Amerigroup: disclosed hospital rates

iDirect answer

Based on the published hospital price files, Amerigroup appears in disclosed negotiated rates across 4 hospitals and 6624 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.

6,624 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
""Y SET"" TUBING Outpatient	CHRISTUS Health - West Beaumont	A4719 HCPCS	—	—	—	—
<50% TOTAL PT OUTPT RA ENCTS Outpatient	CHRISTUS Health - West Beaumont	M1008 HCPCS	—	—	—	—
<6YR NEW ONSET HD ACHE Outpatient	CHRISTUS Health - West Beaumont	G2193 HCPCS	—	—	—	—
>= 2 SAME HI-RSK MED NOT ORD Outpatient	CHRISTUS Health - West Beaumont	G9368 HCPCS	—	—	—	—
>= 2 SAME HI-RSK MED ORD Outpatient	CHRISTUS Health - West Beaumont	G9367 HCPCS	—	—	—	—
>=2 SAME HI-RSK MED W/O DIAG Outpatient	CHRISTUS Health - West Beaumont	M1209 HCPCS	—	—	—	—
>=2 SAME MEDS TBL4 NOT ORD Outpatient	CHRISTUS Health - West Beaumont	M1210 HCPCS	—	—	—	—
>=50% TOTAL PT OUTPT RA ENCT Outpatient	CHRISTUS Health - West Beaumont	M1007 HCPCS	—	—	—	—
>=86Y NO HX COLO CA/RSN SCOP Outpatient	CHRISTUS Health - West Beaumont	G9659 HCPCS	—	—	—	—
>55 YRS TEMP HD ACHE Outpatient	CHRISTUS Health - West Beaumont	G2192 HCPCS	—	—	—	—
0.45% NaCl + KCl 20 mEq/L infusion Outpatient	CHRISTUS Health - West Beaumont	J3480 HCPCS	$147	$48.39	$0.18 – $125	—
0.9% NaCl + KCl 20 mEq/L infusion Outpatient	CHRISTUS Health - West Beaumont	J3480 HCPCS	$147	$48.39	$0.18 – $125	—
0.9% NaCl + KCl 40 mEq/L infusion Outpatient	CHRISTUS Health - West Beaumont	J3480 HCPCS	$147	$48.39	$0.18 – $125	—
1 BOD TEMP >=35.5 Outpatient	CHRISTUS Health - West Beaumont	G9773 HCPCS	—	—	—	—
1 BODYTEMP >=35.5CW/IN 30MIN Outpatient	CHRISTUS Health - West Beaumont	4559F CPT	—	—	—	—
1 CC STERILE SYRINGE&NEEDLE Outpatient	CHRISTUS Health - West Beaumont	A4206 HCPCS	—	—	$0.76 – $0.76	—
1 EM CORE SESSION Outpatient	CHRISTUS Health - West Beaumont	G9873 HCPCS	—	—	$214 – $306	—
1 MED VISIT IN 24MO Outpatient	CHRISTUS Health - West Beaumont	G9247 HCPCS	—	—	—	—
1 OR NO CT SINUS W/IN 90D DX Outpatient	CHRISTUS Health - West Beaumont	G9354 HCPCS	—	—	—	—
100 INSULIN SYRINGES Outpatient	CHRISTUS Health - West Beaumont	S8490 HCPCS	—	—	—	—
11-DEOXYCORTISOL REF1 Outpatient	Texas Health Center for Diagnostics and Surgery Plano	82634 CPT	$286	$171	$24.60 – $269	—
11042 DEBRID SKN & SUBCU TIS Outpatient	Texas Health Center for Diagnostics and Surgery Plano	11042 CPT	$1,859	$1,115	$172 – $1,749	—
12-LEAD ECG PERFORMED Outpatient	CHRISTUS Health - West Beaumont	3120F CPT	—	—	—	—
12031 LAC INTRM (<1") Outpatient	Texas Health Center for Diagnostics and Surgery Plano	12031 CPT	$749	$449	$143 – $705	—
17 OH PROGESTERONE REF1 Outpatient	Texas Health Center for Diagnostics and Surgery Plano	83498 CPT	$240	$144	$22.82 – $225	—