|
pompe disease enzyme ana REF451830
|
Facility
|
IP
|
$385.00
|
|
|
Service Code
|
CPT 82657
|
| Hospital Charge Code |
2299557
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.90 |
| Max. Negotiated Rate |
$365.75 |
| Rate for Payer: Cash Price |
$231.00
|
| Rate for Payer: Cash Price |
$231.00
|
| Rate for Payer: Cigna Commercial |
$327.25
|
| Rate for Payer: First Health Commercial |
$346.50
|
| Rate for Payer: First Health Workers Compensation |
$32.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$346.50
|
| Rate for Payer: GEHA Commercial |
$269.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$346.50
|
| Rate for Payer: Multiplan All |
$350.35
|
| Rate for Payer: OMNI Networks Commercial |
$269.50
|
| Rate for Payer: One Health Plan PPO/POS |
$346.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$365.75
|
| Rate for Payer: Three Rivers Provider Network All |
$288.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$358.05
|
| Rate for Payer: Zelis Auto |
$154.00
|
| Rate for Payer: Zelis Worker's Compensation |
$22.90
|
|
|
pompe disease enzyme ana REF451830
|
Facility
|
OP
|
$385.00
|
|
|
Service Code
|
CPT 82657
|
| Hospital Charge Code |
2299557
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.84 |
| Max. Negotiated Rate |
$365.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$39.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$231.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$39.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$31.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$22.17
|
| Rate for Payer: Cash Price |
$231.00
|
| Rate for Payer: Cash Price |
$231.00
|
| Rate for Payer: Cigna Commercial |
$327.25
|
| Rate for Payer: First Health Commercial |
$346.50
|
| Rate for Payer: First Health Workers Compensation |
$32.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$346.50
|
| Rate for Payer: GEHA Commercial |
$308.00
|
| Rate for Payer: GEHA Medicare |
$22.17
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$346.50
|
| Rate for Payer: Humana ChoiceCare |
$24.39
|
| Rate for Payer: Humana Medicare Advantage |
$22.17
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$37.25
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$32.25
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$22.17
|
| Rate for Payer: Multiplan All |
$350.35
|
| Rate for Payer: New Mexico Health Connections Medicare |
$37.69
|
| Rate for Payer: OMNI Networks Commercial |
$269.50
|
| Rate for Payer: One Health Plan PPO/POS |
$346.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$37.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$32.25
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$22.17
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$365.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$44.34
|
| Rate for Payer: Three Rivers Provider Network All |
$288.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$21.73
|
| Rate for Payer: United Healthcare Commercial |
$327.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$32.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22.17
|
| Rate for Payer: United Payors & United Providers UP&UP |
$358.05
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$22.17
|
| Rate for Payer: Zelis Auto |
$154.00
|
| Rate for Payer: Zelis Medicare |
$18.84
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$26.60
|
| Rate for Payer: Zelis Worker's Compensation |
$22.90
|
|
|
pop 10 myositis spec 11 abs panel
|
Facility
|
OP
|
$338.00
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
2200583
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$321.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$52.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$202.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$52.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$41.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$29.21
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cigna Commercial |
$287.30
|
| Rate for Payer: First Health Commercial |
$304.20
|
| Rate for Payer: First Health Workers Compensation |
$52.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$304.20
|
| Rate for Payer: GEHA Commercial |
$270.40
|
| Rate for Payer: GEHA Medicare |
$29.21
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$304.20
|
| Rate for Payer: Humana ChoiceCare |
$32.13
|
| Rate for Payer: Humana Medicare Advantage |
$29.21
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$49.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$42.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$29.21
|
| Rate for Payer: Multiplan All |
$307.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$49.66
|
| Rate for Payer: OMNI Networks Commercial |
$236.60
|
| Rate for Payer: One Health Plan PPO/POS |
$304.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$49.07
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$42.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$29.21
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$321.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$58.42
|
| Rate for Payer: Three Rivers Provider Network All |
$253.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$28.63
|
| Rate for Payer: United Healthcare Commercial |
$287.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$42.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29.21
|
| Rate for Payer: United Payors & United Providers UP&UP |
$314.34
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$29.21
|
| Rate for Payer: Zelis Auto |
$135.20
|
| Rate for Payer: Zelis Medicare |
$24.83
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$35.05
|
| Rate for Payer: Zelis Worker's Compensation |
$37.31
|
|
|
pop 10 myositis spec 11 abs panel
|
Facility
|
IP
|
$338.00
