|
pop ck isoenzymes
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT 82552
|
| Hospital Charge Code |
2232293
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.38 |
| Max. Negotiated Rate |
$199.50 |
| 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 |
$126.00
|
| 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 |
$126.00
|
| Rate for Payer: Cash Price |
$126.00
|
| Rate for Payer: Cigna Commercial |
$178.50
|
| Rate for Payer: First Health Commercial |
$189.00
|
| Rate for Payer: First Health Workers Compensation |
$23.97
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$189.00
|
| Rate for Payer: GEHA Commercial |
$168.00
|
| Rate for Payer: GEHA Medicare |
$13.39
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$189.00
|
| 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 |
$191.10
|
| Rate for Payer: New Mexico Health Connections Medicare |
$22.76
|
| Rate for Payer: OMNI Networks Commercial |
$147.00
|
| Rate for Payer: One Health Plan PPO/POS |
$189.00
|
| 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 |
$199.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$26.78
|
| Rate for Payer: Three Rivers Provider Network All |
$157.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13.12
|
| Rate for Payer: United Healthcare Commercial |
$178.50
|
| 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 |
$195.30
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$13.39
|
| Rate for Payer: Zelis Auto |
$84.00
|
| Rate for Payer: Zelis Medicare |
$11.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16.07
|
| Rate for Payer: Zelis Worker's Compensation |
$16.95
|
|
|
pop ck isoenzymes
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT 82552
|
| Hospital Charge Code |
2232293
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.95 |
| Max. Negotiated Rate |
$199.50 |
| Rate for Payer: Cash Price |
$126.00
|
| Rate for Payer: Cash Price |
$126.00
|
| Rate for Payer: Cigna Commercial |
$178.50
|
| Rate for Payer: First Health Commercial |
$189.00
|
| Rate for Payer: First Health Workers Compensation |
$23.97
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$189.00
|
| Rate for Payer: GEHA Commercial |
$147.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$189.00
|
| Rate for Payer: Multiplan All |
$191.10
|
| Rate for Payer: OMNI Networks Commercial |
$147.00
|
| Rate for Payer: One Health Plan PPO/POS |
$189.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$199.50
|
| Rate for Payer: Three Rivers Provider Network All |
$157.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$195.30
|
| Rate for Payer: Zelis Auto |
$84.00
|
| Rate for Payer: Zelis Worker's Compensation |
$16.95
|
|
|
pop coccidioides ab IgG REF
|
Facility
|
IP
|
$131.00
|
|
|
Service Code
|
CPT 86635
|
| Hospital Charge Code |
2300105
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.15 |
| Max. Negotiated Rate |
$124.45 |
| Rate for Payer: Cash Price |
$78.60
|
| Rate for Payer: Cash Price |
$78.60
|
| Rate for Payer: Cigna Commercial |
$111.35
|
| Rate for Payer: First Health Commercial |
$117.90
|
| Rate for Payer: First Health Workers Compensation |
$18.59
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$117.90
|
| Rate for Payer: GEHA Commercial |
$91.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$117.90
|
| Rate for Payer: Multiplan All |
$119.21
|
| Rate for Payer: OMNI Networks Commercial |
$91.70
|
| Rate for Payer: One Health Plan PPO/POS |
$117.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$124.45
|
| Rate for Payer: Three Rivers Provider Network All |
$98.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$121.83
|
| Rate for Payer: Zelis Auto |
$52.40
|
| Rate for Payer: Zelis Worker's Compensation |
$13.15
|
|
|
pop coccidioides ab IgG REF
|
Facility
|
OP
|
$131.00
|
|
|
Service Code
|
CPT 86635
|
| Hospital Charge Code |
2300105
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$124.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$20.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$78.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$20.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11.47
|
| Rate for Payer: Cash Price |
$78.60
|
| Rate for Payer: Cash Price |
$78.60
|
| Rate for Payer: Cigna Commercial |
$111.35
|
| Rate for Payer: First Health Commercial |
$117.90
|
| Rate for Payer: First Health Workers Compensation |
$18.59
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$117.90
|
| Rate for Payer: GEHA Commercial |
$104.80
|
| Rate for Payer: GEHA Medicare |
$11.47
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$117.90
|
| Rate for Payer: Humana ChoiceCare |
$12.62
|
| Rate for Payer: Humana Medicare Advantage |
$11.47
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$19.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16.68
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11.47
|
| Rate for Payer: Multiplan All |
$119.21
|
| Rate for Payer: New Mexico Health Connections Medicare |
$19.50
|
| Rate for Payer: OMNI Networks Commercial |
$91.70
|
| Rate for Payer: One Health Plan PPO/POS |
$117.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19.26
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16.68
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11.47
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$124.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$22.94
|
| Rate for Payer: Three Rivers Provider Network All |
