AllyAlign Health: disclosed hospital rates

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Based on the published hospital price files, AllyAlign Health appears in disclosed negotiated rates across 5 hospitals and 245 services. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.

245 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
""Y SET"" TUBING Outpatient	CHRISTUS Coushatta Health Care Center	A4719 HCPCS	—	—	—	—
<50% TOTAL PT OUTPT RA ENCTS Outpatient	CHRISTUS Coushatta Health Care Center	M1008 HCPCS	—	—	—	—
<6YR NEW ONSET HD ACHE Outpatient	CHRISTUS Coushatta Health Care Center	G2193 HCPCS	—	—	—	—
>= 2 SAME HI-RSK MED NOT ORD Outpatient	CHRISTUS Coushatta Health Care Center	G9368 HCPCS	—	—	—	—
>= 2 SAME HI-RSK MED ORD Outpatient	CHRISTUS Coushatta Health Care Center	G9367 HCPCS	—	—	—	—
>=2 SAME HI-RSK MED W/O DIAG Outpatient	CHRISTUS Coushatta Health Care Center	M1209 HCPCS	—	—	—	—
>=2 SAME MEDS TBL4 NOT ORD Outpatient	CHRISTUS Coushatta Health Care Center	M1210 HCPCS	—	—	—	—
>=50% TOTAL PT OUTPT RA ENCT Outpatient	CHRISTUS Coushatta Health Care Center	M1007 HCPCS	—	—	—	—
>=86Y NO HX COLO CA/RSN SCOP Outpatient	CHRISTUS Coushatta Health Care Center	G9659 HCPCS	—	—	—	—
>55 YRS TEMP HD ACHE Outpatient	CHRISTUS Coushatta Health Care Center	G2192 HCPCS	—	—	—	—
1 ADMN RSV MONOC ANTB IM NJX Outpatient	CHRISTUS Coushatta Health Care Center	96381 CPT	—	—	$105 – $105	—
1 BOD TEMP >=35.5 Outpatient	CHRISTUS Coushatta Health Care Center	G9773 HCPCS	—	—	—	—
1 BODYTEMP >=35.5CW/IN 30MIN Outpatient	CHRISTUS Coushatta Health Care Center	4559F CPT	—	—	—	—
1 CC STERILE SYRINGE&NEEDLE Outpatient	CHRISTUS Coushatta Health Care Center	A4206 HCPCS	—	—	—	—
1 EM CORE SESSION Outpatient	CHRISTUS Coushatta Health Care Center	G9873 HCPCS	—	—	—	—
1 MED VISIT IN 24MO Outpatient	CHRISTUS Coushatta Health Care Center	G9247 HCPCS	—	—	—	—
1 OR NO CT SINUS W/IN 90D DX Outpatient	CHRISTUS Coushatta Health Care Center	G9354 HCPCS	—	—	—	—
100 INSULIN SYRINGES Outpatient	CHRISTUS Coushatta Health Care Center	S8490 HCPCS	—	—	—	—
12-LEAD ECG PERFORMED Outpatient	CHRISTUS Coushatta Health Care Center	3120F CPT	—	—	—	—
1DOSE MENIG VAC BTWN 11 & 13 Outpatient	CHRISTUS Coushatta Health Care Center	G9414 HCPCS	—	—	—	—
1ST HOSP IP/OBS HIGH 75 Outpatient	CHRISTUS Coushatta Health Care Center	99223 CPT	—	—	$3,632 – $3,632	—
1ST HOSP IP/OBS MODERATE 55 Outpatient	CHRISTUS Coushatta Health Care Center	99222 CPT	—	—	$3,632 – $3,632	—
1ST HOSP IP/OBS SF/LOW 40 Outpatient	CHRISTUS Coushatta Health Care Center	99221 CPT	—	—	$3,632 – $3,632	—
1ST NF CARE HIGH MDM 50 Outpatient	CHRISTUS Coushatta Health Care Center	99306 CPT	—	—	—	—
1ST NF CARE MODERATE MDM 35 Outpatient	CHRISTUS Coushatta Health Care Center	99305 CPT	—	—	—	—