|
pop motor neuro pan- ganglioside 5
|
Facility
|
OP
|
$249.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
2200606
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.31 |
| Max. Negotiated Rate |
$236.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$31.08
|
| 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 |
$31.08
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$24.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17.27
|
| 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 |
$20.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$224.10
|
| Rate for Payer: GEHA Commercial |
$199.20
|
| Rate for Payer: GEHA Medicare |
$17.27
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$224.10
|
| Rate for Payer: Humana ChoiceCare |
$19.00
|
| Rate for Payer: Humana Medicare Advantage |
$17.27
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$29.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$25.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17.27
|
| Rate for Payer: Multiplan All |
$226.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$29.36
|
| 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 |
$29.01
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$25.12
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17.27
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$236.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$34.54
|
| Rate for Payer: Three Rivers Provider Network All |
$186.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16.92
|
| Rate for Payer: United Healthcare Commercial |
$211.65
|
| Rate for Payer: United Healthcare Managed Medicaid |
$25.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.27
|
| Rate for Payer: United Payors & United Providers UP&UP |
$231.57
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$17.27
|
| Rate for Payer: Zelis Auto |
$99.60
|
| Rate for Payer: Zelis Medicare |
$14.68
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$20.72
|
| Rate for Payer: Zelis Worker's Compensation |
$14.31
|
|
|
pop motor neuro pan- ganglioside 6
|
Facility
|
IP
|
$249.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
2200607
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.31 |
| Max. Negotiated Rate |
$236.55 |
| 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 |
$20.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$224.10
|
| Rate for Payer: GEHA Commercial |
$174.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$224.10
|
| Rate for Payer: Multiplan All |
$226.59
|
| Rate for Payer: OMNI Networks Commercial |
$174.30
|
| Rate for Payer: One Health Plan PPO/POS |
$224.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$236.55
|
| Rate for Payer: Three Rivers Provider Network All |
$186.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$231.57
|
| Rate for Payer: Zelis Auto |
$99.60
|
| Rate for Payer: Zelis Worker's Compensation |
$14.31
|
|
|
pop motor neuro pan- ganglioside 6
|
Facility
|
OP
|
$249.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
2200607
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.31 |
| Max. Negotiated Rate |
$236.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$31.08
|
| 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 |
$31.08
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$24.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$17.27
|
| 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 |
$20.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$224.10
|
| Rate for Payer: GEHA Commercial |
$199.20
|
| Rate for Payer: GEHA Medicare |
$17.27
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$224.10
|
| Rate for Payer: Humana ChoiceCare |
$19.00
|
| Rate for Payer: Humana Medicare Advantage |
$17.27
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$29.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$25.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$17.27
|
| Rate for Payer: Multiplan All |
$226.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$29.36
|
| 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 |
$29.01
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$25.12
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17.27
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$236.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$34.54
|
| Rate for Payer: Three Rivers Provider Network All |
$186.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16.92
|
| Rate for Payer: United Healthcare Commercial |
$211.65
|
| Rate for Payer: United Healthcare Managed Medicaid |
$25.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.27
|
| Rate for Payer: United Payors & United Providers UP&UP |
$231.57
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$17.27
|
| Rate for Payer: Zelis Auto |
$99.60
|
| Rate for Payer: Zelis Medicare |
$14.68
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$20.72
|
| Rate for Payer: Zelis Worker's Compensation |
$14.31
|
|
|
pop mycobacteria tuberculosis,amp probe
|
Facility
|
IP
|
$421.00
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
2200570
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.21 |
| Max. Negotiated Rate |
$399.95 |
| Rate for Payer: Cash Price |
$252.60
|
