|
PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$366.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
23500060
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$99.92 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$264.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$219.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$264.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$209.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cigna Commercial |
$311.10
|
| Rate for Payer: First Health Commercial |
$329.40
|
| Rate for Payer: First Health Workers Compensation |
$141.31
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$329.40
|
| Rate for Payer: GEHA Commercial |
$292.80
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$329.40
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$213.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$333.06
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$256.20
|
| Rate for Payer: One Health Plan PPO/POS |
$329.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$247.03
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$213.95
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$347.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$274.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$213.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$340.38
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$146.40
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$99.92
|
|
|
PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$366.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
20300132
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$99.92 |
| Max. Negotiated Rate |
$347.70 |
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cigna Commercial |
$311.10
|
| Rate for Payer: First Health Commercial |
$329.40
|
| Rate for Payer: First Health Workers Compensation |
$141.31
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$329.40
|
| Rate for Payer: GEHA Commercial |
$256.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$329.40
|
| Rate for Payer: Multiplan All |
$333.06
|
| Rate for Payer: OMNI Networks Commercial |
$256.20
|
| Rate for Payer: One Health Plan PPO/POS |
$329.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$347.70
|
| Rate for Payer: Three Rivers Provider Network All |
$274.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$340.38
|
| Rate for Payer: Zelis Auto |
$146.40
|
| Rate for Payer: Zelis Worker's Compensation |
$99.92
|
|
|
PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$335.10
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
7211104
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$91.48 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$264.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$201.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$264.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$209.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$201.06
|
| Rate for Payer: Cash Price |
$201.06
|
| Rate for Payer: Cigna Commercial |
$284.83
|
| Rate for Payer: First Health Commercial |
$301.59
|
| Rate for Payer: First Health Workers Compensation |
$129.38
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$301.59
|
| Rate for Payer: GEHA Commercial |
$268.08
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$301.59
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$213.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$304.94
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$234.57
|
| Rate for Payer: One Health Plan PPO/POS |
$301.59
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$247.03
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$213.95
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$318.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$251.32
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$213.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$311.64
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$134.04
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$91.48
|
|
|
PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$366.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
21600213
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$99.92 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$264.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$219.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$264.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$209.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cigna Commercial |
$311.10
|
| Rate for Payer: First Health Commercial |
$329.40
|
| Rate for Payer: First Health Workers Compensation |
$141.31
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$329.40
|
| Rate for Payer: GEHA Commercial |
$292.80
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$329.40
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$213.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$333.06
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$256.20
|
| Rate for Payer: One Health Plan PPO/POS |
$329.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$247.03
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$213.95
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$347.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$274.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$213.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$340.38
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$146.40
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$99.92
|
|
|
PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$901.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
6111104
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$209.68 |
| Max. Negotiated Rate |
$855.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$264.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$264.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$209.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$540.60
|
| Rate for Payer: Cash Price |
$540.60
|
| Rate for Payer: Cigna Commercial |
$765.85
|
| Rate for Payer: First Health Commercial |
$810.90
|
| Rate for Payer: First Health Workers Compensation |
$347.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$810.90
|
| Rate for Payer: GEHA Commercial |
