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Showing 20 of 20 matching rows
Service | Code | Rev Code | Payer | Gross Charge | Discounted Cash Price | Negotiated Rate | Avg Patient Responsibility |
|---|---|---|---|---|---|---|---|
New patient office or other outpatient visit, typically 30 min | 99203 | 0521 | BCBS CHOICE | $149.00 | $74.50 | $26.26 | $43.77 |
New patient office or other outpatient visit, typically 30 min | 99203 | 0521 | BCBS TRADITIONAL | $149.00 | $74.50 | $26.26 | $43.61 |
New patient office or other outpatient visit, typically 30 min | 99203 | 0521 | HEALTHCHOICE | $149.00 | $74.50 | $125.69 | $67.99 |
New patient office or other outpatient visit, typically 30 min | 99203 | 0521 | HUMANA MEDICAID | $149.00 | $74.50 | $145.79 | $17.81 |
New patient office or other outpatient visit, typically 30 min | 99203 | 0521 | HUMANA MEDICARE | $149.00 | $74.50 | $139.00 | $41.16 |
New patient office or other outpatient visit, typically 30 min | 99203 | 0521 | MEDICAID | $149.00 | $74.50 | $6.83 | |
New patient office or other outpatient visit, typically 30 min | 99203 | 0521 | MEDICARE | $149.00 | $74.50 | $127.00 | $36.50 |
New patient office or other outpatient visit, typically 30 min | 99203 | 0521 | Self Pay | $149.00 | $74.50 | ||
New patient office or other outpatient visit, typically 30 min | 99203 | 0521 | TRICARE FOR LIFE | $149.00 | $74.50 | $120.23 | $64.00 |
New patient office or other outpatient visit, typically 45 min | 99204 | 0510 | AETNA | $162.00 | $81.00 | $122.18 | $59.50 |
New patient office or other outpatient visit, typically 45 min | 99204 | 0510 | BCBS ADVANTAGE | $162.00 | $81.00 | $162.00 | $46.61 |
New patient office or other outpatient visit, typically 45 min | 99204 | 0510 | BCBS CHOICE | $162.00 | $81.00 | $24.44 | $52.35 |
New patient office or other outpatient visit, typically 45 min | 99204 | 0510 | BCBS PREFERRED | $162.00 | $81.00 | $26.26 | $54.28 |
New patient office or other outpatient visit, typically 45 min | 99204 | 0510 | BCBS TRADITIONAL | $162.00 | $81.00 | $24.44 | $56.10 |
New patient office or other outpatient visit, typically 45 min | 99204 | 0510 | CHAMPVA | $162.00 | $81.00 | $122.18 | $39.43 |
New patient office or other outpatient visit, typically 45 min | 99204 | 0510 | HEALTHCHOICE | $162.00 | $81.00 | $76.89 | |
New patient office or other outpatient visit, typically 45 min | 99204 | 0510 | HUMANA MEDICAID | $162.00 | $81.00 | $150.60 | |
New patient office or other outpatient visit, typically 45 min | 99204 | 0510 | HUMANA MEDICARE | $162.00 | $81.00 | $139.00 | $42.47 |
New patient office or other outpatient visit, typically 45 min | 99204 | 0510 | MEDICARE | $162.00 | $81.00 | $162.00 | $36.42 |
New patient office or other outpatient visit, typically 45 min | 99204 | 0510 | Self Pay | $162.00 | $81.00 |
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