""XR FOREARM LEFT"" at Stonewall Memorial Hospital

79502, TX

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Pricing by billing methodology

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Payers reporting CPT 73090-LT at Stonewall Memorial Hospital

Negotiated rates from the hospital’s own file: 5 payers, 8 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Aetna mdc adv percent of total billed charges · outpatientfrom % of charges	$77	$77	—	—	—	$77 – $77
2	Humana mdc adv percent of total billed charges · outpatientfrom % of charges	$77	$77	—	—	—	$77 – $77
3	UnitedHealthcare mdc adv percent of total billed charges · outpatientfrom % of charges	$77	$77	—	—	—	$77 – $77
4	Cigna comm percent of total billed charges · inpatientfrom % of charges	$98	$98	—	—	—	$98 – $98
5	Cigna comm percent of total billed charges · outpatientfrom % of charges	$98	$98	—	—	—	$98 – $98
6	UnitedHealthcare comm percent of total billed charges · outpatientfrom % of charges	$98	$98	—	—	—	$98 – $98
7	Blue Cross Blue Shield comm percent of total billed charges · inpatientfrom % of charges	$112	$112	—	—	—	$112 – $112
8	Blue Cross Blue Shield comm percent of total billed charges · outpatientfrom % of charges	$112	$112	—	—	—	$112 – $112

Last updated: Mar 11, 2026

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