,100% of BCBSTX fee schedule,$225.24 ,90% of total billed charges for oupatient setting,$11.25 ,100% of TX Medicaid OPPS fee schedule,$225.24 ,90% of total billed charges for oupatient setting,$13.39 ,100% CMS Medicare OPPS fee schedule,$13.39 ,100% CMS Medicare OPPS fee schedule,$13.39 ,100% CMS Medicare OPPS fee schedule,$8.70 ,65% CMS Medicare OPPS fee schedule,$11.03 ,98% of TX Medicaid OPPS fee schedule,$237.76 ,95% of total billed charges for outpatient setting,$10.04 ,75% CMS Medicare OPPS fee schedule,$220.24 ,88% of total billed charges for outpatient setting,$220.24 ,88% of total billed charges for outpatient setting,$13.39 ,100% CMS Medicare OPPS fee schedule,$12.05 ,90% CMS Medicare OPPS fee schedule,$13.39 ,100% CMS Medicare OPPS fee schedule,$13.39 ,100% CMS Medicare OPPS fee schedule,$13.39 ,100% CMS Medicare OPPS fee schedule,$13.39 ,100% CMS Medicare OPPS fee schedule,$13.39 ,100% CMS Medicare OPPS fee schedule,$13.39 ,100% CMS Medicare OPPS fee schedule,$13.39 ,100% CMS Medicare OPPS fee schedule,$13.39 ,100% CMS Medicare OPPS fee schedule,$13.39 ,100% CMS Medicare OPPS fee schedule,$13.39 ,100% CMS Medicare OPPS fee schedule,$11.25 ,100% of TX Medicaid OPPS fee schedule,$11.25 ,100% of TX Medicaid OPPS fee schedule,$11.25 ,100% of TX Medicaid OPPS fee schedule,$11.25 ,100% of TX Medicaid OPPS fee schedule,$11.25 ,100% of TX Medicaid OPPS fee schedule,$11.25 ,100% of TX Medicaid OPPS fee schedule,$11.25 ,100% of TX Medicaid OPPS fee schedule,$11.25 ,100% of TX Medicaid OPPS fee schedule,$11.25 ,100% of TX Medicaid OPPS fee schedule,$8.70 ,$237.76 ,$162.68 
Outpatient Medical Services,LAB,80053,COMPREHENSIVE METABO,301,$285.55 ,$13.20 ,125% CMS Medicare OPPS fee schedule,$217.02 ,76%  of total billed charges for outpatient setting,$10.56 ,100% CMS Medicare OPPS fee schedule,,Not seperately reimbursable,,Not seperately reimbursable,$10.56 ,100% CMS Medicare OPPS fee schedule,,Not seperately reimbursable,,Not seperately reimbursable,$257.00 ,90% of total billed charges for oupatient setting,$8.87 ,100% of TX Medicaid OPPS fee schedule,$257.00 ,90% of total billed charges for oupatient setting,$10.56 ,100% CMS Medicare OPPS fee schedule,$10.56 ,100% CMS Medicare OPPS fee schedule,$10.56 ,100% CMS Medicare OPPS fee schedule,$6.86 ,65% CMS Medicare OPPS fee schedule,$8.69 ,98% of TX Medicaid OPPS fee schedule,$271.27 ,95% of total billed charges for outpatient setting,$7.92 ,75% CMS Medicare OPPS fee schedule,$251.28 ,88% of total billed charges for outpatient setting,$251.28 ,88% of total billed charges for outpatient setting,$10.56 ,100% CMS Medicare OPPS fee schedule,$9.50 ,90% CMS Medicare OPPS fee schedule,$10.56 ,100% CMS Medicare OPPS fee schedule,$10.56 ,100% CMS Medicare OPPS fee schedule,$10.56 ,100% CMS Medicare OPPS fee schedule,$10.56 ,100% CMS Medicare OPPS fee schedule,$10.56 ,100% CMS Medicare OPPS fee schedule,$10.56 ,100% CMS Medicare OPPS fee schedule,$10.56 ,100% CMS Medicare OPPS fee schedule,$10.56 ,100% CMS Medicare OPPS fee schedule,$10.56 ,100% CMS Medicare OPPS fee schedule,$10.56 ,100% CMS Medicare OPPS fee schedule,$8.87 ,100% of TX Medicaid OPPS fee schedule,$8.87 ,100% of TX Medicaid OPPS fee schedule,$8.87 ,100% of TX Medicaid OPPS fee schedule,$8.87 ,100% of TX Medicaid OPPS fee schedule,$8.87 ,100% of TX Medicaid OPPS fee schedule,$8.87 ,100% of TX Medicaid OPPS fee schedule,$8.87 ,100% of TX Medicaid OPPS fee schedule,$8.87 ,100% of TX Medicaid OPPS fee schedule,$8.87 ,100% of TX Medicaid OPPS fee schedule,$6.86 ,$271.27 ,$185.61 
Outpatient Medical Services,LAB,80048,BASIC METABOLIC PANE,301,$178.61 ,$10.57 ,125% CMS Medicare OPPS fee schedule,$135.74 ,76%  of total billed charges for outpatient setting,$8.46 ,100% CMS Medicare OPPS fee schedule,$41.76 ,400% of BCBSTX fee schedule,$41.76 ,400% of BCBSTX fee schedule,$8.46 ,100% CMS Medicare OPPS fee schedule,$41.76 ,400% of BCBSTX fee schedule,$10.44 ,100% of BCBSTX fee schedule,$160.75 ,90% of total billed charges for oupatient setting,$7.11 ,100% of TX Medicaid OPPS fee schedule,$160.75 ,90% of total billed charges for oupatient setting,$8.46 ,100% CMS Medicare OPPS fee schedule,$8.46 ,100% CMS Medicare OPPS fee schedule,$8.46 ,100% CMS Medicare OPPS fee schedule,$5.50 ,65% CMS Medicare OPPS fee schedule,$6.97 ,98% of TX Medicaid OPPS fee schedule,$169.68 ,95% of total billed charges for outpatient setting,$6.34 ,75% CMS Medicare OPPS fee schedule,$157.18 ,88% of total billed charges for outpatient setting,$157.18 ,88% of total billed charges for outpatient setting,$8.46 ,100% CMS Medicare OPPS fee schedule,$7.61 ,90% CMS Medicare OPPS fee schedule,$8.46 ,100% CMS Medicare OPPS fee schedule,$8.46 ,100% CMS Medicare OPPS fee schedule,$8.46 ,100% CMS Medicare OPPS fee schedule,$8.46 ,100% CMS Medicare OPPS fee schedule,$8.46 ,100% CMS Medicare OPPS fee schedule,$8.46 ,100% CMS Medicare OPPS fee schedule,$8.46 ,100% CMS Medicare OPPS fee schedule,$8.46 ,100% CMS Medicare OPPS fee schedule,$8.46 ,100% CMS Medicare OPPS fee schedule,$8.46 ,100% CMS Medicare OPPS fee schedule,$7.11 ,100% of TX Medicaid OPPS fee schedule,$7.11 ,100% of TX Medicaid OPPS fee schedule,$7.11 ,100% of TX Medicaid OPPS fee schedule,$7.11 ,100% of TX Medicaid OPPS fee schedule,$7.11 ,100% of TX Medicaid OPPS fee schedule,$7.11 ,100% of TX Medicaid OPPS fee schedule,$7.11 ,100% of TX Medicaid OPPS fee schedule,$7.11 ,100% of TX Medicaid OPPS fee schedule,$7.11 ,100% of TX Medicaid OPPS fee schedule,$5.50 ,$169.68 ,$116.10 
Outpatient Medical Services,LAB,99001,Send Out Test Handling Fee,300,$56.25 ,,125% CMS Medicare OPPS fee schedule,,76%  of total billed charges for outpatient setting,,100% CMS Medicare OPPS fee schedule,$24.40 ,400% of BCBSTX fee schedule,$24.40 ,400% of BCBSTX fee schedule,,100% CMS Medicare OPPS fee schedule,$24.40 ,400% of BCBSTX fee schedule,$6.10 ,100% of BCBSTX fee schedule,$50.63 ,90% of total billed charges for oupatient setting,$25.31 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.63 ,90% of total billed charges for oupatient setting,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,65% CMS Medicare OPPS fee schedule,$24.81 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$53.44 ,95% of total billed charges for outpatient setting,,100% CMS Medicare OPPS fee schedule,$49.50 ,88% of total billed charges for outpatient setting,$49.50 ,88% of total billed charges for outpatient setting,,100% CMS Medicare OPPS fee schedule,,90% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,$25.31 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$25.31 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$25.31 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$25.31 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$25.31 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$25.31 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$25.31 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$25.31 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$25.31 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,,$53.44 ,$36.56 
Outpatient Medical Services,LAB,82306,VITAMIN D 25OH (VVRMC),300,$472.97 ,$37.00 ,125% CMS Medicare OPPS fee schedule,$359.46 ,76%  of total billed charges for outpatient setting,$29.60 ,100% CMS Medicare OPPS fee schedule,$146.20 ,400% of BCBSTX fee schedule,$146.20 ,400% of BCBSTX fee schedule,$29.60 ,100% CMS Medicare OPPS fee schedule,$146.20 ,400% of BCBSTX fee schedule,$36.55 ,100% of BCBSTX fee schedule,$425.67 ,90% of total billed charges for oupatient setting,$24.86 ,100% of TX Medicaid OPPS fee schedule,$425.67 ,90% of total billed charges for oupatient setting,$29.60 ,100% CMS Medicare OPPS fee schedule,$29.60 ,100% CMS Medicare OPPS fee schedule,$29.60 ,100% CMS Medicare OPPS fee schedule,$19.24 ,65% CMS Medicare OPPS fee schedule,$24.36 ,98% of TX Medicaid OPPS fee schedule,$449.32 ,95% of total billed charges for outpatient setting,$22.20 ,75% CMS Medicare OPPS fee schedule,$416.21 ,88% of total billed charges for outpatient setting,$416.21 ,88% of total billed charges for outpatient setting,$29.60 ,100% CMS Medicare OPPS fee schedule,$26.64 ,90% CMS Medicare OPPS fee schedule,$29.60 ,100% CMS Medicare OPPS fee schedule,$29.60 ,100% CMS Medicare OPPS fee schedule,$29.60 ,100% CMS Medicare OPPS fee schedule,$29.60 ,100% CMS Medicare OPPS fee schedule,$29.60 ,100% CMS Medicare OPPS fee schedule,$29.60 ,100% CMS Medicare OPPS fee schedule,$29.60 ,100% CMS Medicare OPPS fee schedule,$29.60 ,100% CMS Medicare OPPS fee schedule,$29.60 ,100% CMS Medicare OPPS fee schedule,$29.60 ,100% CMS Medicare OPPS fee schedule,$24.86 ,100% of TX Medicaid OPPS fee schedule,$24.86 ,100% of TX Medicaid OPPS fee schedule,$24.86 ,100% of TX Medicaid OPPS fee schedule,$24.86 ,100% of TX Medicaid OPPS fee schedule,$24.86 ,100% of TX Medicaid OPPS fee schedule,$24.86 ,100% of TX Medicaid OPPS fee schedule,$24.86 ,100% of TX Medicaid OPPS fee schedule,$24.86 ,100% of TX Medicaid OPPS fee schedule,$24.86 ,100% of TX Medicaid OPPS fee schedule,$19.24 ,$449.32 ,$307.43 
Outpatient Medical Services,LAB,81001,URINALYSIS WITH REFLEX CULTURE,300,$105.69 ,$3.96 ,125% CMS Medicare OPPS fee schedule,$80.32 ,76%  of total billed charges for outpatient setting,$3.17 ,100% CMS Medicare OPPS fee schedule,$15.68 ,400% of BCBSTX fee schedule,$15.68 ,400% of BCBSTX fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$15.68 ,400% of BCBSTX fee schedule,$3.92 ,100% of BCBSTX fee schedule,$95.12 ,90% of total billed charges for oupatient setting,$2.66 ,100% of TX Medicaid OPPS fee schedule,$95.12 ,90% of total billed charges for oupatient setting,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$2.06 ,65% CMS Medicare OPPS fee schedule,$2.61 ,98% of TX Medicaid OPPS fee schedule,$100.41 ,95% of total billed charges for outpatient setting,$2.37 ,75% CMS Medicare OPPS fee schedule,$93.01 ,88% of total billed charges for outpatient setting,$93.01 ,88% of total billed charges for outpatient setting,$3.17 ,100% CMS Medicare OPPS fee schedule,$2.85 ,90% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$3.17 ,100% CMS Medicare OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.66 ,100% of TX Medicaid OPPS fee schedule,$2.06 ,$100.41 ,$68.70 
Outpatient Medical Services,LAB,81003,SPEFC GRAVITY UA W/O,307,$38.59 ,$2.81 ,125% CMS Medicare OPPS fee schedule,$29.33 ,76%  of total billed charges for outpatient setting,$2.25 ,100% CMS Medicare OPPS fee schedule,$11.08 ,400% of BCBSTX fee schedule,$11.08 ,400% of BCBSTX fee schedule,$2.25 ,100% CMS Medicare OPPS fee schedule,$11.08 ,400% of BCBSTX fee schedule,$2.77 ,100% of BCBSTX fee schedule,$34.73 ,90% of total billed charges for oupatient setting,$1.89 ,100% of TX Medicaid OPPS fee schedule,$34.73 ,90% of total billed charges for oupatient setting,$2.25 ,100% CMS Medicare OPPS fee schedule,$2.25 ,100% CMS Medicare OPPS fee schedule,$2.25 ,100% CMS Medicare OPPS fee schedule,$1.46 ,65% CMS Medicare OPPS fee schedule,$1.85 ,98% of TX Medicaid OPPS fee schedule,$36.66 ,95% of total billed charges for outpatient setting,$1.68 ,75% CMS Medicare OPPS fee schedule,$33.96 ,88% of total billed charges for outpatient setting,$33.96 ,88% of total billed charges for outpatient setting,$2.25 ,100% CMS Medicare OPPS fee schedule,$2.02 ,90% CMS Medicare OPPS fee schedule,$2.25 ,100% CMS Medicare OPPS fee schedule,$2.25 ,100% CMS Medicare OPPS fee schedule,$2.25 ,100% CMS Medicare OPPS fee schedule,$2.25 ,100% CMS Medicare OPPS fee schedule,$2.25 ,100% CMS Medicare OPPS fee schedule,$2.25 ,100% CMS Medicare OPPS fee schedule,$2.25 ,100% CMS Medicare OPPS fee schedule,$2.25 ,100% CMS Medicare OPPS fee schedule,$2.25 ,100% CMS Medicare OPPS fee schedule,$2.25 ,100% CMS Medicare OPPS fee schedule,$1.89 ,100% of TX Medicaid OPPS fee schedule,$1.89 ,100% of TX Medicaid OPPS fee schedule,$1.89 ,100% of TX Medicaid OPPS fee schedule,$1.89 ,100% of TX Medicaid OPPS fee schedule,$1.89 ,100% of TX Medicaid OPPS fee schedule,$1.89 ,100% of TX Medicaid OPPS fee schedule,$1.89 ,100% of TX Medicaid OPPS fee schedule,$1.89 ,100% of TX Medicaid OPPS fee schedule,$1.89 ,100% of TX Medicaid OPPS fee schedule,$1.46 ,$36.66 ,$25.08 
Outpatient Medical Services,LAB,84154,PSA FREE,301,$60.64 ,$22.98 ,125% CMS Medicare OPPS fee schedule,$46.09 ,76%  of total billed charges for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule,$90.84 ,400% of BCBSTX fee schedule,$90.84 ,400% of BCBSTX fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$90.84 ,400% of BCBSTX fee schedule,$22.71 ,100% of BCBSTX fee schedule,$54.58 ,90% of total billed charges for oupatient setting,$15.45 ,100% of TX Medicaid OPPS fee schedule,$54.58 ,90% of total billed charges for oupatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$11.95 ,65% CMS Medicare OPPS fee schedule,$15.14 ,98% of TX Medicaid OPPS fee schedule,$57.61 ,95% of total billed charges for outpatient setting,$13.79 ,75% CMS Medicare OPPS fee schedule,$53.36 ,88% of total billed charges for outpatient setting,$53.36 ,88% of total billed charges for outpatient setting,$18.39 ,100% CMS Medicare OPPS fee schedule,$16.55 ,90% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$18.39 ,100% CMS Medicare OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$15.45 ,100% of TX Medicaid OPPS fee schedule,$11.95 ,$90.84 ,$39.42 
Outpatient Medical Services,RADIOLOGY,77066,DIG DIAGN MAMMO W/CAD BILAT,401,$549.04 ,$134.31 ,125% CMS Medicare OPPS fee schedule,$417.27 ,76%  of total billed charges for outpatient setting,$107.45 ,100% CMS Medicare OPPS fee schedule,$686.55 ,561% of BCBSTX fee schedule,$686.55 ,561% of BCBSTX fee schedule,$107.45 ,100% CMS Medicare OPPS fee schedule,$686.55 ,561% of BCBSTX fee schedule,$122.38 ,100% of BCBSTX fee schedule,$494.14 ,90% of total billed charges for oupatient setting,$247.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$494.14 ,90% of total billed charges for oupatient setting,$107.45 ,100% CMS Medicare OPPS fee schedule,$107.45 ,100% CMS Medicare OPPS fee schedule,$107.45 ,100% CMS Medicare OPPS fee schedule,$69.84 ,65% CMS Medicare OPPS fee schedule,$242.13 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$521.59 ,95% of total billed charges for outpatient setting,$107.45 ,100% CMS Medicare OPPS fee schedule,$483.16 ,88% of total billed charges for outpatient setting,$483.16 ,88% of total billed charges for outpatient setting,$107.45 ,100% CMS Medicare OPPS fee schedule,$96.71 ,90% CMS Medicare OPPS fee schedule,$107.45 ,100% CMS Medicare OPPS fee schedule,$107.45 ,100% CMS Medicare OPPS fee schedule,$107.45 ,100% CMS Medicare OPPS fee schedule,$107.45 ,100% CMS Medicare OPPS fee schedule,$107.45 ,100% CMS Medicare OPPS fee schedule,$107.45 ,100% CMS Medicare OPPS fee schedule,$107.45 ,100% CMS Medicare OPPS fee schedule,$107.45 ,100% CMS Medicare OPPS fee schedule,$107.45 ,100% CMS Medicare OPPS fee schedule,$107.45 ,100% CMS Medicare OPPS fee schedule,$247.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$247.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$247.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$247.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$247.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$247.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$247.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$247.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$247.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$69.84 ,$686.55 ,$356.88 
Outpatient Medical Services,RADIOLOGY,73140,FINGERS MIN 2 VW LT,320,$244.76 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$186.02 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$220.28 ,90% of total billed charges for oupatient setting,$38.09 ,100% of TX Medicaid OPPS fee schedule,$220.28 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$37.33 ,98% of TX Medicaid OPPS fee schedule,$232.52 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$215.39 ,88% of total billed charges for outpatient setting,$215.39 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$37.33 ,$348.49 ,$159.09 
Outpatient Medical Services,RADIOLOGY,77065,DIG DIAGN MAMMO W/CAD  UNILAT,401,$448.72 ,$105.35 ,125% CMS Medicare OPPS fee schedule,$341.03 ,76%  of total billed charges for outpatient setting,$84.28 ,100% CMS Medicare OPPS fee schedule,$537.55 ,561% of BCBSTX fee schedule,$537.55 ,561% of BCBSTX fee schedule,$84.28 ,100% CMS Medicare OPPS fee schedule,$537.55 ,561% of BCBSTX fee schedule,$95.82 ,100% of BCBSTX fee schedule,$403.85 ,90% of total billed charges for oupatient setting,$201.92 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$403.85 ,90% of total billed charges for oupatient setting,$84.28 ,100% CMS Medicare OPPS fee schedule,$84.28 ,100% CMS Medicare OPPS fee schedule,$84.28 ,100% CMS Medicare OPPS fee schedule,$54.78 ,65% CMS Medicare OPPS fee schedule,$197.89 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$426.28 ,95% of total billed charges for outpatient setting,$84.28 ,100% CMS Medicare OPPS fee schedule,$394.87 ,88% of total billed charges for outpatient setting,$394.87 ,88% of total billed charges for outpatient setting,$84.28 ,100% CMS Medicare OPPS fee schedule,$75.85 ,90% CMS Medicare OPPS fee schedule,$84.28 ,100% CMS Medicare OPPS fee schedule,$84.28 ,100% CMS Medicare OPPS fee schedule,$84.28 ,100% CMS Medicare OPPS fee schedule,$84.28 ,100% CMS Medicare OPPS fee schedule,$84.28 ,100% CMS Medicare OPPS fee schedule,$84.28 ,100% CMS Medicare OPPS fee schedule,$84.28 ,100% CMS Medicare OPPS fee schedule,$84.28 ,100% CMS Medicare OPPS fee schedule,$84.28 ,100% CMS Medicare OPPS fee schedule,$84.28 ,100% CMS Medicare OPPS fee schedule,$201.92 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$201.92 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$201.92 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$201.92 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$201.92 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$201.92 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$201.92 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$201.92 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$201.92 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$54.78 ,$537.55 ,$291.67 
Outpatient Medical Services,RADIOLOGY,73600,ANKLE 2VW RT,320,$255.78 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$194.39 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$230.20 ,90% of total billed charges for oupatient setting,$32.75 ,100% of TX Medicaid OPPS fee schedule,$230.20 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$32.10 ,98% of TX Medicaid OPPS fee schedule,$242.99 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$225.09 ,88% of total billed charges for outpatient setting,$225.09 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.10 ,$348.49 ,$166.26 
Outpatient Medical Services,RADIOLOGY,73552,FEMUR 2 VW LT,320,$159.86 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$121.49 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$143.87 ,90% of total billed charges for oupatient setting,$35.75 ,100% of TX Medicaid OPPS fee schedule,$143.87 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$35.04 ,98% of TX Medicaid OPPS fee schedule,$151.87 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$140.68 ,88% of total billed charges for outpatient setting,$140.68 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.04 ,$348.49 ,$103.91 
Outpatient Medical Services,RADIOLOGY,73630,FOOT 3 VW LT,320,$340.67 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$258.91 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$306.60 ,90% of total billed charges for oupatient setting,$34.41 ,100% of TX Medicaid OPPS fee schedule,$306.60 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$33.72 ,98% of TX Medicaid OPPS fee schedule,$323.64 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$299.79 ,88% of total billed charges for outpatient setting,$299.79 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$33.72 ,$348.49 ,$221.44 
Outpatient Medical Services,RADIOLOGY,73552,FEMUR 2 VW RT,320,$159.86 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$121.49 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$143.87 ,90% of total billed charges for oupatient setting,$35.75 ,100% of TX Medicaid OPPS fee schedule,$143.87 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$35.04 ,98% of TX Medicaid OPPS fee schedule,$151.87 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$140.68 ,88% of total billed charges for outpatient setting,$140.68 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.75 ,100% of TX Medicaid OPPS fee schedule,$35.04 ,$348.49 ,$103.91 
Outpatient Medical Services,RADIOLOGY,73502,HIP 2 V  W PELVIS  RT,320,$260.19 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$197.74 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$234.17 ,90% of total billed charges for oupatient setting,$47.11 ,100% of TX Medicaid OPPS fee schedule,$234.17 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$46.17 ,98% of TX Medicaid OPPS fee schedule,$247.18 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$228.97 ,88% of total billed charges for outpatient setting,$228.97 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$46.17 ,$348.49 ,$169.12 
Outpatient Medical Services,RADIOLOGY,73620,FOOT 2 VW LT,320,$270.11 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$205.28 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$243.10 ,90% of total billed charges for oupatient setting,$28.40 ,100% of TX Medicaid OPPS fee schedule,$243.10 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$27.83 ,98% of TX Medicaid OPPS fee schedule,$256.60 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$237.70 ,88% of total billed charges for outpatient setting,$237.70 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$27.83 ,$348.49 ,$175.57 
Outpatient Medical Services,RADIOLOGY,73562,KNEE 3 VW RT,320,$316.42 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$240.48 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$284.78 ,90% of total billed charges for oupatient setting,$40.76 ,100% of TX Medicaid OPPS fee schedule,$284.78 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$39.94 ,98% of TX Medicaid OPPS fee schedule,$300.60 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$278.45 ,88% of total billed charges for outpatient setting,$278.45 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$39.94 ,$348.49 ,$205.67 
Outpatient Medical Services,RADIOLOGY,77067,DIG SCREENING MAMMO W/CAD,403,$417.85 ,$111.38 ,125% CMS Medicare OPPS fee schedule,$317.57 ,76%  of total billed charges for outpatient setting,$89.10 ,100% CMS Medicare OPPS fee schedule,$567.79 ,561% of BCBSTX fee schedule,$567.79 ,561% of BCBSTX fee schedule,$89.10 ,100% CMS Medicare OPPS fee schedule,$567.79 ,561% of BCBSTX fee schedule,$101.21 ,100% of BCBSTX fee schedule,$376.07 ,90% of total billed charges for oupatient setting,$188.03 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$376.07 ,90% of total billed charges for oupatient setting,$89.10 ,100% CMS Medicare OPPS fee schedule,$89.10 ,100% CMS Medicare OPPS fee schedule,$89.10 ,100% CMS Medicare OPPS fee schedule,$57.92 ,65% CMS Medicare OPPS fee schedule,$184.27 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$396.96 ,95% of total billed charges for outpatient setting,$89.10 ,100% CMS Medicare OPPS fee schedule,$367.71 ,88% of total billed charges for outpatient setting,$367.71 ,88% of total billed charges for outpatient setting,$89.10 ,100% CMS Medicare OPPS fee schedule,$80.19 ,90% CMS Medicare OPPS fee schedule,$89.10 ,100% CMS Medicare OPPS fee schedule,$89.10 ,100% CMS Medicare OPPS fee schedule,$89.10 ,100% CMS Medicare OPPS fee schedule,$89.10 ,100% CMS Medicare OPPS fee schedule,$89.10 ,100% CMS Medicare OPPS fee schedule,$89.10 ,100% CMS Medicare OPPS fee schedule,$89.10 ,100% CMS Medicare OPPS fee schedule,$89.10 ,100% CMS Medicare OPPS fee schedule,$89.10 ,100% CMS Medicare OPPS fee schedule,$89.10 ,100% CMS Medicare OPPS fee schedule,$188.03 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$188.03 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$188.03 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$188.03 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$188.03 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$188.03 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$188.03 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$188.03 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$188.03 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$57.92 ,$567.79 ,$271.60 
Outpatient Medical Services,RADIOLOGY,73610,ANKLE 3 VW LT,320,$358.31 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$272.32 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$322.48 ,90% of total billed charges for oupatient setting,$37.09 ,100% of TX Medicaid OPPS fee schedule,$322.48 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$36.35 ,98% of TX Medicaid OPPS fee schedule,$340.39 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$315.31 ,88% of total billed charges for outpatient setting,$315.31 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$36.35 ,$348.49 ,$232.90 
Outpatient Medical Services,RADIOLOGY,73620,FOOT 2 VW RT,320,$270.11 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$205.28 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$243.10 ,90% of total billed charges for oupatient setting,$28.40 ,100% of TX Medicaid OPPS fee schedule,$243.10 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$27.83 ,98% of TX Medicaid OPPS fee schedule,$256.60 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$237.70 ,88% of total billed charges for outpatient setting,$237.70 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$28.40 ,100% of TX Medicaid OPPS fee schedule,$27.83 ,$348.49 ,$175.57 
Outpatient Medical Services,RADIOLOGY,73130,HAND 3 VW LT,320,$318.62 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$242.15 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$286.76 ,90% of total billed charges for oupatient setting,$37.09 ,100% of TX Medicaid OPPS fee schedule,$286.76 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$36.35 ,98% of TX Medicaid OPPS fee schedule,$302.69 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$280.39 ,88% of total billed charges for outpatient setting,$280.39 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$36.35 ,$348.49 ,$207.10 
Outpatient Medical Services,RADIOLOGY,73120,HAND 2 VW LT,320,$269.01 ,$128.78 ,125% CMS Medicare OPPS fee schedule,$204.45 ,76%  of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$642.12 ,561% of BCBSTX fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,$242.11 ,90% of total billed charges for oupatient setting,$31.41 ,100% of TX Medicaid OPPS fee schedule,$242.11 ,90% of total billed charges for oupatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$30.78 ,98% of TX Medicaid OPPS fee schedule,$255.56 ,95% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$236.73 ,88% of total billed charges for outpatient setting,$236.73 ,88% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$30.78 ,$642.12 ,$174.86 
Outpatient Medical Services,RADIOLOGY,73590,LOWER LEG 2 VW RT,320,$343.98 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$261.42 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$309.58 ,90% of total billed charges for oupatient setting,$31.74 ,100% of TX Medicaid OPPS fee schedule,$309.58 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$31.11 ,98% of TX Medicaid OPPS fee schedule,$326.78 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$302.70 ,88% of total billed charges for outpatient setting,$302.70 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.11 ,$348.49 ,$223.59 
Outpatient Medical Services,RADIOLOGY,73130,HAND 3 VW RT,320,$318.62 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$242.15 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$286.76 ,90% of total billed charges for oupatient setting,$37.09 ,100% of TX Medicaid OPPS fee schedule,$286.76 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$36.35 ,98% of TX Medicaid OPPS fee schedule,$302.69 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$280.39 ,88% of total billed charges for outpatient setting,$280.39 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$36.35 ,$348.49 ,$207.10 
Outpatient Medical Services,RADIOLOGY,73560,KNEE 1 OR 2 VW LT,320,$263.50 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$200.26 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$237.15 ,90% of total billed charges for oupatient setting,$34.41 ,100% of TX Medicaid OPPS fee schedule,$237.15 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$33.72 ,98% of TX Medicaid OPPS fee schedule,$250.33 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$231.88 ,88% of total billed charges for outpatient setting,$231.88 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$33.72 ,$348.49 ,$171.28 
Outpatient Medical Services,RADIOLOGY,73600,ANKLE 2VWS LT,320,$255.78 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$194.39 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$230.20 ,90% of total billed charges for oupatient setting,$32.75 ,100% of TX Medicaid OPPS fee schedule,$230.20 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$32.10 ,98% of TX Medicaid OPPS fee schedule,$242.99 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$225.09 ,88% of total billed charges for outpatient setting,$225.09 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.10 ,$348.49 ,$166.26 
Outpatient Medical Services,RADIOLOGY,73120,HAND 2 VW RT,320,$269.01 ,$128.78 ,125% CMS Medicare OPPS fee schedule,$204.45 ,76%  of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$642.12 ,561% of BCBSTX fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,$242.11 ,90% of total billed charges for oupatient setting,$31.41 ,100% of TX Medicaid OPPS fee schedule,$242.11 ,90% of total billed charges for oupatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$30.78 ,98% of TX Medicaid OPPS fee schedule,$255.56 ,95% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$236.73 ,88% of total billed charges for outpatient setting,$236.73 ,88% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$31.41 ,100% of TX Medicaid OPPS fee schedule,$30.78 ,$642.12 ,$174.86 
Outpatient Medical Services,RADIOLOGY,73610,ANKLE 3VW RT,320,$358.31 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$272.32 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$322.48 ,90% of total billed charges for oupatient setting,$37.09 ,100% of TX Medicaid OPPS fee schedule,$322.48 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$36.35 ,98% of TX Medicaid OPPS fee schedule,$340.39 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$315.31 ,88% of total billed charges for outpatient setting,$315.31 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$36.35 ,$348.49 ,$232.90 
Outpatient Medical Services,RADIOLOGY,73590,LOWER LEG 2 VW LT,320,$343.98 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$261.42 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$309.58 ,90% of total billed charges for oupatient setting,$31.74 ,100% of TX Medicaid OPPS fee schedule,$309.58 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$31.11 ,98% of TX Medicaid OPPS fee schedule,$326.78 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$302.70 ,88% of total billed charges for outpatient setting,$302.70 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.11 ,$348.49 ,$223.59 
Outpatient Medical Services,RADIOLOGY,G0279,Diag dig Brst Tomosynthesis,401,$60.83 ,$28.96 ,125% CMS Medicare OPPS fee schedule,$46.23 ,76%  of total billed charges for outpatient setting,$23.17 ,100% CMS Medicare OPPS fee schedule,$142.94 ,561% of BCBSTX fee schedule,$142.94 ,561% of BCBSTX fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$142.94 ,561% of BCBSTX fee schedule,$25.48 ,100% of BCBSTX fee schedule,$54.75 ,90% of total billed charges for oupatient setting,$52.79 ,100% of TX Medicaid OPPS fee schedule,$54.75 ,90% of total billed charges for oupatient setting,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$15.06 ,65% CMS Medicare OPPS fee schedule,$51.73 ,98% of TX Medicaid OPPS fee schedule,$57.79 ,95% of total billed charges for outpatient setting,$23.17 ,100% CMS Medicare OPPS fee schedule,$53.53 ,88% of total billed charges for outpatient setting,$53.53 ,88% of total billed charges for outpatient setting,$23.17 ,100% CMS Medicare OPPS fee schedule,$20.85 ,90% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$15.06 ,$142.94 ,$39.54 