$720.80
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$810.90
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$213.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$819.91
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$630.70
|
| Rate for Payer: One Health Plan PPO/POS |
$810.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$247.03
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$213.95
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$855.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$675.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$213.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$837.93
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$360.40
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$245.97
|
|
|
PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$901.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
6111104
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$245.97 |
| Max. Negotiated Rate |
$855.95 |
| Rate for Payer: Cash Price |
$540.60
|
| Rate for Payer: Cigna Commercial |
$765.85
|
| Rate for Payer: First Health Commercial |
$810.90
|
| Rate for Payer: First Health Workers Compensation |
$347.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$810.90
|
| Rate for Payer: GEHA Commercial |
$630.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$810.90
|
| Rate for Payer: Multiplan All |
$819.91
|
| Rate for Payer: OMNI Networks Commercial |
$630.70
|
| Rate for Payer: One Health Plan PPO/POS |
$810.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$855.95
|
| Rate for Payer: Three Rivers Provider Network All |
$675.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$837.93
|
| Rate for Payer: Zelis Auto |
$360.40
|
| Rate for Payer: Zelis Worker's Compensation |
$245.97
|
|
|
PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$335.10
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
7211104
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$91.48 |
| Max. Negotiated Rate |
$318.35 |
| Rate for Payer: Cash Price |
$201.06
|
| Rate for Payer: Cigna Commercial |
$284.83
|
| Rate for Payer: First Health Commercial |
$301.59
|
| Rate for Payer: First Health Workers Compensation |
$129.38
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$301.59
|
| Rate for Payer: GEHA Commercial |
$234.57
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$301.59
|
| Rate for Payer: Multiplan All |
$304.94
|
| Rate for Payer: OMNI Networks Commercial |
$234.57
|
| Rate for Payer: One Health Plan PPO/POS |
$301.59
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$318.35
|
| Rate for Payer: Three Rivers Provider Network All |
$251.32
|
| Rate for Payer: United Payors & United Providers UP&UP |
$311.64
|
| Rate for Payer: Zelis Auto |
$134.04
|
| Rate for Payer: Zelis Worker's Compensation |
$91.48
|
|
|
PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$335.10
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
8511117
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$91.48 |
| Max. Negotiated Rate |
$318.35 |
| Rate for Payer: Cash Price |
$201.06
|
| Rate for Payer: Cigna Commercial |
$284.83
|
| Rate for Payer: First Health Commercial |
$301.59
|
| Rate for Payer: First Health Workers Compensation |
$129.38
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$301.59
|
| Rate for Payer: GEHA Commercial |
$234.57
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$301.59
|
| Rate for Payer: Multiplan All |
$304.94
|
| Rate for Payer: OMNI Networks Commercial |
$234.57
|
| Rate for Payer: One Health Plan PPO/POS |
$301.59
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$318.35
|
| Rate for Payer: Three Rivers Provider Network All |
$251.32
|
| Rate for Payer: United Payors & United Providers UP&UP |
$311.64
|
| Rate for Payer: Zelis Auto |
$134.04
|
| Rate for Payer: Zelis Worker's Compensation |
$91.48
|
|
|
PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$901.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
9611104
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$245.97 |
| Max. Negotiated Rate |
$855.95 |
| Rate for Payer: Cash Price |
$540.60
|
| Rate for Payer: Cigna Commercial |
$765.85
|
| Rate for Payer: First Health Commercial |
$810.90
|
| Rate for Payer: First Health Workers Compensation |
$347.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$810.90
|
| Rate for Payer: GEHA Commercial |
$630.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$810.90
|
| Rate for Payer: Multiplan All |
$819.91
|
| Rate for Payer: OMNI Networks Commercial |
$630.70
|
| Rate for Payer: One Health Plan PPO/POS |
$810.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$855.95
|
| Rate for Payer: Three Rivers Provider Network All |
$675.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$837.93
|
| Rate for Payer: Zelis Auto |
$360.40
|
| Rate for Payer: Zelis Worker's Compensation |
$245.97
|
|
|
PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$892.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
1999250
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$209.68 |
| Max. Negotiated Rate |
$847.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$264.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$535.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$264.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$209.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cigna Commercial |
$758.20
|
| Rate for Payer: First Health Commercial |
$802.80
|
| Rate for Payer: First Health Workers Compensation |
$344.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$802.80
|
| Rate for Payer: GEHA Commercial |
$713.60
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$802.80
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$213.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$811.72
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$624.40
|
| Rate for Payer: One Health Plan PPO/POS |
$802.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$247.03
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$213.95
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$847.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$669.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$213.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$829.56
