|
PSYCHOTHERAPY COMPLEX INTERACTIVE
|
Facility
|
IP
|
$46.00
|
|
|
Service Code
|
CPT 90785
|
| Hospital Charge Code |
8499231
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$12.56 |
| Max. Negotiated Rate |
$43.70 |
| Rate for Payer: Cash Price |
$27.60
|
| Rate for Payer: Cigna Commercial |
$39.10
|
| Rate for Payer: First Health Commercial |
$41.40
|
| Rate for Payer: First Health Workers Compensation |
$17.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$41.40
|
| Rate for Payer: GEHA Commercial |
$32.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$41.40
|
| Rate for Payer: Multiplan All |
$41.86
|
| Rate for Payer: OMNI Networks Commercial |
$32.20
|
| Rate for Payer: One Health Plan PPO/POS |
$41.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$43.70
|
| Rate for Payer: Three Rivers Provider Network All |
$34.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$42.78
|
| Rate for Payer: Zelis Auto |
$18.40
|
| Rate for Payer: Zelis Worker's Compensation |
$12.56
|
|
|
PSYCHOTHERAPY W/PATIENT 30 MINUTES
|
Facility
|
IP
|
$207.00
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
9599232
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$56.51 |
| Max. Negotiated Rate |
$196.65 |
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$175.95
|
| Rate for Payer: First Health Commercial |
$186.30
|
| Rate for Payer: First Health Workers Compensation |
$79.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$186.30
|
| Rate for Payer: GEHA Commercial |
$144.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$186.30
|
| Rate for Payer: Multiplan All |
$188.37
|
| Rate for Payer: OMNI Networks Commercial |
$144.90
|
| Rate for Payer: One Health Plan PPO/POS |
$186.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$196.65
|
| Rate for Payer: Three Rivers Provider Network All |
$155.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$192.51
|
| Rate for Payer: Zelis Auto |
$82.80
|
| Rate for Payer: Zelis Worker's Compensation |
$56.51
|
|
|
PSYCHOTHERAPY W/PATIENT 30 MINUTES
|
Facility
|
OP
|
$207.00
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
8499232
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$56.51 |
| Max. Negotiated Rate |
$305.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$117.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$117.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$93.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$152.56
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$175.95
|
| Rate for Payer: First Health Commercial |
$186.30
|
| Rate for Payer: First Health Workers Compensation |
$79.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$186.30
|
| Rate for Payer: GEHA Commercial |
$165.60
|
| Rate for Payer: GEHA Medicare |
$152.56
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$186.30
|
| Rate for Payer: Humana ChoiceCare |
$167.82
|
| Rate for Payer: Humana Medicare Advantage |
$152.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$256.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$94.96
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$152.56
|
| Rate for Payer: Multiplan All |
$188.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$259.35
|
| Rate for Payer: OMNI Networks Commercial |
$144.90
|
| Rate for Payer: One Health Plan PPO/POS |
$186.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$109.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$80.00
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$152.56
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$196.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$305.12
|
| Rate for Payer: Three Rivers Provider Network All |
$155.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$149.51
|
| Rate for Payer: United Healthcare Managed Medicaid |
$94.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$152.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$192.51
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$152.56
|
| Rate for Payer: Zelis Auto |
$82.80
|
| Rate for Payer: Zelis Medicare |
$129.68
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$183.07
|
| Rate for Payer: Zelis Worker's Compensation |
$56.51
|
|
|
PSYCHOTHERAPY W/PATIENT 30 MINUTES
|
Facility
|
OP
|
$207.00
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
9599232
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$56.51 |
| Max. Negotiated Rate |
$305.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$117.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$117.48
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$93.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$152.56
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$175.95
|
| Rate for Payer: First Health Commercial |