$98.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11.24
|
| Rate for Payer: United Healthcare Commercial |
$111.35
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.47
|
| Rate for Payer: United Payors & United Providers UP&UP |
$121.83
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$11.47
|
| Rate for Payer: Zelis Auto |
$52.40
|
| Rate for Payer: Zelis Medicare |
$9.75
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13.76
|
| Rate for Payer: Zelis Worker's Compensation |
$13.15
|
|
|
pop coccidioides ab IgM REF
|
Facility
|
OP
|
$131.00
|
|
|
Service Code
|
CPT 86635
|
| Hospital Charge Code |
2200145
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$124.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$20.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$78.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$20.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16.35
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11.47
|
| Rate for Payer: Cash Price |
$78.60
|
| Rate for Payer: Cash Price |
$78.60
|
| Rate for Payer: Cigna Commercial |
$111.35
|
| Rate for Payer: First Health Commercial |
$117.90
|
| Rate for Payer: First Health Workers Compensation |
$18.59
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$117.90
|
| Rate for Payer: GEHA Commercial |
$104.80
|
| Rate for Payer: GEHA Medicare |
$11.47
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$117.90
|
| Rate for Payer: Humana ChoiceCare |
$12.62
|
| Rate for Payer: Humana Medicare Advantage |
$11.47
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$19.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16.68
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11.47
|
| Rate for Payer: Multiplan All |
$119.21
|
| Rate for Payer: New Mexico Health Connections Medicare |
$19.50
|
| Rate for Payer: OMNI Networks Commercial |
$91.70
|
| Rate for Payer: One Health Plan PPO/POS |
$117.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19.26
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16.68
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11.47
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$124.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$22.94
|
| Rate for Payer: Three Rivers Provider Network All |
$98.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11.24
|
| Rate for Payer: United Healthcare Commercial |
$111.35
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.47
|
| Rate for Payer: United Payors & United Providers UP&UP |
$121.83
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$11.47
|
| Rate for Payer: Zelis Auto |
$52.40
|
| Rate for Payer: Zelis Medicare |
$9.75
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13.76
|
| Rate for Payer: Zelis Worker's Compensation |
$13.15
|
|
|
pop coccidioides ab IgM REF
|
Facility
|
IP
|
$131.00
|
|
|
Service Code
|
CPT 86635
|
| Hospital Charge Code |
2200145
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.15 |
| Max. Negotiated Rate |
$124.45 |
| Rate for Payer: Cash Price |
$78.60
|
| Rate for Payer: Cash Price |
$78.60
|
| Rate for Payer: Cigna Commercial |
$111.35
|
| Rate for Payer: First Health Commercial |
$117.90
|
| Rate for Payer: First Health Workers Compensation |
$18.59
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$117.90
|
| Rate for Payer: GEHA Commercial |
$91.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$117.90
|
| Rate for Payer: Multiplan All |
$119.21
|
| Rate for Payer: OMNI Networks Commercial |
$91.70
|
| Rate for Payer: One Health Plan PPO/POS |
$117.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$124.45
|
| Rate for Payer: Three Rivers Provider Network All |
$98.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$121.83
|
| Rate for Payer: Zelis Auto |
$52.40
|
| Rate for Payer: Zelis Worker's Compensation |
$13.15
|
|
|
pop comp thyroglob ab
|
Facility
|
IP
|
$168.00
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
2200444
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.15 |
| Max. Negotiated Rate |
$159.60 |
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cigna Commercial |
$142.80
|
| Rate for Payer: First Health Commercial |
$151.20
|
| Rate for Payer: First Health Workers Compensation |
$25.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$151.20
|
| Rate for Payer: GEHA Commercial |
$117.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$151.20
|
| Rate for Payer: Multiplan All |
$152.88
|
| Rate for Payer: OMNI Networks Commercial |
$117.60
|
| Rate for Payer: One Health Plan PPO/POS |
$151.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$159.60
|
| Rate for Payer: Three Rivers Provider Network All |
$126.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$156.24
|
| Rate for Payer: Zelis Auto |
$67.20
|
| Rate for Payer: Zelis Worker's Compensation |
$18.15
|
|
|
pop comp thyroglob ab
|
Facility
|
OP
|
$168.00
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
2200444
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.52 |
| Max. Negotiated Rate |
$159.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$28.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$100.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$28.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$22.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15.91
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cigna Commercial |
$142.80
|
| Rate for Payer: First Health Commercial |
$151.20
|