Outpatient Medical Services,RADIOLOGY,73560,KNEE 1 OR 2 VW RT,320,$263.50 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$200.26 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$237.15 ,90% of total billed charges for oupatient setting,$34.41 ,100% of TX Medicaid OPPS fee schedule,$237.15 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$33.72 ,98% of TX Medicaid OPPS fee schedule,$250.33 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$231.88 ,88% of total billed charges for outpatient setting,$231.88 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$34.41 ,100% of TX Medicaid OPPS fee schedule,$33.72 ,$348.49 ,$171.28 
Outpatient Medical Services,RADIOLOGY,77063,Scrn Diag Brst Tomosyntesis Bi,401,$60.83 ,$28.96 ,125% CMS Medicare OPPS fee schedule,$46.23 ,76%  of total billed charges for outpatient setting,$23.17 ,100% CMS Medicare OPPS fee schedule,$142.94 ,561% of BCBSTX fee schedule,$142.94 ,561% of BCBSTX fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$142.94 ,561% of BCBSTX fee schedule,$25.48 ,100% of BCBSTX fee schedule,$54.75 ,90% of total billed charges for oupatient setting,$51.79 ,100% of TX Medicaid OPPS fee schedule,$54.75 ,90% of total billed charges for oupatient setting,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$15.06 ,65% CMS Medicare OPPS fee schedule,$50.75 ,98% of TX Medicaid OPPS fee schedule,$57.79 ,95% of total billed charges for outpatient setting,$23.17 ,100% CMS Medicare OPPS fee schedule,$53.53 ,88% of total billed charges for outpatient setting,$53.53 ,88% of total billed charges for outpatient setting,$23.17 ,100% CMS Medicare OPPS fee schedule,$20.85 ,90% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$23.17 ,100% CMS Medicare OPPS fee schedule,$51.79 ,100% of TX Medicaid OPPS fee schedule,$51.79 ,100% of TX Medicaid OPPS fee schedule,$51.79 ,100% of TX Medicaid OPPS fee schedule,$51.79 ,100% of TX Medicaid OPPS fee schedule,$51.79 ,100% of TX Medicaid OPPS fee schedule,$51.79 ,100% of TX Medicaid OPPS fee schedule,$51.79 ,100% of TX Medicaid OPPS fee schedule,$51.79 ,100% of TX Medicaid OPPS fee schedule,$51.79 ,100% of TX Medicaid OPPS fee schedule,$15.06 ,$142.94 ,$39.54 
Outpatient Medical Services,RADIOLOGY,73502,HIP 2 V W PELVIS LT,320,$260.19 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$197.74 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$234.17 ,90% of total billed charges for oupatient setting,$47.11 ,100% of TX Medicaid OPPS fee schedule,$234.17 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$46.17 ,98% of TX Medicaid OPPS fee schedule,$247.18 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$228.97 ,88% of total billed charges for outpatient setting,$228.97 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$46.17 ,$348.49 ,$169.12 
Outpatient Medical Services,RADIOLOGY,73562,KNEE 3 VW LT,320,$316.42 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$240.48 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$284.78 ,90% of total billed charges for oupatient setting,$40.76 ,100% of TX Medicaid OPPS fee schedule,$284.78 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$39.94 ,98% of TX Medicaid OPPS fee schedule,$300.60 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$278.45 ,88% of total billed charges for outpatient setting,$278.45 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$40.76 ,100% of TX Medicaid OPPS fee schedule,$39.94 ,$348.49 ,$205.67 
Outpatient Medical Services,RADIOLOGY,73140,FINGERS MIN 2 VW RT,320,$244.76 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$186.02 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$220.28 ,90% of total billed charges for oupatient setting,$38.09 ,100% of TX Medicaid OPPS fee schedule,$220.28 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$37.33 ,98% of TX Medicaid OPPS fee schedule,$232.52 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$215.39 ,88% of total billed charges for outpatient setting,$215.39 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$37.33 ,$348.49 ,$159.09 
Outpatient Medical Services,RADIOLOGY,73110,WRIST COMP MIN 3VW R,320,$310.91 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$236.29 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$279.82 ,90% of total billed charges for oupatient setting,$41.10 ,100% of TX Medicaid OPPS fee schedule,$279.82 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$40.28 ,98% of TX Medicaid OPPS fee schedule,$295.36 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$273.60 ,88% of total billed charges for outpatient setting,$273.60 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$40.28 ,$348.49 ,$202.09 
Outpatient Medical Services,RADIOLOGY,73110,WRIST COMP MIN 3VW L,320,$310.91 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$236.29 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$279.82 ,90% of total billed charges for oupatient setting,$41.10 ,100% of TX Medicaid OPPS fee schedule,$279.82 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$40.28 ,98% of TX Medicaid OPPS fee schedule,$295.36 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$273.60 ,88% of total billed charges for outpatient setting,$273.60 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$41.10 ,100% of TX Medicaid OPPS fee schedule,$40.28 ,$348.49 ,$202.09 
Outpatient Medical Services,RADIOLOGY,73100,WRIST 2VWS RT,320,$294.37 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$223.72 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$264.93 ,90% of total billed charges for oupatient setting,$34.09 ,100% of TX Medicaid OPPS fee schedule,$264.93 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$33.41 ,98% of TX Medicaid OPPS fee schedule,$279.65 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$259.05 ,88% of total billed charges for outpatient setting,$259.05 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$33.41 ,$348.49 ,$191.34 
Outpatient Medical Services,RADIOLOGY,73100,WRIST 2VWS LT,320,$294.37 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$223.72 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$264.93 ,90% of total billed charges for oupatient setting,$34.09 ,100% of TX Medicaid OPPS fee schedule,$264.93 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$33.41 ,98% of TX Medicaid OPPS fee schedule,$279.65 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$259.05 ,88% of total billed charges for outpatient setting,$259.05 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$34.09 ,100% of TX Medicaid OPPS fee schedule,$33.41 ,$348.49 ,$191.34 
Outpatient Medical Services,RADIOLOGY,73090,FOREARM 2 VW RT,320,$307.60 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$233.78 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$276.84 ,90% of total billed charges for oupatient setting,$29.40 ,100% of TX Medicaid OPPS fee schedule,$276.84 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$28.81 ,98% of TX Medicaid OPPS fee schedule,$292.22 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$270.69 ,88% of total billed charges for outpatient setting,$270.69 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$28.81 ,$348.49 ,$199.94 
Outpatient Medical Services,RADIOLOGY,73090,FOREARM 2 VW LT,320,$307.60 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$233.78 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$276.84 ,90% of total billed charges for oupatient setting,$29.40 ,100% of TX Medicaid OPPS fee schedule,$276.84 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$28.81 ,98% of TX Medicaid OPPS fee schedule,$292.22 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$270.69 ,88% of total billed charges for outpatient setting,$270.69 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$28.81 ,$348.49 ,$199.94 
Outpatient Medical Services,RADIOLOGY,73080,ELBOW 3 VW RT,320,$361.62 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$274.83 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$325.46 ,90% of total billed charges for oupatient setting,$32.75 ,100% of TX Medicaid OPPS fee schedule,$325.46 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$32.10 ,98% of TX Medicaid OPPS fee schedule,$343.54 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$318.23 ,88% of total billed charges for outpatient setting,$318.23 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.10 ,$348.49 ,$235.05 
Outpatient Medical Services,RADIOLOGY,73080,ELBOW 3 VW LT,320,$361.62 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$274.83 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$325.46 ,90% of total billed charges for oupatient setting,$32.75 ,100% of TX Medicaid OPPS fee schedule,$325.46 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$32.10 ,98% of TX Medicaid OPPS fee schedule,$343.54 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$318.23 ,88% of total billed charges for outpatient setting,$318.23 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.10 ,$348.49 ,$235.05 
Outpatient Medical Services,RADIOLOGY,73070,ELBOW 2VW RT,320,$299.88 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$227.91 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$269.89 ,90% of total billed charges for oupatient setting,$29.40 ,100% of TX Medicaid OPPS fee schedule,$269.89 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$28.81 ,98% of TX Medicaid OPPS fee schedule,$284.89 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$263.89 ,88% of total billed charges for outpatient setting,$263.89 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$28.81 ,$348.49 ,$194.92 
Outpatient Medical Services,RADIOLOGY,73070,ELBOW 2VW LT,320,$299.88 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$227.91 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$269.89 ,90% of total billed charges for oupatient setting,$29.40 ,100% of TX Medicaid OPPS fee schedule,$269.89 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$28.81 ,98% of TX Medicaid OPPS fee schedule,$284.89 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$263.89 ,88% of total billed charges for outpatient setting,$263.89 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$29.40 ,100% of TX Medicaid OPPS fee schedule,$28.81 ,$348.49 ,$194.92 
Outpatient Medical Services,RADIOLOGY,73060,HUMERUS 2 VW RT,320,$291.06 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$221.21 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$261.95 ,90% of total billed charges for oupatient setting,$32.41 ,100% of TX Medicaid OPPS fee schedule,$261.95 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$31.76 ,98% of TX Medicaid OPPS fee schedule,$276.51 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$256.13 ,88% of total billed charges for outpatient setting,$256.13 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$31.76 ,$348.49 ,$189.19 
Outpatient Medical Services,RADIOLOGY,73060,HUMERUS 2VW LT,320,$291.06 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$221.21 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$261.95 ,90% of total billed charges for oupatient setting,$32.41 ,100% of TX Medicaid OPPS fee schedule,$261.95 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$31.76 ,98% of TX Medicaid OPPS fee schedule,$276.51 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$256.13 ,88% of total billed charges for outpatient setting,$256.13 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$31.76 ,$348.49 ,$189.19 
Outpatient Medical Services,RADIOLOGY,73030,SHLDR COMP MIN 2 VW,320,$328.55 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$249.70 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$295.70 ,90% of total billed charges for oupatient setting,$34.75 ,100% of TX Medicaid OPPS fee schedule,$295.70 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$34.06 ,98% of TX Medicaid OPPS fee schedule,$312.12 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$289.12 ,88% of total billed charges for outpatient setting,$289.12 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.06 ,$348.49 ,$213.56 
Outpatient Medical Services,RADIOLOGY,73030,SHLDR COMP MIN 2 VW,320,$328.55 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$249.70 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$295.70 ,90% of total billed charges for oupatient setting,$34.75 ,100% of TX Medicaid OPPS fee schedule,$295.70 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$34.06 ,98% of TX Medicaid OPPS fee schedule,$312.12 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$289.12 ,88% of total billed charges for outpatient setting,$289.12 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.75 ,100% of TX Medicaid OPPS fee schedule,$34.06 ,$348.49 ,$213.56 
Outpatient Medical Services,RADIOLOGY,73000,CLAVICLE COMPLETE LT,320,$319.73 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$242.99 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$287.76 ,90% of total billed charges for oupatient setting,$32.41 ,100% of TX Medicaid OPPS fee schedule,$287.76 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$31.76 ,98% of TX Medicaid OPPS fee schedule,$303.74 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$281.36 ,88% of total billed charges for outpatient setting,$281.36 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$32.41 ,100% of TX Medicaid OPPS fee schedule,$31.76 ,$348.49 ,$207.82 
Outpatient Medical Services,RADIOLOGY,71101,RIBS UNL/PA CHSTMIN,320,$347.29 ,$128.78 ,125% CMS Medicare OPPS fee schedule,$263.94 ,76%  of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$642.12 ,561% of BCBSTX fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,$312.56 ,90% of total billed charges for oupatient setting,$42.44 ,100% of TX Medicaid OPPS fee schedule,$312.56 ,90% of total billed charges for oupatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$41.59 ,98% of TX Medicaid OPPS fee schedule,$329.93 ,95% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$305.62 ,88% of total billed charges for outpatient setting,$305.62 ,88% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$42.44 ,100% of TX Medicaid OPPS fee schedule,$42.44 ,100% of TX Medicaid OPPS fee schedule,$42.44 ,100% of TX Medicaid OPPS fee schedule,$42.44 ,100% of TX Medicaid OPPS fee schedule,$42.44 ,100% of TX Medicaid OPPS fee schedule,$42.44 ,100% of TX Medicaid OPPS fee schedule,$42.44 ,100% of TX Medicaid OPPS fee schedule,$42.44 ,100% of TX Medicaid OPPS fee schedule,$42.44 ,100% of TX Medicaid OPPS fee schedule,$41.59 ,$642.12 ,$225.74 
Outpatient Medical Services,RADIOLOGY,71100,RIBS UNILAT 2 VWS RT,320,$355.01 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$269.81 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$319.51 ,90% of total billed charges for oupatient setting,$37.09 ,100% of TX Medicaid OPPS fee schedule,$319.51 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$36.35 ,98% of TX Medicaid OPPS fee schedule,$337.26 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$312.41 ,88% of total billed charges for outpatient setting,$312.41 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$36.35 ,$348.49 ,$230.76 
Outpatient Medical Services,RADIOLOGY,71100,RIBS UNILAT 2 VWS LT,320,$355.01 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$269.81 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$319.51 ,90% of total billed charges for oupatient setting,$37.09 ,100% of TX Medicaid OPPS fee schedule,$319.51 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$36.35 ,98% of TX Medicaid OPPS fee schedule,$337.26 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$312.41 ,88% of total billed charges for outpatient setting,$312.41 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$36.35 ,$348.49 ,$230.76 
Outpatient Medical Services,RADIOLOGY,77080,DEXA ONE OR MORE AXI,320,$587.63 ,$128.77 ,125% CMS Medicare OPPS fee schedule,$446.60 ,76%  of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$181.20 ,561% of BCBSTX fee schedule,$181.20 ,561% of BCBSTX fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$181.20 ,561% of BCBSTX fee schedule,$32.30 ,100% of BCBSTX fee schedule,$528.87 ,90% of total billed charges for oupatient setting,$38.09 ,100% of TX Medicaid OPPS fee schedule,$528.87 ,90% of total billed charges for oupatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$37.33 ,98% of TX Medicaid OPPS fee schedule,$558.25 ,95% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$517.11 ,88% of total billed charges for outpatient setting,$517.11 ,88% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$38.09 ,100% of TX Medicaid OPPS fee schedule,$32.30 ,$558.25 ,$381.96 
Outpatient Medical Services,RADIOLOGY,76098,MAMMO SURG SPECIMEN,320,$229.32 ,$606.23 ,125% CMS Medicare OPPS fee schedule,$174.28 ,76%  of total billed charges for outpatient setting,$484.98 ,100% CMS Medicare OPPS fee schedule,"$2,730.33 ",561% of BCBSTX fee schedule,"$2,730.33 ",561% of BCBSTX fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,"$2,730.33 ",561% of BCBSTX fee schedule,$486.69 ,100% of BCBSTX fee schedule,$206.39 ,90% of total billed charges for oupatient setting,$42.10 ,100% of TX Medicaid OPPS fee schedule,$206.39 ,90% of total billed charges for oupatient setting,$229.32 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$315.24 ,65% CMS Medicare OPPS fee schedule,$41.26 ,98% of TX Medicaid OPPS fee schedule,$217.85 ,95% of total billed charges for outpatient setting,$229.32 ,100% CMS Medicare OPPS fee schedule,$201.80 ,88% of total billed charges for outpatient setting,$201.80 ,88% of total billed charges for outpatient setting,$484.98 ,100% CMS Medicare OPPS fee schedule,$407.55 ,90% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$42.10 ,100% of TX Medicaid OPPS fee schedule,$42.10 ,100% of TX Medicaid OPPS fee schedule,$42.10 ,100% of TX Medicaid OPPS fee schedule,$42.10 ,100% of TX Medicaid OPPS fee schedule,$42.10 ,100% of TX Medicaid OPPS fee schedule,$42.10 ,100% of TX Medicaid OPPS fee schedule,$42.10 ,100% of TX Medicaid OPPS fee schedule,$42.10 ,100% of TX Medicaid OPPS fee schedule,$42.10 ,100% of TX Medicaid OPPS fee schedule,$41.26 ,"$2,730.33 ",$149.06 
Outpatient Medical Services,RADIOLOGY,74420,PYELOGRAM RETROGRADE,320,$953.66 ,$443.91 ,125% CMS Medicare OPPS fee schedule,$724.78 ,76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,552.94 ",561% of BCBSTX fee schedule,"$2,552.94 ",561% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,552.94 ",561% of BCBSTX fee schedule,$455.07 ,100% of BCBSTX fee schedule,$858.29 ,90% of total billed charges for oupatient setting,$77.19 ,100% of TX Medicaid OPPS fee schedule,$858.29 ,90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$75.65 ,98% of TX Medicaid OPPS fee schedule,$905.98 ,95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$839.22 ,88% of total billed charges for outpatient setting,$839.22 ,88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$77.19 ,100% of TX Medicaid OPPS fee schedule,$77.19 ,100% of TX Medicaid OPPS fee schedule,$77.19 ,100% of TX Medicaid OPPS fee schedule,$77.19 ,100% of TX Medicaid OPPS fee schedule,$77.19 ,100% of TX Medicaid OPPS fee schedule,$77.19 ,100% of TX Medicaid OPPS fee schedule,$77.19 ,100% of TX Medicaid OPPS fee schedule,$77.19 ,100% of TX Medicaid OPPS fee schedule,$77.19 ,100% of TX Medicaid OPPS fee schedule,$75.65 ,"$2,552.94 ",$619.88 
Outpatient Medical Services,RADIOLOGY,74270,BE SINGLE,320,$807.03 ,$217.29 ,125% CMS Medicare OPPS fee schedule,$613.34 ,76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,417.87 ",561% of BCBSTX fee schedule,"$1,417.87 ",561% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,417.87 ",561% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,$726.33 ,90% of total billed charges for oupatient setting,$156.04 ,100% of TX Medicaid OPPS fee schedule,$726.33 ,90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$152.92 ,98% of TX Medicaid OPPS fee schedule,$766.68 ,95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$710.19 ,88% of total billed charges for outpatient setting,$710.19 ,88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.08 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$156.04 ,100% of TX Medicaid OPPS fee schedule,$156.04 ,100% of TX Medicaid OPPS fee schedule,$156.04 ,100% of TX Medicaid OPPS fee schedule,$156.04 ,100% of TX Medicaid OPPS fee schedule,$156.04 ,100% of TX Medicaid OPPS fee schedule,$156.04 ,100% of TX Medicaid OPPS fee schedule,$156.04 ,100% of TX Medicaid OPPS fee schedule,$156.04 ,100% of TX Medicaid OPPS fee schedule,$156.04 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$1,417.87 ",$524.57 
Outpatient Medical Services,RADIOLOGY,74246,UPPER GI SERIES DBL,320,"$1,005.48 ",$217.29 ,125% CMS Medicare OPPS fee schedule,$764.16 ,76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,417.87 ",561% of BCBSTX fee schedule,"$1,417.87 ",561% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,417.87 ",561% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,$904.93 ,90% of total billed charges for oupatient setting,$141.68 ,100% of TX Medicaid OPPS fee schedule,$904.93 ,90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$138.85 ,98% of TX Medicaid OPPS fee schedule,$955.21 ,95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$884.82 ,88% of total billed charges for outpatient setting,$884.82 ,88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.08 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$141.68 ,100% of TX Medicaid OPPS fee schedule,$141.68 ,100% of TX Medicaid OPPS fee schedule,$141.68 ,100% of TX Medicaid OPPS fee schedule,$141.68 ,100% of TX Medicaid OPPS fee schedule,$141.68 ,100% of TX Medicaid OPPS fee schedule,$141.68 ,100% of TX Medicaid OPPS fee schedule,$141.68 ,100% of TX Medicaid OPPS fee schedule,$141.68 ,100% of TX Medicaid OPPS fee schedule,$141.68 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$1,417.87 ",$653.56 
Outpatient Medical Services,RADIOLOGY,74230,MODIFIED BA SWALLOW,320,$368.24 ,$217.29 ,125% CMS Medicare OPPS fee schedule,$279.86 ,76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$642.12 ,561% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,$331.42 ,90% of total billed charges for oupatient setting,$127.64 ,100% of TX Medicaid OPPS fee schedule,$331.42 ,90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$125.09 ,98% of TX Medicaid OPPS fee schedule,$349.83 ,95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$324.05 ,88% of total billed charges for outpatient setting,$324.05 ,88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.08 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$127.64 ,100% of TX Medicaid OPPS fee schedule,$127.64 ,100% of TX Medicaid OPPS fee schedule,$127.64 ,100% of TX Medicaid OPPS fee schedule,$127.64 ,100% of TX Medicaid OPPS fee schedule,$127.64 ,100% of TX Medicaid OPPS fee schedule,$127.64 ,100% of TX Medicaid OPPS fee schedule,$127.64 ,100% of TX Medicaid OPPS fee schedule,$127.64 ,100% of TX Medicaid OPPS fee schedule,$127.64 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,$642.12 ,$239.36 
Outpatient Medical Services,RADIOLOGY,74220,ESOPHAGRAM W/SPOTS,320,$495.02 ,$217.29 ,125% CMS Medicare OPPS fee schedule,$376.22 ,76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,417.87 ",561% of BCBSTX fee schedule,"$1,417.87 ",561% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,417.87 ",561% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,$445.52 ,90% of total billed charges for oupatient setting,$99.90 ,100% of TX Medicaid OPPS fee schedule,$445.52 ,90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$97.90 ,98% of TX Medicaid OPPS fee schedule,$470.27 ,95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$435.62 ,88% of total billed charges for outpatient setting,$435.62 ,88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.08 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$99.90 ,100% of TX Medicaid OPPS fee schedule,$99.90 ,100% of TX Medicaid OPPS fee schedule,$99.90 ,100% of TX Medicaid OPPS fee schedule,$99.90 ,100% of TX Medicaid OPPS fee schedule,$99.90 ,100% of TX Medicaid OPPS fee schedule,$99.90 ,100% of TX Medicaid OPPS fee schedule,$99.90 ,100% of TX Medicaid OPPS fee schedule,$99.90 ,100% of TX Medicaid OPPS fee schedule,$99.90 ,100% of TX Medicaid OPPS fee schedule,$97.90 ,"$1,417.87 ",$321.76 
Outpatient Medical Services,RADIOLOGY,74019,ABDOMEN UP TO 5V DECUB/UPRIGHT,320,$447.62 ,$128.78 ,125% CMS Medicare OPPS fee schedule,$340.19 ,76%  of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$642.12 ,561% of BCBSTX fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,$402.86 ,90% of total billed charges for oupatient setting,$37.09 ,100% of TX Medicaid OPPS fee schedule,$402.86 ,90% of total billed charges for oupatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$36.35 ,98% of TX Medicaid OPPS fee schedule,$425.24 ,95% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$393.91 ,88% of total billed charges for outpatient setting,$393.91 ,88% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$37.09 ,100% of TX Medicaid OPPS fee schedule,$36.35 ,$642.12 ,$290.95 
Outpatient Medical Services,RADIOLOGY,74018,ABDOMEN 1 VIEW,320,$352.80 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$268.13 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$317.52 ,90% of total billed charges for oupatient setting,$30.08 ,100% of TX Medicaid OPPS fee schedule,$317.52 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$29.48 ,98% of TX Medicaid OPPS fee schedule,$335.16 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$310.46 ,88% of total billed charges for outpatient setting,$310.46 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$30.08 ,100% of TX Medicaid OPPS fee schedule,$30.08 ,100% of TX Medicaid OPPS fee schedule,$30.08 ,100% of TX Medicaid OPPS fee schedule,$30.08 ,100% of TX Medicaid OPPS fee schedule,$30.08 ,100% of TX Medicaid OPPS fee schedule,$30.08 ,100% of TX Medicaid OPPS fee schedule,$30.08 ,100% of TX Medicaid OPPS fee schedule,$30.08 ,100% of TX Medicaid OPPS fee schedule,$30.08 ,100% of TX Medicaid OPPS fee schedule,$29.48 ,$348.49 ,$229.32 
Outpatient Medical Services,RADIOLOGY,73521,BILAT HIP/AP PELVIC,320,$345.08 ,$128.78 ,125% CMS Medicare OPPS fee schedule,$262.26 ,76%  of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$642.12 ,561% of BCBSTX fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,$310.57 ,90% of total billed charges for oupatient setting,$41.44 ,100% of TX Medicaid OPPS fee schedule,$310.57 ,90% of total billed charges for oupatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$40.61 ,98% of TX Medicaid OPPS fee schedule,$327.83 ,95% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$303.67 ,88% of total billed charges for outpatient setting,$303.67 ,88% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$41.44 ,100% of TX Medicaid OPPS fee schedule,$41.44 ,100% of TX Medicaid OPPS fee schedule,$41.44 ,100% of TX Medicaid OPPS fee schedule,$41.44 ,100% of TX Medicaid OPPS fee schedule,$41.44 ,100% of TX Medicaid OPPS fee schedule,$41.44 ,100% of TX Medicaid OPPS fee schedule,$41.44 ,100% of TX Medicaid OPPS fee schedule,$41.44 ,100% of TX Medicaid OPPS fee schedule,$41.44 ,100% of TX Medicaid OPPS fee schedule,$40.61 ,$642.12 ,$224.30 
Outpatient Medical Services,RADIOLOGY,72220,SACRUM COCCYX MIN 2,320,$265.70 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$201.93 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$239.13 ,90% of total billed charges for oupatient setting,$32.75 ,100% of TX Medicaid OPPS fee schedule,$239.13 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$32.10 ,98% of TX Medicaid OPPS fee schedule,$252.42 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$233.82 ,88% of total billed charges for outpatient setting,$233.82 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.75 ,100% of TX Medicaid OPPS fee schedule,$32.10 ,$348.49 ,$172.71 
Outpatient Medical Services,RADIOLOGY,72170,PELVIS 1 OR 2 VIEWS,320,$291.06 ,$128.78 ,125% CMS Medicare OPPS fee schedule,$221.21 ,76%  of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$642.12 ,561% of BCBSTX fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,$261.95 ,90% of total billed charges for oupatient setting,$28.06 ,100% of TX Medicaid OPPS fee schedule,$261.95 ,90% of total billed charges for oupatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$27.50 ,98% of TX Medicaid OPPS fee schedule,$276.51 ,95% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$256.13 ,88% of total billed charges for outpatient setting,$256.13 ,88% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$28.06 ,100% of TX Medicaid OPPS fee schedule,$28.06 ,100% of TX Medicaid OPPS fee schedule,$28.06 ,100% of TX Medicaid OPPS fee schedule,$28.06 ,100% of TX Medicaid OPPS fee schedule,$28.06 ,100% of TX Medicaid OPPS fee schedule,$28.06 ,100% of TX Medicaid OPPS fee schedule,$28.06 ,100% of TX Medicaid OPPS fee schedule,$28.06 ,100% of TX Medicaid OPPS fee schedule,$28.06 ,100% of TX Medicaid OPPS fee schedule,$27.50 ,$642.12 ,$189.19 
Outpatient Medical Services,RADIOLOGY,72110,SPINE LUMBAR MIN 4 V,320,$543.53 ,$128.78 ,125% CMS Medicare OPPS fee schedule,$413.08 ,76%  of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$642.12 ,561% of BCBSTX fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,$489.18 ,90% of total billed charges for oupatient setting,$51.45 ,100% of TX Medicaid OPPS fee schedule,$489.18 ,90% of total billed charges for oupatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$50.42 ,98% of TX Medicaid OPPS fee schedule,$516.35 ,95% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$478.31 ,88% of total billed charges for outpatient setting,$478.31 ,88% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$51.45 ,100% of TX Medicaid OPPS fee schedule,$51.45 ,100% of TX Medicaid OPPS fee schedule,$51.45 ,100% of TX Medicaid OPPS fee schedule,$51.45 ,100% of TX Medicaid OPPS fee schedule,$51.45 ,100% of TX Medicaid OPPS fee schedule,$51.45 ,100% of TX Medicaid OPPS fee schedule,$51.45 ,100% of TX Medicaid OPPS fee schedule,$51.45 ,100% of TX Medicaid OPPS fee schedule,$51.45 ,100% of TX Medicaid OPPS fee schedule,$50.42 ,$642.12 ,$353.29 
Outpatient Medical Services,RADIOLOGY,72072,SPINE DORSAL 3 VWS,320,$401.31 ,$128.78 ,125% CMS Medicare OPPS fee schedule,$305.00 ,76%  of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$642.12 ,561% of BCBSTX fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,$361.18 ,90% of total billed charges for oupatient setting,$39.43 ,100% of TX Medicaid OPPS fee schedule,$361.18 ,90% of total billed charges for oupatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$38.64 ,98% of TX Medicaid OPPS fee schedule,$381.24 ,95% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$353.15 ,88% of total billed charges for outpatient setting,$353.15 ,88% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$39.43 ,100% of TX Medicaid OPPS fee schedule,$39.43 ,100% of TX Medicaid OPPS fee schedule,$39.43 ,100% of TX Medicaid OPPS fee schedule,$39.43 ,100% of TX Medicaid OPPS fee schedule,$39.43 ,100% of TX Medicaid OPPS fee schedule,$39.43 ,100% of TX Medicaid OPPS fee schedule,$39.43 ,100% of TX Medicaid OPPS fee schedule,$39.43 ,100% of TX Medicaid OPPS fee schedule,$39.43 ,100% of TX Medicaid OPPS fee schedule,$38.64 ,$642.12 ,$260.85 
Outpatient Medical Services,RADIOLOGY,72070,SPINE DORSAL 2 VWS,320,$482.90 ,$128.78 ,125% CMS Medicare OPPS fee schedule,$367.00 ,76%  of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$642.12 ,561% of BCBSTX fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,$434.61 ,90% of total billed charges for oupatient setting,$33.08 ,100% of TX Medicaid OPPS fee schedule,$434.61 ,90% of total billed charges for oupatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$32.42 ,98% of TX Medicaid OPPS fee schedule,$458.76 ,95% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$424.95 ,88% of total billed charges for outpatient setting,$424.95 ,88% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$33.08 ,100% of TX Medicaid OPPS fee schedule,$33.08 ,100% of TX Medicaid OPPS fee schedule,$33.08 ,100% of TX Medicaid OPPS fee schedule,$33.08 ,100% of TX Medicaid OPPS fee schedule,$33.08 ,100% of TX Medicaid OPPS fee schedule,$33.08 ,100% of TX Medicaid OPPS fee schedule,$33.08 ,100% of TX Medicaid OPPS fee schedule,$33.08 ,100% of TX Medicaid OPPS fee schedule,$33.08 ,100% of TX Medicaid OPPS fee schedule,$32.42 ,$642.12 ,$313.89 
