|
REGEN-COV 1200 MG/10 ML INJ SUBQ
|
Facility
|
OP
|
$1,370.00
|
|
|
Service Code
|
CPT M0243
|
| Hospital Charge Code |
3303108
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$356.20 |
| Max. Negotiated Rate |
$1,301.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$715.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$822.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$715.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$566.82
|
| Rate for Payer: Cash Price |
$822.00
|
| Rate for Payer: Cash Price |
$822.00
|
| Rate for Payer: Cigna Commercial |
$1,164.50
|
| Rate for Payer: First Health Commercial |
$1,233.00
|
| Rate for Payer: First Health Workers Compensation |
$528.96
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,233.00
|
| Rate for Payer: GEHA Commercial |
$1,096.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,233.00
|
| Rate for Payer: Humana ChoiceCare |
$356.20
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$578.36
|
| Rate for Payer: Multiplan All |
$1,246.70
|
| Rate for Payer: New Mexico Health Connections Medicare |
$822.00
|
| Rate for Payer: OMNI Networks Commercial |
$959.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,233.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$667.80
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$578.36
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,301.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,027.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,205.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$578.36
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,274.10
|
| Rate for Payer: Zelis Auto |
$548.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$685.00
|
| Rate for Payer: Zelis Worker's Compensation |
$374.01
|
|
|
REGEN-COV 600 MG/600 MG/10 ML INJ
|
Facility
|
OP
|
$1,370.00
|
|
|
Service Code
|
CPT Q0243
|
| Hospital Charge Code |
3303087
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1,301.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$0.02
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$822.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$0.02
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$0.01
|
| Rate for Payer: Cash Price |
$822.00
|
| Rate for Payer: Cash Price |
$822.00
|
| Rate for Payer: Cigna Commercial |
$1,164.50
|
| Rate for Payer: First Health Commercial |
$1,233.00
|
| Rate for Payer: First Health Workers Compensation |
$528.96
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,233.00
|
| Rate for Payer: GEHA Commercial |
$1,096.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,233.00
|
| Rate for Payer: Humana ChoiceCare |
$356.20
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$0.01
|
| Rate for Payer: Multiplan All |
$1,246.70
|
| Rate for Payer: New Mexico Health Connections Medicare |
$822.00
|
| Rate for Payer: OMNI Networks Commercial |
$959.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,233.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$0.01
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$0.01
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,301.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,027.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,205.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$0.01
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,274.10
|
| Rate for Payer: Zelis Auto |
$548.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$685.00
|
| Rate for Payer: Zelis Worker's Compensation |
$374.01
|
|
|
REGEN-COV 600 MG/600 MG/10 ML INJ
|
Facility
|
IP
|
$1,370.00
|
|
|
Service Code
|
CPT Q0243
|
| Hospital Charge Code |
3303087
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$374.01 |
| Max. Negotiated Rate |
$1,301.50 |
| Rate for Payer: Cash Price |
$822.00
|
| Rate for Payer: Cigna Commercial |
$1,164.50
|
| Rate for Payer: First Health Commercial |
$1,233.00
|
| Rate for Payer: First Health Workers Compensation |
$528.96
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,233.00
|
| Rate for Payer: GEHA Commercial |
$959.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,233.00
|
| Rate for Payer: Multiplan All |
$1,246.70
|
| Rate for Payer: OMNI Networks Commercial |
$959.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,233.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,301.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,027.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,274.10
