|
PIN TO ROD DELTA COUPLING
|
Facility
|
OP
|
$2,806.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006435
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$701.50 |
| Max. Negotiated Rate |
$2,665.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,683.60
|
| Rate for Payer: Cash Price |
$1,683.60
|
| Rate for Payer: Cash Price |
$1,683.60
|
| Rate for Payer: Cigna Commercial |
$2,385.10
|
| Rate for Payer: First Health Commercial |
$2,525.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,525.40
|
| Rate for Payer: GEHA Commercial |
$2,244.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,525.40
|
| Rate for Payer: Humana ChoiceCare |
$729.56
|
| Rate for Payer: Multiplan All |
$2,553.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,683.60
|
| Rate for Payer: OMNI Networks Commercial |
$1,964.20
|
| Rate for Payer: One Health Plan PPO/POS |
$2,525.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,665.70
|
| Rate for Payer: Three Rivers Provider Network All |
$2,104.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,469.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$701.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,609.58
|
| Rate for Payer: Zelis Auto |
$1,122.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,403.00
|
|
|
PIN TO ROD DELTA COUPLING
|
Facility
|
IP
|
$2,806.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006435
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,122.40 |
| Max. Negotiated Rate |
$2,665.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,244.80
|
| Rate for Payer: Cash Price |
$1,683.60
|
| Rate for Payer: Cash Price |
$1,683.60
|
| Rate for Payer: Cigna Commercial |
$2,385.10
|
| Rate for Payer: First Health Commercial |
$2,525.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,525.40
|
| Rate for Payer: GEHA Commercial |
$1,964.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,525.40
|
| Rate for Payer: Multiplan All |
$2,553.46
|
| Rate for Payer: OMNI Networks Commercial |
$1,964.20
|
| Rate for Payer: One Health Plan PPO/POS |
$2,525.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,665.70
|
| Rate for Payer: Three Rivers Provider Network All |
$2,104.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,609.58
|
| Rate for Payer: Zelis Auto |
$1,122.40
|
|
|
PIN ULNAR STYLOID FRACTURE
|
Facility
|
OP
|
$978.00
|
|
|
Service Code
|
CPT 25651
|
| Hospital Charge Code |
6125651
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$266.99 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,613.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$586.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,613.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,070.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$586.80
|
| Rate for Payer: Cash Price |
$586.80
|
| Rate for Payer: Cigna Commercial |
$831.30
|
| Rate for Payer: First Health Commercial |
$880.20
|
| Rate for Payer: First Health Workers Compensation |
$377.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$880.20
|
| Rate for Payer: GEHA Commercial |
$782.40
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$880.20
|
| Rate for Payer: Humana ChoiceCare |
$3,388.98
|
| Rate for Payer: Humana Medicare Advantage |
$3,080.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,175.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,112.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$889.98
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$684.60
|
| Rate for Payer: One Health Plan PPO/POS |
$880.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,438.91
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,112.27
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$929.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$733.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,112.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$909.54
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$391.20
|
| Rate for Payer: Zelis Medicare |
$2,618.76
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,697.07
|
| Rate for Payer: Zelis Worker's Compensation |
$266.99
|
|
|
PIN ULNAR STYLOID FRACTURE
|
Facility
|
IP
|
$978.00
|
|
|
Service Code
|
CPT 25651
|
| Hospital Charge Code |
6125651
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$266.99 |
| Max. Negotiated Rate |
$929.10 |
| Rate for Payer: Cash Price |
$586.80
|
| Rate for Payer: Cigna Commercial |
$831.30
|
| Rate for Payer: First Health Commercial |
$880.20
|
| Rate for Payer: First Health Workers Compensation |
$377.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$880.20
|
| Rate for Payer: GEHA Commercial |
$684.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$880.20
|
| Rate for Payer: Multiplan All |
$889.98
|
| Rate for Payer: OMNI Networks Commercial |
$684.60
|