Outpatient Medical Services,RADIOLOGY,72040,SPINE CERVICAL 2OR3,320,$421.16 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$320.08 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$379.04 ,90% of total billed charges for oupatient setting,$39.76 ,100% of TX Medicaid OPPS fee schedule,$379.04 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$38.96 ,98% of TX Medicaid OPPS fee schedule,$400.10 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$370.62 ,88% of total billed charges for outpatient setting,$370.62 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$39.76 ,100% of TX Medicaid OPPS fee schedule,$39.76 ,100% of TX Medicaid OPPS fee schedule,$39.76 ,100% of TX Medicaid OPPS fee schedule,$39.76 ,100% of TX Medicaid OPPS fee schedule,$39.76 ,100% of TX Medicaid OPPS fee schedule,$39.76 ,100% of TX Medicaid OPPS fee schedule,$39.76 ,100% of TX Medicaid OPPS fee schedule,$39.76 ,100% of TX Medicaid OPPS fee schedule,$39.76 ,100% of TX Medicaid OPPS fee schedule,$38.96 ,$400.10 ,$273.75 
Outpatient Medical Services,RADIOLOGY,71111,RIBS BILT MIN 4VW/PA,320,$481.79 ,$128.78 ,125% CMS Medicare OPPS fee schedule,$366.16 ,76%  of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$642.12 ,561% of BCBSTX fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,$433.61 ,90% of total billed charges for oupatient setting,$52.79 ,100% of TX Medicaid OPPS fee schedule,$433.61 ,90% of total billed charges for oupatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$51.73 ,98% of TX Medicaid OPPS fee schedule,$457.70 ,95% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$423.98 ,88% of total billed charges for outpatient setting,$423.98 ,88% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$52.79 ,100% of TX Medicaid OPPS fee schedule,$51.73 ,$642.12 ,$313.16 
Outpatient Medical Services,RADIOLOGY,71046,CHEST 2 VIEWS,320,$457.54 ,$104.67 ,125% CMS Medicare OPPS fee schedule,$347.73 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$411.79 ,90% of total billed charges for oupatient setting,$33.75 ,100% of TX Medicaid OPPS fee schedule,$411.79 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$33.08 ,98% of TX Medicaid OPPS fee schedule,$434.66 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$402.64 ,88% of total billed charges for outpatient setting,$402.64 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$33.75 ,100% of TX Medicaid OPPS fee schedule,$33.75 ,100% of TX Medicaid OPPS fee schedule,$33.75 ,100% of TX Medicaid OPPS fee schedule,$33.75 ,100% of TX Medicaid OPPS fee schedule,$33.75 ,100% of TX Medicaid OPPS fee schedule,$33.75 ,100% of TX Medicaid OPPS fee schedule,$33.75 ,100% of TX Medicaid OPPS fee schedule,$33.75 ,100% of TX Medicaid OPPS fee schedule,$33.75 ,100% of TX Medicaid OPPS fee schedule,$33.08 ,$434.66 ,$297.40 
Outpatient Medical Services,RADIOLOGY,71045,CHEST 1 VIEW,320,$260.19 ,$104.67 ,125% CMS Medicare OPPS fee schedule,$197.74 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$234.17 ,90% of total billed charges for oupatient setting,$26.06 ,100% of TX Medicaid OPPS fee schedule,$234.17 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$25.54 ,98% of TX Medicaid OPPS fee schedule,$247.18 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$228.97 ,88% of total billed charges for outpatient setting,$228.97 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$26.06 ,100% of TX Medicaid OPPS fee schedule,$26.06 ,100% of TX Medicaid OPPS fee schedule,$26.06 ,100% of TX Medicaid OPPS fee schedule,$26.06 ,100% of TX Medicaid OPPS fee schedule,$26.06 ,100% of TX Medicaid OPPS fee schedule,$26.06 ,100% of TX Medicaid OPPS fee schedule,$26.06 ,100% of TX Medicaid OPPS fee schedule,$26.06 ,100% of TX Medicaid OPPS fee schedule,$26.06 ,100% of TX Medicaid OPPS fee schedule,$25.54 ,$348.49 ,$169.12 
Outpatient Medical Services,RADIOLOGY,70360,NECK SOFT TISSUE,320,$271.22 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$206.13 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$244.10 ,90% of total billed charges for oupatient setting,$31.74 ,100% of TX Medicaid OPPS fee schedule,$244.10 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$31.11 ,98% of TX Medicaid OPPS fee schedule,$257.66 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$238.67 ,88% of total billed charges for outpatient setting,$238.67 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.74 ,100% of TX Medicaid OPPS fee schedule,$31.11 ,$348.49 ,$176.29 
Outpatient Medical Services,RADIOLOGY,70250,SKULL LESS THN 4 VWS,320,$362.72 ,$128.78 ,125% CMS Medicare OPPS fee schedule,$275.67 ,76%  of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$642.12 ,561% of BCBSTX fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,$326.45 ,90% of total billed charges for oupatient setting,$36.09 ,100% of TX Medicaid OPPS fee schedule,$326.45 ,90% of total billed charges for oupatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$35.37 ,98% of TX Medicaid OPPS fee schedule,$344.58 ,95% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$319.19 ,88% of total billed charges for outpatient setting,$319.19 ,88% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$36.09 ,100% of TX Medicaid OPPS fee schedule,$36.09 ,100% of TX Medicaid OPPS fee schedule,$36.09 ,100% of TX Medicaid OPPS fee schedule,$36.09 ,100% of TX Medicaid OPPS fee schedule,$36.09 ,100% of TX Medicaid OPPS fee schedule,$36.09 ,100% of TX Medicaid OPPS fee schedule,$36.09 ,100% of TX Medicaid OPPS fee schedule,$36.09 ,100% of TX Medicaid OPPS fee schedule,$36.09 ,100% of TX Medicaid OPPS fee schedule,$35.37 ,$642.12 ,$235.77 
Outpatient Medical Services,RADIOLOGY,70150,FACIAL BONE MIN 3 VI,320,$207.27 ,$128.78 ,125% CMS Medicare OPPS fee schedule,$157.53 ,76%  of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$642.12 ,561% of BCBSTX fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,$186.54 ,90% of total billed charges for oupatient setting,$47.11 ,100% of TX Medicaid OPPS fee schedule,$186.54 ,90% of total billed charges for oupatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$46.17 ,98% of TX Medicaid OPPS fee schedule,$196.91 ,95% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$182.40 ,88% of total billed charges for outpatient setting,$182.40 ,88% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$47.11 ,100% of TX Medicaid OPPS fee schedule,$46.17 ,$642.12 ,$134.73 
Outpatient Medical Services,RADIOLOGY,72081,SCOLIOSIS EVAL ONE VIEW ONLY,320,$482.90 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$367.00 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$348.49 ,561% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$348.49 ,561% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$434.61 ,90% of total billed charges for oupatient setting,$42.78 ,100% of TX Medicaid OPPS fee schedule,$434.61 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$41.92 ,98% of TX Medicaid OPPS fee schedule,$458.76 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$424.95 ,88% of total billed charges for outpatient setting,$424.95 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$42.78 ,100% of TX Medicaid OPPS fee schedule,$42.78 ,100% of TX Medicaid OPPS fee schedule,$42.78 ,100% of TX Medicaid OPPS fee schedule,$42.78 ,100% of TX Medicaid OPPS fee schedule,$42.78 ,100% of TX Medicaid OPPS fee schedule,$42.78 ,100% of TX Medicaid OPPS fee schedule,$42.78 ,100% of TX Medicaid OPPS fee schedule,$42.78 ,100% of TX Medicaid OPPS fee schedule,$42.78 ,100% of TX Medicaid OPPS fee schedule,$41.92 ,$458.76 ,$313.89 
Outpatient Medical Services,RADIOLOGY,72082,SCOLIOSIS EVAL 2 OR 3 VIEWS,320,$361.31 ,$128.78 ,125% CMS Medicare OPPS fee schedule,$274.60 ,76%  of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$642.12 ,561% of BCBSTX fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,$325.18 ,90% of total billed charges for oupatient setting,$70.50 ,100% of TX Medicaid OPPS fee schedule,$325.18 ,90% of total billed charges for oupatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$69.09 ,98% of TX Medicaid OPPS fee schedule,$343.24 ,95% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$317.95 ,88% of total billed charges for outpatient setting,$317.95 ,88% of total billed charges for outpatient setting,$103.02 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$103.02 ,100% CMS Medicare OPPS fee schedule,$70.50 ,100% of TX Medicaid OPPS fee schedule,$70.50 ,100% of TX Medicaid OPPS fee schedule,$70.50 ,100% of TX Medicaid OPPS fee schedule,$70.50 ,100% of TX Medicaid OPPS fee schedule,$70.50 ,100% of TX Medicaid OPPS fee schedule,$70.50 ,100% of TX Medicaid OPPS fee schedule,$70.50 ,100% of TX Medicaid OPPS fee schedule,$70.50 ,100% of TX Medicaid OPPS fee schedule,$70.50 ,100% of TX Medicaid OPPS fee schedule,$66.96 ,$642.12 ,$234.85 
Outpatient Medical Services,RADIOLOGY,70549,MRA NECK W/WO CONT,615,"$4,235.81 ",$443.91 ,125% CMS Medicare OPPS fee schedule,"$3,219.22 ",76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$456.37 ,100% of BCBSTX fee schedule,"$3,812.23 ",90% of total billed charges for oupatient setting,$360.53 ,100% of TX Medicaid OPPS fee schedule,"$3,812.23 ",90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$353.32 ,98% of TX Medicaid OPPS fee schedule,"$4,024.02 ",95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$3,727.51 ",88% of total billed charges for outpatient setting,"$3,727.51 ",88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$360.53 ,100% of TX Medicaid OPPS fee schedule,$360.53 ,100% of TX Medicaid OPPS fee schedule,$360.53 ,100% of TX Medicaid OPPS fee schedule,$360.53 ,100% of TX Medicaid OPPS fee schedule,$360.53 ,100% of TX Medicaid OPPS fee schedule,$360.53 ,100% of TX Medicaid OPPS fee schedule,$360.53 ,100% of TX Medicaid OPPS fee schedule,$360.53 ,100% of TX Medicaid OPPS fee schedule,$360.53 ,100% of TX Medicaid OPPS fee schedule,$230.84 ,"$4,024.02 ","$2,753.28 "
Outpatient Medical Services,RADIOLOGY,70547,MRA NECK W/O CONT,615,"$2,683.49 ",$281.37 ,125% CMS Medicare OPPS fee schedule,"$2,039.45 ",76%  of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$232.31 ,100% of BCBSTX fee schedule,"$2,415.14 ",90% of total billed charges for oupatient setting,$224.88 ,100% of TX Medicaid OPPS fee schedule,"$2,415.14 ",90% of total billed charges for oupatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$146.31 ,65% CMS Medicare OPPS fee schedule,$220.38 ,98% of TX Medicaid OPPS fee schedule,"$2,549.32 ",95% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$2,361.47 ",88% of total billed charges for outpatient setting,"$2,361.47 ",88% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$189.15 ,90% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$224.88 ,100% of TX Medicaid OPPS fee schedule,$224.88 ,100% of TX Medicaid OPPS fee schedule,$224.88 ,100% of TX Medicaid OPPS fee schedule,$224.88 ,100% of TX Medicaid OPPS fee schedule,$224.88 ,100% of TX Medicaid OPPS fee schedule,$224.88 ,100% of TX Medicaid OPPS fee schedule,$224.88 ,100% of TX Medicaid OPPS fee schedule,$224.88 ,100% of TX Medicaid OPPS fee schedule,$224.88 ,100% of TX Medicaid OPPS fee schedule,$146.31 ,"$2,549.32 ","$1,744.27 "
Outpatient Medical Services,RADIOLOGY,70544,MRA HEAD WO CONT,615,"$2,683.49 ",$281.37 ,125% CMS Medicare OPPS fee schedule,"$2,039.45 ",76%  of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$232.31 ,100% of BCBSTX fee schedule,"$2,415.14 ",90% of total billed charges for oupatient setting,$224.54 ,100% of TX Medicaid OPPS fee schedule,"$2,415.14 ",90% of total billed charges for oupatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$146.31 ,65% CMS Medicare OPPS fee schedule,$220.05 ,98% of TX Medicaid OPPS fee schedule,"$2,549.32 ",95% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$2,361.47 ",88% of total billed charges for outpatient setting,"$2,361.47 ",88% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$189.15 ,90% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$224.54 ,100% of TX Medicaid OPPS fee schedule,$224.54 ,100% of TX Medicaid OPPS fee schedule,$224.54 ,100% of TX Medicaid OPPS fee schedule,$224.54 ,100% of TX Medicaid OPPS fee schedule,$224.54 ,100% of TX Medicaid OPPS fee schedule,$224.54 ,100% of TX Medicaid OPPS fee schedule,$224.54 ,100% of TX Medicaid OPPS fee schedule,$224.54 ,100% of TX Medicaid OPPS fee schedule,$224.54 ,100% of TX Medicaid OPPS fee schedule,$146.31 ,"$2,549.32 ","$1,744.27 "
Outpatient Medical Services,RADIOLOGY,74183,MRI ABD W/WO CONT,614,"$6,465.06 ",$443.91 ,125% CMS Medicare OPPS fee schedule,"$4,913.45 ",76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$456.37 ,100% of BCBSTX fee schedule,"$5,818.55 ",90% of total billed charges for oupatient setting,$354.51 ,100% of TX Medicaid OPPS fee schedule,"$5,818.55 ",90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$347.42 ,98% of TX Medicaid OPPS fee schedule,"$6,141.81 ",95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$5,689.25 ",88% of total billed charges for outpatient setting,"$5,689.25 ",88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$354.51 ,100% of TX Medicaid OPPS fee schedule,$354.51 ,100% of TX Medicaid OPPS fee schedule,$354.51 ,100% of TX Medicaid OPPS fee schedule,$354.51 ,100% of TX Medicaid OPPS fee schedule,$354.51 ,100% of TX Medicaid OPPS fee schedule,$354.51 ,100% of TX Medicaid OPPS fee schedule,$354.51 ,100% of TX Medicaid OPPS fee schedule,$354.51 ,100% of TX Medicaid OPPS fee schedule,$354.51 ,100% of TX Medicaid OPPS fee schedule,$230.84 ,"$6,141.81 ","$4,202.29 "
Outpatient Medical Services,RADIOLOGY,72158,MRI SPINE LUMBR W/WO,612,"$4,373.62 ",$443.91 ,125% CMS Medicare OPPS fee schedule,"$3,323.95 ",76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$456.37 ,100% of BCBSTX fee schedule,"$3,936.26 ",90% of total billed charges for oupatient setting,$333.80 ,100% of TX Medicaid OPPS fee schedule,"$3,936.26 ",90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$327.12 ,98% of TX Medicaid OPPS fee schedule,"$4,154.94 ",95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$3,848.79 ",88% of total billed charges for outpatient setting,"$3,848.79 ",88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$333.80 ,100% of TX Medicaid OPPS fee schedule,$333.80 ,100% of TX Medicaid OPPS fee schedule,$333.80 ,100% of TX Medicaid OPPS fee schedule,$333.80 ,100% of TX Medicaid OPPS fee schedule,$333.80 ,100% of TX Medicaid OPPS fee schedule,$333.80 ,100% of TX Medicaid OPPS fee schedule,$333.80 ,100% of TX Medicaid OPPS fee schedule,$333.80 ,100% of TX Medicaid OPPS fee schedule,$333.80 ,100% of TX Medicaid OPPS fee schedule,$230.84 ,"$4,154.94 ","$2,842.85 "
Outpatient Medical Services,RADIOLOGY,72157,MRI SPNE THORAC W/WO,612,"$4,373.62 ",$443.91 ,125% CMS Medicare OPPS fee schedule,"$3,323.95 ",76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$456.37 ,100% of BCBSTX fee schedule,"$3,936.26 ",90% of total billed charges for oupatient setting,$335.14 ,100% of TX Medicaid OPPS fee schedule,"$3,936.26 ",90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$328.44 ,98% of TX Medicaid OPPS fee schedule,"$4,154.94 ",95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$3,848.79 ",88% of total billed charges for outpatient setting,"$3,848.79 ",88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$335.14 ,100% of TX Medicaid OPPS fee schedule,$335.14 ,100% of TX Medicaid OPPS fee schedule,$335.14 ,100% of TX Medicaid OPPS fee schedule,$335.14 ,100% of TX Medicaid OPPS fee schedule,$335.14 ,100% of TX Medicaid OPPS fee schedule,$335.14 ,100% of TX Medicaid OPPS fee schedule,$335.14 ,100% of TX Medicaid OPPS fee schedule,$335.14 ,100% of TX Medicaid OPPS fee schedule,$335.14 ,100% of TX Medicaid OPPS fee schedule,$230.84 ,"$4,154.94 ","$2,842.85 "
Outpatient Medical Services,RADIOLOGY,72156,MRI SPINE CERV W/WO,612,"$4,626.09 ",$443.91 ,125% CMS Medicare OPPS fee schedule,"$3,515.83 ",76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$456.37 ,100% of BCBSTX fee schedule,"$4,163.48 ",90% of total billed charges for oupatient setting,$334.46 ,100% of TX Medicaid OPPS fee schedule,"$4,163.48 ",90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$327.77 ,98% of TX Medicaid OPPS fee schedule,"$4,394.79 ",95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$4,070.96 ",88% of total billed charges for outpatient setting,"$4,070.96 ",88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$334.46 ,100% of TX Medicaid OPPS fee schedule,$334.46 ,100% of TX Medicaid OPPS fee schedule,$334.46 ,100% of TX Medicaid OPPS fee schedule,$334.46 ,100% of TX Medicaid OPPS fee schedule,$334.46 ,100% of TX Medicaid OPPS fee schedule,$334.46 ,100% of TX Medicaid OPPS fee schedule,$334.46 ,100% of TX Medicaid OPPS fee schedule,$334.46 ,100% of TX Medicaid OPPS fee schedule,$334.46 ,100% of TX Medicaid OPPS fee schedule,$230.84 ,"$4,394.79 ","$3,006.96 "
Outpatient Medical Services,RADIOLOGY,72148,MRI SPINE LUMBAR W/O,612,"$4,075.94 ",$281.37 ,125% CMS Medicare OPPS fee schedule,"$3,097.71 ",76%  of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$232.31 ,100% of BCBSTX fee schedule,"$3,668.35 ",90% of total billed charges for oupatient setting,$199.14 ,100% of TX Medicaid OPPS fee schedule,"$3,668.35 ",90% of total billed charges for oupatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$146.31 ,65% CMS Medicare OPPS fee schedule,$195.16 ,98% of TX Medicaid OPPS fee schedule,"$3,872.14 ",95% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$3,586.83 ",88% of total billed charges for outpatient setting,"$3,586.83 ",88% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$189.15 ,90% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$199.14 ,100% of TX Medicaid OPPS fee schedule,$199.14 ,100% of TX Medicaid OPPS fee schedule,$199.14 ,100% of TX Medicaid OPPS fee schedule,$199.14 ,100% of TX Medicaid OPPS fee schedule,$199.14 ,100% of TX Medicaid OPPS fee schedule,$199.14 ,100% of TX Medicaid OPPS fee schedule,$199.14 ,100% of TX Medicaid OPPS fee schedule,$199.14 ,100% of TX Medicaid OPPS fee schedule,$199.14 ,100% of TX Medicaid OPPS fee schedule,$146.31 ,"$3,872.14 ","$2,649.36 "
Outpatient Medical Services,RADIOLOGY,72146,MRI SPINE THORAC W/O,612,"$2,810.27 ",$281.37 ,125% CMS Medicare OPPS fee schedule,"$2,135.81 ",76%  of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$232.31 ,100% of BCBSTX fee schedule,"$2,529.24 ",90% of total billed charges for oupatient setting,$198.48 ,100% of TX Medicaid OPPS fee schedule,"$2,529.24 ",90% of total billed charges for oupatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$146.31 ,65% CMS Medicare OPPS fee schedule,$194.51 ,98% of TX Medicaid OPPS fee schedule,"$2,669.76 ",95% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$2,473.04 ",88% of total billed charges for outpatient setting,"$2,473.04 ",88% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$189.15 ,90% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$146.31 ,"$2,669.76 ","$1,826.68 "
Outpatient Medical Services,RADIOLOGY,72141,MRI SPINL CERVICL WO,612,"$4,075.94 ",$281.37 ,125% CMS Medicare OPPS fee schedule,"$3,097.71 ",76%  of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$232.31 ,100% of BCBSTX fee schedule,"$3,668.35 ",90% of total billed charges for oupatient setting,$198.48 ,100% of TX Medicaid OPPS fee schedule,"$3,668.35 ",90% of total billed charges for oupatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$146.31 ,65% CMS Medicare OPPS fee schedule,$194.51 ,98% of TX Medicaid OPPS fee schedule,"$3,872.14 ",95% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$3,586.83 ",88% of total billed charges for outpatient setting,"$3,586.83 ",88% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$189.15 ,90% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$198.48 ,100% of TX Medicaid OPPS fee schedule,$146.31 ,"$3,872.14 ","$2,649.36 "
Outpatient Medical Services,RADIOLOGY,70553,MRI BRAIN W/WO CONT,611,"$4,540.10 ",$443.91 ,125% CMS Medicare OPPS fee schedule,"$3,450.48 ",76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$456.37 ,100% of BCBSTX fee schedule,"$4,086.09 ",90% of total billed charges for oupatient setting,$332.80 ,100% of TX Medicaid OPPS fee schedule,"$4,086.09 ",90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$326.14 ,98% of TX Medicaid OPPS fee schedule,"$4,313.10 ",95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$3,995.29 ",88% of total billed charges for outpatient setting,"$3,995.29 ",88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$230.84 ,"$4,313.10 ","$2,951.07 "
Outpatient Medical Services,RADIOLOGY,70551,MRI BRAIN W/O CONT,611,"$4,092.48 ",$281.37 ,125% CMS Medicare OPPS fee schedule,"$3,110.28 ",76%  of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$232.31 ,100% of BCBSTX fee schedule,"$3,683.23 ",90% of total billed charges for oupatient setting,$204.15 ,100% of TX Medicaid OPPS fee schedule,"$3,683.23 ",90% of total billed charges for oupatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$146.31 ,65% CMS Medicare OPPS fee schedule,$200.07 ,98% of TX Medicaid OPPS fee schedule,"$3,887.86 ",95% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$3,601.38 ",88% of total billed charges for outpatient setting,"$3,601.38 ",88% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$189.15 ,90% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$204.15 ,100% of TX Medicaid OPPS fee schedule,$204.15 ,100% of TX Medicaid OPPS fee schedule,$204.15 ,100% of TX Medicaid OPPS fee schedule,$204.15 ,100% of TX Medicaid OPPS fee schedule,$204.15 ,100% of TX Medicaid OPPS fee schedule,$204.15 ,100% of TX Medicaid OPPS fee schedule,$204.15 ,100% of TX Medicaid OPPS fee schedule,$204.15 ,100% of TX Medicaid OPPS fee schedule,$204.15 ,100% of TX Medicaid OPPS fee schedule,$146.31 ,"$3,887.86 ","$2,660.11 "
Outpatient Medical Services,RADIOLOGY,70553,MRI PITUITARY W  W/O CONTRAST,611,"$4,540.10 ",$443.91 ,125% CMS Medicare OPPS fee schedule,"$3,450.48 ",76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$456.37 ,100% of BCBSTX fee schedule,"$4,086.09 ",90% of total billed charges for oupatient setting,$332.80 ,100% of TX Medicaid OPPS fee schedule,"$4,086.09 ",90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$326.14 ,98% of TX Medicaid OPPS fee schedule,"$4,313.10 ",95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$3,995.29 ",88% of total billed charges for outpatient setting,"$3,995.29 ",88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$332.80 ,100% of TX Medicaid OPPS fee schedule,$230.84 ,"$4,313.10 ","$2,951.07 "
Outpatient Medical Services,RADIOLOGY,77049,MR BREAST BL WO/ W CON,610,"$6,500.00 ",,125% CMS Medicare OPPS fee schedule,"$4,940.00 ",76%  of total billed charges for outpatient setting,,100% CMS Medicare OPPS fee schedule,"$1,429.72 ",490% of BCBSTX fee schedule,"$1,429.72 ",490% of BCBSTX fee schedule,,100% CMS Medicare OPPS fee schedule,"$1,429.72 ",490% of BCBSTX fee schedule,$291.78 ,100% of BCBSTX fee schedule,"$5,850.00 ",90% of total billed charges for oupatient setting,"$2,925.00 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$5,850.00 ",90% of total billed charges for oupatient setting,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,65% CMS Medicare OPPS fee schedule,"$2,866.50 ",44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,"$6,175.00 ",95% of total billed charges for outpatient setting,,100% CMS Medicare OPPS fee schedule,"$5,720.00 ",88% of total billed charges for outpatient setting,"$5,720.00 ",88% of total billed charges for outpatient setting,,100% CMS Medicare OPPS fee schedule,,90% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,,100% CMS Medicare OPPS fee schedule,"$2,925.00 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$2,925.00 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$2,925.00 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$2,925.00 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$2,925.00 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$2,925.00 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$2,925.00 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$2,925.00 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$2,925.00 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,,"$6,175.00 ","$4,225.00 "
Outpatient Medical Services,RADIOLOGY,73723,MRI EXT LWR JT W/WO,610,"$5,849.87 ",$443.91 ,125% CMS Medicare OPPS fee schedule,"$4,445.90 ",76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$456.37 ,100% of BCBSTX fee schedule,"$5,264.88 ",90% of total billed charges for oupatient setting,$368.43 ,100% of TX Medicaid OPPS fee schedule,"$5,264.88 ",90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$361.06 ,98% of TX Medicaid OPPS fee schedule,"$5,557.38 ",95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$5,147.89 ",88% of total billed charges for outpatient setting,"$5,147.89 ",88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$230.84 ,"$5,557.38 ","$3,802.42 "
Outpatient Medical Services,RADIOLOGY,73721,MRI EX LW JT WO CONT,610,"$3,962.39 ",$281.37 ,125% CMS Medicare OPPS fee schedule,"$3,011.42 ",76%  of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$232.31 ,100% of BCBSTX fee schedule,"$3,566.15 ",90% of total billed charges for oupatient setting,$210.84 ,100% of TX Medicaid OPPS fee schedule,"$3,566.15 ",90% of total billed charges for oupatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$146.31 ,65% CMS Medicare OPPS fee schedule,$206.62 ,98% of TX Medicaid OPPS fee schedule,"$3,764.27 ",95% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$3,486.90 ",88% of total billed charges for outpatient setting,"$3,486.90 ",88% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$189.15 ,90% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$210.84 ,100% of TX Medicaid OPPS fee schedule,$210.84 ,100% of TX Medicaid OPPS fee schedule,$210.84 ,100% of TX Medicaid OPPS fee schedule,$210.84 ,100% of TX Medicaid OPPS fee schedule,$210.84 ,100% of TX Medicaid OPPS fee schedule,$210.84 ,100% of TX Medicaid OPPS fee schedule,$210.84 ,100% of TX Medicaid OPPS fee schedule,$210.84 ,100% of TX Medicaid OPPS fee schedule,$210.84 ,100% of TX Medicaid OPPS fee schedule,$146.31 ,"$3,764.27 ","$2,575.55 "
Outpatient Medical Services,RADIOLOGY,73720,MRI LE NOT JT W/WO,610,"$4,324.01 ",$443.91 ,125% CMS Medicare OPPS fee schedule,"$3,286.25 ",76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$456.37 ,100% of BCBSTX fee schedule,"$3,891.61 ",90% of total billed charges for oupatient setting,$353.51 ,100% of TX Medicaid OPPS fee schedule,"$3,891.61 ",90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$346.44 ,98% of TX Medicaid OPPS fee schedule,"$4,107.81 ",95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$3,805.13 ",88% of total billed charges for outpatient setting,"$3,805.13 ",88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$353.51 ,100% of TX Medicaid OPPS fee schedule,$353.51 ,100% of TX Medicaid OPPS fee schedule,$353.51 ,100% of TX Medicaid OPPS fee schedule,$353.51 ,100% of TX Medicaid OPPS fee schedule,$353.51 ,100% of TX Medicaid OPPS fee schedule,$353.51 ,100% of TX Medicaid OPPS fee schedule,$353.51 ,100% of TX Medicaid OPPS fee schedule,$353.51 ,100% of TX Medicaid OPPS fee schedule,$353.51 ,100% of TX Medicaid OPPS fee schedule,$230.84 ,"$4,107.81 ","$2,810.61 "
Outpatient Medical Services,RADIOLOGY,73718,MRI EXT LR O/T JT WO,610,"$3,749.60 ",$281.37 ,125% CMS Medicare OPPS fee schedule,"$2,849.70 ",76%  of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$232.31 ,100% of BCBSTX fee schedule,"$3,374.64 ",90% of total billed charges for oupatient setting,$233.52 ,100% of TX Medicaid OPPS fee schedule,"$3,374.64 ",90% of total billed charges for oupatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$146.31 ,65% CMS Medicare OPPS fee schedule,$228.85 ,98% of TX Medicaid OPPS fee schedule,"$3,562.12 ",95% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$3,299.65 ",88% of total billed charges for outpatient setting,"$3,299.65 ",88% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$189.15 ,90% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$146.31 ,"$3,562.12 ","$2,437.24 "
Outpatient Medical Services,RADIOLOGY,73223,MRI EX UP NE JT W/WO,610,"$4,324.01 ",$443.91 ,125% CMS Medicare OPPS fee schedule,"$3,286.25 ",76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$456.37 ,100% of BCBSTX fee schedule,"$3,891.61 ",90% of total billed charges for oupatient setting,$368.43 ,100% of TX Medicaid OPPS fee schedule,"$3,891.61 ",90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$361.06 ,98% of TX Medicaid OPPS fee schedule,"$4,107.81 ",95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$3,805.13 ",88% of total billed charges for outpatient setting,"$3,805.13 ",88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$230.84 ,"$4,107.81 ","$2,810.61 "
Outpatient Medical Services,RADIOLOGY,73222,MRI EX UP NE JT W/CO,610,"$3,845.52 ",$892.53 ,125% CMS Medicare OPPS fee schedule,"$2,922.60 ",76%  of total billed charges for outpatient setting,$714.03 ,100% CMS Medicare OPPS fee schedule,"$3,341.21 ",490% of BCBSTX fee schedule,"$3,341.21 ",490% of BCBSTX fee schedule,$714.03 ,100% CMS Medicare OPPS fee schedule,"$3,341.21 ",490% of BCBSTX fee schedule,$681.88 ,100% of BCBSTX fee schedule,"$3,460.97 ",90% of total billed charges for oupatient setting,$328.45 ,100% of TX Medicaid OPPS fee schedule,"$3,460.97 ",90% of total billed charges for oupatient setting,$714.03 ,100% CMS Medicare OPPS fee schedule,$714.03 ,100% CMS Medicare OPPS fee schedule,$714.03 ,100% CMS Medicare OPPS fee schedule,$464.12 ,65% CMS Medicare OPPS fee schedule,$321.88 ,98% of TX Medicaid OPPS fee schedule,"$3,653.24 ",95% of total billed charges for outpatient setting,$714.03 ,100% CMS Medicare OPPS fee schedule,"$3,384.06 ",88% of total billed charges for outpatient setting,"$3,384.06 ",88% of total billed charges for outpatient setting,$714.03 ,100% CMS Medicare OPPS fee schedule,$600.03 ,90% CMS Medicare OPPS fee schedule,$714.03 ,100% CMS Medicare OPPS fee schedule,$714.03 ,100% CMS Medicare OPPS fee schedule,$714.03 ,100% CMS Medicare OPPS fee schedule,$714.03 ,100% CMS Medicare OPPS fee schedule,$714.03 ,100% CMS Medicare OPPS fee schedule,$714.03 ,100% CMS Medicare OPPS fee schedule,$714.03 ,100% CMS Medicare OPPS fee schedule,$714.03 ,100% CMS Medicare OPPS fee schedule,$714.03 ,100% CMS Medicare OPPS fee schedule,$714.03 ,100% CMS Medicare OPPS fee schedule,$328.45 ,100% of TX Medicaid OPPS fee schedule,$328.45 ,100% of TX Medicaid OPPS fee schedule,$328.45 ,100% of TX Medicaid OPPS fee schedule,$328.45 ,100% of TX Medicaid OPPS fee schedule,$328.45 ,100% of TX Medicaid OPPS fee schedule,$328.45 ,100% of TX Medicaid OPPS fee schedule,$328.45 ,100% of TX Medicaid OPPS fee schedule,$328.45 ,100% of TX Medicaid OPPS fee schedule,$328.45 ,100% of TX Medicaid OPPS fee schedule,$321.88 ,"$3,653.24 ","$2,499.59 "
Outpatient Medical Services,RADIOLOGY,73221,MRI Uppr Extrmty w/o contrast,610,"$3,547.85 ",$281.37 ,125% CMS Medicare OPPS fee schedule,"$2,696.37 ",76%  of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$232.31 ,100% of BCBSTX fee schedule,"$3,193.07 ",90% of total billed charges for oupatient setting,$211.18 ,100% of TX Medicaid OPPS fee schedule,"$3,193.07 ",90% of total billed charges for oupatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$146.31 ,65% CMS Medicare OPPS fee schedule,$206.96 ,98% of TX Medicaid OPPS fee schedule,"$3,370.46 ",95% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$3,122.11 ",88% of total billed charges for outpatient setting,"$3,122.11 ",88% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$189.15 ,90% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$211.18 ,100% of TX Medicaid OPPS fee schedule,$211.18 ,100% of TX Medicaid OPPS fee schedule,$211.18 ,100% of TX Medicaid OPPS fee schedule,$211.18 ,100% of TX Medicaid OPPS fee schedule,$211.18 ,100% of TX Medicaid OPPS fee schedule,$211.18 ,100% of TX Medicaid OPPS fee schedule,$211.18 ,100% of TX Medicaid OPPS fee schedule,$211.18 ,100% of TX Medicaid OPPS fee schedule,$211.18 ,100% of TX Medicaid OPPS fee schedule,$146.31 ,"$3,370.46 ","$2,306.10 "
Outpatient Medical Services,RADIOLOGY,73220,MRI EX UP OT JT W/WO,610,"$4,324.01 ",$443.91 ,125% CMS Medicare OPPS fee schedule,"$3,286.25 ",76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$456.37 ,100% of BCBSTX fee schedule,"$3,891.61 ",90% of total billed charges for oupatient setting,$368.43 ,100% of TX Medicaid OPPS fee schedule,"$3,891.61 ",90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$361.06 ,98% of TX Medicaid OPPS fee schedule,"$4,107.81 ",95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$3,805.13 ",88% of total billed charges for outpatient setting,"$3,805.13 ",88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$230.84 ,"$4,107.81 ","$2,810.61 "