|
| Rate for Payer: Zelis Auto |
$548.00
|
| Rate for Payer: Zelis Worker's Compensation |
$374.01
|
|
|
REGIONAL ANESTHESIA FAC ADD 15 MINS
|
Facility
|
IP
|
$406.00
|
|
| Hospital Charge Code |
3750007
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$110.84 |
| Max. Negotiated Rate |
$385.70 |
| Rate for Payer: Cash Price |
$243.60
|
| Rate for Payer: Cigna Commercial |
$345.10
|
| Rate for Payer: First Health Commercial |
$365.40
|
| Rate for Payer: First Health Workers Compensation |
$156.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$365.40
|
| Rate for Payer: GEHA Commercial |
$284.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$365.40
|
| Rate for Payer: Multiplan All |
$369.46
|
| Rate for Payer: OMNI Networks Commercial |
$284.20
|
| Rate for Payer: One Health Plan PPO/POS |
$365.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$385.70
|
| Rate for Payer: Three Rivers Provider Network All |
$304.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$377.58
|
| Rate for Payer: Zelis Auto |
$162.40
|
| Rate for Payer: Zelis Worker's Compensation |
$110.84
|
|
|
REGIONAL ANESTHESIA FAC ADD 15 MINS
|
Facility
|
OP
|
$406.00
|
|
| Hospital Charge Code |
3750007
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$101.50 |
| Max. Negotiated Rate |
$385.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$243.60
|
| Rate for Payer: Cash Price |
$243.60
|
| Rate for Payer: Cigna Commercial |
$345.10
|
| Rate for Payer: First Health Commercial |
$365.40
|
| Rate for Payer: First Health Workers Compensation |
$156.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$365.40
|
| Rate for Payer: GEHA Commercial |
$324.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$365.40
|
| Rate for Payer: Humana ChoiceCare |
$105.56
|
| Rate for Payer: Multiplan All |
$369.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$243.60
|
| Rate for Payer: OMNI Networks Commercial |
$284.20
|
| Rate for Payer: One Health Plan PPO/POS |
$365.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$385.70
|
| Rate for Payer: Three Rivers Provider Network All |
$304.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$357.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$101.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$377.58
|
| Rate for Payer: Zelis Auto |
$162.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$203.00
|
| Rate for Payer: Zelis Worker's Compensation |
$110.84
|
|
|
REGIONAL ANESTHESIA FAC REG 1ST HOUR
|
Facility
|
OP
|
$1,472.00
|
|
| Hospital Charge Code |
3750010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$368.00 |
| Max. Negotiated Rate |
$1,398.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$883.20
|
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cigna Commercial |
$1,251.20
|
| Rate for Payer: First Health Commercial |
$1,324.80
|
| Rate for Payer: First Health Workers Compensation |
$568.34
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,324.80
|
| Rate for Payer: GEHA Commercial |
$1,177.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,324.80
|
| Rate for Payer: Humana ChoiceCare |
$382.72
|
| Rate for Payer: Multiplan All |
$1,339.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$883.20
|
| Rate for Payer: OMNI Networks Commercial |
$1,030.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,324.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,398.40
|
| Rate for Payer: Three Rivers Provider Network All |
$1,104.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,295.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$368.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,368.96
|
| Rate for Payer: Zelis Auto |
$588.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$736.00
|
| Rate for Payer: Zelis Worker's Compensation |
$401.86
|
|
|
REGIONAL ANESTHESIA FAC REG 1ST HOUR
|
Facility
|
IP
|
$1,472.00
|
|
| Hospital Charge Code |
3750010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$401.86 |
| Max. Negotiated Rate |
$1,398.40 |
| Rate for Payer: Cash Price |
$883.20
|
| Rate for Payer: Cigna Commercial |
$1,251.20
|
| Rate for Payer: First Health Commercial |
$1,324.80
|
| Rate for Payer: First Health Workers Compensation |
$568.34
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,324.80
|
| Rate for Payer: GEHA Commercial |
$1,030.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,324.80
|