| Rate for Payer: One Health Plan PPO/POS |
$880.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$929.10
|
| Rate for Payer: Three Rivers Provider Network All |
$733.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$909.54
|
| Rate for Payer: Zelis Auto |
$391.20
|
| Rate for Payer: Zelis Worker's Compensation |
$266.99
|
|
|
PIOGLITAZONE HCL15 MG TAB
|
Facility
|
OP
|
$46.00
|
|
|
Service Code
|
NDC 60687039111
|
| Hospital Charge Code |
3300724
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$43.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$27.60
|
| Rate for Payer: Cash Price |
$27.60
|
| Rate for Payer: Cigna Commercial |
$39.10
|
| Rate for Payer: First Health Commercial |
$41.40
|
| Rate for Payer: First Health Workers Compensation |
$17.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$41.40
|
| Rate for Payer: GEHA Commercial |
$36.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$41.40
|
| Rate for Payer: Humana ChoiceCare |
$11.96
|
| Rate for Payer: Multiplan All |
$41.86
|
| Rate for Payer: New Mexico Health Connections Medicare |
$27.60
|
| Rate for Payer: OMNI Networks Commercial |
$32.20
|
| Rate for Payer: One Health Plan PPO/POS |
$41.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$43.70
|
| Rate for Payer: Three Rivers Provider Network All |
$34.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$40.48
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$42.78
|
| Rate for Payer: Zelis Auto |
$18.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$23.00
|
| Rate for Payer: Zelis Worker's Compensation |
$12.56
|
|
|
PIOGLITAZONE HCL15 MG TAB
|
Facility
|
IP
|
$46.00
|
|
|
Service Code
|
NDC 60687039111
|
| Hospital Charge Code |
3300724
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.56 |
| Max. Negotiated Rate |
$43.70 |
| Rate for Payer: Cash Price |
$27.60
|
| Rate for Payer: Cigna Commercial |
$39.10
|
| Rate for Payer: First Health Commercial |
$41.40
|
| Rate for Payer: First Health Workers Compensation |
$17.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$41.40
|
| Rate for Payer: GEHA Commercial |
$32.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$41.40
|
| Rate for Payer: Multiplan All |
$41.86
|
| Rate for Payer: OMNI Networks Commercial |
$32.20
|
| Rate for Payer: One Health Plan PPO/POS |
$41.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$43.70
|
| Rate for Payer: Three Rivers Provider Network All |
$34.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$42.78
|
| Rate for Payer: Zelis Auto |
$18.40
|
| Rate for Payer: Zelis Worker's Compensation |
$12.56
|
|
|
PIPERACILLIN/TAZOBACTAM 2.25GM VIAL
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT J2543
|
| Hospital Charge Code |
3300725
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.83 |
| Max. Negotiated Rate |
$23.75 |
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cigna Commercial |
$21.25
|
| Rate for Payer: First Health Commercial |
$22.50
|
| Rate for Payer: First Health Workers Compensation |
$9.65
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$22.50
|
| Rate for Payer: GEHA Commercial |
$17.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$22.50
|
| Rate for Payer: Multiplan All |
$22.75
|
| Rate for Payer: OMNI Networks Commercial |
$17.50
|
| Rate for Payer: One Health Plan PPO/POS |
$22.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$23.75
|
| Rate for Payer: Three Rivers Provider Network All |
$18.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$23.25
|
| Rate for Payer: Zelis Auto |
$10.00
|
| Rate for Payer: Zelis Worker's Compensation |
$6.83
|
|
|
PIPERACILLIN/TAZOBACTAM 2.25GM VIAL
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT J2543
|
| Hospital Charge Code |
3300725
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.18 |
| Max. Negotiated Rate |
$23.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$15.00
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cigna Commercial |
$21.25
|
| Rate for Payer: First Health Commercial |
$22.50
|
| Rate for Payer: First Health Workers Compensation |
$9.65
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$22.50
|
| Rate for Payer: GEHA Commercial |
$1.18
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$22.50
|
| Rate for Payer: Humana ChoiceCare |
$6.50
|
| Rate for Payer: Multiplan All |
$22.75
|
| Rate for Payer: New Mexico Health Connections Medicare |
$15.00
|
| Rate for Payer: OMNI Networks Commercial |
$17.50
|
| Rate for Payer: One Health Plan PPO/POS |
$22.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$23.75
|
| Rate for Payer: Three Rivers Provider Network All |
$18.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$22.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$23.25
|
| Rate for Payer: Zelis Auto |
$10.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12.50
|