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$356.80
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$243.52
|
|
|
PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$335.10
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
8511117
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$91.48 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$264.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$201.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$264.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$209.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$201.06
|
| Rate for Payer: Cash Price |
$201.06
|
| Rate for Payer: Cigna Commercial |
$284.83
|
| Rate for Payer: First Health Commercial |
$301.59
|
| Rate for Payer: First Health Workers Compensation |
$129.38
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$301.59
|
| Rate for Payer: GEHA Commercial |
$268.08
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$301.59
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$213.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$304.94
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$234.57
|
| Rate for Payer: One Health Plan PPO/POS |
$301.59
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$247.03
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$213.95
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$318.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$251.32
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$213.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$311.64
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$134.04
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$91.48
|
|
|
PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$366.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
23500060
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$99.92 |
| Max. Negotiated Rate |
$347.70 |
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cigna Commercial |
$311.10
|
| Rate for Payer: First Health Commercial |
$329.40
|
| Rate for Payer: First Health Workers Compensation |
$141.31
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$329.40
|
| Rate for Payer: GEHA Commercial |
$256.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$329.40
|
| Rate for Payer: Multiplan All |
$333.06
|
| Rate for Payer: OMNI Networks Commercial |
$256.20
|
| Rate for Payer: One Health Plan PPO/POS |
$329.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$347.70
|
| Rate for Payer: Three Rivers Provider Network All |
$274.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$340.38
|
| Rate for Payer: Zelis Auto |
$146.40
|
| Rate for Payer: Zelis Worker's Compensation |
$99.92
|
|
|
PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$892.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
1999250
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$243.52 |
| Max. Negotiated Rate |
$847.40 |
| Rate for Payer: Cash Price |
$535.20
|
| Rate for Payer: Cigna Commercial |
$758.20
|
| Rate for Payer: First Health Commercial |
$802.80
|
| Rate for Payer: First Health Workers Compensation |
$344.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$802.80
|
| Rate for Payer: GEHA Commercial |
$624.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$802.80
|
| Rate for Payer: Multiplan All |
$811.72
|
| Rate for Payer: OMNI Networks Commercial |
$624.40
|
| Rate for Payer: One Health Plan PPO/POS |
$802.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$847.40
|
| Rate for Payer: Three Rivers Provider Network All |
$669.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$829.56
|
| Rate for Payer: Zelis Auto |
$356.80
|
| Rate for Payer: Zelis Worker's Compensation |
$243.52
|
|
|
PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$366.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
20300132
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$99.92 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$264.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$219.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$264.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$209.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cigna Commercial |
$311.10
|
| Rate for Payer: First Health Commercial |
$329.40
|
| Rate for Payer: First Health Workers Compensation |
$141.31
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$329.40
|
| Rate for Payer: GEHA Commercial |
$292.80
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$329.40
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$213.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$333.06
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$256.20
|
| Rate for Payer: One Health Plan PPO/POS |
$329.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$247.03
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$213.95
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$347.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$274.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$213.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$340.38
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$146.40
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$99.92
|
|
|
PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$366.00
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
21600213
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$99.92 |
| Max. Negotiated Rate |
$347.70 |
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cigna Commercial |
$311.10
|
| Rate for Payer: First Health Commercial |
$329.40
|
| Rate for Payer: First Health Workers Compensation |
$141.31
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$329.40
|
| Rate for Payer: GEHA Commercial |
$256.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$329.40
|
| Rate for Payer: Multiplan All |
$333.06
|
| Rate for Payer: OMNI Networks Commercial |
$256.20
|
| Rate for Payer: One Health Plan PPO/POS |
$329.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$347.70
|
| Rate for Payer: Three Rivers Provider Network All |
$274.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$340.38
|
| Rate for Payer: Zelis Auto |
$146.40
|
| Rate for Payer: Zelis Worker's Compensation |
$99.92
|
|
|
PUNCT ASPIRAT ABSCESS HEMATOMA BULLA/CYS
|
Facility
|
OP
|
$1,073.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
