|
pop calcium ua 306266
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
2202025
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$54.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6.03
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cigna Commercial |
$76.50
|
| Rate for Payer: First Health Commercial |
$81.00
|
| Rate for Payer: First Health Workers Compensation |
$10.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$81.00
|
| Rate for Payer: GEHA Commercial |
$72.00
|
| Rate for Payer: GEHA Medicare |
$6.03
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$81.00
|
| Rate for Payer: Humana ChoiceCare |
$6.63
|
| Rate for Payer: Humana Medicare Advantage |
$6.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$10.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6.03
|
| Rate for Payer: Multiplan All |
$81.90
|
| Rate for Payer: New Mexico Health Connections Medicare |
$10.25
|
| Rate for Payer: OMNI Networks Commercial |
$63.00
|
| Rate for Payer: One Health Plan PPO/POS |
$81.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10.14
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8.78
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6.03
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$85.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12.06
|
| Rate for Payer: Three Rivers Provider Network All |
$67.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5.91
|
| Rate for Payer: United Healthcare Commercial |
$76.50
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.03
|
| Rate for Payer: United Payors & United Providers UP&UP |
$83.70
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6.03
|
| Rate for Payer: Zelis Auto |
$36.00
|
| Rate for Payer: Zelis Medicare |
$5.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7.24
|
| Rate for Payer: Zelis Worker's Compensation |
$7.72
|
|
|
pop c-anca 162400
|
Facility
|
IP
|
$36.00
|
|
|
Service Code
|
CPT 86037
|
| Hospital Charge Code |
2200799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.67 |
| Max. Negotiated Rate |
$34.20 |
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cigna Commercial |
$30.60
|
| Rate for Payer: First Health Commercial |
$32.40
|
| Rate for Payer: First Health Workers Compensation |
$13.68
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$32.40
|
| Rate for Payer: GEHA Commercial |
$25.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$32.40
|
| Rate for Payer: Multiplan All |
$32.76
|
| Rate for Payer: OMNI Networks Commercial |
$25.20
|
| Rate for Payer: One Health Plan PPO/POS |
$32.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$34.20
|
| Rate for Payer: Three Rivers Provider Network All |
$27.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$33.48
|
| Rate for Payer: Zelis Auto |
$14.40
|
| Rate for Payer: Zelis Worker's Compensation |
$9.67
|
|
|
pop c-anca 162400
|
Facility
|
OP
|
$36.00
|
|
|
Service Code
|
CPT 86037
|
| Hospital Charge Code |
2200799
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.67 |
| Max. Negotiated Rate |
$34.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$18.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$21.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$18.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cigna Commercial |
$30.60
|
| Rate for Payer: First Health Commercial |
$32.40
|
| Rate for Payer: First Health Workers Compensation |
$13.68
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$32.40
|
| Rate for Payer: GEHA Commercial |
$28.80
|
| Rate for Payer: GEHA Medicare |
$12.05
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$32.40
|
| Rate for Payer: Humana ChoiceCare |
$13.26
|
| Rate for Payer: Humana Medicare Advantage |
$12.05
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20.24
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$14.61
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12.05
|
| Rate for Payer: Multiplan All |
$32.76
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20.48
|
| Rate for Payer: OMNI Networks Commercial |
$25.20
|
| Rate for Payer: One Health Plan PPO/POS |
$32.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$16.87
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$14.61
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12.05
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$34.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24.10
|
| Rate for Payer: Three Rivers Provider Network All |
$27.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11.81
|
| Rate for Payer: United Healthcare Commercial |
$30.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$14.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.05
|
| Rate for Payer: United Payors & United Providers UP&UP |
$33.48
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$12.05
|
| Rate for Payer: Zelis Auto |
$14.40
|
| Rate for Payer: Zelis Medicare |
$10.24
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14.46
|
| Rate for Payer: Zelis Worker's Compensation |
$9.67
|
|
|
pop c anca REF
|
Facility
|
IP
|
$239.00
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
22990332
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.21 |
| Max. Negotiated Rate |
$227.05 |
| Rate for Payer: Cash Price |
$143.40
|
| Rate for Payer: Cash Price |
$143.40
|
| Rate for Payer: Cigna Commercial |
$203.15
|
| Rate for Payer: First Health Commercial |
$215.10
|
| Rate for Payer: First Health Workers Compensation |
$35.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$215.10
|
| Rate for Payer: GEHA Commercial |
$167.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$215.10
|
| Rate for Payer: Multiplan All |