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
2200583
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.31 |
| Max. Negotiated Rate |
$321.10 |
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cigna Commercial |
$287.30
|
| Rate for Payer: First Health Commercial |
$304.20
|
| Rate for Payer: First Health Workers Compensation |
$52.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$304.20
|
| Rate for Payer: GEHA Commercial |
$236.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$304.20
|
| Rate for Payer: Multiplan All |
$307.58
|
| Rate for Payer: OMNI Networks Commercial |
$236.60
|
| Rate for Payer: One Health Plan PPO/POS |
$304.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$321.10
|
| Rate for Payer: Three Rivers Provider Network All |
$253.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$314.34
|
| Rate for Payer: Zelis Auto |
$135.20
|
| Rate for Payer: Zelis Worker's Compensation |
$37.31
|
|
|
pop 11 myositis spec 11 abs panel
|
Facility
|
IP
|
$338.00
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
2200584
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.31 |
| Max. Negotiated Rate |
$321.10 |
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cigna Commercial |
$287.30
|
| Rate for Payer: First Health Commercial |
$304.20
|
| Rate for Payer: First Health Workers Compensation |
$52.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$304.20
|
| Rate for Payer: GEHA Commercial |
$236.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$304.20
|
| Rate for Payer: Multiplan All |
$307.58
|
| Rate for Payer: OMNI Networks Commercial |
$236.60
|
| Rate for Payer: One Health Plan PPO/POS |
$304.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$321.10
|
| Rate for Payer: Three Rivers Provider Network All |
$253.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$314.34
|
| Rate for Payer: Zelis Auto |
$135.20
|
| Rate for Payer: Zelis Worker's Compensation |
$37.31
|
|
|
pop 11 myositis spec 11 abs panel
|
Facility
|
OP
|
$338.00
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
2200584
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$321.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$52.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$202.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$52.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$41.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$29.21
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cigna Commercial |
$287.30
|
| Rate for Payer: First Health Commercial |
$304.20
|
| Rate for Payer: First Health Workers Compensation |
$52.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$304.20
|
| Rate for Payer: GEHA Commercial |
$270.40
|
| Rate for Payer: GEHA Medicare |
$29.21
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$304.20
|
| Rate for Payer: Humana ChoiceCare |
$32.13
|
| Rate for Payer: Humana Medicare Advantage |
$29.21
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$49.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$42.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$29.21
|
| Rate for Payer: Multiplan All |
$307.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$49.66
|
| Rate for Payer: OMNI Networks Commercial |
$236.60
|
| Rate for Payer: One Health Plan PPO/POS |
$304.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$49.07
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$42.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$29.21
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$321.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$58.42
|
| Rate for Payer: Three Rivers Provider Network All |
$253.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$28.63
|
| Rate for Payer: United Healthcare Commercial |
$287.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$42.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29.21
|
| Rate for Payer: United Payors & United Providers UP&UP |
$314.34
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$29.21
|
| Rate for Payer: Zelis Auto |
$135.20
|
| Rate for Payer: Zelis Medicare |
$24.83
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$35.05
|
| Rate for Payer: Zelis Worker's Compensation |
$37.31
|
|
|
pop 1 myositis spec 11 abs panel
|
Facility
|
IP
|
$192.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2200574
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.72 |
| Max. Negotiated Rate |
$182.40 |
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cigna Commercial |
$163.20
|
| Rate for Payer: First Health Commercial |
$172.80
|
| Rate for Payer: First Health Workers Compensation |
$29.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$172.80
|
| Rate for Payer: GEHA Commercial |
$134.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$172.80
|
| Rate for Payer: Multiplan All |
$174.72
|
| Rate for Payer: OMNI Networks Commercial |
$134.40
|
| Rate for Payer: One Health Plan PPO/POS |
$172.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$182.40
|
| Rate for Payer: Three Rivers Provider Network All |
$144.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$178.56
|
| Rate for Payer: Zelis Auto |
$76.80
|
| Rate for Payer: Zelis Worker's Compensation |
$20.72
|
|
|
pop 1 myositis spec 11 abs panel
|
Facility
|
OP
|
$192.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2200574
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.24 |
| Max. Negotiated Rate |
$182.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$32.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$115.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$32.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$25.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cigna Commercial |
$163.20
|
| Rate for Payer: First Health Commercial |