| Rate for Payer: Multiplan All |
$1,339.52
|
| Rate for Payer: OMNI Networks Commercial |
$1,030.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,324.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,398.40
|
| Rate for Payer: Three Rivers Provider Network All |
$1,104.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,368.96
|
| Rate for Payer: Zelis Auto |
$588.80
|
| Rate for Payer: Zelis Worker's Compensation |
$401.86
|
|
|
REIMPLANT URETER IN BLADDER
|
Facility
|
IP
|
$2,342.00
|
|
|
Service Code
|
CPT 50783
|
| Hospital Charge Code |
6150783
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$639.37 |
| Max. Negotiated Rate |
$2,224.90 |
| Rate for Payer: Cash Price |
$1,405.20
|
| Rate for Payer: Cigna Commercial |
$1,990.70
|
| Rate for Payer: First Health Commercial |
$2,107.80
|
| Rate for Payer: First Health Workers Compensation |
$904.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,107.80
|
| Rate for Payer: GEHA Commercial |
$1,639.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,107.80
|
| Rate for Payer: Multiplan All |
$2,131.22
|
| Rate for Payer: OMNI Networks Commercial |
$1,639.40
|
| Rate for Payer: One Health Plan PPO/POS |
$2,107.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,224.90
|
| Rate for Payer: Three Rivers Provider Network All |
$1,756.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,178.06
|
| Rate for Payer: Zelis Auto |
$936.80
|
| Rate for Payer: Zelis Worker's Compensation |
$639.37
|
|
|
REIMPLANT URETER IN BLADDER
|
Facility
|
IP
|
$2,215.00
|
|
|
Service Code
|
CPT 50782
|
| Hospital Charge Code |
6150782
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$604.70 |
| Max. Negotiated Rate |
$2,104.25 |
| Rate for Payer: Cash Price |
$1,329.00
|
| Rate for Payer: Cigna Commercial |
$1,882.75
|
| Rate for Payer: First Health Commercial |
$1,993.50
|
| Rate for Payer: First Health Workers Compensation |
$855.21
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,993.50
|
| Rate for Payer: GEHA Commercial |
$1,550.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,993.50
|
| Rate for Payer: Multiplan All |
$2,015.65
|
| Rate for Payer: OMNI Networks Commercial |
$1,550.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,993.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,104.25
|
| Rate for Payer: Three Rivers Provider Network All |
$1,661.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,059.95
|
| Rate for Payer: Zelis Auto |
$886.00
|
| Rate for Payer: Zelis Worker's Compensation |
$604.70
|
|
|
REIMPLANT URETER IN BLADDER
|
Facility
|
OP
|
$2,215.00
|
|
|
Service Code
|
CPT 50782
|
| Hospital Charge Code |
6150782
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$553.75 |
| Max. Negotiated Rate |
$2,104.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,329.00
|
| Rate for Payer: Cash Price |
$1,329.00
|
| Rate for Payer: Cigna Commercial |
$1,882.75
|
| Rate for Payer: First Health Commercial |
$1,993.50
|
| Rate for Payer: First Health Workers Compensation |
$855.21
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,993.50
|
| Rate for Payer: GEHA Commercial |
$1,772.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,993.50
|
| Rate for Payer: Humana ChoiceCare |
$575.90
|
| Rate for Payer: Multiplan All |
$2,015.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,329.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,550.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,993.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,104.25
|
| Rate for Payer: Three Rivers Provider Network All |
$1,661.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,949.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$553.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,059.95
|
| Rate for Payer: Zelis Auto |
$886.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,107.50
|
| Rate for Payer: Zelis Worker's Compensation |
$604.70
|
|
|
REIMPLANT URETER IN BLADDER
|
Facility
|
IP
|
$2,509.00
|
|
|
Service Code
|
CPT 50785
|
| Hospital Charge Code |
6150785
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$684.96 |
| Max. Negotiated Rate |
$2,383.55 |
| Rate for Payer: Cash Price |
$1,505.40
|
| Rate for Payer: Cigna Commercial |
$2,132.65
|
| Rate for Payer: First Health Commercial |
$2,258.10
|
| Rate for Payer: First Health Workers Compensation |
$968.72
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,258.10
|
| Rate for Payer: GEHA Commercial |