$217.49
|
| Rate for Payer: OMNI Networks Commercial |
$167.30
|
| Rate for Payer: One Health Plan PPO/POS |
$215.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$227.05
|
| Rate for Payer: Three Rivers Provider Network All |
$179.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$222.27
|
| Rate for Payer: Zelis Auto |
$95.60
|
| Rate for Payer: Zelis Worker's Compensation |
$25.21
|
|
|
pop c anca REF
|
Facility
|
OP
|
$239.00
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
22990332
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.24 |
| Max. Negotiated Rate |
$227.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$21.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$143.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$21.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$17.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$143.40
|
| Rate for Payer: Cash Price |
$143.40
|
| Rate for Payer: Cigna Commercial |
$203.15
|
| Rate for Payer: First Health Commercial |
$215.10
|
| Rate for Payer: First Health Workers Compensation |
$35.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$215.10
|
| Rate for Payer: GEHA Commercial |
$191.20
|
| Rate for Payer: GEHA Medicare |
$12.05
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$215.10
|
| Rate for Payer: Humana ChoiceCare |
$13.26
|
| Rate for Payer: Humana Medicare Advantage |
$12.05
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20.24
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$17.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12.05
|
| Rate for Payer: Multiplan All |
$217.49
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20.48
|
| Rate for Payer: OMNI Networks Commercial |
$167.30
|
| Rate for Payer: One Health Plan PPO/POS |
$215.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$20.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$17.53
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12.05
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$227.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24.10
|
| Rate for Payer: Three Rivers Provider Network All |
$179.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11.81
|
| Rate for Payer: United Healthcare Commercial |
$203.15
|
| Rate for Payer: United Healthcare Managed Medicaid |
$17.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.05
|
| Rate for Payer: United Payors & United Providers UP&UP |
$222.27
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$12.05
|
| Rate for Payer: Zelis Auto |
$95.60
|
| Rate for Payer: Zelis Medicare |
$10.24
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14.46
|
| Rate for Payer: Zelis Worker's Compensation |
$25.21
|
|
|
pop Candidiasis albicans dna
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT 87481
|
| Hospital Charge Code |
2200753
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.83 |
| Max. Negotiated Rate |
$80.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$63.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$63.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$50.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cigna Commercial |
$72.25
|
| Rate for Payer: First Health Commercial |
$76.50
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$76.50
|
| Rate for Payer: GEHA Commercial |
$68.00
|
| Rate for Payer: GEHA Medicare |
$35.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$76.50
|
| Rate for Payer: Humana ChoiceCare |
$38.60
|
| Rate for Payer: Humana Medicare Advantage |
$35.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$58.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$51.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$35.09
|
| Rate for Payer: Multiplan All |
$77.35
|
| Rate for Payer: New Mexico Health Connections Medicare |
$59.65
|
| Rate for Payer: OMNI Networks Commercial |
$59.50
|
| Rate for Payer: One Health Plan PPO/POS |
$76.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$58.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$51.06
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$35.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$80.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$70.18
|
| Rate for Payer: Three Rivers Provider Network All |
$63.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$34.39
|
| Rate for Payer: United Healthcare Commercial |
$72.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$51.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$79.05
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$35.09
|
| Rate for Payer: Zelis Auto |
$34.00
|
| Rate for Payer: Zelis Medicare |
$29.83
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$42.11
|
| Rate for Payer: Zelis Worker's Compensation |
$39.21
|
|
|
pop Candidiasis albicans dna
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT 87481
|
| Hospital Charge Code |
2200753
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$80.75 |
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cigna Commercial |
$72.25
|
| Rate for Payer: First Health Commercial |
$76.50
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$76.50
|
| Rate for Payer: GEHA Commercial |
$59.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$76.50
|
| Rate for Payer: Multiplan All |
$77.35
|
| Rate for Payer: OMNI Networks Commercial |
$59.50
|
| Rate for Payer: One Health Plan PPO/POS |
$76.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$80.75
|
| Rate for Payer: Three Rivers Provider Network All |
$63.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$79.05
|
| Rate for Payer: Zelis Auto |
$34.00
|
| Rate for Payer: Zelis Worker's Compensation |