$186.30
|
| Rate for Payer: First Health Workers Compensation |
$79.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$186.30
|
| Rate for Payer: GEHA Commercial |
$165.60
|
| Rate for Payer: GEHA Medicare |
$152.56
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$186.30
|
| Rate for Payer: Humana ChoiceCare |
$167.82
|
| Rate for Payer: Humana Medicare Advantage |
$152.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$256.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$94.96
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$152.56
|
| Rate for Payer: Multiplan All |
$188.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$259.35
|
| Rate for Payer: OMNI Networks Commercial |
$144.90
|
| Rate for Payer: One Health Plan PPO/POS |
$186.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$109.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$94.96
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$152.56
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$196.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$305.12
|
| Rate for Payer: Three Rivers Provider Network All |
$155.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$149.51
|
| Rate for Payer: United Healthcare Managed Medicaid |
$94.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$152.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$192.51
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$152.56
|
| Rate for Payer: Zelis Auto |
$82.80
|
| Rate for Payer: Zelis Medicare |
$129.68
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$183.07
|
| Rate for Payer: Zelis Worker's Compensation |
$56.51
|
|
|
PSYCHOTHERAPY W/PATIENT 30 MINUTES
|
Facility
|
IP
|
$207.00
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
8499232
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$56.51 |
| Max. Negotiated Rate |
$196.65 |
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$175.95
|
| Rate for Payer: First Health Commercial |
$186.30
|
| Rate for Payer: First Health Workers Compensation |
$79.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$186.30
|
| Rate for Payer: GEHA Commercial |
$144.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$186.30
|
| Rate for Payer: Multiplan All |
$188.37
|
| Rate for Payer: OMNI Networks Commercial |
$144.90
|
| Rate for Payer: One Health Plan PPO/POS |
$186.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$196.65
|
| Rate for Payer: Three Rivers Provider Network All |
$155.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$192.51
|
| Rate for Payer: Zelis Auto |
$82.80
|
| Rate for Payer: Zelis Worker's Compensation |
$56.51
|
|
|
PSYCHOTHERAPY W/PATIENT 45 MINUTES
|
Facility
|
OP
|
$275.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
9599233
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$75.08 |
| Max. Negotiated Rate |
$305.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$156.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$165.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$156.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$123.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$152.56
|
| Rate for Payer: Cash Price |
$165.00
|
| Rate for Payer: Cash Price |
$165.00
|
| Rate for Payer: Cigna Commercial |
$233.75
|
| Rate for Payer: First Health Commercial |
$247.50
|
| Rate for Payer: First Health Workers Compensation |
$106.18
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$247.50
|
| Rate for Payer: GEHA Commercial |
$220.00
|
| Rate for Payer: GEHA Medicare |
$152.56
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$247.50
|
| Rate for Payer: Humana ChoiceCare |
$167.82
|
| Rate for Payer: Humana Medicare Advantage |
$152.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$256.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$126.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$152.56
|
| Rate for Payer: Multiplan All |
$250.25
|
| Rate for Payer: New Mexico Health Connections Medicare |
$259.35
|
| Rate for Payer: OMNI Networks Commercial |
$192.50
|
| Rate for Payer: One Health Plan PPO/POS |
$247.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$145.78
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$126.26
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$152.56
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$261.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$305.12
|
| Rate for Payer: Three Rivers Provider Network All |
$206.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$149.51
|
| Rate for Payer: United Healthcare Managed Medicaid |
$126.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$152.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$255.75
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$152.56