| Rate for Payer: Cash Price |
$252.60
|
| Rate for Payer: Cigna Commercial |
$357.85
|
| Rate for Payer: First Health Commercial |
$378.90
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$378.90
|
| Rate for Payer: GEHA Commercial |
$294.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$378.90
|
| Rate for Payer: Multiplan All |
$383.11
|
| Rate for Payer: OMNI Networks Commercial |
$294.70
|
| Rate for Payer: One Health Plan PPO/POS |
$378.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$399.95
|
| Rate for Payer: Three Rivers Provider Network All |
$315.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$391.53
|
| Rate for Payer: Zelis Auto |
$168.40
|
| Rate for Payer: Zelis Worker's Compensation |
$39.21
|
|
|
pop mycobacteria tuberculosis,amp probe
|
Facility
|
OP
|
$421.00
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
2200570
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.43 |
| Max. Negotiated Rate |
$399.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$75.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$252.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$75.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$59.44
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$41.68
|
| Rate for Payer: Cash Price |
$252.60
|
| Rate for Payer: Cash Price |
$252.60
|
| Rate for Payer: Cigna Commercial |
$357.85
|
| Rate for Payer: First Health Commercial |
$378.90
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$378.90
|
| Rate for Payer: GEHA Commercial |
$336.80
|
| Rate for Payer: GEHA Medicare |
$41.68
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$378.90
|
| Rate for Payer: Humana ChoiceCare |
$45.85
|
| Rate for Payer: Humana Medicare Advantage |
$41.68
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$70.02
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$60.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$41.68
|
| Rate for Payer: Multiplan All |
$383.11
|
| Rate for Payer: New Mexico Health Connections Medicare |
$70.86
|
| Rate for Payer: OMNI Networks Commercial |
$294.70
|
| Rate for Payer: One Health Plan PPO/POS |
$378.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$70.03
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$60.65
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$41.68
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$399.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$83.36
|
| Rate for Payer: Three Rivers Provider Network All |
$315.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$40.85
|
| Rate for Payer: United Healthcare Commercial |
$357.85
|
| Rate for Payer: United Healthcare Managed Medicaid |
$60.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$41.68
|
| Rate for Payer: United Payors & United Providers UP&UP |
$391.53
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$41.68
|
| Rate for Payer: Zelis Auto |
$168.40
|
| Rate for Payer: Zelis Medicare |
$35.43
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$50.02
|
| Rate for Payer: Zelis Worker's Compensation |
$39.21
|
|
|
pop mycoplasma genitalium NAA
|
Facility
|
IP
|
$340.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
2200765
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.21 |
| Max. Negotiated Rate |
$323.00 |
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cigna Commercial |
$289.00
|
| Rate for Payer: First Health Commercial |
$306.00
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$306.00
|
| Rate for Payer: GEHA Commercial |
$238.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$306.00
|
| Rate for Payer: Multiplan All |
$309.40
|
| Rate for Payer: OMNI Networks Commercial |
$238.00
|
| Rate for Payer: One Health Plan PPO/POS |
$306.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$323.00
|
| Rate for Payer: Three Rivers Provider Network All |
$255.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$316.20
|
| Rate for Payer: Zelis Auto |
$136.00
|
| Rate for Payer: Zelis Worker's Compensation |
$39.21
|
|
|
pop mycoplasma genitalium NAA
|
Facility
|
OP
|
$340.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
2200765
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.83 |
| Max. Negotiated Rate |
$323.00 |
| 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 |
$204.00
|
| 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 |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cigna Commercial |
$289.00
|
| Rate for Payer: First Health Commercial |
$306.00
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$306.00
|
| Rate for Payer: GEHA Commercial |
$272.00
|
| Rate for Payer: GEHA Medicare |
$35.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$306.00
|
| 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 |
$309.40
|
| Rate for Payer: New Mexico Health Connections Medicare |
$59.65
|
| Rate for Payer: OMNI Networks Commercial |
$238.00
|
| Rate for Payer: One Health Plan PPO/POS |
$306.00
|
| 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 |
$323.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$70.18
|
| Rate for Payer: Three Rivers Provider Network All |
$255.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$34.39
|
| Rate for Payer: United Healthcare Commercial |