| Rate for Payer: Zelis Worker's Compensation |
$6.83
|
|
|
PIPERACILLIN/TAZOBACTAM 3.375GM VIAL
|
Facility
|
IP
|
$133.00
|
|
|
Service Code
|
CPT J2543
|
| Hospital Charge Code |
3300726
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$36.31 |
| Max. Negotiated Rate |
$126.35 |
| Rate for Payer: Cash Price |
$79.80
|
| Rate for Payer: Cigna Commercial |
$113.05
|
| Rate for Payer: First Health Commercial |
$119.70
|
| Rate for Payer: First Health Workers Compensation |
$51.35
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$119.70
|
| Rate for Payer: GEHA Commercial |
$93.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$119.70
|
| Rate for Payer: Multiplan All |
$121.03
|
| Rate for Payer: OMNI Networks Commercial |
$93.10
|
| Rate for Payer: One Health Plan PPO/POS |
$119.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$126.35
|
| Rate for Payer: Three Rivers Provider Network All |
$99.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$123.69
|
| Rate for Payer: Zelis Auto |
$53.20
|
| Rate for Payer: Zelis Worker's Compensation |
$36.31
|
|
|
PIPERACILLIN/TAZOBACTAM 3.375GM VIAL
|
Facility
|
OP
|
$133.00
|
|
|
Service Code
|
CPT J2543
|
| Hospital Charge Code |
3300726
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.18 |
| Max. Negotiated Rate |
$126.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$79.80
|
| Rate for Payer: Cash Price |
$79.80
|
| Rate for Payer: Cash Price |
$79.80
|
| Rate for Payer: Cigna Commercial |
$113.05
|
| Rate for Payer: First Health Commercial |
$119.70
|
| Rate for Payer: First Health Workers Compensation |
$51.35
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$119.70
|
| Rate for Payer: GEHA Commercial |
$1.18
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$119.70
|
| Rate for Payer: Humana ChoiceCare |
$34.58
|
| Rate for Payer: Multiplan All |
$121.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$79.80
|
| Rate for Payer: OMNI Networks Commercial |
$93.10
|
| Rate for Payer: One Health Plan PPO/POS |
$119.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$126.35
|
| Rate for Payer: Three Rivers Provider Network All |
$99.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$117.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$33.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$123.69
|
| Rate for Payer: Zelis Auto |
$53.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$66.50
|
| Rate for Payer: Zelis Worker's Compensation |
$36.31
|
|
|
PIPERACILLIN/TAZOBACTAM 4.5 GM VIAL
|
Facility
|
OP
|
$28.00
|
|
|
Service Code
|
CPT J2543
|
| Hospital Charge Code |
3303144
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.18 |
| Max. Negotiated Rate |
$26.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$23.80
|
| Rate for Payer: First Health Commercial |
$25.20
|
| Rate for Payer: First Health Workers Compensation |
$10.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$25.20
|
| Rate for Payer: GEHA Commercial |
$1.18
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$25.20
|
| Rate for Payer: Humana ChoiceCare |
$7.28
|
| Rate for Payer: Multiplan All |
$25.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16.80
|
| Rate for Payer: OMNI Networks Commercial |
$19.60
|
| Rate for Payer: One Health Plan PPO/POS |
$25.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$26.60
|
| Rate for Payer: Three Rivers Provider Network All |
$21.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$24.64
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$26.04
|
| Rate for Payer: Zelis Auto |
$11.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14.00
|
| Rate for Payer: Zelis Worker's Compensation |
$7.64
|
|
|
PIPERACILLIN/TAZOBACTAM 4.5 GM VIAL
|
Facility
|
IP
|
$28.00
|
|
|
Service Code
|
CPT J2543
|
| Hospital Charge Code |
3303144
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.64 |
| Max. Negotiated Rate |
$26.60 |
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$23.80
|
| Rate for Payer: First Health Commercial |
$25.20
|
| Rate for Payer: First Health Workers Compensation |
$10.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$25.20
|
| Rate for Payer: GEHA Commercial |
$19.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$25.20
|
| Rate for Payer: Multiplan All |
$25.48
|
| Rate for Payer: OMNI Networks Commercial |
$19.60
|
| Rate for Payer: One Health Plan PPO/POS |
$25.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$26.60
|
| Rate for Payer: Three Rivers Provider Network All |
$21.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$26.04
|
| Rate for Payer: Zelis Auto |
$11.20
|
| Rate for Payer: Zelis Worker's Compensation |
$7.64
|
|
|
PIROXICAM 20MG CAP
|
Facility
|
IP
|
$35.00
|
|
|
Service Code
|
NDC 00093075701
|
| Hospital Charge Code |
3300727
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.55 |