$1,756.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,258.10
|
| Rate for Payer: Multiplan All |
$2,283.19
|
| Rate for Payer: OMNI Networks Commercial |
$1,756.30
|
| Rate for Payer: One Health Plan PPO/POS |
$2,258.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,383.55
|
| Rate for Payer: Three Rivers Provider Network All |
$1,881.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,333.37
|
| Rate for Payer: Zelis Auto |
$1,003.60
|
| Rate for Payer: Zelis Worker's Compensation |
$684.96
|
|
|
REIMPLANT URETER IN BLADDER
|
Facility
|
OP
|
$2,509.00
|
|
|
Service Code
|
CPT 50785
|
| Hospital Charge Code |
6150785
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$627.25 |
| Max. Negotiated Rate |
$2,383.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,505.40
|
| Rate for Payer: Cash Price |
$1,505.40
|
| Rate for Payer: Cigna Commercial |
$2,132.65
|
| Rate for Payer: First Health Commercial |
$2,258.10
|
| Rate for Payer: First Health Workers Compensation |
$968.72
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,258.10
|
| Rate for Payer: GEHA Commercial |
$2,007.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,258.10
|
| Rate for Payer: Humana ChoiceCare |
$652.34
|
| Rate for Payer: Multiplan All |
$2,283.19
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,505.40
|
| Rate for Payer: OMNI Networks Commercial |
$1,756.30
|
| Rate for Payer: One Health Plan PPO/POS |
$2,258.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,383.55
|
| Rate for Payer: Three Rivers Provider Network All |
$1,881.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,207.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$627.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,333.37
|
| Rate for Payer: Zelis Auto |
$1,003.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,254.50
|
| Rate for Payer: Zelis Worker's Compensation |
$684.96
|
|
|
REIMPLANT URETER IN BLADDER
|
Facility
|
OP
|
$2,342.00
|
|
|
Service Code
|
CPT 50783
|
| Hospital Charge Code |
6150783
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$585.50 |
| Max. Negotiated Rate |
$2,224.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,405.20
|
| Rate for Payer: Cash Price |
$1,405.20
|
| Rate for Payer: Cigna Commercial |
$1,990.70
|
| Rate for Payer: First Health Commercial |
$2,107.80
|
| Rate for Payer: First Health Workers Compensation |
$904.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,107.80
|
| Rate for Payer: GEHA Commercial |
$1,873.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,107.80
|
| Rate for Payer: Humana ChoiceCare |
$608.92
|
| Rate for Payer: Multiplan All |
$2,131.22
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,405.20
|
| Rate for Payer: OMNI Networks Commercial |
$1,639.40
|
| Rate for Payer: One Health Plan PPO/POS |
$2,107.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,224.90
|
| Rate for Payer: Three Rivers Provider Network All |
$1,756.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,060.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$585.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,178.06
|
| Rate for Payer: Zelis Auto |
$936.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,171.00
|
| Rate for Payer: Zelis Worker's Compensation |
$639.37
|
|
|
REIMPLANT URETER IN BLADDER
|
Facility
|
OP
|
$2,294.00
|
|
|
Service Code
|
CPT 50780
|
| Hospital Charge Code |
6150780
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$573.50 |
| Max. Negotiated Rate |
$2,179.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,376.40
|
| Rate for Payer: Cash Price |
$1,376.40
|
| Rate for Payer: Cigna Commercial |
$1,949.90
|
| Rate for Payer: First Health Commercial |
$2,064.60
|
| Rate for Payer: First Health Workers Compensation |
$885.71
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,064.60
|
| Rate for Payer: GEHA Commercial |
$1,835.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,064.60
|
| Rate for Payer: Humana ChoiceCare |
$596.44
|
| Rate for Payer: Multiplan All |
$2,087.54
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,376.40
|
| Rate for Payer: OMNI Networks Commercial |
$1,605.80
|
| Rate for Payer: One Health Plan PPO/POS |
$2,064.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,179.30
|
| Rate for Payer: Three Rivers Provider Network All |
$1,720.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,018.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$573.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,133.42