Outpatient Medical Services,RADIOLOGY,73218,MRI EXT UP O/T JT WO,610,"$3,359.32 ",$281.37 ,125% CMS Medicare OPPS fee schedule,"$2,553.08 ",76%  of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$232.31 ,100% of BCBSTX fee schedule,"$3,023.39 ",90% of total billed charges for oupatient setting,$233.52 ,100% of TX Medicaid OPPS fee schedule,"$3,023.39 ",90% of total billed charges for oupatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$146.31 ,65% CMS Medicare OPPS fee schedule,$228.85 ,98% of TX Medicaid OPPS fee schedule,"$3,191.35 ",95% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$2,956.20 ",88% of total billed charges for outpatient setting,"$2,956.20 ",88% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$189.15 ,90% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$146.31 ,"$3,191.35 ","$2,183.56 "
Outpatient Medical Services,RADIOLOGY,74181,MRCP MRI ABD WO/ CONT,610,"$5,263.34 ",$281.37 ,125% CMS Medicare OPPS fee schedule,"$4,000.14 ",76%  of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$232.31 ,100% of BCBSTX fee schedule,"$4,737.01 ",90% of total billed charges for oupatient setting,$204.83 ,100% of TX Medicaid OPPS fee schedule,"$4,737.01 ",90% of total billed charges for oupatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$146.31 ,65% CMS Medicare OPPS fee schedule,$200.73 ,98% of TX Medicaid OPPS fee schedule,"$5,000.17 ",95% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$4,631.74 ",88% of total billed charges for outpatient setting,"$4,631.74 ",88% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$189.15 ,90% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$204.83 ,100% of TX Medicaid OPPS fee schedule,$204.83 ,100% of TX Medicaid OPPS fee schedule,$204.83 ,100% of TX Medicaid OPPS fee schedule,$204.83 ,100% of TX Medicaid OPPS fee schedule,$204.83 ,100% of TX Medicaid OPPS fee schedule,$204.83 ,100% of TX Medicaid OPPS fee schedule,$204.83 ,100% of TX Medicaid OPPS fee schedule,$204.83 ,100% of TX Medicaid OPPS fee schedule,$204.83 ,100% of TX Medicaid OPPS fee schedule,$146.31 ,"$5,000.17 ","$3,421.17 "
Outpatient Medical Services,RADIOLOGY,72197,MRI PELVIS W/WO CONT,610,"$5,572.04 ",$443.91 ,125% CMS Medicare OPPS fee schedule,"$4,234.75 ",76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$456.37 ,100% of BCBSTX fee schedule,"$5,014.84 ",90% of total billed charges for oupatient setting,$353.18 ,100% of TX Medicaid OPPS fee schedule,"$5,014.84 ",90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$346.12 ,98% of TX Medicaid OPPS fee schedule,"$5,293.44 ",95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$4,903.40 ",88% of total billed charges for outpatient setting,"$4,903.40 ",88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$353.18 ,100% of TX Medicaid OPPS fee schedule,$353.18 ,100% of TX Medicaid OPPS fee schedule,$353.18 ,100% of TX Medicaid OPPS fee schedule,$353.18 ,100% of TX Medicaid OPPS fee schedule,$353.18 ,100% of TX Medicaid OPPS fee schedule,$353.18 ,100% of TX Medicaid OPPS fee schedule,$353.18 ,100% of TX Medicaid OPPS fee schedule,$353.18 ,100% of TX Medicaid OPPS fee schedule,$353.18 ,100% of TX Medicaid OPPS fee schedule,$230.84 ,"$5,293.44 ","$3,621.83 "
Outpatient Medical Services,RADIOLOGY,72195,MRI PELVIS WO/CONT,610,"$3,760.63 ",$281.37 ,125% CMS Medicare OPPS fee schedule,"$2,858.08 ",76%  of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$232.31 ,100% of BCBSTX fee schedule,"$3,384.57 ",90% of total billed charges for oupatient setting,$233.52 ,100% of TX Medicaid OPPS fee schedule,"$3,384.57 ",90% of total billed charges for oupatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$146.31 ,65% CMS Medicare OPPS fee schedule,$228.85 ,98% of TX Medicaid OPPS fee schedule,"$3,572.60 ",95% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$3,309.35 ",88% of total billed charges for outpatient setting,"$3,309.35 ",88% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$189.15 ,90% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$146.31 ,"$3,572.60 ","$2,444.41 "
Outpatient Medical Services,RADIOLOGY,70543,MRI ORBT FAC NK W/W0,610,"$5,730.80 ",$443.91 ,125% CMS Medicare OPPS fee schedule,"$4,355.41 ",76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$2,236.21 ",490% of BCBSTX fee schedule,$456.37 ,100% of BCBSTX fee schedule,"$5,157.72 ",90% of total billed charges for oupatient setting,$354.85 ,100% of TX Medicaid OPPS fee schedule,"$5,157.72 ",90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$347.75 ,98% of TX Medicaid OPPS fee schedule,"$5,444.26 ",95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$5,043.10 ",88% of total billed charges for outpatient setting,"$5,043.10 ",88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$354.85 ,100% of TX Medicaid OPPS fee schedule,$354.85 ,100% of TX Medicaid OPPS fee schedule,$354.85 ,100% of TX Medicaid OPPS fee schedule,$354.85 ,100% of TX Medicaid OPPS fee schedule,$354.85 ,100% of TX Medicaid OPPS fee schedule,$354.85 ,100% of TX Medicaid OPPS fee schedule,$354.85 ,100% of TX Medicaid OPPS fee schedule,$354.85 ,100% of TX Medicaid OPPS fee schedule,$354.85 ,100% of TX Medicaid OPPS fee schedule,$230.84 ,"$5,444.26 ","$3,725.02 "
Outpatient Medical Services,RADIOLOGY,70540,MRI ORBIT FACE NK WO,610,"$3,630.53 ",$281.37 ,125% CMS Medicare OPPS fee schedule,"$2,759.20 ",76%  of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$232.31 ,100% of BCBSTX fee schedule,"$3,267.48 ",90% of total billed charges for oupatient setting,$233.52 ,100% of TX Medicaid OPPS fee schedule,"$3,267.48 ",90% of total billed charges for oupatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$146.31 ,65% CMS Medicare OPPS fee schedule,$228.85 ,98% of TX Medicaid OPPS fee schedule,"$3,449.00 ",95% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$3,194.87 ",88% of total billed charges for outpatient setting,"$3,194.87 ",88% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$189.15 ,90% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$233.52 ,100% of TX Medicaid OPPS fee schedule,$146.31 ,"$3,449.00 ","$2,359.84 "
Outpatient Medical Services,RADIOLOGY,74178,CT ABD & PEL W/WO CO,352,"$8,474.92 ",$443.91 ,125% CMS Medicare OPPS fee schedule,"$6,440.94 ",76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$7,627.43 ",90% of total billed charges for oupatient setting,$356.19 ,100% of TX Medicaid OPPS fee schedule,"$7,627.43 ",90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$349.07 ,98% of TX Medicaid OPPS fee schedule,"$8,051.17 ",95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$7,457.93 ",88% of total billed charges for outpatient setting,"$7,457.93 ",88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$356.19 ,100% of TX Medicaid OPPS fee schedule,$356.19 ,100% of TX Medicaid OPPS fee schedule,$356.19 ,100% of TX Medicaid OPPS fee schedule,$356.19 ,100% of TX Medicaid OPPS fee schedule,$356.19 ,100% of TX Medicaid OPPS fee schedule,$356.19 ,100% of TX Medicaid OPPS fee schedule,$356.19 ,100% of TX Medicaid OPPS fee schedule,$356.19 ,100% of TX Medicaid OPPS fee schedule,$356.19 ,100% of TX Medicaid OPPS fee schedule,$230.84 ,"$8,051.17 ","$5,508.70 "
Outpatient Medical Services,RADIOLOGY,74177,CT ABD & PEL W/ CONT,352,"$7,525.67 ",$443.91 ,125% CMS Medicare OPPS fee schedule,"$5,719.51 ",76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$6,773.10 ",90% of total billed charges for oupatient setting,$318.09 ,100% of TX Medicaid OPPS fee schedule,"$6,773.10 ",90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$311.73 ,98% of TX Medicaid OPPS fee schedule,"$7,149.39 ",95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$6,622.59 ",88% of total billed charges for outpatient setting,"$6,622.59 ",88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$318.09 ,100% of TX Medicaid OPPS fee schedule,$318.09 ,100% of TX Medicaid OPPS fee schedule,$318.09 ,100% of TX Medicaid OPPS fee schedule,$318.09 ,100% of TX Medicaid OPPS fee schedule,$318.09 ,100% of TX Medicaid OPPS fee schedule,$318.09 ,100% of TX Medicaid OPPS fee schedule,$318.09 ,100% of TX Medicaid OPPS fee schedule,$318.09 ,100% of TX Medicaid OPPS fee schedule,$318.09 ,100% of TX Medicaid OPPS fee schedule,$230.84 ,"$7,149.39 ","$4,891.69 "
Outpatient Medical Services,RADIOLOGY,74176,CT ABD & PEL W/O CON,352,"$5,670.16 ",$281.37 ,125% CMS Medicare OPPS fee schedule,"$4,309.32 ",76%  of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,"$1,138.32 ",490% of BCBSTX fee schedule,$232.31 ,100% of BCBSTX fee schedule,"$5,103.14 ",90% of total billed charges for oupatient setting,$189.79 ,100% of TX Medicaid OPPS fee schedule,"$5,103.14 ",90% of total billed charges for oupatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$146.31 ,65% CMS Medicare OPPS fee schedule,$185.99 ,98% of TX Medicaid OPPS fee schedule,"$5,386.65 ",95% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,"$4,989.74 ",88% of total billed charges for outpatient setting,"$4,989.74 ",88% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$189.15 ,90% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$189.79 ,100% of TX Medicaid OPPS fee schedule,$189.79 ,100% of TX Medicaid OPPS fee schedule,$189.79 ,100% of TX Medicaid OPPS fee schedule,$189.79 ,100% of TX Medicaid OPPS fee schedule,$189.79 ,100% of TX Medicaid OPPS fee schedule,$189.79 ,100% of TX Medicaid OPPS fee schedule,$189.79 ,100% of TX Medicaid OPPS fee schedule,$189.79 ,100% of TX Medicaid OPPS fee schedule,$189.79 ,100% of TX Medicaid OPPS fee schedule,$146.31 ,"$5,386.65 ","$3,685.60 "
Outpatient Medical Services,RADIOLOGY,74175,CTA ABD,352,"$2,760.66 ",$217.28 ,125% CMS Medicare OPPS fee schedule,"$2,098.10 ",76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$2,484.59 ",90% of total billed charges for oupatient setting,$180.34 ,100% of TX Medicaid OPPS fee schedule,"$2,484.59 ",90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$176.73 ,98% of TX Medicaid OPPS fee schedule,"$2,622.63 ",95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$2,429.38 ",88% of total billed charges for outpatient setting,"$2,429.38 ",88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.07 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$2,622.63 ","$1,794.43 "
Outpatient Medical Services,RADIOLOGY,74170,CT ABD W/WO CONT,352,"$3,953.57 ",$217.28 ,125% CMS Medicare OPPS fee schedule,"$3,004.71 ",76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$3,558.21 ",90% of total billed charges for oupatient setting,$180.34 ,100% of TX Medicaid OPPS fee schedule,"$3,558.21 ",90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$176.73 ,98% of TX Medicaid OPPS fee schedule,"$3,755.89 ",95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$3,479.14 ",88% of total billed charges for outpatient setting,"$3,479.14 ",88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.07 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$3,755.89 ","$2,569.82 "
Outpatient Medical Services,RADIOLOGY,74160,CT ABD W/CONT,352,"$3,510.36 ",$217.28 ,125% CMS Medicare OPPS fee schedule,"$2,667.87 ",76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$3,159.32 ",90% of total billed charges for oupatient setting,$180.34 ,100% of TX Medicaid OPPS fee schedule,"$3,159.32 ",90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$176.73 ,98% of TX Medicaid OPPS fee schedule,"$3,334.84 ",95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$3,089.12 ",88% of total billed charges for outpatient setting,"$3,089.12 ",88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.07 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$3,334.84 ","$2,281.73 "
Outpatient Medical Services,RADIOLOGY,74150,CT ABD W/O CONT,352,"$2,229.26 ",$128.77 ,125% CMS Medicare OPPS fee schedule,"$1,694.24 ",76%  of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$560.85 ,490% of BCBSTX fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,"$2,006.33 ",90% of total billed charges for oupatient setting,$106.88 ,100% of TX Medicaid OPPS fee schedule,"$2,006.33 ",90% of total billed charges for oupatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$104.74 ,98% of TX Medicaid OPPS fee schedule,"$2,117.80 ",95% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,"$1,961.75 ",88% of total billed charges for outpatient setting,"$1,961.75 ",88% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$66.96 ,"$2,117.80 ","$1,449.02 "
Outpatient Medical Services,RADIOLOGY,72193,CT PELVIC W/CONT,352,"$3,511.46 ",$217.28 ,125% CMS Medicare OPPS fee schedule,"$2,668.71 ",76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$3,160.31 ",90% of total billed charges for oupatient setting,$180.34 ,100% of TX Medicaid OPPS fee schedule,"$3,160.31 ",90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$176.73 ,98% of TX Medicaid OPPS fee schedule,"$3,335.89 ",95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$3,090.08 ",88% of total billed charges for outpatient setting,"$3,090.08 ",88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.07 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$3,335.89 ","$2,282.45 "
Outpatient Medical Services,RADIOLOGY,72192,CT PELVIC W/O CONT,352,"$3,061.64 ",$128.77 ,125% CMS Medicare OPPS fee schedule,"$2,326.85 ",76%  of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$560.85 ,490% of BCBSTX fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,"$2,755.48 ",90% of total billed charges for oupatient setting,$106.88 ,100% of TX Medicaid OPPS fee schedule,"$2,755.48 ",90% of total billed charges for oupatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$104.74 ,98% of TX Medicaid OPPS fee schedule,"$2,908.56 ",95% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,"$2,694.24 ",88% of total billed charges for outpatient setting,"$2,694.24 ",88% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$66.96 ,"$2,908.56 ","$1,990.07 "
Outpatient Medical Services,RADIOLOGY,72131,CT LSPINE W/O CON,352,"$2,047.34 ",$128.77 ,125% CMS Medicare OPPS fee schedule,"$1,555.98 ",76%  of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$560.85 ,490% of BCBSTX fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,"$1,842.61 ",90% of total billed charges for oupatient setting,$106.88 ,100% of TX Medicaid OPPS fee schedule,"$1,842.61 ",90% of total billed charges for oupatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$104.74 ,98% of TX Medicaid OPPS fee schedule,"$1,944.97 ",95% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,"$1,801.66 ",88% of total billed charges for outpatient setting,"$1,801.66 ",88% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$66.96 ,"$1,944.97 ","$1,330.77 "
Outpatient Medical Services,RADIOLOGY,72128,CT TSPINE W/O CON,352,"$2,278.87 ",$128.77 ,125% CMS Medicare OPPS fee schedule,"$1,731.94 ",76%  of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$560.85 ,490% of BCBSTX fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,"$2,050.98 ",90% of total billed charges for oupatient setting,$106.88 ,100% of TX Medicaid OPPS fee schedule,"$2,050.98 ",90% of total billed charges for oupatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$104.74 ,98% of TX Medicaid OPPS fee schedule,"$2,164.93 ",95% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,"$2,005.41 ",88% of total billed charges for outpatient setting,"$2,005.41 ",88% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$66.96 ,"$2,164.93 ","$1,481.27 "
Outpatient Medical Services,RADIOLOGY,72125,CT CSPINE W/O CON,352,"$3,370.55 ",$128.77 ,125% CMS Medicare OPPS fee schedule,"$2,561.62 ",76%  of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$560.85 ,490% of BCBSTX fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,"$3,033.50 ",90% of total billed charges for oupatient setting,$106.88 ,100% of TX Medicaid OPPS fee schedule,"$3,033.50 ",90% of total billed charges for oupatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$104.74 ,98% of TX Medicaid OPPS fee schedule,"$3,202.02 ",95% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,"$2,966.08 ",88% of total billed charges for outpatient setting,"$2,966.08 ",88% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$66.96 ,"$3,202.02 ","$2,190.86 "
Outpatient Medical Services,RADIOLOGY,71275,CTA CHEST,352,"$2,760.66 ",$217.28 ,125% CMS Medicare OPPS fee schedule,"$2,098.10 ",76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$2,484.59 ",90% of total billed charges for oupatient setting,$180.34 ,100% of TX Medicaid OPPS fee schedule,"$2,484.59 ",90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$176.73 ,98% of TX Medicaid OPPS fee schedule,"$2,622.63 ",95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$2,429.38 ",88% of total billed charges for outpatient setting,"$2,429.38 ",88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.07 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$2,622.63 ","$1,794.43 "
Outpatient Medical Services,RADIOLOGY,71270,CT CHEST W/WO CONT,352,"$3,760.63 ",$217.28 ,125% CMS Medicare OPPS fee schedule,"$2,858.08 ",76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$3,384.57 ",90% of total billed charges for oupatient setting,$180.34 ,100% of TX Medicaid OPPS fee schedule,"$3,384.57 ",90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$176.73 ,98% of TX Medicaid OPPS fee schedule,"$3,572.60 ",95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$3,309.35 ",88% of total billed charges for outpatient setting,"$3,309.35 ",88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.07 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$3,572.60 ","$2,444.41 "
Outpatient Medical Services,RADIOLOGY,71260,CT CHEST W/CONT,352,"$2,646.00 ",$217.28 ,125% CMS Medicare OPPS fee schedule,"$2,010.96 ",76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$2,381.40 ",90% of total billed charges for oupatient setting,$173.08 ,100% of TX Medicaid OPPS fee schedule,"$2,381.40 ",90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$169.62 ,98% of TX Medicaid OPPS fee schedule,"$2,513.70 ",95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$2,328.48 ",88% of total billed charges for outpatient setting,"$2,328.48 ",88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.07 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$2,513.70 ","$1,719.90 "
Outpatient Medical Services,RADIOLOGY,71250,CT CHEST W/O CONT,352,"$2,378.09 ",$128.77 ,125% CMS Medicare OPPS fee schedule,"$1,807.35 ",76%  of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$560.85 ,490% of BCBSTX fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,"$2,140.28 ",90% of total billed charges for oupatient setting,$106.88 ,100% of TX Medicaid OPPS fee schedule,"$2,140.28 ",90% of total billed charges for oupatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$104.74 ,98% of TX Medicaid OPPS fee schedule,"$2,259.19 ",95% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,"$2,092.72 ",88% of total billed charges for outpatient setting,"$2,092.72 ",88% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$66.96 ,"$2,259.19 ","$1,545.76 "
Outpatient Medical Services,RADIOLOGY,70498,CTA NECK,352,"$2,760.66 ",$217.28 ,125% CMS Medicare OPPS fee schedule,"$2,098.10 ",76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$2,484.59 ",90% of total billed charges for oupatient setting,$180.34 ,100% of TX Medicaid OPPS fee schedule,"$2,484.59 ",90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$176.73 ,98% of TX Medicaid OPPS fee schedule,"$2,622.63 ",95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$2,429.38 ",88% of total billed charges for outpatient setting,"$2,429.38 ",88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.07 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$2,622.63 ","$1,794.43 "
Outpatient Medical Services,RADIOLOGY,74174,CTA ABD AND PELVIS,351,"$5,521.32 ",$443.91 ,125% CMS Medicare OPPS fee schedule,"$4,196.20 ",76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$1,234.51 ",490% of BCBSTX fee schedule,"$1,234.51 ",490% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$1,234.51 ",490% of BCBSTX fee schedule,$251.94 ,100% of BCBSTX fee schedule,"$4,969.19 ",90% of total billed charges for oupatient setting,$368.43 ,100% of TX Medicaid OPPS fee schedule,"$4,969.19 ",90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$361.06 ,98% of TX Medicaid OPPS fee schedule,"$5,245.25 ",95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$4,858.76 ",88% of total billed charges for outpatient setting,"$4,858.76 ",88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$368.43 ,100% of TX Medicaid OPPS fee schedule,$230.84 ,"$5,245.25 ","$3,588.86 "
Outpatient Medical Services,RADIOLOGY,70496,CTA HEAD,351,"$2,760.66 ",$217.28 ,125% CMS Medicare OPPS fee schedule,"$2,098.10 ",76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$2,484.59 ",90% of total billed charges for oupatient setting,$180.34 ,100% of TX Medicaid OPPS fee schedule,"$2,484.59 ",90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$176.73 ,98% of TX Medicaid OPPS fee schedule,"$2,622.63 ",95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$2,429.38 ",88% of total billed charges for outpatient setting,"$2,429.38 ",88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.07 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$2,622.63 ","$1,794.43 "
Outpatient Medical Services,RADIOLOGY,70492,CT NECK SFT TIS W/WO,351,"$3,591.95 ",$217.28 ,125% CMS Medicare OPPS fee schedule,"$2,729.88 ",76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$3,232.76 ",90% of total billed charges for oupatient setting,$180.34 ,100% of TX Medicaid OPPS fee schedule,"$3,232.76 ",90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$176.73 ,98% of TX Medicaid OPPS fee schedule,"$3,412.35 ",95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$3,160.92 ",88% of total billed charges for outpatient setting,"$3,160.92 ",88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.07 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$3,412.35 ","$2,334.77 "
Outpatient Medical Services,RADIOLOGY,70491,CT NECKSFT TIS W/,351,"$3,083.69 ",$217.28 ,125% CMS Medicare OPPS fee schedule,"$2,343.60 ",76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$2,775.32 ",90% of total billed charges for oupatient setting,$180.34 ,100% of TX Medicaid OPPS fee schedule,"$2,775.32 ",90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$176.73 ,98% of TX Medicaid OPPS fee schedule,"$2,929.51 ",95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$2,713.65 ",88% of total billed charges for outpatient setting,"$2,713.65 ",88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.07 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$2,929.51 ","$2,004.40 "
Outpatient Medical Services,RADIOLOGY,70490,CT NECKSFT TIS W/O,351,"$2,047.34 ",$128.77 ,125% CMS Medicare OPPS fee schedule,"$1,555.98 ",76%  of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$560.85 ,490% of BCBSTX fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,"$1,842.61 ",90% of total billed charges for oupatient setting,$106.88 ,100% of TX Medicaid OPPS fee schedule,"$1,842.61 ",90% of total billed charges for oupatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$104.74 ,98% of TX Medicaid OPPS fee schedule,"$1,944.97 ",95% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,"$1,801.66 ",88% of total billed charges for outpatient setting,"$1,801.66 ",88% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$66.96 ,"$1,944.97 ","$1,330.77 "
Outpatient Medical Services,RADIOLOGY,70487,CT FACIAL BONE W/C,351,"$3,382.47 ",$217.28 ,125% CMS Medicare OPPS fee schedule,"$2,570.68 ",76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$3,044.22 ",90% of total billed charges for oupatient setting,$157.71 ,100% of TX Medicaid OPPS fee schedule,"$3,044.22 ",90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$154.56 ,98% of TX Medicaid OPPS fee schedule,"$3,213.35 ",95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$2,976.57 ",88% of total billed charges for outpatient setting,"$2,976.57 ",88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.07 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$157.71 ,100% of TX Medicaid OPPS fee schedule,$157.71 ,100% of TX Medicaid OPPS fee schedule,$157.71 ,100% of TX Medicaid OPPS fee schedule,$157.71 ,100% of TX Medicaid OPPS fee schedule,$157.71 ,100% of TX Medicaid OPPS fee schedule,$157.71 ,100% of TX Medicaid OPPS fee schedule,$157.71 ,100% of TX Medicaid OPPS fee schedule,$157.71 ,100% of TX Medicaid OPPS fee schedule,$157.71 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$3,213.35 ","$2,198.61 "
Outpatient Medical Services,RADIOLOGY,70486,CT FACIAL BONE W/O,351,"$3,082.59 ",$128.77 ,125% CMS Medicare OPPS fee schedule,"$2,342.77 ",76%  of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$560.85 ,490% of BCBSTX fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,"$2,774.33 ",90% of total billed charges for oupatient setting,$106.88 ,100% of TX Medicaid OPPS fee schedule,"$2,774.33 ",90% of total billed charges for oupatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$104.74 ,98% of TX Medicaid OPPS fee schedule,"$2,928.46 ",95% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,"$2,712.68 ",88% of total billed charges for outpatient setting,"$2,712.68 ",88% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$66.96 ,"$2,928.46 ","$2,003.68 "
Outpatient Medical Services,RADIOLOGY,70480,CT ORBITS W/O CONT,351,"$3,166.38 ",$128.77 ,125% CMS Medicare OPPS fee schedule,"$2,406.45 ",76%  of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$560.85 ,490% of BCBSTX fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,"$2,849.74 ",90% of total billed charges for oupatient setting,$106.88 ,100% of TX Medicaid OPPS fee schedule,"$2,849.74 ",90% of total billed charges for oupatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$104.74 ,98% of TX Medicaid OPPS fee schedule,"$3,008.06 ",95% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,"$2,786.41 ",88% of total billed charges for outpatient setting,"$2,786.41 ",88% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$66.96 ,"$3,008.06 ","$2,058.15 "
Outpatient Medical Services,RADIOLOGY,70470,CT HEAD/BRAIN W/WO,351,"$2,585.36 ",$217.28 ,125% CMS Medicare OPPS fee schedule,"$1,964.87 ",76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$2,326.82 ",90% of total billed charges for oupatient setting,$180.34 ,100% of TX Medicaid OPPS fee schedule,"$2,326.82 ",90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$176.73 ,98% of TX Medicaid OPPS fee schedule,"$2,456.09 ",95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$2,275.12 ",88% of total billed charges for outpatient setting,"$2,275.12 ",88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.07 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$2,456.09 ","$1,680.48 "
Outpatient Medical Services,RADIOLOGY,70460,CT HEAD/BRAIN W/CO,351,"$1,582.09 ",$217.28 ,125% CMS Medicare OPPS fee schedule,"$1,202.39 ",76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$1,423.88 ",90% of total billed charges for oupatient setting,$153.36 ,100% of TX Medicaid OPPS fee schedule,"$1,423.88 ",90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$150.29 ,98% of TX Medicaid OPPS fee schedule,"$1,502.99 ",95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,392.24 ",88% of total billed charges for outpatient setting,"$1,392.24 ",88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.07 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$153.36 ,100% of TX Medicaid OPPS fee schedule,$153.36 ,100% of TX Medicaid OPPS fee schedule,$153.36 ,100% of TX Medicaid OPPS fee schedule,$153.36 ,100% of TX Medicaid OPPS fee schedule,$153.36 ,100% of TX Medicaid OPPS fee schedule,$153.36 ,100% of TX Medicaid OPPS fee schedule,$153.36 ,100% of TX Medicaid OPPS fee schedule,$153.36 ,100% of TX Medicaid OPPS fee schedule,$153.36 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$1,502.99 ","$1,028.36 "
Outpatient Medical Services,RADIOLOGY,70450,CT HEAD/BRAIN W/O,351,"$2,923.67 ",$128.77 ,125% CMS Medicare OPPS fee schedule,"$2,221.99 ",76%  of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$560.85 ,490% of BCBSTX fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,"$2,631.30 ",90% of total billed charges for oupatient setting,$106.88 ,100% of TX Medicaid OPPS fee schedule,"$2,631.30 ",90% of total billed charges for oupatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$104.74 ,98% of TX Medicaid OPPS fee schedule,"$2,777.49 ",95% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,"$2,572.83 ",88% of total billed charges for outpatient setting,"$2,572.83 ",88% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$66.96 ,"$2,777.49 ","$1,900.39 "
Outpatient Medical Services,RADIOLOGY,75574,CTA HEART  W 3D IMAGE,350,"$3,230.47 ",$217.28 ,125% CMS Medicare OPPS fee schedule,"$2,455.16 ",76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,234.51 ",490% of BCBSTX fee schedule,"$1,234.51 ",490% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,234.51 ",490% of BCBSTX fee schedule,$251.94 ,100% of BCBSTX fee schedule,"$2,907.42 ",90% of total billed charges for oupatient setting,$180.34 ,100% of TX Medicaid OPPS fee schedule,"$2,907.42 ",90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$176.73 ,98% of TX Medicaid OPPS fee schedule,"$3,068.95 ",95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$2,842.81 ",88% of total billed charges for outpatient setting,"$2,842.81 ",88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.07 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$3,068.95 ","$2,099.81 "
Outpatient Medical Services,RADIOLOGY,75571,CT CALCIUM SCORING,350,$195.18 ,$104.68 ,125% CMS Medicare OPPS fee schedule,$148.34 ,76%  of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$304.39 ,490% of BCBSTX fee schedule,$304.39 ,490% of BCBSTX fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$304.39 ,490% of BCBSTX fee schedule,$62.12 ,100% of BCBSTX fee schedule,$175.66 ,90% of total billed charges for oupatient setting,$86.88 ,100% of TX Medicaid OPPS fee schedule,$175.66 ,90% of total billed charges for oupatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$54.43 ,65% CMS Medicare OPPS fee schedule,$85.14 ,98% of TX Medicaid OPPS fee schedule,$185.42 ,95% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$171.76 ,88% of total billed charges for outpatient setting,$171.76 ,88% of total billed charges for outpatient setting,$83.74 ,100% CMS Medicare OPPS fee schedule,$70.37 ,90% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$83.74 ,100% CMS Medicare OPPS fee schedule,$86.88 ,100% of TX Medicaid OPPS fee schedule,$86.88 ,100% of TX Medicaid OPPS fee schedule,$86.88 ,100% of TX Medicaid OPPS fee schedule,$86.88 ,100% of TX Medicaid OPPS fee schedule,$86.88 ,100% of TX Medicaid OPPS fee schedule,$86.88 ,100% of TX Medicaid OPPS fee schedule,$86.88 ,100% of TX Medicaid OPPS fee schedule,$86.88 ,100% of TX Medicaid OPPS fee schedule,$86.88 ,100% of TX Medicaid OPPS fee schedule,$54.43 ,$304.39 ,$126.87 
Outpatient Medical Services,RADIOLOGY,73706,CTA LOWER EXTREM,350,"$2,760.66 ",$217.28 ,125% CMS Medicare OPPS fee schedule,"$2,098.10 ",76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$2,484.59 ",90% of total billed charges for oupatient setting,$180.34 ,100% of TX Medicaid OPPS fee schedule,"$2,484.59 ",90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$176.73 ,98% of TX Medicaid OPPS fee schedule,"$2,622.63 ",95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$2,429.38 ",88% of total billed charges for outpatient setting,"$2,429.38 ",88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.07 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$180.34 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$2,622.63 ","$1,794.43 "
Outpatient Medical Services,RADIOLOGY,73701,CT LOWER EXTRE W/C,350,"$2,674.67 ",$217.28 ,125% CMS Medicare OPPS fee schedule,"$2,032.75 ",76%  of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$2,407.20 ",90% of total billed charges for oupatient setting,$173.08 ,100% of TX Medicaid OPPS fee schedule,"$2,407.20 ",90% of total billed charges for oupatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$112.99 ,65% CMS Medicare OPPS fee schedule,$169.62 ,98% of TX Medicaid OPPS fee schedule,"$2,540.94 ",95% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,"$2,353.71 ",88% of total billed charges for outpatient setting,"$2,353.71 ",88% of total billed charges for outpatient setting,$173.83 ,100% CMS Medicare OPPS fee schedule,$146.07 ,90% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.83 ,100% CMS Medicare OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$173.08 ,100% of TX Medicaid OPPS fee schedule,$112.99 ,"$2,540.94 ","$1,738.54 "