| Max. Negotiated Rate |
$33.25 |
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cigna Commercial |
$29.75
|
| Rate for Payer: First Health Commercial |
$31.50
|
| Rate for Payer: First Health Workers Compensation |
$13.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$31.50
|
| Rate for Payer: GEHA Commercial |
$24.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$31.50
|
| Rate for Payer: Multiplan All |
$31.85
|
| Rate for Payer: OMNI Networks Commercial |
$24.50
|
| Rate for Payer: One Health Plan PPO/POS |
$31.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$33.25
|
| Rate for Payer: Three Rivers Provider Network All |
$26.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$32.55
|
| Rate for Payer: Zelis Auto |
$14.00
|
| Rate for Payer: Zelis Worker's Compensation |
$9.55
|
|
|
PIROXICAM 20MG CAP
|
Facility
|
OP
|
$35.00
|
|
|
Service Code
|
NDC 00093075701
|
| Hospital Charge Code |
3300727
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.75 |
| Max. Negotiated Rate |
$33.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$21.00
|
| Rate for Payer: Cash Price |
$21.00
|
| Rate for Payer: Cigna Commercial |
$29.75
|
| Rate for Payer: First Health Commercial |
$31.50
|
| Rate for Payer: First Health Workers Compensation |
$13.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$31.50
|
| Rate for Payer: GEHA Commercial |
$28.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$31.50
|
| Rate for Payer: Humana ChoiceCare |
$9.10
|
| Rate for Payer: Multiplan All |
$31.85
|
| Rate for Payer: New Mexico Health Connections Medicare |
$21.00
|
| Rate for Payer: OMNI Networks Commercial |
$24.50
|
| Rate for Payer: One Health Plan PPO/POS |
$31.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$33.25
|
| Rate for Payer: Three Rivers Provider Network All |
$26.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$30.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$32.55
|
| Rate for Payer: Zelis Auto |
$14.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$17.50
|
| Rate for Payer: Zelis Worker's Compensation |
$9.55
|
|
|
PLACE BREAST CATH FOR RAD
|
Facility
|
OP
|
$302.00
|
|
|
Service Code
|
CPT 19297
|
| Hospital Charge Code |
6119297
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$78.52 |
| Max. Negotiated Rate |
$5,887.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,887.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$181.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,887.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,663.96
|
| Rate for Payer: Cash Price |
$181.20
|
| Rate for Payer: Cash Price |
$181.20
|
| Rate for Payer: Cigna Commercial |
$256.70
|
| Rate for Payer: First Health Commercial |
$271.80
|
| Rate for Payer: First Health Workers Compensation |
$116.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$271.80
|
| Rate for Payer: GEHA Commercial |
$241.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$271.80
|
| Rate for Payer: Humana ChoiceCare |
$78.52
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,758.94
|
| Rate for Payer: Multiplan All |
$274.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$181.20
|
| Rate for Payer: OMNI Networks Commercial |
$211.40
|
| Rate for Payer: One Health Plan PPO/POS |
$271.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$5,494.86
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,758.94
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$286.90
|
| Rate for Payer: Three Rivers Provider Network All |
$226.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$265.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,758.94
|
| Rate for Payer: United Payors & United Providers UP&UP |
$280.86
|
| Rate for Payer: Zelis Auto |
$120.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$151.00
|
| Rate for Payer: Zelis Worker's Compensation |
$82.45
|
|
|
PLACE BREAST CATH FOR RAD
|
Facility
|
IP
|
$302.00
|
|
|
Service Code
|
CPT 19297
|
| Hospital Charge Code |
6119297
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$82.45 |
| Max. Negotiated Rate |
$286.90 |
| Rate for Payer: Cash Price |
$181.20
|
| Rate for Payer: Cigna Commercial |
$256.70
|
| Rate for Payer: First Health Commercial |
$271.80
|
| Rate for Payer: First Health Workers Compensation |
$116.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$271.80
|
| Rate for Payer: GEHA Commercial |
$211.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$271.80
|
| Rate for Payer: Multiplan All |
$274.82
|
| Rate for Payer: OMNI Networks Commercial |
$211.40
|
| Rate for Payer: One Health Plan PPO/POS |
$271.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$286.90
|
| Rate for Payer: Three Rivers Provider Network All |
$226.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$280.86
|
| Rate for Payer: Zelis Auto |
$120.80
|