|
| Rate for Payer: Zelis Auto |
$110.00
|
| Rate for Payer: Zelis Medicare |
$129.68
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$183.07
|
| Rate for Payer: Zelis Worker's Compensation |
$75.08
|
|
|
PSYCHOTHERAPY W/PATIENT 45 MINUTES
|
Facility
|
IP
|
$275.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
9599233
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$75.08 |
| Max. Negotiated Rate |
$261.25 |
| Rate for Payer: Cash Price |
$165.00
|
| Rate for Payer: Cigna Commercial |
$233.75
|
| Rate for Payer: First Health Commercial |
$247.50
|
| Rate for Payer: First Health Workers Compensation |
$106.18
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$247.50
|
| Rate for Payer: GEHA Commercial |
$192.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$247.50
|
| Rate for Payer: Multiplan All |
$250.25
|
| Rate for Payer: OMNI Networks Commercial |
$192.50
|
| Rate for Payer: One Health Plan PPO/POS |
$247.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$261.25
|
| Rate for Payer: Three Rivers Provider Network All |
$206.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$255.75
|
| Rate for Payer: Zelis Auto |
$110.00
|
| Rate for Payer: Zelis Worker's Compensation |
$75.08
|
|
|
PSYCHOTHERAPY W/PATIENT 45 MINUTES
|
Facility
|
OP
|
$275.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
8499233
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$75.08 |
| Max. Negotiated Rate |
$305.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$156.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$165.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$156.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$123.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$152.56
|
| Rate for Payer: Cash Price |
$165.00
|
| Rate for Payer: Cash Price |
$165.00
|
| Rate for Payer: Cash Price |
$165.00
|
| Rate for Payer: Cigna Commercial |
$233.75
|
| Rate for Payer: First Health Commercial |
$247.50
|
| Rate for Payer: First Health Workers Compensation |
$106.18
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$247.50
|
| Rate for Payer: GEHA Commercial |
$220.00
|
| Rate for Payer: GEHA Medicare |
$152.56
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$247.50
|
| Rate for Payer: Humana ChoiceCare |
$167.82
|
| Rate for Payer: Humana Medicare Advantage |
$152.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$256.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$126.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$152.56
|
| Rate for Payer: Multiplan All |
$250.25
|
| Rate for Payer: New Mexico Health Connections Medicare |
$259.35
|
| Rate for Payer: OMNI Networks Commercial |
$192.50
|
| Rate for Payer: One Health Plan PPO/POS |
$247.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$145.78
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$80.00
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$152.56
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$261.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$305.12
|
| Rate for Payer: Three Rivers Provider Network All |
$206.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$149.51
|
| Rate for Payer: United Healthcare Managed Medicaid |
$126.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$152.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$255.75
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$152.56
|
| Rate for Payer: Zelis Auto |
$110.00
|
| Rate for Payer: Zelis Medicare |
$129.68
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$183.07
|
| Rate for Payer: Zelis Worker's Compensation |
$75.08
|
|
|
PSYCHOTHERAPY W/PATIENT 45 MINUTES
|
Facility
|
IP
|
$275.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
8499233
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$75.08 |
| Max. Negotiated Rate |
$261.25 |
| Rate for Payer: Cash Price |
$165.00
|
| Rate for Payer: Cigna Commercial |
$233.75
|
| Rate for Payer: First Health Commercial |
$247.50
|
| Rate for Payer: First Health Workers Compensation |
$106.18
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$247.50
|
| Rate for Payer: GEHA Commercial |
$192.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$247.50
|
| Rate for Payer: Multiplan All |
$250.25
|
| Rate for Payer: OMNI Networks Commercial |
$192.50
|
| Rate for Payer: One Health Plan PPO/POS |
$247.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$261.25
|
| Rate for Payer: Three Rivers Provider Network All |
$206.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$255.75
|
| Rate for Payer: Zelis Auto |
$110.00
|
| Rate for Payer: Zelis Worker's Compensation |
$75.08
|
|
|
PSYCHOTHERAPY W/PATIENT 60 MINUTES
|
Facility
|
IP
|
$414.00
|
|
|
Service Code
|
CPT 90837
|
| Hospital Charge Code |