$39.21
|
|
|
pop Candidiasis glabrata dna
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT 87481
|
| Hospital Charge Code |
2200754
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.83 |
| Max. Negotiated Rate |
$80.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$63.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$63.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$50.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cigna Commercial |
$72.25
|
| Rate for Payer: First Health Commercial |
$76.50
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$76.50
|
| Rate for Payer: GEHA Commercial |
$68.00
|
| Rate for Payer: GEHA Medicare |
$35.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$76.50
|
| Rate for Payer: Humana ChoiceCare |
$38.60
|
| Rate for Payer: Humana Medicare Advantage |
$35.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$58.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$51.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$35.09
|
| Rate for Payer: Multiplan All |
$77.35
|
| Rate for Payer: New Mexico Health Connections Medicare |
$59.65
|
| Rate for Payer: OMNI Networks Commercial |
$59.50
|
| Rate for Payer: One Health Plan PPO/POS |
$76.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$58.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$51.06
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$35.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$80.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$70.18
|
| Rate for Payer: Three Rivers Provider Network All |
$63.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$34.39
|
| Rate for Payer: United Healthcare Commercial |
$72.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$51.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$79.05
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$35.09
|
| Rate for Payer: Zelis Auto |
$34.00
|
| Rate for Payer: Zelis Medicare |
$29.83
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$42.11
|
| Rate for Payer: Zelis Worker's Compensation |
$39.21
|
|
|
pop Candidiasis glabrata dna
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT 87481
|
| Hospital Charge Code |
2200754
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$80.75 |
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cigna Commercial |
$72.25
|
| Rate for Payer: First Health Commercial |
$76.50
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$76.50
|
| Rate for Payer: GEHA Commercial |
$59.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$76.50
|
| Rate for Payer: Multiplan All |
$77.35
|
| Rate for Payer: OMNI Networks Commercial |
$59.50
|
| Rate for Payer: One Health Plan PPO/POS |
$76.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$80.75
|
| Rate for Payer: Three Rivers Provider Network All |
$63.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$79.05
|
| Rate for Payer: Zelis Auto |
$34.00
|
| Rate for Payer: Zelis Worker's Compensation |
$39.21
|
|
|
pop Candidiasis parapsilosis dna
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT 87481
|
| Hospital Charge Code |
2200756
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$80.75 |
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cigna Commercial |
$72.25
|
| Rate for Payer: First Health Commercial |
$76.50
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$76.50
|
| Rate for Payer: GEHA Commercial |
$59.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$76.50
|
| Rate for Payer: Multiplan All |
$77.35
|
| Rate for Payer: OMNI Networks Commercial |
$59.50
|
| Rate for Payer: One Health Plan PPO/POS |
$76.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$80.75
|
| Rate for Payer: Three Rivers Provider Network All |
$63.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$79.05
|
| Rate for Payer: Zelis Auto |
$34.00
|
| Rate for Payer: Zelis Worker's Compensation |
$39.21
|
|
|
pop Candidiasis parapsilosis dna
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT 87481
|
| Hospital Charge Code |
2200756
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.83 |
| Max. Negotiated Rate |
$80.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$63.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$63.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$50.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cigna Commercial |
$72.25
|
| Rate for Payer: First Health Commercial |
$76.50
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$76.50
|
| Rate for Payer: GEHA Commercial |
$68.00
|
| Rate for Payer: GEHA Medicare |
$35.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$76.50
|
| Rate for Payer: Humana ChoiceCare |
$38.60
|
| Rate for Payer: Humana Medicare Advantage |
$35.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$58.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$51.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$35.09
|
| Rate for Payer: Multiplan All |
$77.35
|
| Rate for Payer: New Mexico Health Connections Medicare |
$59.65
|
| Rate for Payer: OMNI Networks Commercial |
$59.50
|
| Rate for Payer: One Health Plan PPO/POS |
$76.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$58.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$51.06
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$35.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$80.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$70.18
|
| Rate for Payer: Three Rivers Provider Network All |
$63.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$34.39
|
| Rate for Payer: United Healthcare Commercial |
$72.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$51.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$79.05