| Rate for Payer: Zelis Worker's Compensation |
$82.45
|
|
|
PLACE BREAST RAD TUBE/CATHS
|
Facility
|
OP
|
$1,005.00
|
|
|
Service Code
|
CPT 19298
|
| Hospital Charge Code |
6119298
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$274.37 |
| Max. Negotiated Rate |
$12,384.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,887.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$603.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,887.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,663.96
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,192.39
|
| Rate for Payer: Cash Price |
$603.00
|
| Rate for Payer: Cash Price |
$603.00
|
| Rate for Payer: Cigna Commercial |
$854.25
|
| Rate for Payer: First Health Commercial |
$904.50
|
| Rate for Payer: First Health Workers Compensation |
$388.03
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$904.50
|
| Rate for Payer: GEHA Commercial |
$804.00
|
| Rate for Payer: GEHA Medicare |
$6,192.39
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$904.50
|
| Rate for Payer: Humana ChoiceCare |
$6,811.63
|
| Rate for Payer: Humana Medicare Advantage |
$6,192.39
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$10,403.22
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,758.94
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,192.39
|
| Rate for Payer: Multiplan All |
$914.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$10,527.06
|
| Rate for Payer: OMNI Networks Commercial |
$703.50
|
| Rate for Payer: One Health Plan PPO/POS |
$904.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$5,494.86
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,758.94
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,192.39
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$954.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12,384.78
|
| Rate for Payer: Three Rivers Provider Network All |
$753.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,068.54
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,758.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,192.39
|
| Rate for Payer: United Payors & United Providers UP&UP |
$934.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,192.39
|
| Rate for Payer: Zelis Auto |
$402.00
|
| Rate for Payer: Zelis Medicare |
$5,263.53
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,430.87
|
| Rate for Payer: Zelis Worker's Compensation |
$274.37
|
|
|
PLACE BREAST RAD TUBE/CATHS
|
Facility
|
IP
|
$1,005.00
|
|
|
Service Code
|
CPT 19298
|
| Hospital Charge Code |
6119298
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$274.37 |
| Max. Negotiated Rate |
$954.75 |
| Rate for Payer: Cash Price |
$603.00
|
| Rate for Payer: Cigna Commercial |
$854.25
|
| Rate for Payer: First Health Commercial |
$904.50
|
| Rate for Payer: First Health Workers Compensation |
$388.03
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$904.50
|
| Rate for Payer: GEHA Commercial |
$703.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$904.50
|
| Rate for Payer: Multiplan All |
$914.55
|
| Rate for Payer: OMNI Networks Commercial |
$703.50
|
| Rate for Payer: One Health Plan PPO/POS |
$904.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$954.75
|
| Rate for Payer: Three Rivers Provider Network All |
$753.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$934.65
|
| Rate for Payer: Zelis Auto |
$402.00
|
| Rate for Payer: Zelis Worker's Compensation |
$274.37
|
|
|
PLACE CATH CAROTD ART
|
Facility
|
IP
|
$1,173.00
|
|
|
Service Code
|
CPT 36224
|
| Hospital Charge Code |
6136224
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$320.23 |
| Max. Negotiated Rate |
$1,114.35 |
| Rate for Payer: Cash Price |
$703.80
|
| Rate for Payer: Cigna Commercial |
$997.05
|
| Rate for Payer: First Health Commercial |
$1,055.70
|
| Rate for Payer: First Health Workers Compensation |
$452.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,055.70
|
| Rate for Payer: GEHA Commercial |
$821.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,055.70
|
| Rate for Payer: Multiplan All |
$1,067.43
|
| Rate for Payer: OMNI Networks Commercial |
$821.10
|
| Rate for Payer: One Health Plan PPO/POS |
$1,055.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,114.35
|
| Rate for Payer: Three Rivers Provider Network All |
$879.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,090.89
|
| Rate for Payer: Zelis Auto |
$469.20
|
| Rate for Payer: Zelis Worker's Compensation |
$320.23
|
|
|
PLACE CATH CAROTD ART
|
Facility
|
OP
|
$1,173.00
|
|
|
Service Code
|
CPT 36224
|
| Hospital Charge Code |
6136224
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$320.23 |
| Max. Negotiated Rate |
$10,265.86 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,147.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$703.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,147.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,077.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,132.93