1910160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.60 |
| Max. Negotiated Rate |
$1,019.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$147.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$643.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$147.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$116.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$643.80
|
| Rate for Payer: Cash Price |
$643.80
|
| Rate for Payer: Cigna Commercial |
$912.05
|
| Rate for Payer: First Health Commercial |
$965.70
|
| Rate for Payer: First Health Workers Compensation |
$414.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$965.70
|
| Rate for Payer: GEHA Commercial |
$858.40
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$965.70
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$118.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$976.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$751.10
|
| Rate for Payer: One Health Plan PPO/POS |
$965.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$137.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$118.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,019.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$804.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$118.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$997.89
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$429.20
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$292.93
|
|
|
PUNCT ASPIRAT ABSCESS HEMATOMA BULLA/CYS
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
21600210
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$106.47 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$147.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$234.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$147.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$116.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$234.00
|
| Rate for Payer: Cash Price |
$234.00
|
| Rate for Payer: Cigna Commercial |
$331.50
|
| Rate for Payer: First Health Commercial |
$351.00
|
| Rate for Payer: First Health Workers Compensation |
$150.58
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$351.00
|
| Rate for Payer: GEHA Commercial |
$312.00
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$351.00
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$118.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$354.90
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$273.00
|
| Rate for Payer: One Health Plan PPO/POS |
$351.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$137.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$118.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$370.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$292.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$118.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$362.70
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$156.00
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$106.47
|
|
|
PUNCT ASPIRAT ABSCESS HEMATOMA BULLA/CYS
|
Facility
|
IP
|
$370.23
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
20300047
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$101.07 |
| Max. Negotiated Rate |
$351.72 |
| Rate for Payer: Cash Price |
$222.14
|
| Rate for Payer: Cigna Commercial |
$314.70
|
| Rate for Payer: First Health Commercial |
$333.21
|
| Rate for Payer: First Health Workers Compensation |
$142.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$333.21
|
| Rate for Payer: GEHA Commercial |
$259.16
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$333.21
|
| Rate for Payer: Multiplan All |
$336.91
|
| Rate for Payer: OMNI Networks Commercial |
$259.16
|
| Rate for Payer: One Health Plan PPO/POS |
$333.21
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$351.72
|
| Rate for Payer: Three Rivers Provider Network All |
$277.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$344.31
|
| Rate for Payer: Zelis Auto |
$148.09
|
| Rate for Payer: Zelis Worker's Compensation |
$101.07
|
|
|
PUNCT ASPIRAT ABSCESS HEMATOMA BULLA/CYS
|
Facility
|
IP
|
$1,073.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
1910160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$292.93 |
| Max. Negotiated Rate |
$1,019.35 |
| Rate for Payer: Cash Price |
$643.80
|
| Rate for Payer: Cigna Commercial |
$912.05
|
| Rate for Payer: First Health Commercial |
$965.70
|
| Rate for Payer: First Health Workers Compensation |
$414.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$965.70
|
| Rate for Payer: GEHA Commercial |
$751.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$965.70
|
| Rate for Payer: Multiplan All |
$976.43
|
| Rate for Payer: OMNI Networks Commercial |
$751.10
|
| Rate for Payer: One Health Plan PPO/POS |
$965.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,019.35
|
| Rate for Payer: Three Rivers Provider Network All |
$804.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$997.89
|
| Rate for Payer: Zelis Auto |
$429.20
|
| Rate for Payer: Zelis Worker's Compensation |
$292.93
|
|
|
PUNCT ASPIRAT ABSCESS HEMATOMA BULLA/CYS
|
Facility
|
IP
|
$1,057.00
|
|
| Hospital Charge Code |
8110160
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$288.56 |
| Max. Negotiated Rate |
$1,004.15 |
| Rate for Payer: Cash Price |
$634.20
|
| Rate for Payer: Cigna Commercial |
$898.45
|
| Rate for Payer: First Health Commercial |
$951.30
|
| Rate for Payer: First Health Workers Compensation |
$408.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$951.30
|
| Rate for Payer: GEHA Commercial |
$739.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$951.30
|
| Rate for Payer: Multiplan All |
$961.87
|
| Rate for Payer: OMNI Networks Commercial |
$739.90
|
| Rate for Payer: One Health Plan PPO/POS |
$951.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,004.15
|
| Rate for Payer: Three Rivers Provider Network All |
$792.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$983.01
|
| Rate for Payer: Zelis Auto |
$422.80
|
| Rate for Payer: Zelis Worker's Compensation |
$288.56
|
|
|
PUNCT ASPIRAT ABSCESS HEMATOMA BULLA/CYS
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
21600210
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$106.47 |
| Max. Negotiated Rate |
$370.50 |