8499234
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$113.02 |
| Max. Negotiated Rate |
$393.30 |
| Rate for Payer: Cash Price |
$248.40
|
| Rate for Payer: Cigna Commercial |
$351.90
|
| Rate for Payer: First Health Commercial |
$372.60
|
| Rate for Payer: First Health Workers Compensation |
$159.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$372.60
|
| Rate for Payer: GEHA Commercial |
$289.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$372.60
|
| Rate for Payer: Multiplan All |
$376.74
|
| Rate for Payer: OMNI Networks Commercial |
$289.80
|
| Rate for Payer: One Health Plan PPO/POS |
$372.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$393.30
|
| Rate for Payer: Three Rivers Provider Network All |
$310.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$385.02
|
| Rate for Payer: Zelis Auto |
$165.60
|
| Rate for Payer: Zelis Worker's Compensation |
$113.02
|
|
|
PSYCHOTHERAPY W/PATIENT 60 MINUTES
|
Facility
|
OP
|
$414.00
|
|
|
Service Code
|
CPT 90837
|
| Hospital Charge Code |
8499234
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$393.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$156.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$248.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$156.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$123.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$152.56
|
| Rate for Payer: Cash Price |
$248.40
|
| Rate for Payer: Cash Price |
$248.40
|
| Rate for Payer: Cash Price |
$248.40
|
| Rate for Payer: Cigna Commercial |
$351.90
|
| Rate for Payer: First Health Commercial |
$372.60
|
| Rate for Payer: First Health Workers Compensation |
$159.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$372.60
|
| Rate for Payer: GEHA Commercial |
$331.20
|
| Rate for Payer: GEHA Medicare |
$152.56
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$372.60
|
| Rate for Payer: Humana ChoiceCare |
$167.82
|
| Rate for Payer: Humana Medicare Advantage |
$152.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$256.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$126.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$152.56
|
| Rate for Payer: Multiplan All |
$376.74
|
| Rate for Payer: New Mexico Health Connections Medicare |
$259.35
|
| Rate for Payer: OMNI Networks Commercial |
$289.80
|
| Rate for Payer: One Health Plan PPO/POS |
$372.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$145.78
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$80.00
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$152.56
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$393.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$305.12
|
| Rate for Payer: Three Rivers Provider Network All |
$310.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$149.51
|
| Rate for Payer: United Healthcare Managed Medicaid |
$126.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$152.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$385.02
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$152.56
|
| Rate for Payer: Zelis Auto |
$165.60
|
| Rate for Payer: Zelis Medicare |
$129.68
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$183.07
|
| Rate for Payer: Zelis Worker's Compensation |
$113.02
|
|
|
PSYCHOTHERAPY W/PATIENT 60 MINUTES
|
Facility
|
OP
|
$414.00
|
|
|
Service Code
|
CPT 90837
|
| Hospital Charge Code |
9599234
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$113.02 |
| Max. Negotiated Rate |
$393.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$156.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$248.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$156.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$123.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$152.56
|
| Rate for Payer: Cash Price |
$248.40
|
| Rate for Payer: Cash Price |
$248.40
|
| Rate for Payer: Cigna Commercial |
$351.90
|
| Rate for Payer: First Health Commercial |
$372.60
|
| Rate for Payer: First Health Workers Compensation |
$159.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$372.60
|
| Rate for Payer: GEHA Commercial |
$331.20
|
| Rate for Payer: GEHA Medicare |
$152.56
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$372.60
|
| Rate for Payer: Humana ChoiceCare |
$167.82
|
| Rate for Payer: Humana Medicare Advantage |
$152.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$256.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$126.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$152.56
|
| Rate for Payer: Multiplan All |
$376.74
|
| Rate for Payer: New Mexico Health Connections Medicare |
$259.35
|
| Rate for Payer: OMNI Networks Commercial |
$289.80
|
| Rate for Payer: One Health Plan PPO/POS |