$289.00
|
| 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 |
$316.20
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$35.09
|
| Rate for Payer: Zelis Auto |
$136.00
|
| 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 mycoplasma hominis NAA
|
Facility
|
OP
|
$340.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
2200764
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.83 |
| Max. Negotiated Rate |
$323.00 |
| 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 |
$204.00
|
| 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 |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cigna Commercial |
$289.00
|
| Rate for Payer: First Health Commercial |
$306.00
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$306.00
|
| Rate for Payer: GEHA Commercial |
$272.00
|
| Rate for Payer: GEHA Medicare |
$35.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$306.00
|
| 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 |
$309.40
|
| Rate for Payer: New Mexico Health Connections Medicare |
$59.65
|
| Rate for Payer: OMNI Networks Commercial |
$238.00
|
| Rate for Payer: One Health Plan PPO/POS |
$306.00
|
| 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 |
$323.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$70.18
|
| Rate for Payer: Three Rivers Provider Network All |
$255.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$34.39
|
| Rate for Payer: United Healthcare Commercial |
$289.00
|
| 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 |
$316.20
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$35.09
|
| Rate for Payer: Zelis Auto |
$136.00
|
| 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 mycoplasma hominis NAA
|
Facility
|
IP
|
$340.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
2200764
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$39.21 |
| Max. Negotiated Rate |
$323.00 |
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cigna Commercial |
$289.00
|
| Rate for Payer: First Health Commercial |
$306.00
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$306.00
|
| Rate for Payer: GEHA Commercial |
$238.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$306.00
|
| Rate for Payer: Multiplan All |
$309.40
|
| Rate for Payer: OMNI Networks Commercial |
$238.00
|
| Rate for Payer: One Health Plan PPO/POS |
$306.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$323.00
|
| Rate for Payer: Three Rivers Provider Network All |
$255.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$316.20
|
| Rate for Payer: Zelis Auto |
$136.00
|
| Rate for Payer: Zelis Worker's Compensation |
$39.21
|
|
|
pop nephelometry not spec ref
|
Facility
|
OP
|
$155.00
|
|
|
Service Code
|
CPT 83883
|
| Hospital Charge Code |
2200099
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.56 |
| Max. Negotiated Rate |
$147.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$24.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$93.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$24.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$19.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$13.60
|
| Rate for Payer: Cash Price |
$93.00
|
| Rate for Payer: Cash Price |
$93.00
|
| Rate for Payer: Cigna Commercial |
$131.75
|
| Rate for Payer: First Health Commercial |
$139.50
|
| Rate for Payer: First Health Workers Compensation |
$17.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$139.50
|
| Rate for Payer: GEHA Commercial |
$124.00
|
| Rate for Payer: GEHA Medicare |
$13.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$139.50
|
| Rate for Payer: Humana ChoiceCare |
$14.96
|
| Rate for Payer: Humana Medicare Advantage |
$13.60
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$22.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$19.79
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$13.60
|
| Rate for Payer: Multiplan All |
$141.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$23.12
|
| Rate for Payer: OMNI Networks Commercial |
$108.50
|
| Rate for Payer: One Health Plan PPO/POS |
$139.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22.85
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$19.79
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$13.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$147.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$27.20
|
| Rate for Payer: Three Rivers Provider Network All |
$116.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$13.33
|
| Rate for Payer: United Healthcare Commercial |
$131.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$19.79
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.60
|
| Rate for Payer: United Payors & United Providers UP&UP |
$144.15
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$13.60
|
| Rate for Payer: Zelis Auto |
$62.00
|
| Rate for Payer: Zelis Medicare |
$11.56
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16.32
|
| Rate for Payer: Zelis Worker's Compensation |
$12.19
|
|
|
pop nephelometry not spec ref
|
Facility
|
IP
|
$155.00
|
|
|
Service Code
|
CPT 83883
|
| Hospital Charge Code |
2200099
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.19 |
| Max. Negotiated Rate |
$147.25 |
| Rate for Payer: Cash Price |
$93.00
|