|
| Rate for Payer: Zelis Auto |
$917.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,147.00
|
| Rate for Payer: Zelis Worker's Compensation |
$626.26
|
|
|
REIMPLANT URETER IN BLADDER
|
Facility
|
IP
|
$2,294.00
|
|
|
Service Code
|
CPT 50780
|
| Hospital Charge Code |
6150780
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$626.26 |
| Max. Negotiated Rate |
$2,179.30 |
| Rate for Payer: Cash Price |
$1,376.40
|
| Rate for Payer: Cigna Commercial |
$1,949.90
|
| Rate for Payer: First Health Commercial |
$2,064.60
|
| Rate for Payer: First Health Workers Compensation |
$885.71
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,064.60
|
| Rate for Payer: GEHA Commercial |
$1,605.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,064.60
|
| Rate for Payer: Multiplan All |
$2,087.54
|
| Rate for Payer: OMNI Networks Commercial |
$1,605.80
|
| Rate for Payer: One Health Plan PPO/POS |
$2,064.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,179.30
|
| Rate for Payer: Three Rivers Provider Network All |
$1,720.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,133.42
|
| Rate for Payer: Zelis Auto |
$917.60
|
| Rate for Payer: Zelis Worker's Compensation |
$626.26
|
|
|
REINFORCE CLAVICLE
|
Facility
|
OP
|
$1,729.00
|
|
|
Service Code
|
CPT 23490
|
| Hospital Charge Code |
6123490
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$472.02 |
| Max. Negotiated Rate |
$13,566.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,709.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,037.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,709.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,730.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,783.26
|
| Rate for Payer: Cash Price |
$1,037.40
|
| Rate for Payer: Cash Price |
$1,037.40
|
| Rate for Payer: Cigna Commercial |
$1,469.65
|
| Rate for Payer: First Health Commercial |
$1,556.10
|
| Rate for Payer: First Health Workers Compensation |
$667.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,556.10
|
| Rate for Payer: GEHA Commercial |
$1,383.20
|
| Rate for Payer: GEHA Medicare |
$6,783.26
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,556.10
|
| Rate for Payer: Humana ChoiceCare |
$7,461.59
|
| Rate for Payer: Humana Medicare Advantage |
$6,783.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,395.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,806.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,783.26
|
| Rate for Payer: Multiplan All |
$1,573.39
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,531.54
|
| Rate for Payer: OMNI Networks Commercial |
$1,210.30
|
| Rate for Payer: One Health Plan PPO/POS |
$1,556.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,395.55
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,806.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,783.26
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,642.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,566.52
|
| Rate for Payer: Three Rivers Provider Network All |
$1,296.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,647.59
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,806.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,783.26
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,607.97
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,783.26
|
| Rate for Payer: Zelis Auto |
$691.60
|
| Rate for Payer: Zelis Medicare |
$5,765.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,139.91
|
| Rate for Payer: Zelis Worker's Compensation |
$472.02
|
|
|
REINFORCE CLAVICLE
|
Facility
|
IP
|
$1,729.00
|
|
|
Service Code
|
CPT 23490
|
| Hospital Charge Code |
6123490
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$472.02 |
| Max. Negotiated Rate |
$1,642.55 |
| Rate for Payer: Cash Price |
$1,037.40
|
| Rate for Payer: Cigna Commercial |
$1,469.65
|
| Rate for Payer: First Health Commercial |
$1,556.10
|
| Rate for Payer: First Health Workers Compensation |
$667.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,556.10
|
| Rate for Payer: GEHA Commercial |
$1,210.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,556.10
|
| Rate for Payer: Multiplan All |
$1,573.39
|
| Rate for Payer: OMNI Networks Commercial |
$1,210.30
|
| Rate for Payer: One Health Plan PPO/POS |
$1,556.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,642.55