$372.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$145.78
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$126.26
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$152.56
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$393.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$305.12
|
| Rate for Payer: Three Rivers Provider Network All |
$310.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$149.51
|
| Rate for Payer: United Healthcare Managed Medicaid |
$126.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$152.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$385.02
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$152.56
|
| Rate for Payer: Zelis Auto |
$165.60
|
| Rate for Payer: Zelis Medicare |
$129.68
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$183.07
|
| Rate for Payer: Zelis Worker's Compensation |
$113.02
|
|
|
PSYCHOTHERAPY W/PATIENT 60 MINUTES
|
Facility
|
IP
|
$414.00
|
|
|
Service Code
|
CPT 90837
|
| Hospital Charge Code |
9599234
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$113.02 |
| Max. Negotiated Rate |
$393.30 |
| Rate for Payer: Cash Price |
$248.40
|
| Rate for Payer: Cigna Commercial |
$351.90
|
| Rate for Payer: First Health Commercial |
$372.60
|
| Rate for Payer: First Health Workers Compensation |
$159.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$372.60
|
| Rate for Payer: GEHA Commercial |
$289.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$372.60
|
| Rate for Payer: Multiplan All |
$376.74
|
| Rate for Payer: OMNI Networks Commercial |
$289.80
|
| Rate for Payer: One Health Plan PPO/POS |
$372.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$393.30
|
| Rate for Payer: Three Rivers Provider Network All |
$310.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$385.02
|
| Rate for Payer: Zelis Auto |
$165.60
|
| Rate for Payer: Zelis Worker's Compensation |
$113.02
|
|
|
PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 M
|
Facility
|
IP
|
$214.00
|
|
|
Service Code
|
CPT 90833
|
| Hospital Charge Code |
8499228
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$58.42 |
| Max. Negotiated Rate |
$203.30 |
| Rate for Payer: Cash Price |
$128.40
|
| Rate for Payer: Cigna Commercial |
$181.90
|
| Rate for Payer: First Health Commercial |
$192.60
|
| Rate for Payer: First Health Workers Compensation |
$82.63
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$192.60
|
| Rate for Payer: GEHA Commercial |
$149.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$192.60
|
| Rate for Payer: Multiplan All |
$194.74
|
| Rate for Payer: OMNI Networks Commercial |
$149.80
|
| Rate for Payer: One Health Plan PPO/POS |
$192.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$203.30
|
| Rate for Payer: Three Rivers Provider Network All |
$160.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$199.02
|
| Rate for Payer: Zelis Auto |
$85.60
|
| Rate for Payer: Zelis Worker's Compensation |
$58.42
|
|
|
PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 M
|
Facility
|
IP
|
$214.00
|
|
|
Service Code
|
CPT 90833
|
| Hospital Charge Code |
9599228
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$58.42 |
| Max. Negotiated Rate |
$203.30 |
| Rate for Payer: Cash Price |
$128.40
|
| Rate for Payer: Cigna Commercial |
$181.90
|
| Rate for Payer: First Health Commercial |
$192.60
|
| Rate for Payer: First Health Workers Compensation |
$82.63
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$192.60
|
| Rate for Payer: GEHA Commercial |
$149.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$192.60
|
| Rate for Payer: Multiplan All |
$194.74
|
| Rate for Payer: OMNI Networks Commercial |
$149.80
|
| Rate for Payer: One Health Plan PPO/POS |
$192.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$203.30
|
| Rate for Payer: Three Rivers Provider Network All |
$160.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$199.02
|
| Rate for Payer: Zelis Auto |
$85.60
|
| Rate for Payer: Zelis Worker's Compensation |
$58.42
|
|
|
PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 M
|
Facility
|
OP
|
$214.00
|
|
|
Service Code
|
CPT 90833
|
| Hospital Charge Code |
8499228
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$48.64 |
| Max. Negotiated Rate |
$203.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$61.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$128.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$61.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$48.64
|
| Rate for Payer: Cash Price |
$128.40
|
| Rate for Payer: Cash Price |
$128.40
|
| Rate for Payer: Cash Price |
$128.40
|
| Rate for Payer: Cigna Commercial |
$181.90
|
| Rate for Payer: First Health Commercial |
$192.60
|
| Rate for Payer: First Health Workers Compensation |
$82.63