| Rate for Payer: Cash Price |
$93.00
|
| Rate for Payer: Cigna Commercial |
$131.75
|
| Rate for Payer: First Health Commercial |
$139.50
|
| Rate for Payer: First Health Workers Compensation |
$17.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$139.50
|
| Rate for Payer: GEHA Commercial |
$108.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$139.50
|
| Rate for Payer: Multiplan All |
$141.05
|
| Rate for Payer: OMNI Networks Commercial |
$108.50
|
| Rate for Payer: One Health Plan PPO/POS |
$139.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$147.25
|
| Rate for Payer: Three Rivers Provider Network All |
$116.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$144.15
|
| Rate for Payer: Zelis Auto |
$62.00
|
| Rate for Payer: Zelis Worker's Compensation |
$12.19
|
|
|
pop neuronal volt gate k channel ab
|
Facility
|
IP
|
$305.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
2299527
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.64 |
| Max. Negotiated Rate |
$289.75 |
| Rate for Payer: Cash Price |
$183.00
|
| Rate for Payer: Cash Price |
$183.00
|
| Rate for Payer: Cigna Commercial |
$259.25
|
| Rate for Payer: First Health Commercial |
$274.50
|
| Rate for Payer: First Health Workers Compensation |
$20.71
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$274.50
|
| Rate for Payer: GEHA Commercial |
$213.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$274.50
|
| Rate for Payer: Multiplan All |
$277.55
|
| Rate for Payer: OMNI Networks Commercial |
$213.50
|
| Rate for Payer: One Health Plan PPO/POS |
$274.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$289.75
|
| Rate for Payer: Three Rivers Provider Network All |
$228.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$283.65
|
| Rate for Payer: Zelis Auto |
$122.00
|
| Rate for Payer: Zelis Worker's Compensation |
$14.64
|
|
|
pop neuronal volt gate k channel ab
|
Facility
|
OP
|
$305.00
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
2299527
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.64 |
| Max. Negotiated Rate |
$289.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$33.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$183.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$33.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$26.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$183.00
|
| Rate for Payer: Cash Price |
$183.00
|
| Rate for Payer: Cigna Commercial |
$259.25
|
| Rate for Payer: First Health Commercial |
$274.50
|
| Rate for Payer: First Health Workers Compensation |
$20.71
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$274.50
|
| Rate for Payer: GEHA Commercial |
$244.00
|
| Rate for Payer: GEHA Medicare |
$18.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$274.50
|
| Rate for Payer: Humana ChoiceCare |
$20.24
|
| Rate for Payer: Humana Medicare Advantage |
$18.40
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$30.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$26.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18.40
|
| Rate for Payer: Multiplan All |
$277.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$31.28
|
| Rate for Payer: OMNI Networks Commercial |
$213.50
|
| Rate for Payer: One Health Plan PPO/POS |
$274.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$30.91
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$26.77
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$289.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$36.80
|
| Rate for Payer: Three Rivers Provider Network All |
$228.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18.03
|
| Rate for Payer: United Healthcare Commercial |
$259.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$26.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.40
|
| Rate for Payer: United Payors & United Providers UP&UP |
$283.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$18.40
|
| Rate for Payer: Zelis Auto |
$122.00
|
| Rate for Payer: Zelis Medicare |
$15.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$22.08
|
| Rate for Payer: Zelis Worker's Compensation |
$14.64
|
|
|
pop N GONORRHEA
|
Facility
|
OP
|
$262.00
|
|
|
Service Code
|
CPT 87591
|
| Hospital Charge Code |
2299091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.83 |
| Max. Negotiated Rate |
$248.90 |
| 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 |
$157.20
|
| 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 |
$157.20
|
| Rate for Payer: Cash Price |
$157.20
|
| Rate for Payer: Cigna Commercial |
$222.70
|
| Rate for Payer: First Health Commercial |
$235.80
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$235.80
|
| Rate for Payer: GEHA Commercial |
$209.60
|
| Rate for Payer: GEHA Medicare |
$35.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$235.80
|
| 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 |
$238.42
|
| Rate for Payer: New Mexico Health Connections Medicare |
$59.65
|
| Rate for Payer: OMNI Networks Commercial |
$183.40
|
| Rate for Payer: One Health Plan PPO/POS |
$235.80
|
| 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 |
$248.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$70.18
|
| Rate for Payer: Three Rivers Provider Network All |