|
| Rate for Payer: Cash Price |
$703.80
|
| Rate for Payer: Cash Price |
$703.80
|
| Rate for Payer: Cigna Commercial |
$997.05
|
| Rate for Payer: First Health Commercial |
$1,055.70
|
| Rate for Payer: First Health Workers Compensation |
$452.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,055.70
|
| Rate for Payer: GEHA Commercial |
$938.40
|
| Rate for Payer: GEHA Medicare |
$5,132.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,055.70
|
| Rate for Payer: Humana ChoiceCare |
$5,646.22
|
| Rate for Payer: Humana Medicare Advantage |
$5,132.93
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$8,623.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,160.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,132.93
|
| Rate for Payer: Multiplan All |
$1,067.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$8,725.98
|
| Rate for Payer: OMNI Networks Commercial |
$821.10
|
| Rate for Payer: One Health Plan PPO/POS |
$1,055.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,804.10
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,160.69
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,132.93
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,114.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,265.86
|
| Rate for Payer: Three Rivers Provider Network All |
$879.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,030.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,160.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,132.93
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,090.89
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,132.93
|
| Rate for Payer: Zelis Auto |
$469.20
|
| Rate for Payer: Zelis Medicare |
$4,362.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,159.52
|
| Rate for Payer: Zelis Worker's Compensation |
$320.23
|
|
|
PLACE CATH CAROTID/INOM ART
|
Facility
|
IP
|
$1,025.00
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
6136223
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$279.82 |
| Max. Negotiated Rate |
$973.75 |
| Rate for Payer: Cash Price |
$615.00
|
| Rate for Payer: Cigna Commercial |
$871.25
|
| Rate for Payer: First Health Commercial |
$922.50
|
| Rate for Payer: First Health Workers Compensation |
$395.75
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$922.50
|
| Rate for Payer: GEHA Commercial |
$717.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$922.50
|
| Rate for Payer: Multiplan All |
$932.75
|
| Rate for Payer: OMNI Networks Commercial |
$717.50
|
| Rate for Payer: One Health Plan PPO/POS |
$922.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$973.75
|
| Rate for Payer: Three Rivers Provider Network All |
$768.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$953.25
|
| Rate for Payer: Zelis Auto |
$410.00
|
| Rate for Payer: Zelis Worker's Compensation |
$279.82
|
|
|
PLACE CATH CAROTID/INOM ART
|
Facility
|
OP
|
$1,025.00
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
6136223
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$279.82 |
| Max. Negotiated Rate |
$10,265.86 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,147.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$615.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,147.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,493.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,132.93
|
| Rate for Payer: Cash Price |
$615.00
|
| Rate for Payer: Cash Price |
$615.00
|
| Rate for Payer: Cigna Commercial |
$871.25
|
| Rate for Payer: First Health Commercial |
$922.50
|
| Rate for Payer: First Health Workers Compensation |
$395.75
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$922.50
|
| Rate for Payer: GEHA Commercial |
$820.00
|
| Rate for Payer: GEHA Medicare |
$5,132.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$922.50
|
| Rate for Payer: Humana ChoiceCare |
$5,646.22
|
| Rate for Payer: Humana Medicare Advantage |
$5,132.93
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$8,623.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,544.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,132.93
|
| Rate for Payer: Multiplan All |
$932.75
|
| Rate for Payer: New Mexico Health Connections Medicare |
$8,725.98
|
| Rate for Payer: OMNI Networks Commercial |
$717.50
|
| Rate for Payer: One Health Plan PPO/POS |
$922.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,937.49
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,544.08
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,132.93
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$973.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,265.86
|
| Rate for Payer: Three Rivers Provider Network All |