$172.80
|
| Rate for Payer: First Health Workers Compensation |
$29.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$172.80
|
| Rate for Payer: GEHA Commercial |
$153.60
|
| Rate for Payer: GEHA Medicare |
$17.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$172.80
|
| Rate for Payer: Humana ChoiceCare |
$19.72
|
| Rate for Payer: Humana Medicare Advantage |
$17.93
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$30.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$26.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17.93
|
| Rate for Payer: Multiplan All |
$174.72
|
| Rate for Payer: New Mexico Health Connections Medicare |
$30.48
|
| Rate for Payer: OMNI Networks Commercial |
$134.40
|
| Rate for Payer: One Health Plan PPO/POS |
$172.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$30.13
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$26.09
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17.93
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$182.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$35.86
|
| Rate for Payer: Three Rivers Provider Network All |
$144.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17.57
|
| Rate for Payer: United Healthcare Commercial |
$163.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$26.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.93
|
| Rate for Payer: United Payors & United Providers UP&UP |
$178.56
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$17.93
|
| Rate for Payer: Zelis Auto |
$76.80
|
| Rate for Payer: Zelis Medicare |
$15.24
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$21.52
|
| Rate for Payer: Zelis Worker's Compensation |
$20.72
|
|
|
pop 2 myositis spec 11 abs panel
|
Facility
|
IP
|
$192.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2200575
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.72 |
| Max. Negotiated Rate |
$182.40 |
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cigna Commercial |
$163.20
|
| Rate for Payer: First Health Commercial |
$172.80
|
| Rate for Payer: First Health Workers Compensation |
$29.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$172.80
|
| Rate for Payer: GEHA Commercial |
$134.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$172.80
|
| Rate for Payer: Multiplan All |
$174.72
|
| Rate for Payer: OMNI Networks Commercial |
$134.40
|
| Rate for Payer: One Health Plan PPO/POS |
$172.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$182.40
|
| Rate for Payer: Three Rivers Provider Network All |
$144.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$178.56
|
| Rate for Payer: Zelis Auto |
$76.80
|
| Rate for Payer: Zelis Worker's Compensation |
$20.72
|
|
|
pop 2 myositis spec 11 abs panel
|
Facility
|
OP
|
$192.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2200575
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.24 |
| Max. Negotiated Rate |
$182.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$32.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$115.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$32.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$25.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cigna Commercial |
$163.20
|
| Rate for Payer: First Health Commercial |
$172.80
|
| Rate for Payer: First Health Workers Compensation |
$29.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$172.80
|
| Rate for Payer: GEHA Commercial |
$153.60
|
| Rate for Payer: GEHA Medicare |
$17.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$172.80
|
| Rate for Payer: Humana ChoiceCare |
$19.72
|
| Rate for Payer: Humana Medicare Advantage |
$17.93
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$30.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$26.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17.93
|
| Rate for Payer: Multiplan All |
$174.72
|
| Rate for Payer: New Mexico Health Connections Medicare |
$30.48
|
| Rate for Payer: OMNI Networks Commercial |
$134.40
|
| Rate for Payer: One Health Plan PPO/POS |
$172.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$30.13
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$26.09
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17.93
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$182.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$35.86
|
| Rate for Payer: Three Rivers Provider Network All |
$144.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17.57
|
| Rate for Payer: United Healthcare Commercial |
$163.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$26.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.93
|
| Rate for Payer: United Payors & United Providers UP&UP |
$178.56
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$17.93
|
| Rate for Payer: Zelis Auto |
$76.80
|
| Rate for Payer: Zelis Medicare |
$15.24
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$21.52
|
| Rate for Payer: Zelis Worker's Compensation |
$20.72
|
|
|
pop 3 myositis spec 11 abs panel
|
Facility
|
OP
|
$192.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2200576
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.24 |
| Max. Negotiated Rate |
$182.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$32.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$115.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$32.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$25.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cigna Commercial |
$163.20
|
| Rate for Payer: First Health Commercial |
$172.80
|
| Rate for Payer: First Health Workers Compensation |
$29.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$172.80
|
| Rate for Payer: GEHA Commercial |
$153.60
|
| Rate for Payer: GEHA Medicare |
$17.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$172.80
|