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$35.09
|
| Rate for Payer: Zelis Auto |
$34.00
|
| Rate for Payer: Zelis Medicare |
$29.83
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$42.11
|
| Rate for Payer: Zelis Worker's Compensation |
$39.21
|
|
|
pop Candidiasis tropicalis dna
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT 87481
|
| Hospital Charge Code |
2200755
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$80.75 |
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cigna Commercial |
$72.25
|
| Rate for Payer: First Health Commercial |
$76.50
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$76.50
|
| Rate for Payer: GEHA Commercial |
$59.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$76.50
|
| Rate for Payer: Multiplan All |
$77.35
|
| Rate for Payer: OMNI Networks Commercial |
$59.50
|
| Rate for Payer: One Health Plan PPO/POS |
$76.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$80.75
|
| Rate for Payer: Three Rivers Provider Network All |
$63.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$79.05
|
| Rate for Payer: Zelis Auto |
$34.00
|
| Rate for Payer: Zelis Worker's Compensation |
$39.21
|
|
|
pop Candidiasis tropicalis dna
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT 87481
|
| Hospital Charge Code |
2200755
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.83 |
| Max. Negotiated Rate |
$80.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$63.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$63.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$50.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cigna Commercial |
$72.25
|
| Rate for Payer: First Health Commercial |
$76.50
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$76.50
|
| Rate for Payer: GEHA Commercial |
$68.00
|
| Rate for Payer: GEHA Medicare |
$35.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$76.50
|
| Rate for Payer: Humana ChoiceCare |
$38.60
|
| Rate for Payer: Humana Medicare Advantage |
$35.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$58.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$51.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$35.09
|
| Rate for Payer: Multiplan All |
$77.35
|
| Rate for Payer: New Mexico Health Connections Medicare |
$59.65
|
| Rate for Payer: OMNI Networks Commercial |
$59.50
|
| Rate for Payer: One Health Plan PPO/POS |
$76.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$58.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$51.06
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$35.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$80.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$70.18
|
| Rate for Payer: Three Rivers Provider Network All |
$63.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$34.39
|
| Rate for Payer: United Healthcare Commercial |
$72.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$51.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$79.05
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$35.09
|
| Rate for Payer: Zelis Auto |
$34.00
|
| Rate for Payer: Zelis Medicare |
$29.83
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$42.11
|
| Rate for Payer: Zelis Worker's Compensation |
$39.21
|
|
|
pop CARDIO IQ PANEL LIPID
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
2299695
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.58 |
| Max. Negotiated Rate |
$239.40 |
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cigna Commercial |
$214.20
|
| Rate for Payer: First Health Commercial |
$226.80
|
| Rate for Payer: First Health Workers Compensation |
$23.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$226.80
|
| Rate for Payer: GEHA Commercial |
$176.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$226.80
|
| Rate for Payer: Multiplan All |
$229.32
|
| Rate for Payer: OMNI Networks Commercial |
$176.40
|
| Rate for Payer: One Health Plan PPO/POS |
$226.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$239.40
|
| Rate for Payer: Three Rivers Provider Network All |
$189.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$234.36
|
| Rate for Payer: Zelis Auto |
$100.80
|
| Rate for Payer: Zelis Worker's Compensation |
$16.58
|
|
|
pop CARDIO IQ PANEL LIPID
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
2299695
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.38 |
| Max. Negotiated Rate |
$239.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$24.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$151.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$24.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$19.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13.39
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cigna Commercial |
$214.20
|
| Rate for Payer: First Health Commercial |
$226.80
|
| Rate for Payer: First Health Workers Compensation |
$23.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$226.80
|
| Rate for Payer: GEHA Commercial |
$201.60
|
| Rate for Payer: GEHA Medicare |
$13.39
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$226.80
|
| Rate for Payer: Humana ChoiceCare |
$14.73
|
| Rate for Payer: Humana Medicare Advantage |
$13.39
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$19.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13.39
|
| Rate for Payer: Multiplan All |
$229.32
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22.76
|
| Rate for Payer: OMNI Networks Commercial |
$176.40
|
| Rate for Payer: One Health Plan PPO/POS |
$226.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22.50
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$19.48