| Rate for Payer: First Health Workers Compensation |
$25.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$151.20
|
| Rate for Payer: GEHA Commercial |
$134.40
|
| Rate for Payer: GEHA Medicare |
$15.91
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$151.20
|
| Rate for Payer: Humana ChoiceCare |
$17.50
|
| Rate for Payer: Humana Medicare Advantage |
$15.91
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$26.73
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$23.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15.91
|
| Rate for Payer: Multiplan All |
$152.88
|
| Rate for Payer: New Mexico Health Connections Medicare |
$27.05
|
| Rate for Payer: OMNI Networks Commercial |
$117.60
|
| Rate for Payer: One Health Plan PPO/POS |
$151.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26.73
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$23.15
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15.91
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$159.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$31.82
|
| Rate for Payer: Three Rivers Provider Network All |
$126.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15.59
|
| Rate for Payer: United Healthcare Commercial |
$142.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$23.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.91
|
| Rate for Payer: United Payors & United Providers UP&UP |
$156.24
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$15.91
|
| Rate for Payer: Zelis Auto |
$67.20
|
| Rate for Payer: Zelis Medicare |
$13.52
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$19.09
|
| Rate for Payer: Zelis Worker's Compensation |
$18.15
|
|
|
pop CREATININE URINE
|
Facility
|
IP
|
$205.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
2299379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$194.75 |
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cigna Commercial |
$174.25
|
| Rate for Payer: First Health Commercial |
$184.50
|
| Rate for Payer: First Health Workers Compensation |
$9.19
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$184.50
|
| Rate for Payer: GEHA Commercial |
$143.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$184.50
|
| Rate for Payer: Multiplan All |
$186.55
|
| Rate for Payer: OMNI Networks Commercial |
$143.50
|
| Rate for Payer: One Health Plan PPO/POS |
$184.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$194.75
|
| Rate for Payer: Three Rivers Provider Network All |
$153.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$190.65
|
| Rate for Payer: Zelis Auto |
$82.00
|
| Rate for Payer: Zelis Worker's Compensation |
$6.50
|
|
|
pop CREATININE URINE
|
Facility
|
OP
|
$205.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
2299379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$194.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$123.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cigna Commercial |
$174.25
|
| Rate for Payer: First Health Commercial |
$184.50
|
| Rate for Payer: First Health Workers Compensation |
$9.19
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$184.50
|
| Rate for Payer: GEHA Commercial |
$164.00
|
| Rate for Payer: GEHA Medicare |
$5.18
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$184.50
|
| Rate for Payer: Humana ChoiceCare |
$5.70
|
| Rate for Payer: Humana Medicare Advantage |
$5.18
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$8.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5.18
|
| Rate for Payer: Multiplan All |
$186.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$8.81
|
| Rate for Payer: OMNI Networks Commercial |
$143.50
|
| Rate for Payer: One Health Plan PPO/POS |
$184.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$8.71
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5.18
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$194.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10.36
|
| Rate for Payer: Three Rivers Provider Network All |
$153.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5.08
|
| Rate for Payer: United Healthcare Commercial |
$174.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.18
|
| Rate for Payer: United Payors & United Providers UP&UP |
$190.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5.18
|
| Rate for Payer: Zelis Auto |
$82.00
|
| Rate for Payer: Zelis Medicare |
$4.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6.22
|
| Rate for Payer: Zelis Worker's Compensation |
$6.50
|
|
|
pop creat urine 306266 REF
|
Facility
|
IP
|
$205.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
2202028
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$194.75 |
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cigna Commercial |
$174.25
|
| Rate for Payer: First Health Commercial |
$184.50
|
| Rate for Payer: First Health Workers Compensation |
$9.19
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$184.50
|
| Rate for Payer: GEHA Commercial |
$143.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$184.50
|
| Rate for Payer: Multiplan All |
$186.55
|
| Rate for Payer: OMNI Networks Commercial |
$143.50
|
| Rate for Payer: One Health Plan PPO/POS |
$184.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$194.75
|
| Rate for Payer: Three Rivers Provider Network All |
$153.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$190.65
|
| Rate for Payer: Zelis Auto |
$82.00
|
| Rate for Payer: Zelis Worker's Compensation |
$6.50
|
|
|
pop creat urine 306266 REF
|