| Rate for Payer: Humana ChoiceCare |
$19.72
|
| Rate for Payer: Humana Medicare Advantage |
$17.93
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$30.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$26.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17.93
|
| Rate for Payer: Multiplan All |
$174.72
|
| Rate for Payer: New Mexico Health Connections Medicare |
$30.48
|
| Rate for Payer: OMNI Networks Commercial |
$134.40
|
| Rate for Payer: One Health Plan PPO/POS |
$172.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$30.13
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$26.09
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17.93
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$182.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$35.86
|
| Rate for Payer: Three Rivers Provider Network All |
$144.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17.57
|
| Rate for Payer: United Healthcare Commercial |
$163.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$26.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.93
|
| Rate for Payer: United Payors & United Providers UP&UP |
$178.56
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$17.93
|
| Rate for Payer: Zelis Auto |
$76.80
|
| Rate for Payer: Zelis Medicare |
$15.24
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$21.52
|
| Rate for Payer: Zelis Worker's Compensation |
$20.72
|
|
|
pop 3 myositis spec 11 abs panel
|
Facility
|
IP
|
$192.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2200576
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.72 |
| Max. Negotiated Rate |
$182.40 |
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cigna Commercial |
$163.20
|
| Rate for Payer: First Health Commercial |
$172.80
|
| Rate for Payer: First Health Workers Compensation |
$29.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$172.80
|
| Rate for Payer: GEHA Commercial |
$134.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$172.80
|
| Rate for Payer: Multiplan All |
$174.72
|
| Rate for Payer: OMNI Networks Commercial |
$134.40
|
| Rate for Payer: One Health Plan PPO/POS |
$172.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$182.40
|
| Rate for Payer: Three Rivers Provider Network All |
$144.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$178.56
|
| Rate for Payer: Zelis Auto |
$76.80
|
| Rate for Payer: Zelis Worker's Compensation |
$20.72
|
|
|
pop 4 myositis spec 11 abs panel
|
Facility
|
IP
|
$192.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2200577
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.72 |
| Max. Negotiated Rate |
$182.40 |
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cigna Commercial |
$163.20
|
| Rate for Payer: First Health Commercial |
$172.80
|
| Rate for Payer: First Health Workers Compensation |
$29.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$172.80
|
| Rate for Payer: GEHA Commercial |
$134.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$172.80
|
| Rate for Payer: Multiplan All |
$174.72
|
| Rate for Payer: OMNI Networks Commercial |
$134.40
|
| Rate for Payer: One Health Plan PPO/POS |
$172.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$182.40
|
| Rate for Payer: Three Rivers Provider Network All |
$144.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$178.56
|
| Rate for Payer: Zelis Auto |
$76.80
|
| Rate for Payer: Zelis Worker's Compensation |
$20.72
|
|
|
pop 4 myositis spec 11 abs panel
|
Facility
|
OP
|
$192.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2200577
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.24 |
| Max. Negotiated Rate |
$182.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$32.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$115.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$32.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$25.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cigna Commercial |
$163.20
|
| Rate for Payer: First Health Commercial |
$172.80
|
| Rate for Payer: First Health Workers Compensation |
$29.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$172.80
|
| Rate for Payer: GEHA Commercial |
$153.60
|
| Rate for Payer: GEHA Medicare |
$17.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$172.80
|
| Rate for Payer: Humana ChoiceCare |
$19.72
|
| Rate for Payer: Humana Medicare Advantage |
$17.93
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$30.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$26.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17.93
|
| Rate for Payer: Multiplan All |
$174.72
|
| Rate for Payer: New Mexico Health Connections Medicare |
$30.48
|
| Rate for Payer: OMNI Networks Commercial |
$134.40
|
| Rate for Payer: One Health Plan PPO/POS |
$172.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$30.13
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$26.09
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17.93
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$182.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$35.86
|
| Rate for Payer: Three Rivers Provider Network All |
$144.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17.57
|
| Rate for Payer: United Healthcare Commercial |
$163.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$26.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.93
|
| Rate for Payer: United Payors & United Providers UP&UP |
$178.56
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$17.93
|
| Rate for Payer: Zelis Auto |
$76.80
|
| Rate for Payer: Zelis Medicare |
$15.24
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$21.52
|
| Rate for Payer: Zelis Worker's Compensation |
$20.72
|
|
|
pop 5 myositis spec 11 abs panel
|
Facility
|
IP
|
$192.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2200578