|
| Rate for Payer: Three Rivers Provider Network All |
$1,296.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,607.97
|
| Rate for Payer: Zelis Auto |
$691.60
|
| Rate for Payer: Zelis Worker's Compensation |
$472.02
|
|
|
REINFORCE HIP BONES
|
Facility
|
IP
|
$2,041.00
|
|
|
Service Code
|
CPT 27187
|
| Hospital Charge Code |
6127187
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$557.19 |
| Max. Negotiated Rate |
$1,938.95 |
| Rate for Payer: Cash Price |
$1,224.60
|
| Rate for Payer: Cigna Commercial |
$1,734.85
|
| Rate for Payer: First Health Commercial |
$1,836.90
|
| Rate for Payer: First Health Workers Compensation |
$788.03
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,836.90
|
| Rate for Payer: GEHA Commercial |
$1,428.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,836.90
|
| Rate for Payer: Multiplan All |
$1,857.31
|
| Rate for Payer: OMNI Networks Commercial |
$1,428.70
|
| Rate for Payer: One Health Plan PPO/POS |
$1,836.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,938.95
|
| Rate for Payer: Three Rivers Provider Network All |
$1,530.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,898.13
|
| Rate for Payer: Zelis Auto |
$816.40
|
| Rate for Payer: Zelis Worker's Compensation |
$557.19
|
|
|
REINFORCE HIP BONES
|
Facility
|
OP
|
$2,041.00
|
|
|
Service Code
|
CPT 27187
|
| Hospital Charge Code |
6127187
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$510.25 |
| Max. Negotiated Rate |
$1,938.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,224.60
|
| Rate for Payer: Cash Price |
$1,224.60
|
| Rate for Payer: Cigna Commercial |
$1,734.85
|
| Rate for Payer: First Health Commercial |
$1,836.90
|
| Rate for Payer: First Health Workers Compensation |
$788.03
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,836.90
|
| Rate for Payer: GEHA Commercial |
$1,632.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,836.90
|
| Rate for Payer: Humana ChoiceCare |
$530.66
|
| Rate for Payer: Multiplan All |
$1,857.31
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,224.60
|
| Rate for Payer: OMNI Networks Commercial |
$1,428.70
|
| Rate for Payer: One Health Plan PPO/POS |
$1,836.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,938.95
|
| Rate for Payer: Three Rivers Provider Network All |
$1,530.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,796.08
|
| Rate for Payer: United Healthcare Managed Medicaid |
$510.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,898.13
|
| Rate for Payer: Zelis Auto |
$816.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,020.50
|
| Rate for Payer: Zelis Worker's Compensation |
$557.19
|
|
|
REINFORCE HUMERUS
|
Facility
|
IP
|
$1,778.00
|
|
|
Service Code
|
CPT 24498
|
| Hospital Charge Code |
6124498
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$485.39 |
| Max. Negotiated Rate |
$1,689.10 |
| Rate for Payer: Cash Price |
$1,066.80
|
| Rate for Payer: Cigna Commercial |
$1,511.30
|
| Rate for Payer: First Health Commercial |
$1,600.20
|
| Rate for Payer: First Health Workers Compensation |
$686.49
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,600.20
|
| Rate for Payer: GEHA Commercial |
$1,244.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,600.20
|
| Rate for Payer: Multiplan All |
$1,617.98
|
| Rate for Payer: OMNI Networks Commercial |
$1,244.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,600.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,689.10
|
| Rate for Payer: Three Rivers Provider Network All |
$1,333.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,653.54
|
| Rate for Payer: Zelis Auto |
$711.20
|
| Rate for Payer: Zelis Worker's Compensation |
$485.39
|
|
|
REINFORCE HUMERUS
|
Facility
|
OP
|
$1,778.00
|
|
|
Service Code
|
CPT 24498
|
| Hospital Charge Code |
6124498
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$485.39 |
| Max. Negotiated Rate |
$24,435.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,963.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,066.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,963.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,100.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,217.56
|
| Rate for Payer: Cash Price |
$1,066.80
|
| Rate for Payer: Cash Price |
$1,066.80
|
| Rate for Payer: Cigna Commercial |
$1,511.30
|
| Rate for Payer: First Health Commercial |
$1,600.20
|
| Rate for Payer: First Health Workers Compensation |