Outpatient Medical Services,RADIOLOGY,73700,CT LOWER EXTRE W/O,350,"$2,340.61 ",$128.77 ,125% CMS Medicare OPPS fee schedule,"$1,778.86 ",76%  of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$560.85 ,490% of BCBSTX fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,"$2,106.55 ",90% of total billed charges for oupatient setting,$106.88 ,100% of TX Medicaid OPPS fee schedule,"$2,106.55 ",90% of total billed charges for oupatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$104.74 ,98% of TX Medicaid OPPS fee schedule,"$2,223.58 ",95% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,"$2,059.74 ",88% of total billed charges for outpatient setting,"$2,059.74 ",88% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$66.96 ,"$2,223.58 ","$1,521.40 "
Outpatient Medical Services,RADIOLOGY,73201,CT UPPER EXT W CONT,350,"$3,618.41 ",$443.91 ,125% CMS Medicare OPPS fee schedule,"$2,749.99 ",76%  of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,"$1,238.43 ",490% of BCBSTX fee schedule,$252.74 ,100% of BCBSTX fee schedule,"$3,256.57 ",90% of total billed charges for oupatient setting,$209.84 ,100% of TX Medicaid OPPS fee schedule,"$3,256.57 ",90% of total billed charges for oupatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$230.84 ,65% CMS Medicare OPPS fee schedule,$205.64 ,98% of TX Medicaid OPPS fee schedule,"$3,437.49 ",95% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,"$3,184.20 ",88% of total billed charges for outpatient setting,"$3,184.20 ",88% of total billed charges for outpatient setting,$355.14 ,100% CMS Medicare OPPS fee schedule,$298.43 ,90% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$355.14 ,100% CMS Medicare OPPS fee schedule,$209.84 ,100% of TX Medicaid OPPS fee schedule,$209.84 ,100% of TX Medicaid OPPS fee schedule,$209.84 ,100% of TX Medicaid OPPS fee schedule,$209.84 ,100% of TX Medicaid OPPS fee schedule,$209.84 ,100% of TX Medicaid OPPS fee schedule,$209.84 ,100% of TX Medicaid OPPS fee schedule,$209.84 ,100% of TX Medicaid OPPS fee schedule,$209.84 ,100% of TX Medicaid OPPS fee schedule,$209.84 ,100% of TX Medicaid OPPS fee schedule,$205.64 ,"$3,437.49 ","$2,351.97 "
Outpatient Medical Services,RADIOLOGY,73200,CT UPPER EXT WO CONT,350,"$2,340.61 ",$128.77 ,125% CMS Medicare OPPS fee schedule,"$1,778.86 ",76%  of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$560.85 ,490% of BCBSTX fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$560.85 ,490% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,"$2,106.55 ",90% of total billed charges for oupatient setting,$106.88 ,100% of TX Medicaid OPPS fee schedule,"$2,106.55 ",90% of total billed charges for oupatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$104.74 ,98% of TX Medicaid OPPS fee schedule,"$2,223.58 ",95% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,"$2,059.74 ",88% of total billed charges for outpatient setting,"$2,059.74 ",88% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$66.96 ,"$2,223.58 ","$1,521.40 "
Outpatient Medical Services,RADIOLOGY,76700,ABDOMEN COMPLETE,402,"$1,270.08 ",$128.77 ,125% CMS Medicare OPPS fee schedule,$965.26 ,76%  of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$642.12 ,561% of BCBSTX fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$642.12 ,561% of BCBSTX fee schedule,$114.46 ,100% of BCBSTX fee schedule,"$1,143.07 ",90% of total billed charges for oupatient setting,$106.88 ,100% of TX Medicaid OPPS fee schedule,"$1,143.07 ",90% of total billed charges for oupatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$104.74 ,98% of TX Medicaid OPPS fee schedule,"$1,206.58 ",95% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,"$1,117.67 ",88% of total billed charges for outpatient setting,"$1,117.67 ",88% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$66.96 ,"$1,206.58 ",$825.55 
Outpatient Medical Services,RADIOLOGY,76830,TRANSVAGINAL,402,"$1,123.45 ",$128.77 ,125% CMS Medicare OPPS fee schedule,$853.82 ,76%  of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$501.31 ,561% of BCBSTX fee schedule,$501.31 ,561% of BCBSTX fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$501.31 ,561% of BCBSTX fee schedule,$89.36 ,100% of BCBSTX fee schedule,"$1,011.11 ",90% of total billed charges for oupatient setting,$106.88 ,100% of TX Medicaid OPPS fee schedule,"$1,011.11 ",90% of total billed charges for oupatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$104.74 ,98% of TX Medicaid OPPS fee schedule,"$1,067.28 ",95% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$988.64 ,88% of total billed charges for outpatient setting,$988.64 ,88% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$66.96 ,"$1,067.28 ",$730.24 
Outpatient Medical Services,RADIOLOGY,76805,TRANS ABD PREG > 14 WKS,402,$823.57 ,$128.77 ,125% CMS Medicare OPPS fee schedule,$625.91 ,76%  of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$527.51 ,561% of BCBSTX fee schedule,$527.51 ,561% of BCBSTX fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$527.51 ,561% of BCBSTX fee schedule,$94.03 ,100% of BCBSTX fee schedule,$741.21 ,90% of total billed charges for oupatient setting,$106.88 ,100% of TX Medicaid OPPS fee schedule,$741.21 ,90% of total billed charges for oupatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$66.96 ,65% CMS Medicare OPPS fee schedule,$104.74 ,98% of TX Medicaid OPPS fee schedule,$782.39 ,95% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$724.74 ,88% of total billed charges for outpatient setting,$724.74 ,88% of total billed charges for outpatient setting,$103.01 ,100% CMS Medicare OPPS fee schedule,$86.57 ,90% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$103.01 ,100% CMS Medicare OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$106.88 ,100% of TX Medicaid OPPS fee schedule,$66.96 ,$782.39 ,$535.32 
Outpatient Medical Services,RESPIRATORY,93005,"EKG, 12 lead",730,$284.45 ,$69.25 ,125% CMS Medicare OPPS fee schedule,$216.18 ,76%  of total billed charges for outpatient setting,$55.40 ,100% CMS Medicare OPPS fee schedule,$160.05 ,286% of BCBSTX fee schedule,$160.05 ,286% of BCBSTX fee schedule,$55.40 ,100% CMS Medicare OPPS fee schedule,$160.05 ,286% of BCBSTX fee schedule,$55.96 ,100% of BCBSTX fee schedule,$256.01 ,90% of total billed charges for oupatient setting,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$256.01 ,90% of total billed charges for oupatient setting,$55.40 ,100% CMS Medicare OPPS fee schedule,$55.40 ,100% CMS Medicare OPPS fee schedule,$55.40 ,100% CMS Medicare OPPS fee schedule,$36.01 ,65% CMS Medicare OPPS fee schedule,$125.44 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$270.23 ,95% of total billed charges for outpatient setting,$55.40 ,100% CMS Medicare OPPS fee schedule,$250.32 ,88% of total billed charges for outpatient setting,$250.32 ,88% of total billed charges for outpatient setting,$55.40 ,100% CMS Medicare OPPS fee schedule,$46.56 ,90% CMS Medicare OPPS fee schedule,$55.40 ,100% CMS Medicare OPPS fee schedule,$55.40 ,100% CMS Medicare OPPS fee schedule,$55.40 ,100% CMS Medicare OPPS fee schedule,$55.40 ,100% CMS Medicare OPPS fee schedule,$55.40 ,100% CMS Medicare OPPS fee schedule,$55.40 ,100% CMS Medicare OPPS fee schedule,$55.40 ,100% CMS Medicare OPPS fee schedule,$55.40 ,100% CMS Medicare OPPS fee schedule,$55.40 ,100% CMS Medicare OPPS fee schedule,$55.40 ,100% CMS Medicare OPPS fee schedule,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$36.01 ,$270.23 ,$184.89 
Outpatient Medical Services,RESPIRATORY,94640,INHALATION TX EA ADD,410,$350.00 ,$230.74 ,125% CMS Medicare OPPS fee schedule,$266.00 ,76%  of total billed charges for outpatient setting,$184.59 ,100% CMS Medicare OPPS fee schedule,$533.05 ,286% of BCBSTX fee schedule,$533.05 ,286% of BCBSTX fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$533.05 ,286% of BCBSTX fee schedule,$186.38 ,100% of BCBSTX fee schedule,$315.00 ,90% of total billed charges for oupatient setting,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$315.00 ,90% of total billed charges for oupatient setting,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$119.98 ,65% CMS Medicare OPPS fee schedule,$154.35 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$332.50 ,95% of total billed charges for outpatient setting,$184.59 ,100% CMS Medicare OPPS fee schedule,$308.00 ,88% of total billed charges for outpatient setting,$308.00 ,88% of total billed charges for outpatient setting,$184.59 ,100% CMS Medicare OPPS fee schedule,$155.12 ,90% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$119.98 ,$533.05 ,$227.50 
Outpatient Medical Services,RESPIRATORY,94640,INHALATION TX,410,$350.00 ,$230.74 ,125% CMS Medicare OPPS fee schedule,$266.00 ,76%  of total billed charges for outpatient setting,$184.59 ,100% CMS Medicare OPPS fee schedule,$533.05 ,286% of BCBSTX fee schedule,$533.05 ,286% of BCBSTX fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$533.05 ,286% of BCBSTX fee schedule,$186.38 ,100% of BCBSTX fee schedule,$315.00 ,90% of total billed charges for oupatient setting,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$315.00 ,90% of total billed charges for oupatient setting,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$119.98 ,65% CMS Medicare OPPS fee schedule,$154.35 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$332.50 ,95% of total billed charges for outpatient setting,$184.59 ,100% CMS Medicare OPPS fee schedule,$308.00 ,88% of total billed charges for outpatient setting,$308.00 ,88% of total billed charges for outpatient setting,$184.59 ,100% CMS Medicare OPPS fee schedule,$155.12 ,90% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$157.50 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$119.98 ,$533.05 ,$227.50 
Outpatient Medical Services,RESPIRATORY,82803,ARTER BLOODGAS STUDY,301,$469.67 ,$32.58 ,125% CMS Medicare OPPS fee schedule,$356.95 ,76%  of total billed charges for outpatient setting,$26.07 ,100% CMS Medicare OPPS fee schedule,$104.28 ,400% of BCBSTX fee schedule,$104.28 ,400% of BCBSTX fee schedule,$26.07 ,100% CMS Medicare OPPS fee schedule,$104.28 ,400% of BCBSTX fee schedule,$26.07 ,100% of BCBSTX fee schedule,$422.70 ,90% of total billed charges for oupatient setting,$21.90 ,100% of TX Medicaid OPPS fee schedule,$422.70 ,90% of total billed charges for oupatient setting,$26.07 ,100% CMS Medicare OPPS fee schedule,$26.07 ,100% CMS Medicare OPPS fee schedule,$26.07 ,100% CMS Medicare OPPS fee schedule,$305.29 ,65% of total billed charges for oupatient setting,$21.46 ,98% of TX Medicaid OPPS fee schedule,$446.19 ,95% of total billed charges for outpatient setting,$19.55 ,75% CMS Medicare OPPS fee schedule,$413.31 ,88% of total billed charges for outpatient setting,$413.31 ,88% of total billed charges for outpatient setting,$26.07 ,100% CMS Medicare OPPS fee schedule,$23.46 ,90% CMS Medicare OPPS fee schedule,$26.07 ,100% CMS Medicare OPPS fee schedule,$26.07 ,100% CMS Medicare OPPS fee schedule,$26.07 ,100% CMS Medicare OPPS fee schedule,$26.07 ,100% CMS Medicare OPPS fee schedule,$26.07 ,100% CMS Medicare OPPS fee schedule,$26.07 ,100% CMS Medicare OPPS fee schedule,$26.07 ,100% CMS Medicare OPPS fee schedule,$26.07 ,100% CMS Medicare OPPS fee schedule,$26.07 ,100% CMS Medicare OPPS fee schedule,$26.07 ,100% CMS Medicare OPPS fee schedule,$21.90 ,100% of TX Medicaid OPPS fee schedule,$21.90 ,100% of TX Medicaid OPPS fee schedule,$21.90 ,100% of TX Medicaid OPPS fee schedule,$21.90 ,100% of TX Medicaid OPPS fee schedule,$21.90 ,100% of TX Medicaid OPPS fee schedule,$21.90 ,100% of TX Medicaid OPPS fee schedule,$21.90 ,100% of TX Medicaid OPPS fee schedule,$21.90 ,100% of TX Medicaid OPPS fee schedule,$21.90 ,100% of TX Medicaid OPPS fee schedule,$19.55 ,$446.19 ,$305.29 
Outpatient Medical Services,RESPIRATORY,36600,ARTERIAL PUNCTURE BLD GAS DRA,300,$300.00 ,$139.90 ,125% CMS Medicare OPPS fee schedule,$228.00 ,76%  of total billed charges for outpatient setting,$111.92 ,100% CMS Medicare OPPS fee schedule,$216.00 ,72% of total billed charges for outpatient setting,$225.00 ,75% of total billed charges for outpatient setting,$111.92 ,100% CMS Medicare OPPS fee schedule,$216.00 ,72% of total billed charges for outpatient setting,$180.00 ,60% of total billed charges for outpatient setting,$270.00 ,90% of total billed charges for oupatient setting,$135.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$270.00 ,90% of total billed charges for oupatient setting,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$72.75 ,65% CMS Medicare OPPS fee schedule,$132.30 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$285.00 ,95% of total billed charges for outpatient setting,$111.92 ,100% CMS Medicare OPPS fee schedule,$264.00 ,88% of total billed charges for outpatient setting,$264.00 ,88% of total billed charges for outpatient setting,$111.92 ,100% CMS Medicare OPPS fee schedule,$94.05 ,90% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$135.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.75 ,$285.00 ,$195.00 
Outpatient Medical Services,RESPIRATORY,94660,CPAP I & M,410,$241.45 ,$230.74 ,125% CMS Medicare OPPS fee schedule,$183.50 ,76%  of total billed charges for outpatient setting,$184.59 ,100% CMS Medicare OPPS fee schedule,$533.05 ,286% of BCBSTX fee schedule,$533.05 ,286% of BCBSTX fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$533.05 ,286% of BCBSTX fee schedule,$186.38 ,100% of BCBSTX fee schedule,$217.31 ,90% of total billed charges for oupatient setting,$108.65 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$217.31 ,90% of total billed charges for oupatient setting,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$119.98 ,65% CMS Medicare OPPS fee schedule,$106.48 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$229.38 ,95% of total billed charges for outpatient setting,$184.59 ,100% CMS Medicare OPPS fee schedule,$212.48 ,88% of total billed charges for outpatient setting,$212.48 ,88% of total billed charges for outpatient setting,$184.59 ,100% CMS Medicare OPPS fee schedule,$155.12 ,90% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$184.59 ,100% CMS Medicare OPPS fee schedule,$108.65 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$108.65 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$108.65 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$108.65 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$108.65 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$108.65 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$108.65 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$108.65 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$108.65 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$106.48 ,$533.05 ,$156.94 
Outpatient Medical Services,RESPIRATORY,94668,MAN CHEST WALL SUB,410,$58.43 ,$139.90 ,125% CMS Medicare OPPS fee schedule,$44.41 ,76%  of total billed charges for outpatient setting,$111.92 ,100% CMS Medicare OPPS fee schedule,$300.41 ,286% of BCBSTX fee schedule,$300.41 ,286% of BCBSTX fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$300.41 ,286% of BCBSTX fee schedule,$105.04 ,100% of BCBSTX fee schedule,$52.59 ,90% of total billed charges for oupatient setting,$26.29 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$52.59 ,90% of total billed charges for oupatient setting,$58.43 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$72.75 ,65% CMS Medicare OPPS fee schedule,$25.77 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$55.51 ,95% of total billed charges for outpatient setting,$58.43 ,100% CMS Medicare OPPS fee schedule,$51.42 ,88% of total billed charges for outpatient setting,$51.42 ,88% of total billed charges for outpatient setting,$111.92 ,100% CMS Medicare OPPS fee schedule,$94.05 ,90% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$26.29 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$26.29 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$26.29 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$26.29 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$26.29 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$26.29 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$26.29 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$26.29 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$26.29 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$25.77 ,$300.41 ,$37.98 
Outpatient Medical Services,RESPIRATORY,94002,VENTILATION 1ST DAY,410,"$1,072.18 ",$670.79 ,125% CMS Medicare OPPS fee schedule,$814.86 ,76%  of total billed charges for outpatient setting,$536.64 ,100% CMS Medicare OPPS fee schedule,"$1,317.60 ",286% of BCBSTX fee schedule,"$1,317.60 ",286% of BCBSTX fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,"$1,317.60 ",286% of BCBSTX fee schedule,$460.70 ,100% of BCBSTX fee schedule,$964.96 ,90% of total billed charges for oupatient setting,$482.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$964.96 ,90% of total billed charges for oupatient setting,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$348.82 ,65% CMS Medicare OPPS fee schedule,$472.83 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,"$1,018.57 ",95% of total billed charges for outpatient setting,$536.64 ,100% CMS Medicare OPPS fee schedule,$943.52 ,88% of total billed charges for outpatient setting,$943.52 ,88% of total billed charges for outpatient setting,$536.64 ,100% CMS Medicare OPPS fee schedule,$450.95 ,90% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$482.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$482.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$482.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$482.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$482.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$482.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$482.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$482.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$482.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$348.82 ,"$1,317.60 ",$696.92 
Outpatient Medical Services,RESPIRATORY,94644,CONT NEB 1ST HR,410,$138.92 ,$139.90 ,125% CMS Medicare OPPS fee schedule,$105.58 ,76%  of total billed charges for outpatient setting,$111.92 ,100% CMS Medicare OPPS fee schedule,$300.41 ,286% of BCBSTX fee schedule,$300.41 ,286% of BCBSTX fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$300.41 ,286% of BCBSTX fee schedule,$105.04 ,100% of BCBSTX fee schedule,$125.03 ,90% of total billed charges for oupatient setting,$62.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$125.03 ,90% of total billed charges for oupatient setting,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$72.75 ,65% CMS Medicare OPPS fee schedule,$61.26 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$131.97 ,95% of total billed charges for outpatient setting,$111.92 ,100% CMS Medicare OPPS fee schedule,$122.25 ,88% of total billed charges for outpatient setting,$122.25 ,88% of total billed charges for outpatient setting,$111.92 ,100% CMS Medicare OPPS fee schedule,$94.05 ,90% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$62.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$62.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$62.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$62.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$62.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$62.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$62.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$62.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$62.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$61.26 ,$300.41 ,$90.30 
Outpatient Medical Services,RESPIRATORY,94003,VENTILATION SUBSEQ,410,$300.98 ,$670.79 ,125% CMS Medicare OPPS fee schedule,$228.74 ,76%  of total billed charges for outpatient setting,$536.64 ,100% CMS Medicare OPPS fee schedule,"$1,317.60 ",286% of BCBSTX fee schedule,"$1,317.60 ",286% of BCBSTX fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,"$1,317.60 ",286% of BCBSTX fee schedule,$460.70 ,100% of BCBSTX fee schedule,$270.88 ,90% of total billed charges for oupatient setting,$135.44 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$270.88 ,90% of total billed charges for oupatient setting,$300.98 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$348.82 ,65% CMS Medicare OPPS fee schedule,$132.73 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$285.93 ,95% of total billed charges for outpatient setting,$300.98 ,100% CMS Medicare OPPS fee schedule,$264.86 ,88% of total billed charges for outpatient setting,$264.86 ,88% of total billed charges for outpatient setting,$536.64 ,100% CMS Medicare OPPS fee schedule,$450.95 ,90% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$536.64 ,100% CMS Medicare OPPS fee schedule,$135.44 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.44 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.44 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.44 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.44 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.44 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.44 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.44 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.44 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$132.73 ,"$1,317.60 ",$195.64 
Outpatient Medical Services,RESPIRATORY,94667,PERCUSSION/POSTURAL,410,$201.20 ,$139.90 ,125% CMS Medicare OPPS fee schedule,$152.91 ,76%  of total billed charges for outpatient setting,$111.92 ,100% CMS Medicare OPPS fee schedule,$300.41 ,286% of BCBSTX fee schedule,$300.41 ,286% of BCBSTX fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$300.41 ,286% of BCBSTX fee schedule,$105.04 ,100% of BCBSTX fee schedule,$181.08 ,90% of total billed charges for oupatient setting,$90.54 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$181.08 ,90% of total billed charges for oupatient setting,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$72.75 ,65% CMS Medicare OPPS fee schedule,$88.73 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$191.14 ,95% of total billed charges for outpatient setting,$111.92 ,100% CMS Medicare OPPS fee schedule,$177.06 ,88% of total billed charges for outpatient setting,$177.06 ,88% of total billed charges for outpatient setting,$111.92 ,100% CMS Medicare OPPS fee schedule,$94.05 ,90% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$111.92 ,100% CMS Medicare OPPS fee schedule,$90.54 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$90.54 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$90.54 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$90.54 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$90.54 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$90.54 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$90.54 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$90.54 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$90.54 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.75 ,$300.41 ,$130.78 
Outpatient Medical Services,RESPIRATORY,94760,PULSE OXIMETRY SINGL,460,$104.74 ,$104.74 ,125% CMS Medicare OPPS fee schedule,$79.60 ,76%  of total billed charges for outpatient setting,$104.74 ,100% CMS Medicare OPPS fee schedule,$8.21 ,286% of BCBSTX fee schedule,$8.21 ,286% of BCBSTX fee schedule,$104.74 ,100% CMS Medicare OPPS fee schedule,$8.21 ,286% of BCBSTX fee schedule,$2.87 ,100% of BCBSTX fee schedule,$94.27 ,90% of total billed charges for oupatient setting,$47.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$94.27 ,90% of total billed charges for oupatient setting,$104.74 ,100% CMS Medicare OPPS fee schedule,$104.74 ,100% CMS Medicare OPPS fee schedule,$104.74 ,100% CMS Medicare OPPS fee schedule,$68.08 ,65% of total billed charges for oupatient setting,$46.19 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$99.50 ,95% of total billed charges for outpatient setting,$104.74 ,100% CMS Medicare OPPS fee schedule,$92.17 ,88% of total billed charges for outpatient setting,$92.17 ,88% of total billed charges for outpatient setting,$104.74 ,100% CMS Medicare OPPS fee schedule,$94.27 ,90% CMS Medicare OPPS fee schedule,$104.74 ,100% CMS Medicare OPPS fee schedule,$104.74 ,100% CMS Medicare OPPS fee schedule,$104.74 ,100% CMS Medicare OPPS fee schedule,$104.74 ,100% CMS Medicare OPPS fee schedule,$104.74 ,100% CMS Medicare OPPS fee schedule,$104.74 ,100% CMS Medicare OPPS fee schedule,$104.74 ,100% CMS Medicare OPPS fee schedule,$104.74 ,100% CMS Medicare OPPS fee schedule,$104.74 ,100% CMS Medicare OPPS fee schedule,$104.74 ,100% CMS Medicare OPPS fee schedule,$47.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$47.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$47.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$47.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$47.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$47.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$47.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$47.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$47.13 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$2.87 ,$104.74 ,$68.08 
Outpatient Medical Services,RESPIRATORY,94060,PUL FUNC PRE/PST BRD,460,$607.53 ,$337.43 ,125% CMS Medicare OPPS fee schedule,$461.72 ,76%  of total billed charges for outpatient setting,$269.95 ,100% CMS Medicare OPPS fee schedule,$138.57 ,286% of BCBSTX fee schedule,$138.57 ,286% of BCBSTX fee schedule,$269.95 ,100% CMS Medicare OPPS fee schedule,$138.57 ,286% of BCBSTX fee schedule,$48.45 ,100% of BCBSTX fee schedule,$546.78 ,90% of total billed charges for oupatient setting,$273.39 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$546.78 ,90% of total billed charges for oupatient setting,$269.95 ,100% CMS Medicare OPPS fee schedule,$269.95 ,100% CMS Medicare OPPS fee schedule,$269.95 ,100% CMS Medicare OPPS fee schedule,$175.47 ,65% CMS Medicare OPPS fee schedule,$267.92 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$577.15 ,95% of total billed charges for outpatient setting,$269.95 ,100% CMS Medicare OPPS fee schedule,$534.63 ,88% of total billed charges for outpatient setting,$534.63 ,88% of total billed charges for outpatient setting,$269.95 ,100% CMS Medicare OPPS fee schedule,$226.85 ,90% CMS Medicare OPPS fee schedule,$269.95 ,100% CMS Medicare OPPS fee schedule,$269.95 ,100% CMS Medicare OPPS fee schedule,$269.95 ,100% CMS Medicare OPPS fee schedule,$269.95 ,100% CMS Medicare OPPS fee schedule,$269.95 ,100% CMS Medicare OPPS fee schedule,$269.95 ,100% CMS Medicare OPPS fee schedule,$269.95 ,100% CMS Medicare OPPS fee schedule,$269.95 ,100% CMS Medicare OPPS fee schedule,$269.95 ,100% CMS Medicare OPPS fee schedule,$269.95 ,100% CMS Medicare OPPS fee schedule,$273.39 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$273.39 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$273.39 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$273.39 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$273.39 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$273.39 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$273.39 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$273.39 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$273.39 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$48.45 ,$577.15 ,$394.89 
Outpatient Medical Services,RESPIRATORY,94010,PFUNC BASIC SCREEN,460,$332.10 ,$175.23 ,125% CMS Medicare OPPS fee schedule,$252.40 ,76%  of total billed charges for outpatient setting,$140.18 ,100% CMS Medicare OPPS fee schedule,$389.88 ,286% of BCBSTX fee schedule,$389.88 ,286% of BCBSTX fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$389.88 ,286% of BCBSTX fee schedule,$136.32 ,100% of BCBSTX fee schedule,$298.89 ,90% of total billed charges for oupatient setting,$149.45 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$298.89 ,90% of total billed charges for oupatient setting,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$91.12 ,65% CMS Medicare OPPS fee schedule,$146.46 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$315.50 ,95% of total billed charges for outpatient setting,$140.18 ,100% CMS Medicare OPPS fee schedule,$292.25 ,88% of total billed charges for outpatient setting,$292.25 ,88% of total billed charges for outpatient setting,$140.18 ,100% CMS Medicare OPPS fee schedule,$117.80 ,90% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$149.45 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$149.45 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$149.45 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$149.45 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$149.45 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$149.45 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$149.45 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$149.45 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$149.45 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$91.12 ,$389.88 ,$215.87 
Outpatient Medical Services,RESPIRATORY,94645,CONT NEB ADDL HR,410,$69.46 ,$69.46 ,125% CMS Medicare OPPS fee schedule,$52.79 ,76%  of total billed charges for outpatient setting,$69.46 ,100% CMS Medicare OPPS fee schedule,$47.22 ,286% of BCBSTX fee schedule,$47.22 ,286% of BCBSTX fee schedule,$69.46 ,100% CMS Medicare OPPS fee schedule,$47.22 ,286% of BCBSTX fee schedule,$16.51 ,100% of BCBSTX fee schedule,$62.51 ,90% of total billed charges for oupatient setting,$31.26 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$62.51 ,90% of total billed charges for oupatient setting,$69.46 ,100% CMS Medicare OPPS fee schedule,$69.46 ,100% CMS Medicare OPPS fee schedule,$69.46 ,100% CMS Medicare OPPS fee schedule,$45.15 ,65% of total billed charges for oupatient setting,$30.63 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$65.99 ,95% of total billed charges for outpatient setting,$69.46 ,100% CMS Medicare OPPS fee schedule,$61.12 ,88% of total billed charges for outpatient setting,$61.12 ,88% of total billed charges for outpatient setting,$69.46 ,100% CMS Medicare OPPS fee schedule,$62.51 ,90% CMS Medicare OPPS fee schedule,$69.46 ,100% CMS Medicare OPPS fee schedule,$69.46 ,100% CMS Medicare OPPS fee schedule,$69.46 ,100% CMS Medicare OPPS fee schedule,$69.46 ,100% CMS Medicare OPPS fee schedule,$69.46 ,100% CMS Medicare OPPS fee schedule,$69.46 ,100% CMS Medicare OPPS fee schedule,$69.46 ,100% CMS Medicare OPPS fee schedule,$69.46 ,100% CMS Medicare OPPS fee schedule,$69.46 ,100% CMS Medicare OPPS fee schedule,$69.46 ,100% CMS Medicare OPPS fee schedule,$31.26 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$31.26 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$31.26 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$31.26 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$31.26 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$31.26 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$31.26 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$31.26 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$31.26 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$16.51 ,$69.46 ,$45.15 
Outpatient Medical Services,RESPIRATORY,94762,PULSE OX CONT,460,$15.44 ,$175.22 ,125% CMS Medicare OPPS fee schedule,$11.73 ,76%  of total billed charges for outpatient setting,$140.18 ,100% CMS Medicare OPPS fee schedule,$389.88 ,286% of BCBSTX fee schedule,$389.88 ,286% of BCBSTX fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$389.88 ,286% of BCBSTX fee schedule,$136.32 ,100% of BCBSTX fee schedule,$13.90 ,90% of total billed charges for oupatient setting,$6.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$13.90 ,90% of total billed charges for oupatient setting,$15.44 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$91.12 ,65% CMS Medicare OPPS fee schedule,$6.81 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$14.67 ,95% of total billed charges for outpatient setting,$15.44 ,100% CMS Medicare OPPS fee schedule,$13.59 ,88% of total billed charges for outpatient setting,$13.59 ,88% of total billed charges for outpatient setting,$140.18 ,100% CMS Medicare OPPS fee schedule,$117.79 ,90% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$140.18 ,100% CMS Medicare OPPS fee schedule,$6.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$6.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$6.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$6.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$6.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$6.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$6.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$6.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$6.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$6.81 ,$389.88 ,$10.04 