| Rate for Payer: Cash Price |
$234.00
|
| Rate for Payer: Cigna Commercial |
$331.50
|
| Rate for Payer: First Health Commercial |
$351.00
|
| Rate for Payer: First Health Workers Compensation |
$150.58
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$351.00
|
| Rate for Payer: GEHA Commercial |
$273.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$351.00
|
| Rate for Payer: Multiplan All |
$354.90
|
| Rate for Payer: OMNI Networks Commercial |
$273.00
|
| Rate for Payer: One Health Plan PPO/POS |
$351.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$370.50
|
| Rate for Payer: Three Rivers Provider Network All |
$292.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$362.70
|
| Rate for Payer: Zelis Auto |
$156.00
|
| Rate for Payer: Zelis Worker's Compensation |
$106.47
|
|
|
PUNCT ASPIRAT ABSCESS HEMATOMA BULLA/CYS
|
Facility
|
OP
|
$370.23
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
20300047
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$101.07 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$147.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$222.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$147.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$116.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$222.14
|
| Rate for Payer: Cash Price |
$222.14
|
| Rate for Payer: Cigna Commercial |
$314.70
|
| Rate for Payer: First Health Commercial |
$333.21
|
| Rate for Payer: First Health Workers Compensation |
$142.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$333.21
|
| Rate for Payer: GEHA Commercial |
$296.18
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$333.21
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$118.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$336.91
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$259.16
|
| Rate for Payer: One Health Plan PPO/POS |
$333.21
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$137.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$118.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$351.72
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$277.67
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$118.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$344.31
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$148.09
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$101.07
|
|
|
PUNCT ASPIRAT ABSCESS HEMATOMA BULLA/CYS
|
Facility
|
IP
|
$370.23
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
6110160
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$101.07 |
| Max. Negotiated Rate |
$351.72 |
| Rate for Payer: Cash Price |
$222.14
|
| Rate for Payer: Cigna Commercial |
$314.70
|
| Rate for Payer: First Health Commercial |
$333.21
|
| Rate for Payer: First Health Workers Compensation |
$142.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$333.21
|
| Rate for Payer: GEHA Commercial |
$259.16
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$333.21
|
| Rate for Payer: Multiplan All |
$336.91
|
| Rate for Payer: OMNI Networks Commercial |
$259.16
|
| Rate for Payer: One Health Plan PPO/POS |
$333.21
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$351.72
|
| Rate for Payer: Three Rivers Provider Network All |
$277.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$344.31
|
| Rate for Payer: Zelis Auto |
$148.09
|
| Rate for Payer: Zelis Worker's Compensation |
$101.07
|
|
|
PUNCT ASPIRAT ABSCESS HEMATOMA BULLA/CYS
|
Facility
|
OP
|
$1,057.00
|
|
| Hospital Charge Code |
8110160
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$264.25 |
| Max. Negotiated Rate |
$1,004.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$634.20
|
| Rate for Payer: Cash Price |
$634.20
|
| Rate for Payer: Cigna Commercial |
$898.45
|
| Rate for Payer: First Health Commercial |
$951.30
|
| Rate for Payer: First Health Workers Compensation |
$408.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$951.30
|
| Rate for Payer: GEHA Commercial |
$845.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$951.30
|
| Rate for Payer: Humana ChoiceCare |
$274.82
|
| Rate for Payer: Multiplan All |
$961.87
|
| Rate for Payer: New Mexico Health Connections Medicare |
$634.20
|
| Rate for Payer: OMNI Networks Commercial |
$739.90
|
| Rate for Payer: One Health Plan PPO/POS |
$951.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,004.15
|
| Rate for Payer: Three Rivers Provider Network All |
$792.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$930.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$264.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$983.01
|
| Rate for Payer: Zelis Auto |
$422.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$528.50
|
| Rate for Payer: Zelis Worker's Compensation |
$288.56
|
|
|
PUNCT ASPIRAT ABSCESS HEMATOMA BULLA/CYS
|
Facility
|
OP
|
$370.23
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
6110160
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$101.07 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$147.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$222.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$147.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$116.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$222.14
|
| Rate for Payer: Cash Price |
$222.14
|
| Rate for Payer: Cigna Commercial |
$314.70
|
| Rate for Payer: First Health Commercial |
$333.21
|
| Rate for Payer: First Health Workers Compensation |
$142.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$333.21
|
| Rate for Payer: GEHA Commercial |
$296.18
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$333.21
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$118.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$336.91
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$259.16
|
| Rate for Payer: One Health Plan PPO/POS |
$333.21
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$137.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$118.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$351.72
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$277.67
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$118.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$344.31
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$148.09
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$101.07
|
|