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.72 |
| Max. Negotiated Rate |
$182.40 |
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cigna Commercial |
$163.20
|
| Rate for Payer: First Health Commercial |
$172.80
|
| Rate for Payer: First Health Workers Compensation |
$29.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$172.80
|
| Rate for Payer: GEHA Commercial |
$134.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$172.80
|
| Rate for Payer: Multiplan All |
$174.72
|
| Rate for Payer: OMNI Networks Commercial |
$134.40
|
| Rate for Payer: One Health Plan PPO/POS |
$172.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$182.40
|
| Rate for Payer: Three Rivers Provider Network All |
$144.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$178.56
|
| Rate for Payer: Zelis Auto |
$76.80
|
| Rate for Payer: Zelis Worker's Compensation |
$20.72
|
|
|
pop 5 myositis spec 11 abs panel
|
Facility
|
OP
|
$192.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
2200578
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.24 |
| Max. Negotiated Rate |
$182.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$32.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$115.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$32.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$25.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cigna Commercial |
$163.20
|
| Rate for Payer: First Health Commercial |
$172.80
|
| Rate for Payer: First Health Workers Compensation |
$29.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$172.80
|
| Rate for Payer: GEHA Commercial |
$153.60
|
| Rate for Payer: GEHA Medicare |
$17.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$172.80
|
| Rate for Payer: Humana ChoiceCare |
$19.72
|
| Rate for Payer: Humana Medicare Advantage |
$17.93
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$30.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$26.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17.93
|
| Rate for Payer: Multiplan All |
$174.72
|
| Rate for Payer: New Mexico Health Connections Medicare |
$30.48
|
| Rate for Payer: OMNI Networks Commercial |
$134.40
|
| Rate for Payer: One Health Plan PPO/POS |
$172.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$30.13
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$26.09
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17.93
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$182.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$35.86
|
| Rate for Payer: Three Rivers Provider Network All |
$144.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17.57
|
| Rate for Payer: United Healthcare Commercial |
$163.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$26.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.93
|
| Rate for Payer: United Payors & United Providers UP&UP |
$178.56
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$17.93
|
| Rate for Payer: Zelis Auto |
$76.80
|
| Rate for Payer: Zelis Medicare |
$15.24
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$21.52
|
| Rate for Payer: Zelis Worker's Compensation |
$20.72
|
|
|
pop 6 myositis spec 11 abs panel
|
Facility
|
IP
|
$338.00
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
2200579
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.31 |
| Max. Negotiated Rate |
$321.10 |
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cigna Commercial |
$287.30
|
| Rate for Payer: First Health Commercial |
$304.20
|
| Rate for Payer: First Health Workers Compensation |
$52.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$304.20
|
| Rate for Payer: GEHA Commercial |
$236.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$304.20
|
| Rate for Payer: Multiplan All |
$307.58
|
| Rate for Payer: OMNI Networks Commercial |
$236.60
|
| Rate for Payer: One Health Plan PPO/POS |
$304.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$321.10
|
| Rate for Payer: Three Rivers Provider Network All |
$253.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$314.34
|
| Rate for Payer: Zelis Auto |
$135.20
|
| Rate for Payer: Zelis Worker's Compensation |
$37.31
|
|
|
pop 6 myositis spec 11 abs panel
|
Facility
|
OP
|
$338.00
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
2200579
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$321.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$52.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$202.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$52.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$41.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$29.21
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cigna Commercial |
$287.30
|
| Rate for Payer: First Health Commercial |
$304.20
|
| Rate for Payer: First Health Workers Compensation |
$52.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$304.20
|
| Rate for Payer: GEHA Commercial |
$270.40
|
| Rate for Payer: GEHA Medicare |
$29.21
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$304.20
|
| Rate for Payer: Humana ChoiceCare |
$32.13
|
| Rate for Payer: Humana Medicare Advantage |
$29.21
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$49.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$42.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$29.21
|
| Rate for Payer: Multiplan All |
$307.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$49.66
|
| Rate for Payer: OMNI Networks Commercial |
$236.60
|
| Rate for Payer: One Health Plan PPO/POS |
$304.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$49.07
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$42.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$29.21
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$321.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$58.42
|