Outpatient Medical Services,RESPIRATORY,89220,RT SPUTUM SPEC  AEROS INDUCED,410,$150.23 ,$189.47 ,125% CMS Medicare OPPS fee schedule,$114.17 ,76%  of total billed charges for outpatient setting,$151.58 ,100% CMS Medicare OPPS fee schedule,$516.72 ,400% of BCBSTX fee schedule,$516.72 ,400% of BCBSTX fee schedule,$151.58 ,100% CMS Medicare OPPS fee schedule,$516.72 ,400% of BCBSTX fee schedule,$129.18 ,100% of BCBSTX fee schedule,$135.21 ,90% of total billed charges for oupatient setting,$67.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.21 ,90% of total billed charges for oupatient setting,$150.23 ,100% CMS Medicare OPPS fee schedule,$151.58 ,100% CMS Medicare OPPS fee schedule,$151.58 ,100% CMS Medicare OPPS fee schedule,$98.53 ,65% CMS Medicare OPPS fee schedule,$66.25 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$142.72 ,95% of total billed charges for outpatient setting,$150.23 ,100% CMS Medicare OPPS fee schedule,$132.20 ,88% of total billed charges for outpatient setting,$132.20 ,88% of total billed charges for outpatient setting,$151.58 ,100% CMS Medicare OPPS fee schedule,$127.37 ,90% CMS Medicare OPPS fee schedule,$151.58 ,100% CMS Medicare OPPS fee schedule,$151.58 ,100% CMS Medicare OPPS fee schedule,$151.58 ,100% CMS Medicare OPPS fee schedule,$151.58 ,100% CMS Medicare OPPS fee schedule,$151.58 ,100% CMS Medicare OPPS fee schedule,$151.58 ,100% CMS Medicare OPPS fee schedule,$151.58 ,100% CMS Medicare OPPS fee schedule,$151.58 ,100% CMS Medicare OPPS fee schedule,$151.58 ,100% CMS Medicare OPPS fee schedule,$151.58 ,100% CMS Medicare OPPS fee schedule,$67.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$66.25 ,$516.72 ,$97.65 
Outpatient Medical Services,CARDIOLOGY,93797,CARDIAC REHAB wo ECG MONITORING,943,$306.69 ,$144.65 ,125% CMS Medicare OPPS fee schedule,$233.08 ,76%  of total billed charges for outpatient setting,$115.73 ,100% CMS Medicare OPPS fee schedule,$25.65 ,286% of BCBSTX fee schedule,$25.65 ,286% of BCBSTX fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$25.65 ,286% of BCBSTX fee schedule,$8.97 ,100% of BCBSTX fee schedule,$276.02 ,90% of total billed charges for oupatient setting,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$276.02 ,90% of total billed charges for oupatient setting,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$75.22 ,65% CMS Medicare OPPS fee schedule,$135.25 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$291.36 ,95% of total billed charges for outpatient setting,$115.73 ,100% CMS Medicare OPPS fee schedule,$269.89 ,88% of total billed charges for outpatient setting,$269.89 ,88% of total billed charges for outpatient setting,$115.73 ,100% CMS Medicare OPPS fee schedule,$97.25 ,90% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$8.97 ,$291.36 ,$199.35 
Outpatient Medical Services,CARDIOLOGY,93797,CARDIAC REHAB/MONITOR,943,$306.69 ,$144.65 ,125% CMS Medicare OPPS fee schedule,$233.08 ,76%  of total billed charges for outpatient setting,$115.73 ,100% CMS Medicare OPPS fee schedule,$25.65 ,286% of BCBSTX fee schedule,$25.65 ,286% of BCBSTX fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$25.65 ,286% of BCBSTX fee schedule,$8.97 ,100% of BCBSTX fee schedule,$276.02 ,90% of total billed charges for oupatient setting,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$276.02 ,90% of total billed charges for oupatient setting,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$75.22 ,65% CMS Medicare OPPS fee schedule,$135.25 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$291.36 ,95% of total billed charges for outpatient setting,$115.73 ,100% CMS Medicare OPPS fee schedule,$269.89 ,88% of total billed charges for outpatient setting,$269.89 ,88% of total billed charges for outpatient setting,$115.73 ,100% CMS Medicare OPPS fee schedule,$97.25 ,90% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$115.73 ,100% CMS Medicare OPPS fee schedule,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$138.01 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$8.97 ,$291.36 ,$199.35 
Outpatient Medical Services,CARDIOLOGY,92960,"CARDIOVERSION ELECTRIC, EXT",481,"$1,751.87 ",$708.65 ,125% CMS Medicare OPPS fee schedule,"$1,331.42 ",76%  of total billed charges for outpatient setting,$566.92 ,100% CMS Medicare OPPS fee schedule,"$1,261.35 ",72% of total billed charges for outpatient setting,"$1,313.90 ",75% of total billed charges for outpatient setting,$566.92 ,100% CMS Medicare OPPS fee schedule,"$1,261.35 ",72% of total billed charges for outpatient setting,"$1,051.12 ",60% of total billed charges for outpatient setting,"$1,576.68 ",90% of total billed charges for oupatient setting,$788.34 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$1,576.68 ",90% of total billed charges for oupatient setting,$566.92 ,100% CMS Medicare OPPS fee schedule,$566.92 ,100% CMS Medicare OPPS fee schedule,$566.92 ,100% CMS Medicare OPPS fee schedule,$368.50 ,65% CMS Medicare OPPS fee schedule,$772.57 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,"$1,664.28 ",95% of total billed charges for outpatient setting,$566.92 ,100% CMS Medicare OPPS fee schedule,"$1,541.65 ",88% of total billed charges for outpatient setting,"$1,541.65 ",88% of total billed charges for outpatient setting,$566.92 ,100% CMS Medicare OPPS fee schedule,$476.40 ,90% CMS Medicare OPPS fee schedule,$566.92 ,100% CMS Medicare OPPS fee schedule,$566.92 ,100% CMS Medicare OPPS fee schedule,$566.92 ,100% CMS Medicare OPPS fee schedule,$566.92 ,100% CMS Medicare OPPS fee schedule,$566.92 ,100% CMS Medicare OPPS fee schedule,$566.92 ,100% CMS Medicare OPPS fee schedule,$566.92 ,100% CMS Medicare OPPS fee schedule,$566.92 ,100% CMS Medicare OPPS fee schedule,$566.92 ,100% CMS Medicare OPPS fee schedule,$566.92 ,100% CMS Medicare OPPS fee schedule,$788.34 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$788.34 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$788.34 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$788.34 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$788.34 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$788.34 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$788.34 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$788.34 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$788.34 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$368.50 ,"$1,664.28 ","$1,138.72 "
Outpatient Medical Services,CARDIOLOGY,93306,ECHO COMPLETE,480,"$2,257.26 ",$606.22 ,125% CMS Medicare OPPS fee schedule,"$1,715.52 ",76%  of total billed charges for outpatient setting,$484.98 ,100% CMS Medicare OPPS fee schedule,$396.20 ,286% of BCBSTX fee schedule,$396.20 ,286% of BCBSTX fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$396.20 ,286% of BCBSTX fee schedule,$138.53 ,100% of BCBSTX fee schedule,"$2,031.53 ",90% of total billed charges for oupatient setting,"$1,015.77 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$2,031.53 ",90% of total billed charges for oupatient setting,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$315.24 ,65% CMS Medicare OPPS fee schedule,$995.45 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,"$2,144.40 ",95% of total billed charges for outpatient setting,$484.98 ,100% CMS Medicare OPPS fee schedule,"$1,986.39 ",88% of total billed charges for outpatient setting,"$1,986.39 ",88% of total billed charges for outpatient setting,$484.98 ,100% CMS Medicare OPPS fee schedule,$407.54 ,90% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,"$1,015.77 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$1,015.77 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$1,015.77 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$1,015.77 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$1,015.77 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$1,015.77 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$1,015.77 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$1,015.77 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$1,015.77 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$138.53 ,"$2,144.40 ","$1,467.22 "
Outpatient Medical Services,CARDIOLOGY,93308,ECHO LIMITED,480,$669.22 ,$281.37 ,125% CMS Medicare OPPS fee schedule,$508.61 ,76%  of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$233.00 ,286% of BCBSTX fee schedule,$233.00 ,286% of BCBSTX fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$233.00 ,286% of BCBSTX fee schedule,$81.47 ,100% of BCBSTX fee schedule,$602.30 ,90% of total billed charges for oupatient setting,$98.56 ,100% of TX Medicaid OPPS fee schedule,$602.30 ,90% of total billed charges for oupatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$146.31 ,65% CMS Medicare OPPS fee schedule,$96.59 ,98% of TX Medicaid OPPS fee schedule,$635.76 ,95% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$588.91 ,88% of total billed charges for outpatient setting,$588.91 ,88% of total billed charges for outpatient setting,$225.09 ,100% CMS Medicare OPPS fee schedule,$189.15 ,90% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$225.09 ,100% CMS Medicare OPPS fee schedule,$98.56 ,100% of TX Medicaid OPPS fee schedule,$98.56 ,100% of TX Medicaid OPPS fee schedule,$98.56 ,100% of TX Medicaid OPPS fee schedule,$98.56 ,100% of TX Medicaid OPPS fee schedule,$98.56 ,100% of TX Medicaid OPPS fee schedule,$98.56 ,100% of TX Medicaid OPPS fee schedule,$98.56 ,100% of TX Medicaid OPPS fee schedule,$98.56 ,100% of TX Medicaid OPPS fee schedule,$98.56 ,100% of TX Medicaid OPPS fee schedule,$81.47 ,$635.76 ,$434.99 
Outpatient Medical Services,CARDIOLOGY,93350,STRESS ECHO,480,"$2,006.55 ",$606.22 ,125% CMS Medicare OPPS fee schedule,"$1,524.98 ",76%  of total billed charges for outpatient setting,$484.98 ,100% CMS Medicare OPPS fee schedule,$397.23 ,286% of BCBSTX fee schedule,$397.23 ,286% of BCBSTX fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$397.23 ,286% of BCBSTX fee schedule,$138.89 ,100% of BCBSTX fee schedule,"$1,805.90 ",90% of total billed charges for oupatient setting,$188.45 ,100% of TX Medicaid OPPS fee schedule,"$1,805.90 ",90% of total billed charges for oupatient setting,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$315.24 ,65% CMS Medicare OPPS fee schedule,$184.68 ,98% of TX Medicaid OPPS fee schedule,"$1,906.22 ",95% of total billed charges for outpatient setting,$484.98 ,100% CMS Medicare OPPS fee schedule,"$1,765.76 ",88% of total billed charges for outpatient setting,"$1,765.76 ",88% of total billed charges for outpatient setting,$484.98 ,100% CMS Medicare OPPS fee schedule,$407.54 ,90% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$484.98 ,100% CMS Medicare OPPS fee schedule,$188.45 ,100% of TX Medicaid OPPS fee schedule,$188.45 ,100% of TX Medicaid OPPS fee schedule,$188.45 ,100% of TX Medicaid OPPS fee schedule,$188.45 ,100% of TX Medicaid OPPS fee schedule,$188.45 ,100% of TX Medicaid OPPS fee schedule,$188.45 ,100% of TX Medicaid OPPS fee schedule,$188.45 ,100% of TX Medicaid OPPS fee schedule,$188.45 ,100% of TX Medicaid OPPS fee schedule,$188.45 ,100% of TX Medicaid OPPS fee schedule,$138.89 ,"$1,906.22 ","$1,304.26 "
Outpatient Medical Services,CARDIOLOGY,93660,TILT TABLE TEST,480,"$1,177.90 ",$582.48 ,125% CMS Medicare OPPS fee schedule,$895.20 ,76%  of total billed charges for outpatient setting,$465.99 ,100% CMS Medicare OPPS fee schedule,"$1,270.96 ",286% of BCBSTX fee schedule,"$1,270.96 ",286% of BCBSTX fee schedule,$465.99 ,100% CMS Medicare OPPS fee schedule,"$1,270.96 ",286% of BCBSTX fee schedule,$444.39 ,100% of BCBSTX fee schedule,"$1,060.11 ",90% of total billed charges for oupatient setting,$530.06 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$1,060.11 ",90% of total billed charges for oupatient setting,$465.99 ,100% CMS Medicare OPPS fee schedule,$465.99 ,100% CMS Medicare OPPS fee schedule,$465.99 ,100% CMS Medicare OPPS fee schedule,$302.89 ,65% CMS Medicare OPPS fee schedule,$519.45 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,"$1,119.01 ",95% of total billed charges for outpatient setting,$465.99 ,100% CMS Medicare OPPS fee schedule,"$1,036.55 ",88% of total billed charges for outpatient setting,"$1,036.55 ",88% of total billed charges for outpatient setting,$465.99 ,100% CMS Medicare OPPS fee schedule,$391.59 ,90% CMS Medicare OPPS fee schedule,$465.99 ,100% CMS Medicare OPPS fee schedule,$465.99 ,100% CMS Medicare OPPS fee schedule,$465.99 ,100% CMS Medicare OPPS fee schedule,$465.99 ,100% CMS Medicare OPPS fee schedule,$465.99 ,100% CMS Medicare OPPS fee schedule,$465.99 ,100% CMS Medicare OPPS fee schedule,$465.99 ,100% CMS Medicare OPPS fee schedule,$465.99 ,100% CMS Medicare OPPS fee schedule,$465.99 ,100% CMS Medicare OPPS fee schedule,$465.99 ,100% CMS Medicare OPPS fee schedule,$530.06 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$530.06 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$530.06 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$530.06 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$530.06 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$530.06 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$530.06 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$530.06 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$530.06 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$302.89 ,"$1,270.96 ",$765.64 
Outpatient Medical Services,CLINIC,90832,"Psychotherapy, 30 min",960,$127.00 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,CLINIC,90834,"Psychotherapy, 45 min",960,$168.00 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,CLINIC,90847,"Family psychotherapy, including patient, 50 min",960,$211.00 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,CLINIC,90853,Group psychotherapy,960,$655.99 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,CLINIC,99203,"OFFICE VISIT, NEW PT LEVEL 3",960,$272.60 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,CLINIC,99204,"OFFICE VISIT, NEW PT LEVEL 4",960,$407.28 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,CLINIC,99205,"OFFICE VISIT, NEW PT LEVEL 5",960,$538.75 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,CLINIC,62322,NXJ INTERLAMINAR LMBR/SAC,960,$302.00 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,PROFESSIONAL,19120,REMOVAL OF BREAST LESION,960,$958.00 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,PROFESSIONAL,29826,SHLDER ARTHROSCOPY/SURG DECOMP,960,$414.57 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,PROFESSIONAL,29881,KNEE ARTHR/SURG DEBRIDEMENT,960,"$1,062.00 ",,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,PROFESSIONAL,43235,"UPPER GI ENDOSCOPY, DIAGNOSIS",960,$494.00 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,PROFESSIONAL,43239,"UPPER GI ENDOSCOPY, BIOPSY",960,$658.00 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,PROFESSIONAL,45378,DIAGNOSTIC COLONOSCOPY,960,$307.00 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,PROFESSIONAL,45380,COLONOSCOPY AND BIOPSY,960,$781.00 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,PROFESSIONAL,45385,LESION REMOVAL COLONOSCOPY,960,$824.00 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,PROFESSIONAL,47562,LAPAROSCOPIC CHOLECYSTECTOMY,960,"$1,301.00 ",,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,PROFESSIONAL,49505,PRP I/HERN INIT REDUC>5 YR,960,"$1,027.00 ",,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,PROFESSIONAL,55700,BIOPSY OF PROSTATE SINGLE/MULTI,960,$481.00 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,PROFESSIONAL,62322,NJX INTERLAMINAR LMBR/SAC,960,$302.00 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,PROFESSIONAL,93452,LHC w Ventriculography,960,"$5,262.50 ",,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,PROFESSIONAL,93000,ELECTROCARDIAM COMPLETE,960,$33.00 ,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,Not reimbursable. Not seperately contracted for physician rates,,,
Outpatient Medical Services,PHYSICAL THERAPY,97110,PT THER EXER 15MIN,420,$155.45 ,$36.28 ,125% CMS Medicare OPPS fee schedule,$118.14 ,76%  of total billed charges for outpatient setting,$29.02 ,100% CMS Medicare OPPS fee schedule,$89.29 ,286% of BCBSTX fee schedule,$89.29 ,286% of BCBSTX fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$89.29 ,286% of BCBSTX fee schedule,$31.22 ,100% of BCBSTX fee schedule,$139.91 ,90% of total billed charges for oupatient setting,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$139.91 ,90% of total billed charges for oupatient setting,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$18.86 ,65% CMS Medicare OPPS fee schedule,$68.55 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$147.68 ,95% of total billed charges for outpatient setting,$29.02 ,100% CMS Medicare OPPS fee schedule,$136.80 ,88% of total billed charges for outpatient setting,$136.80 ,88% of total billed charges for outpatient setting,$29.02 ,100% CMS Medicare OPPS fee schedule,$26.12 ,90% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$18.86 ,$147.68 ,$101.04 
Outpatient Medical Services,PHYSICAL THERAPY,97110,PTA THER EXER 15MIN,420,$155.45 ,$36.28 ,125% CMS Medicare OPPS fee schedule,$118.14 ,76%  of total billed charges for outpatient setting,$29.02 ,100% CMS Medicare OPPS fee schedule,$89.29 ,286% of BCBSTX fee schedule,$89.29 ,286% of BCBSTX fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$89.29 ,286% of BCBSTX fee schedule,$31.22 ,100% of BCBSTX fee schedule,$139.91 ,90% of total billed charges for oupatient setting,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$139.91 ,90% of total billed charges for oupatient setting,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$18.86 ,65% CMS Medicare OPPS fee schedule,$68.55 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$147.68 ,95% of total billed charges for outpatient setting,$29.02 ,100% CMS Medicare OPPS fee schedule,$136.80 ,88% of total billed charges for outpatient setting,$136.80 ,88% of total billed charges for outpatient setting,$29.02 ,100% CMS Medicare OPPS fee schedule,$26.12 ,90% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$69.95 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$18.86 ,$147.68 ,$101.04 
Outpatient Medical Services,PHYSICAL THERAPY,97112,PT NM REED BAL PST CRD,420,$162.07 ,$41.61 ,125% CMS Medicare OPPS fee schedule,$123.17 ,76%  of total billed charges for outpatient setting,$33.29 ,100% CMS Medicare OPPS fee schedule,$101.62 ,286% of BCBSTX fee schedule,$101.62 ,286% of BCBSTX fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$101.62 ,286% of BCBSTX fee schedule,$35.53 ,100% of BCBSTX fee schedule,$145.86 ,90% of total billed charges for oupatient setting,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$145.86 ,90% of total billed charges for oupatient setting,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$21.64 ,65% CMS Medicare OPPS fee schedule,$71.47 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$153.97 ,95% of total billed charges for outpatient setting,$33.29 ,100% CMS Medicare OPPS fee schedule,$142.62 ,88% of total billed charges for outpatient setting,$142.62 ,88% of total billed charges for outpatient setting,$33.29 ,100% CMS Medicare OPPS fee schedule,$29.96 ,90% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$21.64 ,$153.97 ,$105.35 
Outpatient Medical Services,PHYSICAL THERAPY,97162,PT  THERAPY EVAL 30 MIN,424,$302.77 ,$123.65 ,125% CMS Medicare OPPS fee schedule,$230.11 ,76%  of total billed charges for outpatient setting,$98.92 ,100% CMS Medicare OPPS fee schedule,$244.30 ,286% of BCBSTX fee schedule,$244.30 ,286% of BCBSTX fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$244.30 ,286% of BCBSTX fee schedule,$85.42 ,100% of BCBSTX fee schedule,$272.49 ,90% of total billed charges for oupatient setting,$136.25 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$272.49 ,90% of total billed charges for oupatient setting,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$64.30 ,65% CMS Medicare OPPS fee schedule,$133.52 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$287.63 ,95% of total billed charges for outpatient setting,$98.92 ,100% CMS Medicare OPPS fee schedule,$266.44 ,88% of total billed charges for outpatient setting,$266.44 ,88% of total billed charges for outpatient setting,$98.92 ,100% CMS Medicare OPPS fee schedule,$89.03 ,90% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$136.25 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$136.25 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$136.25 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$136.25 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$136.25 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$136.25 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$136.25 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$136.25 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$136.25 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$64.30 ,$287.63 ,$196.80 
Outpatient Medical Services,PHYSICAL THERAPY,97602,PTA NONSEL DEBRIDE RIGHT,420,$414.37 ,$217.58 ,125% CMS Medicare OPPS fee schedule,$314.92 ,76%  of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$483.20 ,286% of BCBSTX fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$168.95 ,100% of BCBSTX fee schedule,$372.93 ,90% of total billed charges for oupatient setting,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$372.93 ,90% of total billed charges for oupatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$113.14 ,65% CMS Medicare OPPS fee schedule,$182.74 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$393.65 ,95% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$364.65 ,88% of total billed charges for outpatient setting,$364.65 ,88% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$146.27 ,90% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$113.14 ,$483.20 ,$269.34 
Outpatient Medical Services,PHYSICAL THERAPY,97602,PT NONSEL DEBRIDE RIGHT,420,$414.37 ,$217.58 ,125% CMS Medicare OPPS fee schedule,$314.92 ,76%  of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$483.20 ,286% of BCBSTX fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$168.95 ,100% of BCBSTX fee schedule,$372.93 ,90% of total billed charges for oupatient setting,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$372.93 ,90% of total billed charges for oupatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$113.14 ,65% CMS Medicare OPPS fee schedule,$182.74 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$393.65 ,95% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$364.65 ,88% of total billed charges for outpatient setting,$364.65 ,88% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$146.27 ,90% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$113.14 ,$483.20 ,$269.34 
Outpatient Medical Services,PHYSICAL THERAPY,97116,PT GAIT TRAINING 15 MIN,420,$111.35 ,$36.28 ,125% CMS Medicare OPPS fee schedule,$84.63 ,76%  of total billed charges for outpatient setting,$29.02 ,100% CMS Medicare OPPS fee schedule,$88.26 ,286% of BCBSTX fee schedule,$88.26 ,286% of BCBSTX fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$88.26 ,286% of BCBSTX fee schedule,$30.86 ,100% of BCBSTX fee schedule,$100.22 ,90% of total billed charges for oupatient setting,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$100.22 ,90% of total billed charges for oupatient setting,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$18.86 ,65% CMS Medicare OPPS fee schedule,$49.11 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$105.78 ,95% of total billed charges for outpatient setting,$29.02 ,100% CMS Medicare OPPS fee schedule,$97.99 ,88% of total billed charges for outpatient setting,$97.99 ,88% of total billed charges for outpatient setting,$29.02 ,100% CMS Medicare OPPS fee schedule,$26.12 ,90% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$18.86 ,$105.78 ,$72.38 
Outpatient Medical Services,PHYSICAL THERAPY,97597,PTA SELECT DEBRIDEMEN<20 RIGHT,420,$414.37 ,$217.57 ,125% CMS Medicare OPPS fee schedule,$314.92 ,76%  of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$69.78 ,286% of BCBSTX fee schedule,$69.78 ,286% of BCBSTX fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$69.78 ,286% of BCBSTX fee schedule,$24.40 ,100% of BCBSTX fee schedule,$372.93 ,90% of total billed charges for oupatient setting,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$372.93 ,90% of total billed charges for oupatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$113.14 ,65% CMS Medicare OPPS fee schedule,$182.74 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$393.65 ,95% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$364.65 ,88% of total billed charges for outpatient setting,$364.65 ,88% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$146.27 ,90% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$24.40 ,$393.65 ,$269.34 
Outpatient Medical Services,PHYSICAL THERAPY,97112,PTA NM REED BAL PST CRD,420,$162.07 ,$41.61 ,125% CMS Medicare OPPS fee schedule,$123.17 ,76%  of total billed charges for outpatient setting,$33.29 ,100% CMS Medicare OPPS fee schedule,$101.62 ,286% of BCBSTX fee schedule,$101.62 ,286% of BCBSTX fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$101.62 ,286% of BCBSTX fee schedule,$35.53 ,100% of BCBSTX fee schedule,$145.86 ,90% of total billed charges for oupatient setting,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$145.86 ,90% of total billed charges for oupatient setting,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$21.64 ,65% CMS Medicare OPPS fee schedule,$71.47 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$153.97 ,95% of total billed charges for outpatient setting,$33.29 ,100% CMS Medicare OPPS fee schedule,$142.62 ,88% of total billed charges for outpatient setting,$142.62 ,88% of total billed charges for outpatient setting,$33.29 ,100% CMS Medicare OPPS fee schedule,$29.96 ,90% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$33.29 ,100% CMS Medicare OPPS fee schedule,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$72.93 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$21.64 ,$153.97 ,$105.35 
Outpatient Medical Services,PHYSICAL THERAPY,97597,PT SELECT DEBRIDEMEN<20 RIGHT,420,$414.37 ,$217.57 ,125% CMS Medicare OPPS fee schedule,$314.92 ,76%  of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$69.78 ,286% of BCBSTX fee schedule,$69.78 ,286% of BCBSTX fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$69.78 ,286% of BCBSTX fee schedule,$24.40 ,100% of BCBSTX fee schedule,$372.93 ,90% of total billed charges for oupatient setting,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$372.93 ,90% of total billed charges for oupatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$113.14 ,65% CMS Medicare OPPS fee schedule,$182.74 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$393.65 ,95% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$364.65 ,88% of total billed charges for outpatient setting,$364.65 ,88% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$146.27 ,90% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$24.40 ,$393.65 ,$269.34 
Outpatient Medical Services,PHYSICAL THERAPY,97116,PTA GAIT TRAINING 15 MIN,420,$111.35 ,$36.28 ,125% CMS Medicare OPPS fee schedule,$84.63 ,76%  of total billed charges for outpatient setting,$29.02 ,100% CMS Medicare OPPS fee schedule,$88.26 ,286% of BCBSTX fee schedule,$88.26 ,286% of BCBSTX fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$88.26 ,286% of BCBSTX fee schedule,$30.86 ,100% of BCBSTX fee schedule,$100.22 ,90% of total billed charges for oupatient setting,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$100.22 ,90% of total billed charges for oupatient setting,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$18.86 ,65% CMS Medicare OPPS fee schedule,$49.11 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$105.78 ,95% of total billed charges for outpatient setting,$29.02 ,100% CMS Medicare OPPS fee schedule,$97.99 ,88% of total billed charges for outpatient setting,$97.99 ,88% of total billed charges for outpatient setting,$29.02 ,100% CMS Medicare OPPS fee schedule,$26.12 ,90% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$29.02 ,100% CMS Medicare OPPS fee schedule,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$18.86 ,$105.78 ,$72.38 
Outpatient Medical Services,PHYSICAL THERAPY,97010,PT COLD OR HOT PACK,420,$93.71 ,$7.69 ,125% CMS Medicare OPPS fee schedule,$71.22 ,76%  of total billed charges for outpatient setting,$6.15 ,100% CMS Medicare OPPS fee schedule,$18.48 ,286% of BCBSTX fee schedule,$18.48 ,286% of BCBSTX fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$18.48 ,286% of BCBSTX fee schedule,$6.46 ,100% of BCBSTX fee schedule,$84.34 ,90% of total billed charges for oupatient setting,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$84.34 ,90% of total billed charges for oupatient setting,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$4.00 ,65% CMS Medicare OPPS fee schedule,$41.33 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$89.02 ,95% of total billed charges for outpatient setting,$6.15 ,100% CMS Medicare OPPS fee schedule,$82.46 ,88% of total billed charges for outpatient setting,$82.46 ,88% of total billed charges for outpatient setting,$6.15 ,100% CMS Medicare OPPS fee schedule,$5.54 ,90% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$4.00 ,$89.02 ,$60.91 
Outpatient Medical Services,PHYSICAL THERAPY,97530,PT THERAPEUTIC ACTIVITS 15MIN,420,$114.66 ,$45.51 ,125% CMS Medicare OPPS fee schedule,$87.14 ,76%  of total billed charges for outpatient setting,$36.41 ,100% CMS Medicare OPPS fee schedule,$118.03 ,286% of BCBSTX fee schedule,$118.03 ,286% of BCBSTX fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$118.03 ,286% of BCBSTX fee schedule,$41.27 ,100% of BCBSTX fee schedule,$103.19 ,90% of total billed charges for oupatient setting,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$103.19 ,90% of total billed charges for oupatient setting,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$23.67 ,65% CMS Medicare OPPS fee schedule,$50.57 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$108.93 ,95% of total billed charges for outpatient setting,$36.41 ,100% CMS Medicare OPPS fee schedule,$100.90 ,88% of total billed charges for outpatient setting,$100.90 ,88% of total billed charges for outpatient setting,$36.41 ,100% CMS Medicare OPPS fee schedule,$32.77 ,90% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$23.67 ,$118.03 ,$74.53 
Outpatient Medical Services,PHYSICAL THERAPY,97140,PTA MOBILZTNJNTS SFT TI 15MIN,420,$190.73 ,$33.43 ,125% CMS Medicare OPPS fee schedule,$144.95 ,76%  of total billed charges for outpatient setting,$26.74 ,100% CMS Medicare OPPS fee schedule,$81.08 ,286% of BCBSTX fee schedule,$81.08 ,286% of BCBSTX fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$81.08 ,286% of BCBSTX fee schedule,$28.35 ,100% of BCBSTX fee schedule,$171.66 ,90% of total billed charges for oupatient setting,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$171.66 ,90% of total billed charges for oupatient setting,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$17.38 ,65% CMS Medicare OPPS fee schedule,$84.11 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$181.19 ,95% of total billed charges for outpatient setting,$26.74 ,100% CMS Medicare OPPS fee schedule,$167.84 ,88% of total billed charges for outpatient setting,$167.84 ,88% of total billed charges for outpatient setting,$26.74 ,100% CMS Medicare OPPS fee schedule,$24.07 ,90% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$17.38 ,$181.19 ,$123.97 
Outpatient Medical Services,PHYSICAL THERAPY,97032,PT ELEC STIM UNATTEND,420,$214.99 ,$17.75 ,125% CMS Medicare OPPS fee schedule,$163.39 ,76%  of total billed charges for outpatient setting,$14.20 ,100% CMS Medicare OPPS fee schedule,$45.16 ,286% of BCBSTX fee schedule,$45.16 ,286% of BCBSTX fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$45.16 ,286% of BCBSTX fee schedule,$15.79 ,100% of BCBSTX fee schedule,$193.49 ,90% of total billed charges for oupatient setting,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$193.49 ,90% of total billed charges for oupatient setting,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$9.23 ,65% CMS Medicare OPPS fee schedule,$94.81 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$204.24 ,95% of total billed charges for outpatient setting,$14.20 ,100% CMS Medicare OPPS fee schedule,$189.19 ,88% of total billed charges for outpatient setting,$189.19 ,88% of total billed charges for outpatient setting,$14.20 ,100% CMS Medicare OPPS fee schedule,$12.78 ,90% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$9.23 ,$204.24 ,$139.74 