Facility
|
OP
|
$205.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
2202028
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$194.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$123.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cigna Commercial |
$174.25
|
| Rate for Payer: First Health Commercial |
$184.50
|
| Rate for Payer: First Health Workers Compensation |
$9.19
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$184.50
|
| Rate for Payer: GEHA Commercial |
$164.00
|
| Rate for Payer: GEHA Medicare |
$5.18
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$184.50
|
| Rate for Payer: Humana ChoiceCare |
$5.70
|
| Rate for Payer: Humana Medicare Advantage |
$5.18
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$8.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5.18
|
| Rate for Payer: Multiplan All |
$186.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$8.81
|
| Rate for Payer: OMNI Networks Commercial |
$143.50
|
| Rate for Payer: One Health Plan PPO/POS |
$184.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$8.71
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5.18
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$194.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10.36
|
| Rate for Payer: Three Rivers Provider Network All |
$153.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5.08
|
| Rate for Payer: United Healthcare Commercial |
$174.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.18
|
| Rate for Payer: United Payors & United Providers UP&UP |
$190.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5.18
|
| Rate for Payer: Zelis Auto |
$82.00
|
| Rate for Payer: Zelis Medicare |
$4.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6.22
|
| Rate for Payer: Zelis Worker's Compensation |
$6.50
|
|
|
pop crmp 5 igg
|
Facility
|
OP
|
$203.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
2299521
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.24 |
| Max. Negotiated Rate |
$192.85 |
| 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 |
$121.80
|
| 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 |
$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 |
$35.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$182.70
|
| Rate for Payer: GEHA Commercial |
$162.40
|
| Rate for Payer: GEHA Medicare |
$12.05
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$182.70
|
| 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 |
$184.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20.48
|
| 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 |
$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 |
$192.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24.10
|
| Rate for Payer: Three Rivers Provider Network All |
$152.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11.81
|
| Rate for Payer: United Healthcare Commercial |
$172.55
|
| 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 |
$188.79
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$12.05
|
| Rate for Payer: Zelis Auto |
$81.20
|
| 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 crmp 5 igg
|
Facility
|
IP
|
$203.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
2299521
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.21 |
| 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 |
$35.66
|
| 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 |
$25.21
|
|
|
pop cytogenetics 10 - 30 REF
|
Facility
|
IP
|
$406.00
|
|
|
Service Code
|
CPT 88273
|
| Hospital Charge Code |
2200305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.69 |
| Max. Negotiated Rate |
$385.70 |
| Rate for Payer: Cash Price |
$243.60
|
| Rate for Payer: Cash Price |
$243.60
|
| Rate for Payer: Cigna Commercial |
$345.10
|
| Rate for Payer: First Health Commercial |
$365.40
|
| Rate for Payer: First Health Workers Compensation |
$49.05
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$365.40
|
| Rate for Payer: GEHA Commercial |
$284.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$365.40
|
| Rate for Payer: Multiplan All |
$369.46
|
| Rate for Payer: OMNI Networks Commercial |
$284.20
|
| Rate for Payer: One Health Plan PPO/POS |
$365.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$385.70
|
| Rate for Payer: Three Rivers Provider Network All |
$304.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$377.58
|
| Rate for Payer: Zelis Auto |
$162.40
|
| Rate for Payer: Zelis Worker's Compensation |
$34.69
|
|
|
pop cytogenetics 10 - 30 REF
|
Facility
|
OP
|
$406.00
|
|
|
Service Code
|
CPT 88273
|
| Hospital Charge Code |
2200305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.59 |
| Max. Negotiated Rate |
$385.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$243.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$34.81
|
| Rate for Payer: Cash Price |
$243.60
|
| Rate for Payer: Cash Price |
$243.60
|
| Rate for Payer: Cigna Commercial |
$345.10
|
| Rate for Payer: First Health Commercial |
$365.40
|
| Rate for Payer: First Health Workers Compensation |
$49.05
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$365.40
|
| Rate for Payer: GEHA Commercial |
$324.80
|
| Rate for Payer: GEHA Medicare |
$34.81
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$365.40
|
| Rate for Payer: Humana ChoiceCare |
$38.29
|
| Rate for Payer: Humana Medicare Advantage |
$34.81
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$58.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$34.81