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$192.60
|
| Rate for Payer: GEHA Commercial |
$171.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$192.60
|
| Rate for Payer: Humana ChoiceCare |
$55.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$49.63
|
| Rate for Payer: Multiplan All |
$194.74
|
| Rate for Payer: New Mexico Health Connections Medicare |
$128.40
|
| Rate for Payer: OMNI Networks Commercial |
$149.80
|
| Rate for Payer: One Health Plan PPO/POS |
$192.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$57.30
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$80.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$203.30
|
| Rate for Payer: Three Rivers Provider Network All |
$160.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$188.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$49.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$199.02
|
| Rate for Payer: Zelis Auto |
$85.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$107.00
|
| Rate for Payer: Zelis Worker's Compensation |
$58.42
|
|
|
PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 M
|
Facility
|
OP
|
$214.00
|
|
|
Service Code
|
CPT 90833
|
| Hospital Charge Code |
9599228
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$48.64 |
| Max. Negotiated Rate |
$203.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$61.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$128.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$61.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$48.64
|
| Rate for Payer: Cash Price |
$128.40
|
| Rate for Payer: Cash Price |
$128.40
|
| Rate for Payer: Cigna Commercial |
$181.90
|
| Rate for Payer: First Health Commercial |
$192.60
|
| Rate for Payer: First Health Workers Compensation |
$82.63
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$192.60
|
| Rate for Payer: GEHA Commercial |
$171.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$192.60
|
| Rate for Payer: Humana ChoiceCare |
$55.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$49.63
|
| Rate for Payer: Multiplan All |
$194.74
|
| Rate for Payer: New Mexico Health Connections Medicare |
$128.40
|
| Rate for Payer: OMNI Networks Commercial |
$149.80
|
| Rate for Payer: One Health Plan PPO/POS |
$192.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$57.30
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$49.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$203.30
|
| Rate for Payer: Three Rivers Provider Network All |
$160.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$188.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$49.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$199.02
|
| Rate for Payer: Zelis Auto |
$85.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$107.00
|
| Rate for Payer: Zelis Worker's Compensation |
$58.42
|
|
|
PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 45 M
|
Facility
|
OP
|
$271.00
|
|
|
Service Code
|
CPT 90836
|
| Hospital Charge Code |
8499229
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$70.46 |
| Max. Negotiated Rate |
$257.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$99.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$162.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$99.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$78.95
|
| Rate for Payer: Cash Price |
$162.60
|
| Rate for Payer: Cash Price |
$162.60
|
| Rate for Payer: Cash Price |
$162.60
|
| Rate for Payer: Cigna Commercial |
$230.35
|
| Rate for Payer: First Health Commercial |
$243.90
|
| Rate for Payer: First Health Workers Compensation |
$104.63
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$243.90
|
| Rate for Payer: GEHA Commercial |
$216.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$243.90
|
| Rate for Payer: Humana ChoiceCare |
$70.46
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$80.56
|
| Rate for Payer: Multiplan All |
$246.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$162.60
|
| Rate for Payer: OMNI Networks Commercial |
$189.70
|
| Rate for Payer: One Health Plan PPO/POS |
$243.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$93.02
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$80.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$257.45
|
| Rate for Payer: Three Rivers Provider Network All |
$203.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$238.48
|
| Rate for Payer: United Healthcare Managed Medicaid |
$80.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$252.03
|
| Rate for Payer: Zelis Auto |
$108.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$135.50
|
| Rate for Payer: Zelis Worker's Compensation |
$73.98
|
|
|
PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 45 M
|
Facility
|
OP
|
$271.00
|
|
|