Outpatient Medical Services,PHYSICAL THERAPY,97140,PT MOBILZTNJNTS SFT TI,420,$190.73 ,$33.43 ,125% CMS Medicare OPPS fee schedule,$144.95 ,76%  of total billed charges for outpatient setting,$26.74 ,100% CMS Medicare OPPS fee schedule,$81.08 ,286% of BCBSTX fee schedule,$81.08 ,286% of BCBSTX fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$81.08 ,286% of BCBSTX fee schedule,$28.35 ,100% of BCBSTX fee schedule,$171.66 ,90% of total billed charges for oupatient setting,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$171.66 ,90% of total billed charges for oupatient setting,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$17.38 ,65% CMS Medicare OPPS fee schedule,$84.11 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$181.19 ,95% of total billed charges for outpatient setting,$26.74 ,100% CMS Medicare OPPS fee schedule,$167.84 ,88% of total billed charges for outpatient setting,$167.84 ,88% of total billed charges for outpatient setting,$26.74 ,100% CMS Medicare OPPS fee schedule,$24.07 ,90% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$26.74 ,100% CMS Medicare OPPS fee schedule,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$85.83 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$17.38 ,$181.19 ,$123.97 
Outpatient Medical Services,PHYSICAL THERAPY,29581,PTA COMP WRP LEG LEFT,420,$334.47 ,$175.62 ,125% CMS Medicare OPPS fee schedule,$254.20 ,76%  of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$240.82 ,72% of total billed charges for outpatient setting,$250.85 ,75% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$240.82 ,72% of total billed charges for outpatient setting,$200.68 ,60% of total billed charges for outpatient setting,$301.02 ,90% of total billed charges for oupatient setting,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$301.02 ,90% of total billed charges for oupatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$91.33 ,65% CMS Medicare OPPS fee schedule,$147.50 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$317.75 ,95% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$294.33 ,88% of total billed charges for outpatient setting,$294.33 ,88% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$118.06 ,90% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$91.33 ,$317.75 ,$217.41 
Outpatient Medical Services,PHYSICAL THERAPY,97014,PTA ELEC STIM UNATTEND,420,$284.45 ,$284.45 ,125% CMS Medicare OPPS fee schedule,$216.18 ,76%  of total billed charges for outpatient setting,$284.45 ,100% CMS Medicare OPPS fee schedule,$45.16 ,286% of BCBSTX fee schedule,$45.16 ,286% of BCBSTX fee schedule,$284.45 ,100% CMS Medicare OPPS fee schedule,$45.16 ,286% of BCBSTX fee schedule,$15.79 ,100% of BCBSTX fee schedule,$256.01 ,90% of total billed charges for oupatient setting,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$256.01 ,90% of total billed charges for oupatient setting,$284.45 ,100% CMS Medicare OPPS fee schedule,$284.45 ,100% CMS Medicare OPPS fee schedule,$284.45 ,100% CMS Medicare OPPS fee schedule,$184.89 ,65% of total billed charges for oupatient setting,$125.44 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$270.23 ,95% of total billed charges for outpatient setting,$284.45 ,100% CMS Medicare OPPS fee schedule,$250.32 ,88% of total billed charges for outpatient setting,$250.32 ,88% of total billed charges for outpatient setting,$284.45 ,100% CMS Medicare OPPS fee schedule,$256.01 ,90% CMS Medicare OPPS fee schedule,$284.45 ,100% CMS Medicare OPPS fee schedule,$284.45 ,100% CMS Medicare OPPS fee schedule,$284.45 ,100% CMS Medicare OPPS fee schedule,$284.45 ,100% CMS Medicare OPPS fee schedule,$284.45 ,100% CMS Medicare OPPS fee schedule,$284.45 ,100% CMS Medicare OPPS fee schedule,$284.45 ,100% CMS Medicare OPPS fee schedule,$284.45 ,100% CMS Medicare OPPS fee schedule,$284.45 ,100% CMS Medicare OPPS fee schedule,$284.45 ,100% CMS Medicare OPPS fee schedule,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$128.00 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$15.79 ,$284.45 ,$184.89 
Outpatient Medical Services,PHYSICAL THERAPY,97161,PT  THERAPY EVAL 20 MIN,424,$275.24 ,$123.65 ,125% CMS Medicare OPPS fee schedule,$209.18 ,76%  of total billed charges for outpatient setting,$98.92 ,100% CMS Medicare OPPS fee schedule,$244.30 ,286% of BCBSTX fee schedule,$244.30 ,286% of BCBSTX fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$244.30 ,286% of BCBSTX fee schedule,$85.42 ,100% of BCBSTX fee schedule,$247.72 ,90% of total billed charges for oupatient setting,$123.86 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$247.72 ,90% of total billed charges for oupatient setting,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$64.30 ,65% CMS Medicare OPPS fee schedule,$121.38 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$261.48 ,95% of total billed charges for outpatient setting,$98.92 ,100% CMS Medicare OPPS fee schedule,$242.21 ,88% of total billed charges for outpatient setting,$242.21 ,88% of total billed charges for outpatient setting,$98.92 ,100% CMS Medicare OPPS fee schedule,$89.03 ,90% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$123.86 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$123.86 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$123.86 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$123.86 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$123.86 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$123.86 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$123.86 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$123.86 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$123.86 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$64.30 ,$261.48 ,$178.91 
Outpatient Medical Services,PHYSICAL THERAPY,29581,PT COMP WRP LEG LEFT,420,$334.47 ,$175.62 ,125% CMS Medicare OPPS fee schedule,$254.20 ,76%  of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$240.82 ,72% of total billed charges for outpatient setting,$250.85 ,75% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$240.82 ,72% of total billed charges for outpatient setting,$200.68 ,60% of total billed charges for outpatient setting,$301.02 ,90% of total billed charges for oupatient setting,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$301.02 ,90% of total billed charges for oupatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$91.33 ,65% CMS Medicare OPPS fee schedule,$147.50 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$317.75 ,95% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$294.33 ,88% of total billed charges for outpatient setting,$294.33 ,88% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$118.06 ,90% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$91.33 ,$317.75 ,$217.41 
Outpatient Medical Services,PHYSICAL THERAPY,97010,PTA COLD OR HOT PACK,420,$93.71 ,$7.69 ,125% CMS Medicare OPPS fee schedule,$71.22 ,76%  of total billed charges for outpatient setting,$6.15 ,100% CMS Medicare OPPS fee schedule,$18.48 ,286% of BCBSTX fee schedule,$18.48 ,286% of BCBSTX fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$18.48 ,286% of BCBSTX fee schedule,$6.46 ,100% of BCBSTX fee schedule,$84.34 ,90% of total billed charges for oupatient setting,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$84.34 ,90% of total billed charges for oupatient setting,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$4.00 ,65% CMS Medicare OPPS fee schedule,$41.33 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$89.02 ,95% of total billed charges for outpatient setting,$6.15 ,100% CMS Medicare OPPS fee schedule,$82.46 ,88% of total billed charges for outpatient setting,$82.46 ,88% of total billed charges for outpatient setting,$6.15 ,100% CMS Medicare OPPS fee schedule,$5.54 ,90% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$6.15 ,100% CMS Medicare OPPS fee schedule,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$42.17 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$4.00 ,$89.02 ,$60.91 
Outpatient Medical Services,PHYSICAL THERAPY,29581,PTA COMP WRAP LEG BELKNE RIGHT,420,$334.47 ,$175.62 ,125% CMS Medicare OPPS fee schedule,$254.20 ,76%  of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$240.82 ,72% of total billed charges for outpatient setting,$250.85 ,75% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$240.82 ,72% of total billed charges for outpatient setting,$200.68 ,60% of total billed charges for outpatient setting,$301.02 ,90% of total billed charges for oupatient setting,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$301.02 ,90% of total billed charges for oupatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$91.33 ,65% CMS Medicare OPPS fee schedule,$147.50 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$317.75 ,95% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$294.33 ,88% of total billed charges for outpatient setting,$294.33 ,88% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$118.06 ,90% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$91.33 ,$317.75 ,$217.41 
Outpatient Medical Services,PHYSICAL THERAPY,97530,PTA THERAPEUTIC ACTIVITS 15MIN,420,$114.66 ,$45.51 ,125% CMS Medicare OPPS fee schedule,$87.14 ,76%  of total billed charges for outpatient setting,$36.41 ,100% CMS Medicare OPPS fee schedule,$118.03 ,286% of BCBSTX fee schedule,$118.03 ,286% of BCBSTX fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$118.03 ,286% of BCBSTX fee schedule,$41.27 ,100% of BCBSTX fee schedule,$103.19 ,90% of total billed charges for oupatient setting,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$103.19 ,90% of total billed charges for oupatient setting,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$23.67 ,65% CMS Medicare OPPS fee schedule,$50.57 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$108.93 ,95% of total billed charges for outpatient setting,$36.41 ,100% CMS Medicare OPPS fee schedule,$100.90 ,88% of total billed charges for outpatient setting,$100.90 ,88% of total billed charges for outpatient setting,$36.41 ,100% CMS Medicare OPPS fee schedule,$32.77 ,90% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$36.41 ,100% CMS Medicare OPPS fee schedule,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.60 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$23.67 ,$118.03 ,$74.53 
Outpatient Medical Services,PHYSICAL THERAPY,97598,PT SELECT DEBRIDEMEN>20 RIGHT,420,$650.52 ,$650.52 ,125% CMS Medicare OPPS fee schedule,$494.40 ,76%  of total billed charges for outpatient setting,$650.52 ,100% CMS Medicare OPPS fee schedule,$32.83 ,286% of BCBSTX fee schedule,$32.83 ,286% of BCBSTX fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$32.83 ,286% of BCBSTX fee schedule,$11.48 ,100% of BCBSTX fee schedule,$585.47 ,90% of total billed charges for oupatient setting,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$585.47 ,90% of total billed charges for oupatient setting,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$422.84 ,65% of total billed charges for oupatient setting,$286.88 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$617.99 ,95% of total billed charges for outpatient setting,$650.52 ,100% CMS Medicare OPPS fee schedule,$572.46 ,88% of total billed charges for outpatient setting,$572.46 ,88% of total billed charges for outpatient setting,$650.52 ,100% CMS Medicare OPPS fee schedule,$585.47 ,90% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$11.48 ,$650.52 ,$422.84 
Outpatient Medical Services,PHYSICAL THERAPY,97163,PT  THERAPY EVAL 45 MIN,424,$333.05 ,$123.65 ,125% CMS Medicare OPPS fee schedule,$253.12 ,76%  of total billed charges for outpatient setting,$98.92 ,100% CMS Medicare OPPS fee schedule,$244.30 ,286% of BCBSTX fee schedule,$244.30 ,286% of BCBSTX fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$244.30 ,286% of BCBSTX fee schedule,$85.42 ,100% of BCBSTX fee schedule,$299.75 ,90% of total billed charges for oupatient setting,$149.87 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$299.75 ,90% of total billed charges for oupatient setting,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$64.30 ,65% CMS Medicare OPPS fee schedule,$146.88 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$316.40 ,95% of total billed charges for outpatient setting,$98.92 ,100% CMS Medicare OPPS fee schedule,$293.08 ,88% of total billed charges for outpatient setting,$293.08 ,88% of total billed charges for outpatient setting,$98.92 ,100% CMS Medicare OPPS fee schedule,$89.03 ,90% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$98.92 ,100% CMS Medicare OPPS fee schedule,$149.87 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$149.87 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$149.87 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$149.87 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$149.87 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$149.87 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$149.87 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$149.87 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$149.87 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$64.30 ,$316.40 ,$216.48 
Outpatient Medical Services,PHYSICAL THERAPY,29581,PT COMP WRAP LEG BEL KNEE RT,420,$334.47 ,$175.62 ,125% CMS Medicare OPPS fee schedule,$254.20 ,76%  of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$240.82 ,72% of total billed charges for outpatient setting,$250.85 ,75% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$240.82 ,72% of total billed charges for outpatient setting,$200.68 ,60% of total billed charges for outpatient setting,$301.02 ,90% of total billed charges for oupatient setting,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$301.02 ,90% of total billed charges for oupatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$91.33 ,65% CMS Medicare OPPS fee schedule,$147.50 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$317.75 ,95% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$294.33 ,88% of total billed charges for outpatient setting,$294.33 ,88% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$118.06 ,90% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$150.51 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$91.33 ,$317.75 ,$217.41 
Outpatient Medical Services,PHYSICAL THERAPY,97597,PT Select Debridement <20 LEFT,420,$414.37 ,$217.57 ,125% CMS Medicare OPPS fee schedule,$314.92 ,76%  of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$69.78 ,286% of BCBSTX fee schedule,$69.78 ,286% of BCBSTX fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$69.78 ,286% of BCBSTX fee schedule,$24.40 ,100% of BCBSTX fee schedule,$372.93 ,90% of total billed charges for oupatient setting,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$372.93 ,90% of total billed charges for oupatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$113.14 ,65% CMS Medicare OPPS fee schedule,$182.74 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$393.65 ,95% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$364.65 ,88% of total billed charges for outpatient setting,$364.65 ,88% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$146.27 ,90% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$24.40 ,$393.65 ,$269.34 
Outpatient Medical Services,PHYSICAL THERAPY,97597,PTA Select Debridement <20 LFT,420,$414.37 ,$217.57 ,125% CMS Medicare OPPS fee schedule,$314.92 ,76%  of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$69.78 ,286% of BCBSTX fee schedule,$69.78 ,286% of BCBSTX fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$69.78 ,286% of BCBSTX fee schedule,$24.40 ,100% of BCBSTX fee schedule,$372.93 ,90% of total billed charges for oupatient setting,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$372.93 ,90% of total billed charges for oupatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$113.14 ,65% CMS Medicare OPPS fee schedule,$182.74 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$393.65 ,95% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$364.65 ,88% of total billed charges for outpatient setting,$364.65 ,88% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$146.27 ,90% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$24.40 ,$393.65 ,$269.34 
Outpatient Medical Services,PHYSICAL THERAPY,97602,PTA Non Select Debride Left,420,$414.37 ,$217.58 ,125% CMS Medicare OPPS fee schedule,$314.92 ,76%  of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$483.20 ,286% of BCBSTX fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$168.95 ,100% of BCBSTX fee schedule,$372.93 ,90% of total billed charges for oupatient setting,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$372.93 ,90% of total billed charges for oupatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$113.14 ,65% CMS Medicare OPPS fee schedule,$182.74 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$393.65 ,95% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$364.65 ,88% of total billed charges for outpatient setting,$364.65 ,88% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$146.27 ,90% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$113.14 ,$483.20 ,$269.34 
Outpatient Medical Services,PHYSICAL THERAPY,97035,PTA ULTRASOUND/15 MIN,420,$151.04 ,$17.66 ,125% CMS Medicare OPPS fee schedule,$114.79 ,76%  of total billed charges for outpatient setting,$14.13 ,100% CMS Medicare OPPS fee schedule,$39.01 ,286% of BCBSTX fee schedule,$39.01 ,286% of BCBSTX fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$39.01 ,286% of BCBSTX fee schedule,$13.64 ,100% of BCBSTX fee schedule,$135.94 ,90% of total billed charges for oupatient setting,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.94 ,90% of total billed charges for oupatient setting,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$9.18 ,65% CMS Medicare OPPS fee schedule,$66.61 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$143.49 ,95% of total billed charges for outpatient setting,$14.13 ,100% CMS Medicare OPPS fee schedule,$132.92 ,88% of total billed charges for outpatient setting,$132.92 ,88% of total billed charges for outpatient setting,$14.13 ,100% CMS Medicare OPPS fee schedule,$12.72 ,90% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$9.18 ,$143.49 ,$98.18 
Outpatient Medical Services,PHYSICAL THERAPY,97035,PT ULTRASOUND/15 MIN,420,$151.04 ,$17.66 ,125% CMS Medicare OPPS fee schedule,$114.79 ,76%  of total billed charges for outpatient setting,$14.13 ,100% CMS Medicare OPPS fee schedule,$39.01 ,286% of BCBSTX fee schedule,$39.01 ,286% of BCBSTX fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$39.01 ,286% of BCBSTX fee schedule,$13.64 ,100% of BCBSTX fee schedule,$135.94 ,90% of total billed charges for oupatient setting,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$135.94 ,90% of total billed charges for oupatient setting,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$9.18 ,65% CMS Medicare OPPS fee schedule,$66.61 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$143.49 ,95% of total billed charges for outpatient setting,$14.13 ,100% CMS Medicare OPPS fee schedule,$132.92 ,88% of total billed charges for outpatient setting,$132.92 ,88% of total billed charges for outpatient setting,$14.13 ,100% CMS Medicare OPPS fee schedule,$12.72 ,90% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$67.97 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$9.18 ,$143.49 ,$98.18 
Outpatient Medical Services,PHYSICAL THERAPY,97034,PTA CONTRAST BATH/15 MIN,420,$113.56 ,$17.66 ,125% CMS Medicare OPPS fee schedule,$86.31 ,76%  of total billed charges for outpatient setting,$14.13 ,100% CMS Medicare OPPS fee schedule,$44.13 ,286% of BCBSTX fee schedule,$44.13 ,286% of BCBSTX fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$44.13 ,286% of BCBSTX fee schedule,$15.43 ,100% of BCBSTX fee schedule,$102.20 ,90% of total billed charges for oupatient setting,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$102.20 ,90% of total billed charges for oupatient setting,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$9.18 ,65% CMS Medicare OPPS fee schedule,$50.08 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$107.88 ,95% of total billed charges for outpatient setting,$14.13 ,100% CMS Medicare OPPS fee schedule,$99.93 ,88% of total billed charges for outpatient setting,$99.93 ,88% of total billed charges for outpatient setting,$14.13 ,100% CMS Medicare OPPS fee schedule,$12.72 ,90% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$9.18 ,$107.88 ,$73.81 
Outpatient Medical Services,PHYSICAL THERAPY,97602,PT NonSel Debrid Head/Trnk/Sac,420,$414.37 ,$217.58 ,125% CMS Medicare OPPS fee schedule,$314.92 ,76%  of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$483.20 ,286% of BCBSTX fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$168.95 ,100% of BCBSTX fee schedule,$372.93 ,90% of total billed charges for oupatient setting,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$372.93 ,90% of total billed charges for oupatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$113.14 ,65% CMS Medicare OPPS fee schedule,$182.74 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$393.65 ,95% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$364.65 ,88% of total billed charges for outpatient setting,$364.65 ,88% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$146.27 ,90% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$113.14 ,$483.20 ,$269.34 
Outpatient Medical Services,PHYSICAL THERAPY,97602,PTA NonSel Debr Head/Trnk/Sacr,420,$414.37 ,$217.58 ,125% CMS Medicare OPPS fee schedule,$314.92 ,76%  of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$483.20 ,286% of BCBSTX fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$168.95 ,100% of BCBSTX fee schedule,$372.93 ,90% of total billed charges for oupatient setting,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$372.93 ,90% of total billed charges for oupatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$113.14 ,65% CMS Medicare OPPS fee schedule,$182.74 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$393.65 ,95% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$364.65 ,88% of total billed charges for outpatient setting,$364.65 ,88% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$146.27 ,90% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$113.14 ,$483.20 ,$269.34 
Outpatient Medical Services,PHYSICAL THERAPY,97124,PT MASSAGE 15 MIN,420,$217.19 ,$36.88 ,125% CMS Medicare OPPS fee schedule,$165.06 ,76%  of total billed charges for outpatient setting,$29.50 ,100% CMS Medicare OPPS fee schedule,$89.29 ,286% of BCBSTX fee schedule,$89.29 ,286% of BCBSTX fee schedule,$29.50 ,100% CMS Medicare OPPS fee schedule,$89.29 ,286% of BCBSTX fee schedule,$31.22 ,100% of BCBSTX fee schedule,$195.47 ,90% of total billed charges for oupatient setting,$97.74 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$195.47 ,90% of total billed charges for oupatient setting,$29.50 ,100% CMS Medicare OPPS fee schedule,$29.50 ,100% CMS Medicare OPPS fee schedule,$29.50 ,100% CMS Medicare OPPS fee schedule,$19.18 ,65% CMS Medicare OPPS fee schedule,$95.78 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$206.33 ,95% of total billed charges for outpatient setting,$29.50 ,100% CMS Medicare OPPS fee schedule,$191.13 ,88% of total billed charges for outpatient setting,$191.13 ,88% of total billed charges for outpatient setting,$29.50 ,100% CMS Medicare OPPS fee schedule,$26.55 ,90% CMS Medicare OPPS fee schedule,$29.50 ,100% CMS Medicare OPPS fee schedule,$29.50 ,100% CMS Medicare OPPS fee schedule,$29.50 ,100% CMS Medicare OPPS fee schedule,$29.50 ,100% CMS Medicare OPPS fee schedule,$29.50 ,100% CMS Medicare OPPS fee schedule,$29.50 ,100% CMS Medicare OPPS fee schedule,$29.50 ,100% CMS Medicare OPPS fee schedule,$29.50 ,100% CMS Medicare OPPS fee schedule,$29.50 ,100% CMS Medicare OPPS fee schedule,$29.50 ,100% CMS Medicare OPPS fee schedule,$97.74 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$97.74 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$97.74 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$97.74 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$97.74 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$97.74 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$97.74 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$97.74 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$97.74 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$19.18 ,$206.33 ,$141.17 
Outpatient Medical Services,PHYSICAL THERAPY,97602,PT Non Select Debride Left,420,$414.37 ,$217.58 ,125% CMS Medicare OPPS fee schedule,$314.92 ,76%  of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$483.20 ,286% of BCBSTX fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$168.95 ,100% of BCBSTX fee schedule,$372.93 ,90% of total billed charges for oupatient setting,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$372.93 ,90% of total billed charges for oupatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$113.14 ,65% CMS Medicare OPPS fee schedule,$182.74 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$393.65 ,95% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$364.65 ,88% of total billed charges for outpatient setting,$364.65 ,88% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$146.27 ,90% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$113.14 ,$483.20 ,$269.34 
Outpatient Medical Services,PHYSICAL THERAPY,97598,PTA SELECT DEBRIDEMEN>20 RIGHT,420,$650.52 ,$650.52 ,125% CMS Medicare OPPS fee schedule,$494.40 ,76%  of total billed charges for outpatient setting,$650.52 ,100% CMS Medicare OPPS fee schedule,$32.83 ,286% of BCBSTX fee schedule,$32.83 ,286% of BCBSTX fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$32.83 ,286% of BCBSTX fee schedule,$11.48 ,100% of BCBSTX fee schedule,$585.47 ,90% of total billed charges for oupatient setting,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$585.47 ,90% of total billed charges for oupatient setting,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$422.84 ,65% of total billed charges for oupatient setting,$286.88 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$617.99 ,95% of total billed charges for outpatient setting,$650.52 ,100% CMS Medicare OPPS fee schedule,$572.46 ,88% of total billed charges for outpatient setting,$572.46 ,88% of total billed charges for outpatient setting,$650.52 ,100% CMS Medicare OPPS fee schedule,$585.47 ,90% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$11.48 ,$650.52 ,$422.84 
Outpatient Medical Services,PHYSICAL THERAPY,97034,PT CONTRAST BATH/15 MIN,420,$113.56 ,$17.66 ,125% CMS Medicare OPPS fee schedule,$86.31 ,76%  of total billed charges for outpatient setting,$14.13 ,100% CMS Medicare OPPS fee schedule,$44.13 ,286% of BCBSTX fee schedule,$44.13 ,286% of BCBSTX fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$44.13 ,286% of BCBSTX fee schedule,$15.43 ,100% of BCBSTX fee schedule,$102.20 ,90% of total billed charges for oupatient setting,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$102.20 ,90% of total billed charges for oupatient setting,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$9.18 ,65% CMS Medicare OPPS fee schedule,$50.08 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$107.88 ,95% of total billed charges for outpatient setting,$14.13 ,100% CMS Medicare OPPS fee schedule,$99.93 ,88% of total billed charges for outpatient setting,$99.93 ,88% of total billed charges for outpatient setting,$14.13 ,100% CMS Medicare OPPS fee schedule,$12.72 ,90% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$14.13 ,100% CMS Medicare OPPS fee schedule,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$51.10 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$9.18 ,$107.88 ,$73.81 
Outpatient Medical Services,PHYSICAL THERAPY,97022,PT WHIRLPOOL SMALL,420,$216.09 ,$20.80 ,125% CMS Medicare OPPS fee schedule,$164.23 ,76%  of total billed charges for outpatient setting,$16.64 ,100% CMS Medicare OPPS fee schedule,$55.43 ,286% of BCBSTX fee schedule,$55.43 ,286% of BCBSTX fee schedule,$16.64 ,100% CMS Medicare OPPS fee schedule,$55.43 ,286% of BCBSTX fee schedule,$19.38 ,100% of BCBSTX fee schedule,$194.48 ,90% of total billed charges for oupatient setting,$97.24 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$194.48 ,90% of total billed charges for oupatient setting,$16.64 ,100% CMS Medicare OPPS fee schedule,$16.64 ,100% CMS Medicare OPPS fee schedule,$16.64 ,100% CMS Medicare OPPS fee schedule,$10.82 ,65% CMS Medicare OPPS fee schedule,$95.30 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$205.29 ,95% of total billed charges for outpatient setting,$16.64 ,100% CMS Medicare OPPS fee schedule,$190.16 ,88% of total billed charges for outpatient setting,$190.16 ,88% of total billed charges for outpatient setting,$16.64 ,100% CMS Medicare OPPS fee schedule,$14.98 ,90% CMS Medicare OPPS fee schedule,$16.64 ,100% CMS Medicare OPPS fee schedule,$16.64 ,100% CMS Medicare OPPS fee schedule,$16.64 ,100% CMS Medicare OPPS fee schedule,$16.64 ,100% CMS Medicare OPPS fee schedule,$16.64 ,100% CMS Medicare OPPS fee schedule,$16.64 ,100% CMS Medicare OPPS fee schedule,$16.64 ,100% CMS Medicare OPPS fee schedule,$16.64 ,100% CMS Medicare OPPS fee schedule,$16.64 ,100% CMS Medicare OPPS fee schedule,$16.64 ,100% CMS Medicare OPPS fee schedule,$97.24 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$97.24 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$97.24 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$97.24 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$97.24 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$97.24 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$97.24 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$97.24 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$97.24 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$10.82 ,$205.29 ,$140.46 
Outpatient Medical Services,PHYSICAL THERAPY,97610,PT ULTRASLOWFRQ NONTHER PR DAY,420,$426.03 ,$217.58 ,125% CMS Medicare OPPS fee schedule,$323.78 ,76%  of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$483.20 ,286% of BCBSTX fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$168.95 ,100% of BCBSTX fee schedule,$383.43 ,90% of total billed charges for oupatient setting,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$383.43 ,90% of total billed charges for oupatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$113.14 ,65% CMS Medicare OPPS fee schedule,$187.88 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$404.73 ,95% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$374.91 ,88% of total billed charges for outpatient setting,$374.91 ,88% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$146.27 ,90% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$113.14 ,$483.20 ,$276.92 
Outpatient Medical Services,PHYSICAL THERAPY,29580,PT UNNA BOOT APPLIC UNILAT,420,$180.81 ,$175.62 ,125% CMS Medicare OPPS fee schedule,$137.42 ,76%  of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$130.18 ,72% of total billed charges for outpatient setting,$135.61 ,75% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$130.18 ,72% of total billed charges for outpatient setting,$108.49 ,60% of total billed charges for outpatient setting,$162.73 ,90% of total billed charges for oupatient setting,$81.36 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$162.73 ,90% of total billed charges for oupatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$91.33 ,65% CMS Medicare OPPS fee schedule,$79.74 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$171.77 ,95% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$159.11 ,88% of total billed charges for outpatient setting,$159.11 ,88% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$118.06 ,90% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$81.36 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$81.36 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$81.36 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$81.36 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$81.36 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$81.36 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$81.36 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$81.36 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$81.36 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$79.74 ,$175.62 ,$117.53 