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13.39
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$239.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$26.78
|
| Rate for Payer: Three Rivers Provider Network All |
$189.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13.12
|
| Rate for Payer: United Healthcare Commercial |
$214.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$19.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.39
|
| Rate for Payer: United Payors & United Providers UP&UP |
$234.36
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$13.39
|
| Rate for Payer: Zelis Auto |
$100.80
|
| Rate for Payer: Zelis Medicare |
$11.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16.07
|
| Rate for Payer: Zelis Worker's Compensation |
$16.58
|
|
|
pop celiac hla 1
|
Facility
|
IP
|
$666.00
|
|
|
Service Code
|
CPT 81377
|
| Hospital Charge Code |
2200655
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$97.36 |
| Max. Negotiated Rate |
$632.70 |
| Rate for Payer: Cash Price |
$399.60
|
| Rate for Payer: Cash Price |
$399.60
|
| Rate for Payer: Cigna Commercial |
$566.10
|
| Rate for Payer: First Health Commercial |
$599.40
|
| Rate for Payer: First Health Workers Compensation |
$137.70
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$599.40
|
| Rate for Payer: GEHA Commercial |
$466.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$599.40
|
| Rate for Payer: Multiplan All |
$606.06
|
| Rate for Payer: OMNI Networks Commercial |
$466.20
|
| Rate for Payer: One Health Plan PPO/POS |
$599.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$632.70
|
| Rate for Payer: Three Rivers Provider Network All |
$499.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$619.38
|
| Rate for Payer: Zelis Auto |
$266.40
|
| Rate for Payer: Zelis Worker's Compensation |
$97.36
|
|
|
pop celiac hla 1
|
Facility
|
OP
|
$666.00
|
|
|
Service Code
|
CPT 81377
|
| Hospital Charge Code |
2200655
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$80.53 |
| Max. Negotiated Rate |
$632.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$170.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$399.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$170.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$135.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$94.74
|
| Rate for Payer: Cash Price |
$399.60
|
| Rate for Payer: Cash Price |
$399.60
|
| Rate for Payer: Cigna Commercial |
$566.10
|
| Rate for Payer: First Health Commercial |
$599.40
|
| Rate for Payer: First Health Workers Compensation |
$137.70
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$599.40
|
| Rate for Payer: GEHA Commercial |
$532.80
|
| Rate for Payer: GEHA Medicare |
$94.74
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$599.40
|
| Rate for Payer: Humana ChoiceCare |
$104.21
|
| Rate for Payer: Humana Medicare Advantage |
$94.74
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$159.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$137.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$94.74
|
| Rate for Payer: Multiplan All |
$606.06
|
| Rate for Payer: New Mexico Health Connections Medicare |
$161.06
|
| Rate for Payer: OMNI Networks Commercial |
$466.20
|
| Rate for Payer: One Health Plan PPO/POS |
$599.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$159.17
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$137.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$94.74
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$632.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$189.48
|
| Rate for Payer: Three Rivers Provider Network All |
$499.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$92.85
|
| Rate for Payer: United Healthcare Commercial |
$566.10
|
| Rate for Payer: United Healthcare Managed Medicaid |
$137.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$94.74
|
| Rate for Payer: United Payors & United Providers UP&UP |
$619.38
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$94.74
|
| Rate for Payer: Zelis Auto |
$266.40
|
| Rate for Payer: Zelis Medicare |
$80.53
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$113.69
|
| Rate for Payer: Zelis Worker's Compensation |
$97.36
|
|
|
pop celiac hla 2
|
Facility
|
IP
|
$528.00
|
|
|
Service Code
|
CPT 81383
|
| Hospital Charge Code |
2200656
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$115.70 |
| Max. Negotiated Rate |
$501.60 |
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cigna Commercial |
$448.80
|
| Rate for Payer: First Health Commercial |
$475.20
|
| Rate for Payer: First Health Workers Compensation |
$163.64
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$475.20
|
| Rate for Payer: GEHA Commercial |
$369.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$475.20
|
| Rate for Payer: Multiplan All |
$480.48
|
| Rate for Payer: OMNI Networks Commercial |
$369.60
|
| Rate for Payer: One Health Plan PPO/POS |
$475.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$501.60
|
| Rate for Payer: Three Rivers Provider Network All |
$396.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$491.04
|
| Rate for Payer: Zelis Auto |
$211.20
|
| Rate for Payer: Zelis Worker's Compensation |
$115.70
|
|
|
pop celiac hla 2
|
Facility
|
OP
|
$528.00
|
|
|
Service Code
|
CPT 81383
|
| Hospital Charge Code |
2200656
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$92.76 |
| Max. Negotiated Rate |
$501.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$196.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$316.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$196.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$155.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$109.13