$768.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,030.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,544.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,132.93
|
| Rate for Payer: United Payors & United Providers UP&UP |
$953.25
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,132.93
|
| Rate for Payer: Zelis Auto |
$410.00
|
| Rate for Payer: Zelis Medicare |
$4,362.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,159.52
|
| Rate for Payer: Zelis Worker's Compensation |
$279.82
|
|
|
PLACE CATH CAROTID/INOM ART
|
Facility
|
IP
|
$920.00
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
6136222
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$251.16 |
| Max. Negotiated Rate |
$874.00 |
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cigna Commercial |
$782.00
|
| Rate for Payer: First Health Commercial |
$828.00
|
| Rate for Payer: First Health Workers Compensation |
$355.21
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$828.00
|
| Rate for Payer: GEHA Commercial |
$644.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$828.00
|
| Rate for Payer: Multiplan All |
$837.20
|
| Rate for Payer: OMNI Networks Commercial |
$644.00
|
| Rate for Payer: One Health Plan PPO/POS |
$828.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$874.00
|
| Rate for Payer: Three Rivers Provider Network All |
$690.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$855.60
|
| Rate for Payer: Zelis Auto |
$368.00
|
| Rate for Payer: Zelis Worker's Compensation |
$251.16
|
|
|
PLACE CATH CAROTID/INOM ART
|
Facility
|
OP
|
$920.00
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
6136222
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$251.16 |
| Max. Negotiated Rate |
$5,977.36 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,147.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$552.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,147.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,493.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,988.68
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cigna Commercial |
$782.00
|
| Rate for Payer: First Health Commercial |
$828.00
|
| Rate for Payer: First Health Workers Compensation |
$355.21
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$828.00
|
| Rate for Payer: GEHA Commercial |
$736.00
|
| Rate for Payer: GEHA Medicare |
$2,988.68
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$828.00
|
| Rate for Payer: Humana ChoiceCare |
$3,287.55
|
| Rate for Payer: Humana Medicare Advantage |
$2,988.68
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,020.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,544.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,988.68
|
| Rate for Payer: Multiplan All |
$837.20
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,080.76
|
| Rate for Payer: OMNI Networks Commercial |
$644.00
|
| Rate for Payer: One Health Plan PPO/POS |
$828.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,937.49
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,544.08
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,988.68
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$874.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,977.36
|
| Rate for Payer: Three Rivers Provider Network All |
$690.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,928.91
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,544.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,988.68
|
| Rate for Payer: United Payors & United Providers UP&UP |
$855.60
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,988.68
|
| Rate for Payer: Zelis Auto |
$368.00
|
| Rate for Payer: Zelis Medicare |
$2,540.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,586.42
|
| Rate for Payer: Zelis Worker's Compensation |
$251.16
|
|
|
PLACE CATHETER IN VEIN
|
Facility
|
IP
|
$354.00
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
6136010
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$96.64 |
| Max. Negotiated Rate |
$336.30 |
| Rate for Payer: Cash Price |
$212.40
|
| Rate for Payer: Cigna Commercial |
$300.90
|
| Rate for Payer: First Health Commercial |
$318.60
|
| Rate for Payer: First Health Workers Compensation |
$136.68
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$318.60
|
| Rate for Payer: GEHA Commercial |
$247.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$318.60
|
| Rate for Payer: Multiplan All |
$322.14
|
| Rate for Payer: OMNI Networks Commercial |
$247.80
|
| Rate for Payer: One Health Plan PPO/POS |
$318.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$336.30
|
| Rate for Payer: Three Rivers Provider Network All |
$265.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$329.22
|
| Rate for Payer: Zelis Auto |
$141.60
|
| Rate for Payer: Zelis Worker's Compensation |
$96.64
|
|