Outpatient Medical Services,PHYSICAL THERAPY,97598,PT Select Debridement>20 LEFT,420,$650.52 ,$650.52 ,125% CMS Medicare OPPS fee schedule,$494.40 ,76%  of total billed charges for outpatient setting,$650.52 ,100% CMS Medicare OPPS fee schedule,$32.83 ,286% of BCBSTX fee schedule,$32.83 ,286% of BCBSTX fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$32.83 ,286% of BCBSTX fee schedule,$11.48 ,100% of BCBSTX fee schedule,$585.47 ,90% of total billed charges for oupatient setting,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$585.47 ,90% of total billed charges for oupatient setting,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$422.84 ,65% of total billed charges for oupatient setting,$286.88 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$617.99 ,95% of total billed charges for outpatient setting,$650.52 ,100% CMS Medicare OPPS fee schedule,$572.46 ,88% of total billed charges for outpatient setting,$572.46 ,88% of total billed charges for outpatient setting,$650.52 ,100% CMS Medicare OPPS fee schedule,$585.47 ,90% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$11.48 ,$650.52 ,$422.84 
Outpatient Medical Services,PHYSICAL THERAPY,97164,PT  THERAPY REEVAL 20 MIN,424,$111.35 ,$85.40 ,125% CMS Medicare OPPS fee schedule,$84.63 ,76%  of total billed charges for outpatient setting,$68.32 ,100% CMS Medicare OPPS fee schedule,$165.25 ,286% of BCBSTX fee schedule,$165.25 ,286% of BCBSTX fee schedule,$68.32 ,100% CMS Medicare OPPS fee schedule,$165.25 ,286% of BCBSTX fee schedule,$57.78 ,100% of BCBSTX fee schedule,$100.22 ,90% of total billed charges for oupatient setting,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$100.22 ,90% of total billed charges for oupatient setting,$68.32 ,100% CMS Medicare OPPS fee schedule,$68.32 ,100% CMS Medicare OPPS fee schedule,$68.32 ,100% CMS Medicare OPPS fee schedule,$44.41 ,65% CMS Medicare OPPS fee schedule,$49.11 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$105.78 ,95% of total billed charges for outpatient setting,$68.32 ,100% CMS Medicare OPPS fee schedule,$97.99 ,88% of total billed charges for outpatient setting,$97.99 ,88% of total billed charges for outpatient setting,$68.32 ,100% CMS Medicare OPPS fee schedule,$61.49 ,90% CMS Medicare OPPS fee schedule,$68.32 ,100% CMS Medicare OPPS fee schedule,$68.32 ,100% CMS Medicare OPPS fee schedule,$68.32 ,100% CMS Medicare OPPS fee schedule,$68.32 ,100% CMS Medicare OPPS fee schedule,$68.32 ,100% CMS Medicare OPPS fee schedule,$68.32 ,100% CMS Medicare OPPS fee schedule,$68.32 ,100% CMS Medicare OPPS fee schedule,$68.32 ,100% CMS Medicare OPPS fee schedule,$68.32 ,100% CMS Medicare OPPS fee schedule,$68.32 ,100% CMS Medicare OPPS fee schedule,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$50.11 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$44.41 ,$165.25 ,$72.38 
Outpatient Medical Services,PHYSICAL THERAPY,97597,PT Sel Debride<20 Hd/Trnk/Sacr,420,$414.37 ,$217.57 ,125% CMS Medicare OPPS fee schedule,$314.92 ,76%  of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$69.78 ,286% of BCBSTX fee schedule,$69.78 ,286% of BCBSTX fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$69.78 ,286% of BCBSTX fee schedule,$24.40 ,100% of BCBSTX fee schedule,$372.93 ,90% of total billed charges for oupatient setting,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$372.93 ,90% of total billed charges for oupatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$113.14 ,65% CMS Medicare OPPS fee schedule,$182.74 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$393.65 ,95% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$364.65 ,88% of total billed charges for outpatient setting,$364.65 ,88% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$146.27 ,90% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$24.40 ,$393.65 ,$269.34 
Outpatient Medical Services,PHYSICAL THERAPY,97605,PT NEG PRESS<50 SQ CM,420,$434.39 ,$217.58 ,125% CMS Medicare OPPS fee schedule,$330.14 ,76%  of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$483.20 ,286% of BCBSTX fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$168.95 ,100% of BCBSTX fee schedule,$390.95 ,90% of total billed charges for oupatient setting,$195.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$390.95 ,90% of total billed charges for oupatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$113.14 ,65% CMS Medicare OPPS fee schedule,$191.57 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$412.67 ,95% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$382.26 ,88% of total billed charges for outpatient setting,$382.26 ,88% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$146.27 ,90% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$195.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$195.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$195.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$195.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$195.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$195.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$195.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$195.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$195.48 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$113.14 ,$483.20 ,$282.35 
Outpatient Medical Services,PHYSICAL THERAPY,97610,PTA ULTRASLWFRQ NONTHER PR DAY,420,$426.03 ,$217.58 ,125% CMS Medicare OPPS fee schedule,$323.78 ,76%  of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$483.20 ,286% of BCBSTX fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$483.20 ,286% of BCBSTX fee schedule,$168.95 ,100% of BCBSTX fee schedule,$383.43 ,90% of total billed charges for oupatient setting,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$383.43 ,90% of total billed charges for oupatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$113.14 ,65% CMS Medicare OPPS fee schedule,$187.88 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$404.73 ,95% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$374.91 ,88% of total billed charges for outpatient setting,$374.91 ,88% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$146.27 ,90% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$191.71 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$113.14 ,$483.20 ,$276.92 
Outpatient Medical Services,PHYSICAL THERAPY,97598,PTA Select Debridement >20 LFT,420,$650.52 ,$650.52 ,125% CMS Medicare OPPS fee schedule,$494.40 ,76%  of total billed charges for outpatient setting,$650.52 ,100% CMS Medicare OPPS fee schedule,$32.83 ,286% of BCBSTX fee schedule,$32.83 ,286% of BCBSTX fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$32.83 ,286% of BCBSTX fee schedule,$11.48 ,100% of BCBSTX fee schedule,$585.47 ,90% of total billed charges for oupatient setting,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$585.47 ,90% of total billed charges for oupatient setting,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$422.84 ,65% of total billed charges for oupatient setting,$286.88 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$617.99 ,95% of total billed charges for outpatient setting,$650.52 ,100% CMS Medicare OPPS fee schedule,$572.46 ,88% of total billed charges for outpatient setting,$572.46 ,88% of total billed charges for outpatient setting,$650.52 ,100% CMS Medicare OPPS fee schedule,$585.47 ,90% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$650.52 ,100% CMS Medicare OPPS fee schedule,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$292.73 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$11.48 ,$650.52 ,$422.84 
Outpatient Medical Services,PHYSICAL THERAPY,97597,PTA Select Deb<20 Hd/trnk/sacr,420,$414.37 ,$217.57 ,125% CMS Medicare OPPS fee schedule,$314.92 ,76%  of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$69.78 ,286% of BCBSTX fee schedule,$69.78 ,286% of BCBSTX fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$69.78 ,286% of BCBSTX fee schedule,$24.40 ,100% of BCBSTX fee schedule,$372.93 ,90% of total billed charges for oupatient setting,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$372.93 ,90% of total billed charges for oupatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$113.14 ,65% CMS Medicare OPPS fee schedule,$182.74 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$393.65 ,95% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$364.65 ,88% of total billed charges for outpatient setting,$364.65 ,88% of total billed charges for outpatient setting,$174.06 ,100% CMS Medicare OPPS fee schedule,$146.27 ,90% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$174.06 ,100% CMS Medicare OPPS fee schedule,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$186.47 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$24.40 ,$393.65 ,$269.34 
Outpatient Medical Services,PHYSICAL THERAPY,97033,PTA IONTOPHRSISATTND/15,420,$119.07 ,$24.20 ,125% CMS Medicare OPPS fee schedule,$90.49 ,76%  of total billed charges for outpatient setting,$19.36 ,100% CMS Medicare OPPS fee schedule,$60.55 ,286% of BCBSTX fee schedule,$60.55 ,286% of BCBSTX fee schedule,$19.36 ,100% CMS Medicare OPPS fee schedule,$60.55 ,286% of BCBSTX fee schedule,$21.17 ,100% of BCBSTX fee schedule,$107.16 ,90% of total billed charges for oupatient setting,$53.58 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$107.16 ,90% of total billed charges for oupatient setting,$19.36 ,100% CMS Medicare OPPS fee schedule,$19.36 ,100% CMS Medicare OPPS fee schedule,$19.36 ,100% CMS Medicare OPPS fee schedule,$12.58 ,65% CMS Medicare OPPS fee schedule,$52.51 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$113.12 ,95% of total billed charges for outpatient setting,$19.36 ,100% CMS Medicare OPPS fee schedule,$104.78 ,88% of total billed charges for outpatient setting,$104.78 ,88% of total billed charges for outpatient setting,$19.36 ,100% CMS Medicare OPPS fee schedule,$17.42 ,90% CMS Medicare OPPS fee schedule,$19.36 ,100% CMS Medicare OPPS fee schedule,$19.36 ,100% CMS Medicare OPPS fee schedule,$19.36 ,100% CMS Medicare OPPS fee schedule,$19.36 ,100% CMS Medicare OPPS fee schedule,$19.36 ,100% CMS Medicare OPPS fee schedule,$19.36 ,100% CMS Medicare OPPS fee schedule,$19.36 ,100% CMS Medicare OPPS fee schedule,$19.36 ,100% CMS Medicare OPPS fee schedule,$19.36 ,100% CMS Medicare OPPS fee schedule,$19.36 ,100% CMS Medicare OPPS fee schedule,$53.58 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$53.58 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$53.58 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$53.58 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$53.58 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$53.58 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$53.58 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$53.58 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$53.58 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$12.58 ,$113.12 ,$77.40 
Outpatient Medical Services,PHYSICAL THERAPY,29580,PT UNNA BOOT APPLIC  BILAT,420,$242.13 ,$175.62 ,125% CMS Medicare OPPS fee schedule,$184.02 ,76%  of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$174.33 ,72% of total billed charges for outpatient setting,$181.60 ,75% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$174.33 ,72% of total billed charges for outpatient setting,$145.28 ,60% of total billed charges for outpatient setting,$217.92 ,90% of total billed charges for oupatient setting,$108.96 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$217.92 ,90% of total billed charges for oupatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$91.33 ,65% CMS Medicare OPPS fee schedule,$106.78 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$230.02 ,95% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$213.07 ,88% of total billed charges for outpatient setting,$213.07 ,88% of total billed charges for outpatient setting,$140.50 ,100% CMS Medicare OPPS fee schedule,$118.06 ,90% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$140.50 ,100% CMS Medicare OPPS fee schedule,$108.96 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$108.96 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$108.96 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$108.96 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$108.96 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$108.96 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$108.96 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$108.96 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$108.96 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$91.33 ,$230.02 ,$157.38 
Outpatient Medical Services,PHYSICAL THERAPY,97018,PTA PARAFFINMODALITY,420,$127.89 ,$6.88 ,125% CMS Medicare OPPS fee schedule,$97.20 ,76%  of total billed charges for outpatient setting,$5.50 ,100% CMS Medicare OPPS fee schedule,$25.65 ,286% of BCBSTX fee schedule,$25.65 ,286% of BCBSTX fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$25.65 ,286% of BCBSTX fee schedule,$8.97 ,100% of BCBSTX fee schedule,$115.10 ,90% of total billed charges for oupatient setting,$57.55 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$115.10 ,90% of total billed charges for oupatient setting,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$3.58 ,65% CMS Medicare OPPS fee schedule,$56.40 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$121.50 ,95% of total billed charges for outpatient setting,$5.50 ,100% CMS Medicare OPPS fee schedule,$112.54 ,88% of total billed charges for outpatient setting,$112.54 ,88% of total billed charges for outpatient setting,$5.50 ,100% CMS Medicare OPPS fee schedule,$4.95 ,90% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$5.50 ,100% CMS Medicare OPPS fee schedule,$57.55 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$57.55 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$57.55 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$57.55 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$57.55 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$57.55 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$57.55 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$57.55 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$57.55 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$3.58 ,$121.50 ,$83.13 
Outpatient Medical Services,PHYSICAL THERAPY,97032,PTA ELEC STIM MAN 15 MIN,420,$214.99 ,$17.75 ,125% CMS Medicare OPPS fee schedule,$163.39 ,76%  of total billed charges for outpatient setting,$14.20 ,100% CMS Medicare OPPS fee schedule,$45.16 ,286% of BCBSTX fee schedule,$45.16 ,286% of BCBSTX fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$45.16 ,286% of BCBSTX fee schedule,$15.79 ,100% of BCBSTX fee schedule,$193.49 ,90% of total billed charges for oupatient setting,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$193.49 ,90% of total billed charges for oupatient setting,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$9.23 ,65% CMS Medicare OPPS fee schedule,$94.81 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$204.24 ,95% of total billed charges for outpatient setting,$14.20 ,100% CMS Medicare OPPS fee schedule,$189.19 ,88% of total billed charges for outpatient setting,$189.19 ,88% of total billed charges for outpatient setting,$14.20 ,100% CMS Medicare OPPS fee schedule,$12.78 ,90% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$14.20 ,100% CMS Medicare OPPS fee schedule,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$96.75 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$9.23 ,$204.24 ,$139.74 
Outpatient Medical Services,PHYSICAL THERAPY,97150,PT GROUP THERAPY,423,$102.53 ,$21.85 ,125% CMS Medicare OPPS fee schedule,$77.92 ,76%  of total billed charges for outpatient setting,$17.48 ,100% CMS Medicare OPPS fee schedule,$53.37 ,286% of BCBSTX fee schedule,$53.37 ,286% of BCBSTX fee schedule,$17.48 ,100% CMS Medicare OPPS fee schedule,$53.37 ,286% of BCBSTX fee schedule,$18.66 ,100% of BCBSTX fee schedule,$92.28 ,90% of total billed charges for oupatient setting,$46.14 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$92.28 ,90% of total billed charges for oupatient setting,$17.48 ,100% CMS Medicare OPPS fee schedule,$17.48 ,100% CMS Medicare OPPS fee schedule,$17.48 ,100% CMS Medicare OPPS fee schedule,$11.36 ,65% CMS Medicare OPPS fee schedule,$45.22 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$97.40 ,95% of total billed charges for outpatient setting,$17.48 ,100% CMS Medicare OPPS fee schedule,$90.23 ,88% of total billed charges for outpatient setting,$90.23 ,88% of total billed charges for outpatient setting,$17.48 ,100% CMS Medicare OPPS fee schedule,$15.73 ,90% CMS Medicare OPPS fee schedule,$17.48 ,100% CMS Medicare OPPS fee schedule,$17.48 ,100% CMS Medicare OPPS fee schedule,$17.48 ,100% CMS Medicare OPPS fee schedule,$17.48 ,100% CMS Medicare OPPS fee schedule,$17.48 ,100% CMS Medicare OPPS fee schedule,$17.48 ,100% CMS Medicare OPPS fee schedule,$17.48 ,100% CMS Medicare OPPS fee schedule,$17.48 ,100% CMS Medicare OPPS fee schedule,$17.48 ,100% CMS Medicare OPPS fee schedule,$17.48 ,100% CMS Medicare OPPS fee schedule,$46.14 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$46.14 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$46.14 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$46.14 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$46.14 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$46.14 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$46.14 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$46.14 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$46.14 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$11.36 ,$97.40 ,$66.64 
Outpatient Medical Services,PHYSICAL THERAPY,97606,PT NEG PRESS>50 SQ CM,420,$543.53 ,$449.52 ,125% CMS Medicare OPPS fee schedule,$413.08 ,76%  of total billed charges for outpatient setting,$359.61 ,100% CMS Medicare OPPS fee schedule,$888.89 ,286% of BCBSTX fee schedule,$888.89 ,286% of BCBSTX fee schedule,$359.61 ,100% CMS Medicare OPPS fee schedule,$888.89 ,286% of BCBSTX fee schedule,$310.80 ,100% of BCBSTX fee schedule,$489.18 ,90% of total billed charges for oupatient setting,$244.59 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$489.18 ,90% of total billed charges for oupatient setting,$359.61 ,100% CMS Medicare OPPS fee schedule,$359.61 ,100% CMS Medicare OPPS fee schedule,$359.61 ,100% CMS Medicare OPPS fee schedule,$233.75 ,65% CMS Medicare OPPS fee schedule,$239.70 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,$516.35 ,95% of total billed charges for outpatient setting,$359.61 ,100% CMS Medicare OPPS fee schedule,$478.31 ,88% of total billed charges for outpatient setting,$478.31 ,88% of total billed charges for outpatient setting,$359.61 ,100% CMS Medicare OPPS fee schedule,$302.20 ,90% CMS Medicare OPPS fee schedule,$359.61 ,100% CMS Medicare OPPS fee schedule,$359.61 ,100% CMS Medicare OPPS fee schedule,$359.61 ,100% CMS Medicare OPPS fee schedule,$359.61 ,100% CMS Medicare OPPS fee schedule,$359.61 ,100% CMS Medicare OPPS fee schedule,$359.61 ,100% CMS Medicare OPPS fee schedule,$359.61 ,100% CMS Medicare OPPS fee schedule,$359.61 ,100% CMS Medicare OPPS fee schedule,$359.61 ,100% CMS Medicare OPPS fee schedule,$359.61 ,100% CMS Medicare OPPS fee schedule,$244.59 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$244.59 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$244.59 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$244.59 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$244.59 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$244.59 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$244.59 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$244.59 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$244.59 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$233.75 ,$888.89 ,$353.29 
Outpatient Medical Services,INJECTION,62323,EPID INJ LUMB OR SACRAL W/IMAGE,761,"$2,113.49 ",$776.37 ,125% CMS Medicare OPPS fee schedule,"$1,606.25 ",76%  of total billed charges for outpatient setting,$621.10 ,100% CMS Medicare OPPS fee schedule,"$1,521.71 ",72% of total billed charges for outpatient setting,"$1,585.12 ",75% of total billed charges for outpatient setting,$621.10 ,100% CMS Medicare OPPS fee schedule,"$1,521.71 ",72% of total billed charges for outpatient setting,"$1,268.09 ",60% of total billed charges for outpatient setting,"$1,902.14 ",90% of total billed charges for oupatient setting,$951.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$1,902.14 ",90% of total billed charges for oupatient setting,$621.10 ,100% CMS Medicare OPPS fee schedule,$621.10 ,100% CMS Medicare OPPS fee schedule,$621.10 ,100% CMS Medicare OPPS fee schedule,$403.72 ,65% CMS Medicare OPPS fee schedule,$932.05 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,"$2,007.82 ",95% of total billed charges for outpatient setting,$621.10 ,100% CMS Medicare OPPS fee schedule,"$1,859.87 ",88% of total billed charges for outpatient setting,"$1,859.87 ",88% of total billed charges for outpatient setting,$621.10 ,100% CMS Medicare OPPS fee schedule,$521.92 ,90% CMS Medicare OPPS fee schedule,$621.10 ,100% CMS Medicare OPPS fee schedule,$621.10 ,100% CMS Medicare OPPS fee schedule,$621.10 ,100% CMS Medicare OPPS fee schedule,$621.10 ,100% CMS Medicare OPPS fee schedule,$621.10 ,100% CMS Medicare OPPS fee schedule,$621.10 ,100% CMS Medicare OPPS fee schedule,$621.10 ,100% CMS Medicare OPPS fee schedule,$621.10 ,100% CMS Medicare OPPS fee schedule,$621.10 ,100% CMS Medicare OPPS fee schedule,$621.10 ,100% CMS Medicare OPPS fee schedule,$951.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$951.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$951.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$951.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$951.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$951.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$951.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$951.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$951.07 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$403.72 ,"$2,007.82 ","$1,373.77 "
Outpatient Medical Services,INJECTION,64483,EPIDURAL INJ FORAMEN L/S 1 LEV,761,"$2,052.86 ","$1,026.81 ",125% CMS Medicare OPPS fee schedule,"$1,560.17 ",76%  of total billed charges for outpatient setting,$821.44 ,100% CMS Medicare OPPS fee schedule,"$1,478.06 ",72% of total billed charges for outpatient setting,"$1,539.65 ",75% of total billed charges for outpatient setting,$821.44 ,100% CMS Medicare OPPS fee schedule,"$1,478.06 ",72% of total billed charges for outpatient setting,"$1,231.72 ",60% of total billed charges for outpatient setting,"$1,847.57 ",90% of total billed charges for oupatient setting,$923.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$1,847.57 ",90% of total billed charges for oupatient setting,$821.44 ,100% CMS Medicare OPPS fee schedule,$821.44 ,100% CMS Medicare OPPS fee schedule,$821.44 ,100% CMS Medicare OPPS fee schedule,$533.94 ,65% CMS Medicare OPPS fee schedule,$905.31 ,44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,"$1,950.22 ",95% of total billed charges for outpatient setting,$821.44 ,100% CMS Medicare OPPS fee schedule,"$1,806.52 ",88% of total billed charges for outpatient setting,"$1,806.52 ",88% of total billed charges for outpatient setting,$821.44 ,100% CMS Medicare OPPS fee schedule,$690.29 ,90% CMS Medicare OPPS fee schedule,$821.44 ,100% CMS Medicare OPPS fee schedule,$821.44 ,100% CMS Medicare OPPS fee schedule,$821.44 ,100% CMS Medicare OPPS fee schedule,$821.44 ,100% CMS Medicare OPPS fee schedule,$821.44 ,100% CMS Medicare OPPS fee schedule,$821.44 ,100% CMS Medicare OPPS fee schedule,$821.44 ,100% CMS Medicare OPPS fee schedule,$821.44 ,100% CMS Medicare OPPS fee schedule,$821.44 ,100% CMS Medicare OPPS fee schedule,$821.44 ,100% CMS Medicare OPPS fee schedule,$923.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$923.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$923.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$923.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$923.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$923.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$923.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$923.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$923.79 ,45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,$533.94 ,"$1,950.22 ","$1,334.36 "
Outpatient Medical Services,SURGERY,55700,US PROSTATE BIOPSY,402,"$4,637.20 ","$2,234.98 ",125% CMS Medicare OPPS fee schedule,"$3,524.27 ",76%  of total billed charges for outpatient setting,"$1,787.99 ",100% CMS Medicare OPPS fee schedule,"$3,338.78 ",72% of total billed charges for outpatient setting,"$3,477.90 ",75% of total billed charges for outpatient setting,"$1,787.99 ",100% CMS Medicare OPPS fee schedule,"$3,338.78 ",72% of total billed charges for outpatient setting,"$2,782.32 ",60% of total billed charges for outpatient setting,"$4,173.48 ",90% of total billed charges for oupatient setting,"$2,086.74 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$4,173.48 ",90% of total billed charges for oupatient setting,"$1,787.99 ",100% CMS Medicare OPPS fee schedule,"$1,787.99 ",100% CMS Medicare OPPS fee schedule,"$1,787.99 ",100% CMS Medicare OPPS fee schedule,"$1,162.19 ",65% CMS Medicare OPPS fee schedule,"$2,045.01 ",44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,"$4,405.34 ",95% of total billed charges for outpatient setting,"$1,787.99 ",100% CMS Medicare OPPS fee schedule,"$4,080.74 ",88% of total billed charges for outpatient setting,"$4,080.74 ",88% of total billed charges for outpatient setting,"$1,787.99 ",100% CMS Medicare OPPS fee schedule,"$1,502.51 ",90% CMS Medicare OPPS fee schedule,"$1,787.99 ",100% CMS Medicare OPPS fee schedule,"$1,787.99 ",100% CMS Medicare OPPS fee schedule,"$1,787.99 ",100% CMS Medicare OPPS fee schedule,"$1,787.99 ",100% CMS Medicare OPPS fee schedule,"$1,787.99 ",100% CMS Medicare OPPS fee schedule,"$1,787.99 ",100% CMS Medicare OPPS fee schedule,"$1,787.99 ",100% CMS Medicare OPPS fee schedule,"$1,787.99 ",100% CMS Medicare OPPS fee schedule,"$1,787.99 ",100% CMS Medicare OPPS fee schedule,"$1,787.99 ",100% CMS Medicare OPPS fee schedule,"$2,086.74 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$2,086.74 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$2,086.74 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$2,086.74 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$2,086.74 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$2,086.74 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$2,086.74 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$2,086.74 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$2,086.74 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$1,162.19 ","$4,405.34 ","$3,014.18 "
Outpatient Medical Services,SURGERY,93452,LHC LV ONLY,481,"$13,586.11 ","$3,564.72 ",125% CMS Medicare OPPS fee schedule,"$10,325.44 ",76%  of total billed charges for outpatient setting,"$2,851.78 ",100% CMS Medicare OPPS fee schedule,"$9,782.00 ",72% of total billed charges for outpatient setting,"$10,189.58 ",75% of total billed charges for outpatient setting,"$2,851.78 ",100% CMS Medicare OPPS fee schedule,"$9,782.00 ",72% of total billed charges for outpatient setting,"$8,151.67 ",60% of total billed charges for outpatient setting,"$12,227.50 ",90% of total billed charges for oupatient setting,"$6,113.75 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$12,227.50 ",90% of total billed charges for oupatient setting,"$2,851.78 ",100% CMS Medicare OPPS fee schedule,"$2,851.78 ",100% CMS Medicare OPPS fee schedule,"$2,851.78 ",100% CMS Medicare OPPS fee schedule,"$1,853.66 ",65% CMS Medicare OPPS fee schedule,"$5,991.47 ",44.1% of total billed charges for outpatient setting which is 98% of the TX Medicaid OP CCR rate,"$12,906.80 ",95% of total billed charges for outpatient setting,"$2,851.78 ",100% CMS Medicare OPPS fee schedule,"$11,955.78 ",88% of total billed charges for outpatient setting,"$11,955.78 ",88% of total billed charges for outpatient setting,"$2,851.78 ",100% CMS Medicare OPPS fee schedule,"$2,396.44 ",90% CMS Medicare OPPS fee schedule,"$2,851.78 ",100% CMS Medicare OPPS fee schedule,"$2,851.78 ",100% CMS Medicare OPPS fee schedule,"$2,851.78 ",100% CMS Medicare OPPS fee schedule,"$2,851.78 ",100% CMS Medicare OPPS fee schedule,"$2,851.78 ",100% CMS Medicare OPPS fee schedule,"$2,851.78 ",100% CMS Medicare OPPS fee schedule,"$2,851.78 ",100% CMS Medicare OPPS fee schedule,"$2,851.78 ",100% CMS Medicare OPPS fee schedule,"$2,851.78 ",100% CMS Medicare OPPS fee schedule,"$2,851.78 ",100% CMS Medicare OPPS fee schedule,"$6,113.75 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$6,113.75 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$6,113.75 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$6,113.75 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$6,113.75 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$6,113.75 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$6,113.75 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$6,113.75 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$6,113.75 ",45% of total billed charges for outpatient setting which is 100% of the TX Medicaid OP CCR rate,"$1,853.66 ","$12,906.80 ","$8,830.97 "
Outpatient Medical Services,BEHAVIORAL,90837,"Psychotherapy, 60 minutes",900,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,BEHAVIORAL,90846,"Family psychotherapy, not including patient, 50 minutes",900,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99243,"Patient office consultation, typically 40 min",761,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99244,"Patient office consultation, typically 60 min",761,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99385,"Initial new patient preventive medicine evaluation, for those ages 18 to 39",761,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OFFICE VISIT,99386,"Initial new patient preventive medicine evaluation, for those ages 40 to 64",761,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,LAB,80055,Obstetric blood test panel,300,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,LAB,81000,Manual urinalysis test with examination using microscope,300,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,LAB,81002,Automated urinalysis test,300,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,42820,Removal of tonsils and adenoid glands patient younger than age 12,360,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,45391,Ultrasound examination of lower large bowel using an endoscope,360,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,55866,Surgical removal of prostate and surrounding lymph nodes using an endoscope,360,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,59400,"Routine obstetric care for vaginal delivery, including pre-and post-delivery care",720,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,59510,"Routine obstetric care for cesarean delivery, including pre-and post-delivery care",720,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,59610,Routine obstetric care for vaginal delivery after prior cesarean delivery including pre-and post-delivery care,720,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,66821,Removal of recurring cataract in lens capsule using laser,360,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,OUTPATIENT SERVICES,66984,Removal of cataract with insertion of lens,360,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Outpatient Medical Services,SLEEP STUDY,95810,Sleep study,920,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Inpatient Medical Services,IP MS DRG,216,Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with major complications or comorbidities,100,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Inpatient Medical Services,IP MS DRG,460,Spinal fusion except cervical without major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Inpatient Medical Services,IP MS DRG,470,Major joint replacement or reattachment of lower extremity without major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A
Inpatient Medical Services,IP MS DRG,473,Cervical spinal fusion without comorbid conditions or major comorbid conditions or complications,100,SERVICE NOT OFFERED,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,Not seperately reimbursable. Service not offered,N/A,N/A,N/A