Service Code
|
CPT 90836
|
| Hospital Charge Code |
9599229
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$70.46 |
| Max. Negotiated Rate |
$257.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$99.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$162.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$99.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$78.95
|
| Rate for Payer: Cash Price |
$162.60
|
| Rate for Payer: Cash Price |
$162.60
|
| Rate for Payer: Cigna Commercial |
$230.35
|
| Rate for Payer: First Health Commercial |
$243.90
|
| Rate for Payer: First Health Workers Compensation |
$104.63
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$243.90
|
| Rate for Payer: GEHA Commercial |
$216.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$243.90
|
| Rate for Payer: Humana ChoiceCare |
$70.46
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$80.56
|
| Rate for Payer: Multiplan All |
$246.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$162.60
|
| Rate for Payer: OMNI Networks Commercial |
$189.70
|
| Rate for Payer: One Health Plan PPO/POS |
$243.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$93.02
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$80.56
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$257.45
|
| Rate for Payer: Three Rivers Provider Network All |
$203.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$238.48
|
| Rate for Payer: United Healthcare Managed Medicaid |
$80.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$252.03
|
| Rate for Payer: Zelis Auto |
$108.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$135.50
|
| Rate for Payer: Zelis Worker's Compensation |
$73.98
|
|
|
PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 45 M
|
Facility
|
IP
|
$271.00
|
|
|
Service Code
|
CPT 90836
|
| Hospital Charge Code |
9599229
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$73.98 |
| Max. Negotiated Rate |
$257.45 |
| Rate for Payer: Cash Price |
$162.60
|
| Rate for Payer: Cigna Commercial |
$230.35
|
| Rate for Payer: First Health Commercial |
$243.90
|
| Rate for Payer: First Health Workers Compensation |
$104.63
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$243.90
|
| Rate for Payer: GEHA Commercial |
$189.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$243.90
|
| Rate for Payer: Multiplan All |
$246.61
|
| Rate for Payer: OMNI Networks Commercial |
$189.70
|
| Rate for Payer: One Health Plan PPO/POS |
$243.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$257.45
|
| Rate for Payer: Three Rivers Provider Network All |
$203.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$252.03
|
| Rate for Payer: Zelis Auto |
$108.40
|
| Rate for Payer: Zelis Worker's Compensation |
$73.98
|
|
|
PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 45 M
|
Facility
|
IP
|
$271.00
|
|
|
Service Code
|
CPT 90836
|
| Hospital Charge Code |
8499229
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$73.98 |
| Max. Negotiated Rate |
$257.45 |
| Rate for Payer: Cash Price |
$162.60
|
| Rate for Payer: Cigna Commercial |
$230.35
|
| Rate for Payer: First Health Commercial |
$243.90
|
| Rate for Payer: First Health Workers Compensation |
$104.63
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$243.90
|
| Rate for Payer: GEHA Commercial |
$189.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$243.90
|
| Rate for Payer: Multiplan All |
$246.61
|
| Rate for Payer: OMNI Networks Commercial |
$189.70
|
| Rate for Payer: One Health Plan PPO/POS |
$243.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$257.45
|
| Rate for Payer: Three Rivers Provider Network All |
$203.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$252.03
|
| Rate for Payer: Zelis Auto |
$108.40
|
| Rate for Payer: Zelis Worker's Compensation |
$73.98
|
|
|
PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 60 M
|
Facility
|
OP
|
$358.00
|
|
|
Service Code
|
CPT 90838
|
| Hospital Charge Code |
8499230
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$340.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$148.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$214.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$148.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$117.38
|
| Rate for Payer: Cash Price |
$214.80
|
| Rate for Payer: Cash Price |
$214.80
|
| Rate for Payer: Cash Price |
$214.80
|
| Rate for Payer: Cigna Commercial |
$304.30
|
| Rate for Payer: First Health Commercial |
$322.20
|
| Rate for Payer: First Health Workers Compensation |
$138.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$322.20
|
| Rate for Payer: GEHA Commercial |
$286.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$322.20
|
| Rate for Payer: Humana ChoiceCare |