$196.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$34.39
|
| Rate for Payer: United Healthcare Commercial |
$222.70
|
| 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 |
$243.66
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$35.09
|
| Rate for Payer: Zelis Auto |
$104.80
|
| 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 N GONORRHEA
|
Facility
|
IP
|
$262.00
|
|
|
Service Code
|
CPT 87591
|
| Hospital Charge Code |
2299091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.21 |
| Max. Negotiated Rate |
$248.90 |
| Rate for Payer: Cash Price |
$157.20
|
| Rate for Payer: Cash Price |
$157.20
|
| Rate for Payer: Cigna Commercial |
$222.70
|
| Rate for Payer: First Health Commercial |
$235.80
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$235.80
|
| Rate for Payer: GEHA Commercial |
$183.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$235.80
|
| Rate for Payer: Multiplan All |
$238.42
|
| Rate for Payer: OMNI Networks Commercial |
$183.40
|
| Rate for Payer: One Health Plan PPO/POS |
$235.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$248.90
|
| Rate for Payer: Three Rivers Provider Network All |
$196.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$243.66
|
| Rate for Payer: Zelis Auto |
$104.80
|
| Rate for Payer: Zelis Worker's Compensation |
$39.21
|
|
|
pop norovirus G1 detect rt pcr REF
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
2200157
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.83 |
| Max. Negotiated Rate |
$96.90 |
| 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 |
$61.20
|
| 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 |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cigna Commercial |
$86.70
|
| Rate for Payer: First Health Commercial |
$91.80
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$91.80
|
| Rate for Payer: GEHA Commercial |
$81.60
|
| Rate for Payer: GEHA Medicare |
$35.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$91.80
|
| 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 |
$92.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$59.65
|
| Rate for Payer: OMNI Networks Commercial |
$71.40
|
| Rate for Payer: One Health Plan PPO/POS |
$91.80
|
| 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 |
$96.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$70.18
|
| Rate for Payer: Three Rivers Provider Network All |
$76.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$34.39
|
| Rate for Payer: United Healthcare Commercial |
$86.70
|
| 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 |
$94.86
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$35.09
|
| Rate for Payer: Zelis Auto |
$40.80
|
| 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 norovirus G1 detect rt pcr REF
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
2200157
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.21 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cigna Commercial |
$86.70
|
| Rate for Payer: First Health Commercial |
$91.80
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$91.80
|
| Rate for Payer: GEHA Commercial |
$71.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$91.80
|
| Rate for Payer: Multiplan All |
$92.82
|
| Rate for Payer: OMNI Networks Commercial |
$71.40
|
| Rate for Payer: One Health Plan PPO/POS |
$91.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$96.90
|
| Rate for Payer: Three Rivers Provider Network All |
$76.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$94.86
|
| Rate for Payer: Zelis Auto |
$40.80
|
| Rate for Payer: Zelis Worker's Compensation |
$39.21
|
|
|
pop norovirus G2 detect rt pcr REF
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
2200158
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.83 |
| Max. Negotiated Rate |
$96.90 |
| 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 |
$61.20
|
| 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 |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cigna Commercial |
$86.70
|
| Rate for Payer: First Health Commercial |
$91.80
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$91.80
|
| Rate for Payer: GEHA Commercial |
$81.60
|
| Rate for Payer: GEHA Medicare |
$35.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$91.80
|
| 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 |
$92.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$59.65
|
| Rate for Payer: OMNI Networks Commercial |
$71.40
|
| Rate for Payer: One Health Plan PPO/POS |
$91.80
|
| 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 |
$96.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$70.18
|
| Rate for Payer: Three Rivers Provider Network All |
$76.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$34.39
|
| Rate for Payer: United Healthcare Commercial |
$86.70
|
| 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 |
$94.86
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$35.09
|
| Rate for Payer: Zelis Auto |
$40.80
|
| 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 norovirus G2 detect rt pcr REF
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
2200158
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.21 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cigna Commercial |