|
| Rate for Payer: Multiplan All |
$369.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$59.18
|
| Rate for Payer: OMNI Networks Commercial |
$284.20
|
| Rate for Payer: One Health Plan PPO/POS |
$365.40
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$34.81
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$385.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$69.62
|
| Rate for Payer: Three Rivers Provider Network All |
$304.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$34.11
|
| Rate for Payer: United Healthcare Commercial |
$345.10
|
| Rate for Payer: United Healthcare Managed Medicaid |
$101.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$34.81
|
| Rate for Payer: United Payors & United Providers UP&UP |
$377.58
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$34.81
|
| Rate for Payer: Zelis Auto |
$162.40
|
| Rate for Payer: Zelis Medicare |
$29.59
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$41.77
|
| Rate for Payer: Zelis Worker's Compensation |
$34.69
|
|
|
pop Detect Agent nos dna q1
|
Facility
|
OP
|
$94.00
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
2200758
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.41 |
| Max. Negotiated Rate |
$89.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$77.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$56.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$77.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$61.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cigna Commercial |
$79.90
|
| Rate for Payer: First Health Commercial |
$84.60
|
| Rate for Payer: First Health Workers Compensation |
$69.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$84.60
|
| Rate for Payer: GEHA Commercial |
$75.20
|
| Rate for Payer: GEHA Medicare |
$42.84
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$84.60
|
| Rate for Payer: Humana ChoiceCare |
$47.12
|
| Rate for Payer: Humana Medicare Advantage |
$42.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$71.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$62.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$42.84
|
| Rate for Payer: Multiplan All |
$85.54
|
| Rate for Payer: New Mexico Health Connections Medicare |
$72.83
|
| Rate for Payer: OMNI Networks Commercial |
$65.80
|
| Rate for Payer: One Health Plan PPO/POS |
$84.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$71.97
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$62.33
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$42.84
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$89.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$85.68
|
| Rate for Payer: Three Rivers Provider Network All |
$70.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$41.98
|
| Rate for Payer: United Healthcare Commercial |
$79.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$62.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$42.84
|
| Rate for Payer: United Payors & United Providers UP&UP |
$87.42
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$42.84
|
| Rate for Payer: Zelis Auto |
$37.60
|
| Rate for Payer: Zelis Medicare |
$36.41
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$51.41
|
| Rate for Payer: Zelis Worker's Compensation |
$49.14
|
|
|
pop Detect Agent nos dna q1
|
Facility
|
IP
|
$94.00
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
2200758
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.60 |
| Max. Negotiated Rate |
$89.30 |
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cigna Commercial |
$79.90
|
| Rate for Payer: First Health Commercial |
$84.60
|
| Rate for Payer: First Health Workers Compensation |
$69.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$84.60
|
| Rate for Payer: GEHA Commercial |
$65.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$84.60
|
| Rate for Payer: Multiplan All |
$85.54
|
| Rate for Payer: OMNI Networks Commercial |
$65.80
|
| Rate for Payer: One Health Plan PPO/POS |
$84.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$89.30
|
| Rate for Payer: Three Rivers Provider Network All |
$70.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$87.42
|
| Rate for Payer: Zelis Auto |
$37.60
|
| Rate for Payer: Zelis Worker's Compensation |
$49.14
|
|
|
pop Detect Agent nos dna q2
|
Facility
|
OP
|
$94.00
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
2200759
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.41 |
| Max. Negotiated Rate |
$89.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$77.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$56.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$77.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$61.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cigna Commercial |
$79.90
|
| Rate for Payer: First Health Commercial |
$84.60
|
| Rate for Payer: First Health Workers Compensation |
$69.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$84.60
|
| Rate for Payer: GEHA Commercial |
$75.20
|
| Rate for Payer: GEHA Medicare |
$42.84
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$84.60
|
| Rate for Payer: Humana ChoiceCare |
$47.12
|
| Rate for Payer: Humana Medicare Advantage |
$42.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$71.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$62.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$42.84
|
| Rate for Payer: Multiplan All |
$85.54
|
| Rate for Payer: New Mexico Health Connections Medicare |