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cigna Commercial |
$448.80
|
| Rate for Payer: First Health Commercial |
$475.20
|
| Rate for Payer: First Health Workers Compensation |
$163.64
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$475.20
|
| Rate for Payer: GEHA Commercial |
$422.40
|
| Rate for Payer: GEHA Medicare |
$109.13
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$475.20
|
| Rate for Payer: Humana ChoiceCare |
$120.04
|
| Rate for Payer: Humana Medicare Advantage |
$109.13
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$183.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$158.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$109.13
|
| Rate for Payer: Multiplan All |
$480.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$185.52
|
| Rate for Payer: OMNI Networks Commercial |
$369.60
|
| Rate for Payer: One Health Plan PPO/POS |
$475.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$183.33
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$158.78
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$109.13
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$501.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$218.26
|
| Rate for Payer: Three Rivers Provider Network All |
$396.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$106.95
|
| Rate for Payer: United Healthcare Commercial |
$448.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$158.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$109.13
|
| Rate for Payer: United Payors & United Providers UP&UP |
$491.04
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$109.13
|
| Rate for Payer: Zelis Auto |
$211.20
|
| Rate for Payer: Zelis Medicare |
$92.76
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$130.96
|
| Rate for Payer: Zelis Worker's Compensation |
$115.70
|
|
|
pop CHLAMYDIA
|
Facility
|
OP
|
$203.00
|
|
|
Service Code
|
CPT 87491
|
| Hospital Charge Code |
2299090
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.83 |
| Max. Negotiated Rate |
$192.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$63.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$121.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$63.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$50.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cigna Commercial |
$172.55
|
| Rate for Payer: First Health Commercial |
$182.70
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$182.70
|
| Rate for Payer: GEHA Commercial |
$162.40
|
| Rate for Payer: GEHA Medicare |
$35.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$182.70
|
| Rate for Payer: Humana ChoiceCare |
$38.60
|
| Rate for Payer: Humana Medicare Advantage |
$35.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$58.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$51.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$35.09
|
| Rate for Payer: Multiplan All |
$184.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$59.65
|
| Rate for Payer: OMNI Networks Commercial |
$142.10
|
| Rate for Payer: One Health Plan PPO/POS |
$182.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$58.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$51.06
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$35.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$192.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$70.18
|
| Rate for Payer: Three Rivers Provider Network All |
$152.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$34.39
|
| Rate for Payer: United Healthcare Commercial |
$172.55
|
| Rate for Payer: United Healthcare Managed Medicaid |
$51.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$188.79
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$35.09
|
| Rate for Payer: Zelis Auto |
$81.20
|
| Rate for Payer: Zelis Medicare |
$29.83
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$42.11
|
| Rate for Payer: Zelis Worker's Compensation |
$39.21
|
|
|
pop CHLAMYDIA
|
Facility
|
IP
|
$203.00
|
|
|
Service Code
|
CPT 87491
|
| Hospital Charge Code |
2299090
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.21 |
| Max. Negotiated Rate |
$192.85 |
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cigna Commercial |
$172.55
|
| Rate for Payer: First Health Commercial |
$182.70
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$182.70
|
| Rate for Payer: GEHA Commercial |
$142.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$182.70
|
| Rate for Payer: Multiplan All |
$184.73
|
| Rate for Payer: OMNI Networks Commercial |
$142.10
|
| Rate for Payer: One Health Plan PPO/POS |
$182.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$192.85
|
| Rate for Payer: Three Rivers Provider Network All |
$152.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$188.79
|
| Rate for Payer: Zelis Auto |
$81.20
|
| Rate for Payer: Zelis Worker's Compensation |
$39.21
|
|
|
pop chloride urine 306266
|
Facility
|
OP
|
$87.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
2202026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.89 |
| Max. Negotiated Rate |
$82.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$52.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5.75
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Cigna Commercial |
$73.95
|
| Rate for Payer: First Health Commercial |
$78.30
|
| Rate for Payer: First Health Workers Compensation |
$10.23
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$78.30
|
| Rate for Payer: GEHA Commercial |
$69.60
|
| Rate for Payer: GEHA Medicare |
$5.75
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$78.30
|
