Questions & corrections

Northeastern Health System Sequoyah · Office o/p est low 20 min

$170.25

Source file dated 2026-02-10 · both

Source note: Emergency Room - $300/case, Observation - $900/case, CT scans - $350/case, MRIs - $450/case, OP cardiac surgeries - $3500/case, Ambulatory Surgery, per case: Group 1 - $482, Group 2 - $646, Group 3 - $738, Group 4 - $912, Group 5 - $1038, Group 6 - $1204, Group 7 - $1440, Group 8 - $1416, Group 9 - $1938, Ungrouped - $912. All other OP services except Lab/Path - 60% of billed charges per line item. Lab/Path: lesser of 70% of OK RBRVS fee schedule per procedure or 60% of hospital's billed charges. Medical Supply - DME: lesser of 60% of ChoiceCare's 005-270 fee schedule or charges, less patient portion for covered for items listed in the fee schedule; 50% of charges, minus patient portion, for items not in the fee schedule. Physician claims (lesser of rates below or billed charges, minus patient portion): drugs & biologicals - 100% of ChoiceCare's 201-544 fee schedule, lab - 65% of ChoiceCare's 005-731 fee schedule, radiology - 87% of ChoiceCare's 201-581 fee schedule, oncology drugs - 100% of 201-580 fee schedule, all other services - 85% of ChoiceCare's 005-731 fee schedule for midlevels, 120% for providers.