$86.70
|
| Rate for Payer: First Health Commercial |
$91.80
|
| Rate for Payer: First Health Workers Compensation |
$55.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$91.80
|
| Rate for Payer: GEHA Commercial |
$71.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$91.80
|
| Rate for Payer: Multiplan All |
$92.82
|
| Rate for Payer: OMNI Networks Commercial |
$71.40
|
| Rate for Payer: One Health Plan PPO/POS |
$91.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$96.90
|
| Rate for Payer: Three Rivers Provider Network All |
$76.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$94.86
|
| Rate for Payer: Zelis Auto |
$40.80
|
| Rate for Payer: Zelis Worker's Compensation |
$39.21
|
|
|
pop n telopeptide crosslinks, urine
|
Facility
|
OP
|
$254.00
|
|
|
Service Code
|
CPT 82523
|
| Hospital Charge Code |
2200620
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.88 |
| Max. Negotiated Rate |
$241.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$33.63
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$152.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$33.63
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$26.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18.68
|
| Rate for Payer: Cash Price |
$152.40
|
| Rate for Payer: Cash Price |
$152.40
|
| Rate for Payer: Cigna Commercial |
$215.90
|
| Rate for Payer: First Health Commercial |
$228.60
|
| Rate for Payer: First Health Workers Compensation |
$33.06
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$228.60
|
| Rate for Payer: GEHA Commercial |
$203.20
|
| Rate for Payer: GEHA Medicare |
$18.68
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$228.60
|
| Rate for Payer: Humana ChoiceCare |
$20.55
|
| Rate for Payer: Humana Medicare Advantage |
$18.68
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$27.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18.68
|
| Rate for Payer: Multiplan All |
$231.14
|
| Rate for Payer: New Mexico Health Connections Medicare |
$31.76
|
| Rate for Payer: OMNI Networks Commercial |
$177.80
|
| Rate for Payer: One Health Plan PPO/POS |
$228.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$31.39
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$27.18
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18.68
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$241.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$37.36
|
| Rate for Payer: Three Rivers Provider Network All |
$190.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18.31
|
| Rate for Payer: United Healthcare Commercial |
$215.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$27.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.68
|
| Rate for Payer: United Payors & United Providers UP&UP |
$236.22
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$18.68
|
| Rate for Payer: Zelis Auto |
$101.60
|
| Rate for Payer: Zelis Medicare |
$15.88
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$22.42
|
| Rate for Payer: Zelis Worker's Compensation |
$23.37
|
|
|
pop n telopeptide crosslinks, urine
|
Facility
|
IP
|
$254.00
|
|
|
Service Code
|
CPT 82523
|
| Hospital Charge Code |
2200620
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.37 |
| Max. Negotiated Rate |
$241.30 |
| Rate for Payer: Cash Price |
$152.40
|
| Rate for Payer: Cash Price |
$152.40
|
| Rate for Payer: Cigna Commercial |
$215.90
|
| Rate for Payer: First Health Commercial |
$228.60
|
| Rate for Payer: First Health Workers Compensation |
$33.06
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$228.60
|
| Rate for Payer: GEHA Commercial |
$177.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$228.60
|
| Rate for Payer: Multiplan All |
$231.14
|
| Rate for Payer: OMNI Networks Commercial |
$177.80
|
| Rate for Payer: One Health Plan PPO/POS |
$228.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$241.30
|
| Rate for Payer: Three Rivers Provider Network All |
$190.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$236.22
|
| Rate for Payer: Zelis Auto |
$101.60
|
| Rate for Payer: Zelis Worker's Compensation |
$23.37
|
|
|
pop osmolality urn 306266 REF
|
Facility
|
IP
|
$180.00
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
2202031
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$171.00 |
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cigna Commercial |
$153.00
|
| Rate for Payer: First Health Commercial |
$162.00
|
| Rate for Payer: First Health Workers Compensation |
$12.32
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$162.00
|
| Rate for Payer: GEHA Commercial |
$126.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$162.00
|
| Rate for Payer: Multiplan All |
$163.80
|
| Rate for Payer: OMNI Networks Commercial |
$126.00
|
| Rate for Payer: One Health Plan PPO/POS |
$162.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$171.00
|
| Rate for Payer: Three Rivers Provider Network All |
$135.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$167.40
|
| Rate for Payer: Zelis Auto |
$72.00
|
| Rate for Payer: Zelis Worker's Compensation |
$8.71
|
|
|
pop osmolality urn 306266 REF
|
Facility
|
OP
|
$180.00
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
2202031