| Rate for Payer: Three Rivers Provider Network All |
$253.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$28.63
|
| Rate for Payer: United Healthcare Commercial |
$287.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$42.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29.21
|
| Rate for Payer: United Payors & United Providers UP&UP |
$314.34
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$29.21
|
| Rate for Payer: Zelis Auto |
$135.20
|
| Rate for Payer: Zelis Medicare |
$24.83
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$35.05
|
| Rate for Payer: Zelis Worker's Compensation |
$37.31
|
|
|
pop 7 myositis spec 11 abs panel
|
Facility
|
OP
|
$338.00
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
2200580
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$321.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$52.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$202.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$52.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$41.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$29.21
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cigna Commercial |
$287.30
|
| Rate for Payer: First Health Commercial |
$304.20
|
| Rate for Payer: First Health Workers Compensation |
$52.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$304.20
|
| Rate for Payer: GEHA Commercial |
$270.40
|
| Rate for Payer: GEHA Medicare |
$29.21
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$304.20
|
| Rate for Payer: Humana ChoiceCare |
$32.13
|
| Rate for Payer: Humana Medicare Advantage |
$29.21
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$49.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$42.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$29.21
|
| Rate for Payer: Multiplan All |
$307.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$49.66
|
| Rate for Payer: OMNI Networks Commercial |
$236.60
|
| Rate for Payer: One Health Plan PPO/POS |
$304.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$49.07
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$42.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$29.21
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$321.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$58.42
|
| Rate for Payer: Three Rivers Provider Network All |
$253.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$28.63
|
| Rate for Payer: United Healthcare Commercial |
$287.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$42.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29.21
|
| Rate for Payer: United Payors & United Providers UP&UP |
$314.34
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$29.21
|
| Rate for Payer: Zelis Auto |
$135.20
|
| Rate for Payer: Zelis Medicare |
$24.83
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$35.05
|
| Rate for Payer: Zelis Worker's Compensation |
$37.31
|
|
|
pop 7 myositis spec 11 abs panel
|
Facility
|
IP
|
$338.00
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
2200580
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.31 |
| Max. Negotiated Rate |
$321.10 |
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cigna Commercial |
$287.30
|
| Rate for Payer: First Health Commercial |
$304.20
|
| Rate for Payer: First Health Workers Compensation |
$52.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$304.20
|
| Rate for Payer: GEHA Commercial |
$236.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$304.20
|
| Rate for Payer: Multiplan All |
$307.58
|
| Rate for Payer: OMNI Networks Commercial |
$236.60
|
| Rate for Payer: One Health Plan PPO/POS |
$304.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$321.10
|
| Rate for Payer: Three Rivers Provider Network All |
$253.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$314.34
|
| Rate for Payer: Zelis Auto |
$135.20
|
| Rate for Payer: Zelis Worker's Compensation |
$37.31
|
|
|
pop 8 myositis spec 11 abs panel
|
Facility
|
OP
|
$338.00
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
2200581
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$321.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$52.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$202.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$52.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$41.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$29.21
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cigna Commercial |
$287.30
|
| Rate for Payer: First Health Commercial |
$304.20
|
| Rate for Payer: First Health Workers Compensation |
$52.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$304.20
|
| Rate for Payer: GEHA Commercial |
$270.40
|
| Rate for Payer: GEHA Medicare |
$29.21
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$304.20
|
| Rate for Payer: Humana ChoiceCare |
$32.13
|
| Rate for Payer: Humana Medicare Advantage |
$29.21
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$49.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$42.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$29.21
|
| Rate for Payer: Multiplan All |
$307.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$49.66
|
| Rate for Payer: OMNI Networks Commercial |
$236.60
|
| Rate for Payer: One Health Plan PPO/POS |
$304.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$49.07
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$42.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$29.21
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$321.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$58.42
|
| Rate for Payer: Three Rivers Provider Network All |
$253.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$28.63
|
| Rate for Payer: United Healthcare Commercial |