$72.83
|
| Rate for Payer: OMNI Networks Commercial |
$65.80
|
| Rate for Payer: One Health Plan PPO/POS |
$84.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$71.97
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$62.33
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$42.84
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$89.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$85.68
|
| Rate for Payer: Three Rivers Provider Network All |
$70.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$41.98
|
| Rate for Payer: United Healthcare Commercial |
$79.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$62.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$42.84
|
| Rate for Payer: United Payors & United Providers UP&UP |
$87.42
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$42.84
|
| Rate for Payer: Zelis Auto |
$37.60
|
| Rate for Payer: Zelis Medicare |
$36.41
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$51.41
|
| Rate for Payer: Zelis Worker's Compensation |
$49.14
|
|
|
pop Detect Agent nos dna q2
|
Facility
|
IP
|
$94.00
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
2200759
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.60 |
| Max. Negotiated Rate |
$89.30 |
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cigna Commercial |
$79.90
|
| Rate for Payer: First Health Commercial |
$84.60
|
| Rate for Payer: First Health Workers Compensation |
$69.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$84.60
|
| Rate for Payer: GEHA Commercial |
$65.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$84.60
|
| Rate for Payer: Multiplan All |
$85.54
|
| Rate for Payer: OMNI Networks Commercial |
$65.80
|
| Rate for Payer: One Health Plan PPO/POS |
$84.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$89.30
|
| Rate for Payer: Three Rivers Provider Network All |
$70.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$87.42
|
| Rate for Payer: Zelis Auto |
$37.60
|
| Rate for Payer: Zelis Worker's Compensation |
$49.14
|
|
|
pop Detect Agent nos dna q3
|
Facility
|
OP
|
$94.00
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
2200760
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.41 |
| Max. Negotiated Rate |
$89.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$77.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$56.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$77.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$61.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cigna Commercial |
$79.90
|
| Rate for Payer: First Health Commercial |
$84.60
|
| Rate for Payer: First Health Workers Compensation |
$69.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$84.60
|
| Rate for Payer: GEHA Commercial |
$75.20
|
| Rate for Payer: GEHA Medicare |
$42.84
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$84.60
|
| Rate for Payer: Humana ChoiceCare |
$47.12
|
| Rate for Payer: Humana Medicare Advantage |
$42.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$71.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$62.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$42.84
|
| Rate for Payer: Multiplan All |
$85.54
|
| Rate for Payer: New Mexico Health Connections Medicare |
$72.83
|
| Rate for Payer: OMNI Networks Commercial |
$65.80
|
| Rate for Payer: One Health Plan PPO/POS |
$84.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$71.97
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$62.33
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$42.84
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$89.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$85.68
|
| Rate for Payer: Three Rivers Provider Network All |
$70.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$41.98
|
| Rate for Payer: United Healthcare Commercial |
$79.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$62.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$42.84
|
| Rate for Payer: United Payors & United Providers UP&UP |
$87.42
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$42.84
|
| Rate for Payer: Zelis Auto |
$37.60
|
| Rate for Payer: Zelis Medicare |
$36.41
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$51.41
|
| Rate for Payer: Zelis Worker's Compensation |
$49.14
|
|
|
pop Detect Agent nos dna q3
|
Facility
|
IP
|
$94.00
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
2200760
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.60 |
| Max. Negotiated Rate |
$89.30 |
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cash Price |
$56.40
|
| Rate for Payer: Cigna Commercial |
$79.90
|
| Rate for Payer: First Health Commercial |
$84.60
|
| Rate for Payer: First Health Workers Compensation |
$69.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$84.60
|
| Rate for Payer: GEHA Commercial |
$65.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$84.60
|
| Rate for Payer: Multiplan All |
$85.54
|
| Rate for Payer: OMNI Networks Commercial |
$65.80
|
| Rate for Payer: One Health Plan PPO/POS |
$84.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$89.30
|
| Rate for Payer: Three Rivers Provider Network All |
$70.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$87.42
|
| Rate for Payer: Zelis Auto |
$37.60
|
| Rate for Payer: Zelis Worker's Compensation |
$49.14
|
|
|
pop drug assay infliximab REF cpt 80230
|
Facility
|
OP
|
$500.00
|
|
|
Service Code
|
CPT 80230
|
| Hospital Charge Code |
2201010
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.29 |