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.80 |
| Max. Negotiated Rate |
$171.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$12.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$108.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$12.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6.82
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cigna Commercial |
$153.00
|
| Rate for Payer: First Health Commercial |
$162.00
|
| Rate for Payer: First Health Workers Compensation |
$12.32
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$162.00
|
| Rate for Payer: GEHA Commercial |
$144.00
|
| Rate for Payer: GEHA Medicare |
$6.82
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$162.00
|
| Rate for Payer: Humana ChoiceCare |
$7.50
|
| Rate for Payer: Humana Medicare Advantage |
$6.82
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11.46
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6.82
|
| Rate for Payer: Multiplan All |
$163.80
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11.59
|
| Rate for Payer: OMNI Networks Commercial |
$126.00
|
| Rate for Payer: One Health Plan PPO/POS |
$162.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11.45
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9.92
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6.82
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$171.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13.64
|
| Rate for Payer: Three Rivers Provider Network All |
$135.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6.68
|
| Rate for Payer: United Healthcare Commercial |
$153.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.82
|
| Rate for Payer: United Payors & United Providers UP&UP |
$167.40
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6.82
|
| Rate for Payer: Zelis Auto |
$72.00
|
| Rate for Payer: Zelis Medicare |
$5.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8.18
|
| Rate for Payer: Zelis Worker's Compensation |
$8.71
|
|
|
pop oxalate urine ref
|
Facility
|
IP
|
$120.00
|
|
|
Service Code
|
CPT 83945
|
| Hospital Charge Code |
2299381
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.21 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cigna Commercial |
$102.00
|
| Rate for Payer: First Health Commercial |
$108.00
|
| Rate for Payer: First Health Workers Compensation |
$24.33
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$108.00
|
| Rate for Payer: GEHA Commercial |
$84.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$108.00
|
| Rate for Payer: Multiplan All |
$109.20
|
| Rate for Payer: OMNI Networks Commercial |
$84.00
|
| Rate for Payer: One Health Plan PPO/POS |
$108.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$114.00
|
| Rate for Payer: Three Rivers Provider Network All |
$90.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$111.60
|
| Rate for Payer: Zelis Auto |
$48.00
|
| Rate for Payer: Zelis Worker's Compensation |
$17.21
|
|
|
pop oxalate urine ref
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
CPT 83945
|
| Hospital Charge Code |
2299381
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.28 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$26.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$72.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$26.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$20.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$14.45
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cigna Commercial |
$102.00
|
| Rate for Payer: First Health Commercial |
$108.00
|
| Rate for Payer: First Health Workers Compensation |
$24.33
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$108.00
|
| Rate for Payer: GEHA Commercial |
$96.00
|
| Rate for Payer: GEHA Medicare |
$14.45
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$108.00
|
| Rate for Payer: Humana ChoiceCare |
$15.89
|
| Rate for Payer: Humana Medicare Advantage |
$14.45
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$24.28
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$21.02
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$14.45
|
| Rate for Payer: Multiplan All |
$109.20
|
| Rate for Payer: New Mexico Health Connections Medicare |
$24.57
|
| Rate for Payer: OMNI Networks Commercial |
$84.00
|
| Rate for Payer: One Health Plan PPO/POS |
$108.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$24.28
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$21.02
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$14.45
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$114.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$28.90
|
| Rate for Payer: Three Rivers Provider Network All |
$90.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$14.16
|
| Rate for Payer: United Healthcare Commercial |
$102.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$21.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.45
|
| Rate for Payer: United Payors & United Providers UP&UP |
$111.60
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$14.45
|
| Rate for Payer: Zelis Auto |
$48.00
|
| Rate for Payer: Zelis Medicare |
$12.28
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$17.34
|
| Rate for Payer: Zelis Worker's Compensation |
$17.21
|
|