$287.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$42.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29.21
|
| Rate for Payer: United Payors & United Providers UP&UP |
$314.34
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$29.21
|
| Rate for Payer: Zelis Auto |
$135.20
|
| Rate for Payer: Zelis Medicare |
$24.83
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$35.05
|
| Rate for Payer: Zelis Worker's Compensation |
$37.31
|
|
|
pop 8 myositis spec 11 abs panel
|
Facility
|
IP
|
$338.00
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
2200581
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.31 |
| Max. Negotiated Rate |
$321.10 |
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cigna Commercial |
$287.30
|
| Rate for Payer: First Health Commercial |
$304.20
|
| Rate for Payer: First Health Workers Compensation |
$52.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$304.20
|
| Rate for Payer: GEHA Commercial |
$236.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$304.20
|
| Rate for Payer: Multiplan All |
$307.58
|
| Rate for Payer: OMNI Networks Commercial |
$236.60
|
| Rate for Payer: One Health Plan PPO/POS |
$304.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$321.10
|
| Rate for Payer: Three Rivers Provider Network All |
$253.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$314.34
|
| Rate for Payer: Zelis Auto |
$135.20
|
| Rate for Payer: Zelis Worker's Compensation |
$37.31
|
|
|
pop 9 myositis spec 11 abs panel
|
Facility
|
OP
|
$338.00
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
2200582
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$321.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$52.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$202.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$52.58
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$41.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$29.21
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cigna Commercial |
$287.30
|
| Rate for Payer: First Health Commercial |
$304.20
|
| Rate for Payer: First Health Workers Compensation |
$52.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$304.20
|
| Rate for Payer: GEHA Commercial |
$270.40
|
| Rate for Payer: GEHA Medicare |
$29.21
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$304.20
|
| Rate for Payer: Humana ChoiceCare |
$32.13
|
| Rate for Payer: Humana Medicare Advantage |
$29.21
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$49.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$42.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$29.21
|
| Rate for Payer: Multiplan All |
$307.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$49.66
|
| Rate for Payer: OMNI Networks Commercial |
$236.60
|
| Rate for Payer: One Health Plan PPO/POS |
$304.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$49.07
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$42.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$29.21
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$321.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$58.42
|
| Rate for Payer: Three Rivers Provider Network All |
$253.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$28.63
|
| Rate for Payer: United Healthcare Commercial |
$287.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$42.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29.21
|
| Rate for Payer: United Payors & United Providers UP&UP |
$314.34
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$29.21
|
| Rate for Payer: Zelis Auto |
$135.20
|
| Rate for Payer: Zelis Medicare |
$24.83
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$35.05
|
| Rate for Payer: Zelis Worker's Compensation |
$37.31
|
|
|
pop 9 myositis spec 11 abs panel
|
Facility
|
IP
|
$338.00
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
2200582
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.31 |
| Max. Negotiated Rate |
$321.10 |
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cash Price |
$202.80
|
| Rate for Payer: Cigna Commercial |
$287.30
|
| Rate for Payer: First Health Commercial |
$304.20
|
| Rate for Payer: First Health Workers Compensation |
$52.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$304.20
|
| Rate for Payer: GEHA Commercial |
$236.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$304.20
|
| Rate for Payer: Multiplan All |
$307.58
|
| Rate for Payer: OMNI Networks Commercial |
$236.60
|
| Rate for Payer: One Health Plan PPO/POS |
$304.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$321.10
|
| Rate for Payer: Three Rivers Provider Network All |
$253.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$314.34
|
| Rate for Payer: Zelis Auto |
$135.20
|
| Rate for Payer: Zelis Worker's Compensation |
$37.31
|
|
|
pop ACH RECP MUSCLE BINDING AB
|
Facility
|
IP
|
$305.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
2299525
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.64 |
| Max. Negotiated Rate |
$289.75 |
| Rate for Payer: Cash Price |
$183.00
|
| Rate for Payer: Cash Price |
$183.00
|
| Rate for Payer: Cigna Commercial |
$259.25
|
| Rate for Payer: First Health Commercial |
$274.50
|
| Rate for Payer: First Health Workers Compensation |
$20.71
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$274.50
|
| Rate for Payer: GEHA Commercial |
$213.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$274.50
|
| Rate for Payer: Multiplan All |
$277.55
|
| Rate for Payer: OMNI Networks Commercial |
$213.50
|
| Rate for Payer: One Health Plan PPO/POS |
$274.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$289.75
|
| Rate for Payer: Three Rivers Provider Network All |
$228.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$283.65
|
| Rate for Payer: Zelis Auto |
$122.00
|
| Rate for Payer: Zelis Worker's Compensation |
$14.64
|
|