$93.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$119.77
|
| Rate for Payer: Multiplan All |
$325.78
|
| Rate for Payer: New Mexico Health Connections Medicare |
$214.80
|
| Rate for Payer: OMNI Networks Commercial |
$250.60
|
| Rate for Payer: One Health Plan PPO/POS |
$322.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$138.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$80.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$340.10
|
| Rate for Payer: Three Rivers Provider Network All |
$268.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$315.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$119.77
|
| Rate for Payer: United Payors & United Providers UP&UP |
$332.94
|
| Rate for Payer: Zelis Auto |
$143.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$179.00
|
| Rate for Payer: Zelis Worker's Compensation |
$97.73
|
|
|
PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 60 M
|
Facility
|
IP
|
$358.00
|
|
|
Service Code
|
CPT 90838
|
| Hospital Charge Code |
8499230
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$97.73 |
| Max. Negotiated Rate |
$340.10 |
| Rate for Payer: Cash Price |
$214.80
|
| Rate for Payer: Cigna Commercial |
$304.30
|
| Rate for Payer: First Health Commercial |
$322.20
|
| Rate for Payer: First Health Workers Compensation |
$138.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$322.20
|
| Rate for Payer: GEHA Commercial |
$250.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$322.20
|
| Rate for Payer: Multiplan All |
$325.78
|
| Rate for Payer: OMNI Networks Commercial |
$250.60
|
| Rate for Payer: One Health Plan PPO/POS |
$322.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$340.10
|
| Rate for Payer: Three Rivers Provider Network All |
$268.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$332.94
|
| Rate for Payer: Zelis Auto |
$143.20
|
| Rate for Payer: Zelis Worker's Compensation |
$97.73
|
|
|
PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 60 M
|
Facility
|
OP
|
$358.00
|
|
|
Service Code
|
CPT 90838
|
| Hospital Charge Code |
9599230
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$93.08 |
| Max. Negotiated Rate |
$340.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$148.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$214.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$148.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$117.38
|
| Rate for Payer: Cash Price |
$214.80
|
| Rate for Payer: Cash Price |
$214.80
|
| Rate for Payer: Cigna Commercial |
$304.30
|
| Rate for Payer: First Health Commercial |
$322.20
|
| Rate for Payer: First Health Workers Compensation |
$138.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$322.20
|
| Rate for Payer: GEHA Commercial |
$286.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$322.20
|
| Rate for Payer: Humana ChoiceCare |
$93.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$119.77
|
| Rate for Payer: Multiplan All |
$325.78
|
| Rate for Payer: New Mexico Health Connections Medicare |
$214.80
|
| Rate for Payer: OMNI Networks Commercial |
$250.60
|
| Rate for Payer: One Health Plan PPO/POS |
$322.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$138.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$119.77
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$340.10
|
| Rate for Payer: Three Rivers Provider Network All |
$268.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$315.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$119.77
|
| Rate for Payer: United Payors & United Providers UP&UP |
$332.94
|
| Rate for Payer: Zelis Auto |
$143.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$179.00
|
| Rate for Payer: Zelis Worker's Compensation |
$97.73
|
|
|
PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 60 M
|
Facility
|
IP
|
$358.00
|
|
|
Service Code
|
CPT 90838
|
| Hospital Charge Code |
9599230
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$97.73 |
| Max. Negotiated Rate |
$340.10 |
| Rate for Payer: Cash Price |
$214.80
|
| Rate for Payer: Cigna Commercial |
$304.30
|
| Rate for Payer: First Health Commercial |
$322.20
|
| Rate for Payer: First Health Workers Compensation |
$138.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$322.20
|
| Rate for Payer: GEHA Commercial |
$250.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$322.20
|
| Rate for Payer: Multiplan All |
$325.78
|
| Rate for Payer: OMNI Networks Commercial |
$250.60
|
| Rate for Payer: One Health Plan PPO/POS |
$322.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$340.10
|
| Rate for Payer: Three Rivers Provider Network All |
$268.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$332.94
|
| Rate for Payer: Zelis Auto |
$143.20
|
| Rate for Payer: Zelis Worker's Compensation |
$97.73
|
|