| Rate for Payer: Humana ChoiceCare |
$6.33
|
| Rate for Payer: Humana Medicare Advantage |
$5.75
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$9.66
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8.37
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5.75
|
| Rate for Payer: Multiplan All |
$79.17
|
| Rate for Payer: New Mexico Health Connections Medicare |
$9.78
|
| Rate for Payer: OMNI Networks Commercial |
$60.90
|
| Rate for Payer: One Health Plan PPO/POS |
$78.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$9.66
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8.37
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5.75
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$82.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11.50
|
| Rate for Payer: Three Rivers Provider Network All |
$65.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5.63
|
| Rate for Payer: United Healthcare Commercial |
$73.95
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$80.91
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5.75
|
| Rate for Payer: Zelis Auto |
$34.80
|
| Rate for Payer: Zelis Medicare |
$4.89
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6.90
|
| Rate for Payer: Zelis Worker's Compensation |
$7.23
|
|
|
pop chloride urine 306266
|
Facility
|
IP
|
$87.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
2202026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.23 |
| Max. Negotiated Rate |
$82.65 |
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Cigna Commercial |
$73.95
|
| Rate for Payer: First Health Commercial |
$78.30
|
| Rate for Payer: First Health Workers Compensation |
$10.23
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$78.30
|
| Rate for Payer: GEHA Commercial |
$60.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$78.30
|
| Rate for Payer: Multiplan All |
$79.17
|
| Rate for Payer: OMNI Networks Commercial |
$60.90
|
| Rate for Payer: One Health Plan PPO/POS |
$78.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$82.65
|
| Rate for Payer: Three Rivers Provider Network All |
$65.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$80.91
|
| Rate for Payer: Zelis Auto |
$34.80
|
| Rate for Payer: Zelis Worker's Compensation |
$7.23
|
|
|
pop citrate urine 306266 REF
|
Facility
|
IP
|
$221.00
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
2202027
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.28 |
| Max. Negotiated Rate |
$209.95 |
| Rate for Payer: Cash Price |
$132.60
|
| Rate for Payer: Cash Price |
$132.60
|
| Rate for Payer: Cigna Commercial |
$187.85
|
| Rate for Payer: First Health Commercial |
$198.90
|
| Rate for Payer: First Health Workers Compensation |
$48.48
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$198.90
|
| Rate for Payer: GEHA Commercial |
$154.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$198.90
|
| Rate for Payer: Multiplan All |
$201.11
|
| Rate for Payer: OMNI Networks Commercial |
$154.70
|
| Rate for Payer: One Health Plan PPO/POS |
$198.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$209.95
|
| Rate for Payer: Three Rivers Provider Network All |
$165.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$205.53
|
| Rate for Payer: Zelis Auto |
$88.40
|
| Rate for Payer: Zelis Worker's Compensation |
$34.28
|
|
|
pop citrate urine 306266 REF
|
Facility
|
OP
|
$221.00
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
2202027
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.63 |
| Max. Negotiated Rate |
$209.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$50.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$132.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$50.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$39.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$27.80
|
| Rate for Payer: Cash Price |
$132.60
|
| Rate for Payer: Cash Price |
$132.60
|
| Rate for Payer: Cigna Commercial |
$187.85
|
| Rate for Payer: First Health Commercial |
$198.90
|
| Rate for Payer: First Health Workers Compensation |
$48.48
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$198.90
|
| Rate for Payer: GEHA Commercial |
$176.80
|
| Rate for Payer: GEHA Medicare |
$27.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$198.90
|
| Rate for Payer: Humana ChoiceCare |
$30.58
|
| Rate for Payer: Humana Medicare Advantage |
$27.80
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$46.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$40.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$27.80
|
| Rate for Payer: Multiplan All |
$201.11
|
| Rate for Payer: New Mexico Health Connections Medicare |
$47.26
|
| Rate for Payer: OMNI Networks Commercial |
$154.70
|
| Rate for Payer: One Health Plan PPO/POS |
$198.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$46.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$40.45
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$27.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$209.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$55.60
|
| Rate for Payer: Three Rivers Provider Network All |
$165.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$27.24
|
| Rate for Payer: United Healthcare Commercial |
$187.85
|
| Rate for Payer: United Healthcare Managed Medicaid |
$40.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27.80
|
| Rate for Payer: United Payors & United Providers UP&UP |
$205.53
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$27.80
|
| Rate for Payer: Zelis Auto |
$88.40
|
| Rate for Payer: Zelis Medicare |
$23.63
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$33.36
|
| Rate for Payer: Zelis Worker's Compensation |
$34.28
|
|