| Max. Negotiated Rate |
$475.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$57.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$300.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$57.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$45.83
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$38.57
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cigna Commercial |
$425.00
|
| Rate for Payer: First Health Commercial |
$450.00
|
| Rate for Payer: First Health Workers Compensation |
$44.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$450.00
|
| Rate for Payer: GEHA Commercial |
$400.00
|
| Rate for Payer: GEHA Medicare |
$38.57
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$450.00
|
| Rate for Payer: Humana ChoiceCare |
$42.43
|
| Rate for Payer: Humana Medicare Advantage |
$38.57
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$64.80
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$46.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$38.57
|
| Rate for Payer: Multiplan All |
$455.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$65.57
|
| Rate for Payer: OMNI Networks Commercial |
$350.00
|
| Rate for Payer: One Health Plan PPO/POS |
$450.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$54.00
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$46.77
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$38.57
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$475.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$77.14
|
| Rate for Payer: Three Rivers Provider Network All |
$375.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$37.80
|
| Rate for Payer: United Healthcare Commercial |
$425.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$46.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$38.57
|
| Rate for Payer: United Payors & United Providers UP&UP |
$465.00
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$38.57
|
| Rate for Payer: Zelis Auto |
$200.00
|
| Rate for Payer: Zelis Medicare |
$32.78
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$46.28
|
| Rate for Payer: Zelis Worker's Compensation |
$31.29
|
|
|
pop drug assay infliximab REF cpt 80230
|
Facility
|
IP
|
$500.00
|
|
|
Service Code
|
CPT 80230
|
| Hospital Charge Code |
2201010
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.29 |
| Max. Negotiated Rate |
$475.00 |
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cigna Commercial |
$425.00
|
| Rate for Payer: First Health Commercial |
$450.00
|
| Rate for Payer: First Health Workers Compensation |
$44.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$450.00
|
| Rate for Payer: GEHA Commercial |
$350.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$450.00
|
| Rate for Payer: Multiplan All |
$455.00
|
| Rate for Payer: OMNI Networks Commercial |
$350.00
|
| Rate for Payer: One Health Plan PPO/POS |
$450.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$475.00
|
| Rate for Payer: Three Rivers Provider Network All |
$375.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$465.00
|
| Rate for Payer: Zelis Auto |
$200.00
|
| Rate for Payer: Zelis Worker's Compensation |
$31.29
|
|
|
pop drug assay infliximab REF cpt 82397
|
Facility
|
OP
|
$249.00
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
2201011
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$236.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$25.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$149.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$25.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$20.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14.12
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Cigna Commercial |
$211.65
|
| Rate for Payer: First Health Commercial |
$224.10
|
| Rate for Payer: First Health Workers Compensation |
$22.35
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$224.10
|
| Rate for Payer: GEHA Commercial |
$199.20
|
| Rate for Payer: GEHA Medicare |
$14.12
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$224.10
|
| Rate for Payer: Humana ChoiceCare |
$15.53
|
| Rate for Payer: Humana Medicare Advantage |
$14.12
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$23.72
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$20.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14.12
|
| Rate for Payer: Multiplan All |
$226.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$24.00
|
| Rate for Payer: OMNI Networks Commercial |
$174.30
|
| Rate for Payer: One Health Plan PPO/POS |
$224.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$23.72
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$20.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14.12
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$236.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$28.24
|
| Rate for Payer: Three Rivers Provider Network All |
$186.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13.84
|
| Rate for Payer: United Healthcare Commercial |
$211.65
|
| Rate for Payer: United Healthcare Managed Medicaid |
$20.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.12
|
| Rate for Payer: United Payors & United Providers UP&UP |
$231.57
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$14.12
|
| Rate for Payer: Zelis Auto |
$99.60
|
| Rate for Payer: Zelis Medicare |
$12.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16.94
|
| Rate for Payer: Zelis Worker's Compensation |
$15.81
|
|