$686.49
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,600.20
|
| Rate for Payer: GEHA Commercial |
$1,422.40
|
| Rate for Payer: GEHA Medicare |
$12,217.56
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,600.20
|
| Rate for Payer: Humana ChoiceCare |
$13,439.32
|
| Rate for Payer: Humana Medicare Advantage |
$12,217.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,525.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,245.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,217.56
|
| Rate for Payer: Multiplan All |
$1,617.98
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,769.85
|
| Rate for Payer: OMNI Networks Commercial |
$1,244.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,600.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$8,365.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,245.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,217.56
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,689.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,435.12
|
| Rate for Payer: Three Rivers Provider Network All |
$1,333.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,973.21
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,245.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,217.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,653.54
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$12,217.56
|
| Rate for Payer: Zelis Auto |
$711.20
|
| Rate for Payer: Zelis Medicare |
$10,384.93
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,661.07
|
| Rate for Payer: Zelis Worker's Compensation |
$485.39
|
|
|
REINFORCE RADIUS
|
Facility
|
IP
|
$1,473.00
|
|
|
Service Code
|
CPT 25490
|
| Hospital Charge Code |
6125490
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$402.13 |
| Max. Negotiated Rate |
$1,399.35 |
| Rate for Payer: Cash Price |
$883.80
|
| Rate for Payer: Cigna Commercial |
$1,252.05
|
| Rate for Payer: First Health Commercial |
$1,325.70
|
| Rate for Payer: First Health Workers Compensation |
$568.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,325.70
|
| Rate for Payer: GEHA Commercial |
$1,031.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,325.70
|
| Rate for Payer: Multiplan All |
$1,340.43
|
| Rate for Payer: OMNI Networks Commercial |
$1,031.10
|
| Rate for Payer: One Health Plan PPO/POS |
$1,325.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,399.35
|
| Rate for Payer: Three Rivers Provider Network All |
$1,104.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,369.89
|
| Rate for Payer: Zelis Auto |
$589.20
|
| Rate for Payer: Zelis Worker's Compensation |
$402.13
|
|
|
REINFORCE RADIUS
|
Facility
|
OP
|
$1,473.00
|
|
|
Service Code
|
CPT 25490
|
| Hospital Charge Code |
6125490
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$402.13 |
| Max. Negotiated Rate |
$13,566.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,709.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$883.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,709.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,730.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,783.26
|
| Rate for Payer: Cash Price |
$883.80
|
| Rate for Payer: Cash Price |
$883.80
|
| Rate for Payer: Cigna Commercial |
$1,252.05
|
| Rate for Payer: First Health Commercial |
$1,325.70
|
| Rate for Payer: First Health Workers Compensation |
$568.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,325.70
|
| Rate for Payer: GEHA Commercial |
$1,178.40
|
| Rate for Payer: GEHA Medicare |
$6,783.26
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,325.70
|
| Rate for Payer: Humana ChoiceCare |
$7,461.59
|
| Rate for Payer: Humana Medicare Advantage |
$6,783.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,395.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,806.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,783.26
|
| Rate for Payer: Multiplan All |
$1,340.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,531.54
|
| Rate for Payer: OMNI Networks Commercial |
$1,031.10
|
| Rate for Payer: One Health Plan PPO/POS |
$1,325.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,395.55
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,806.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,783.26
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,399.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,566.52
|
| Rate for Payer: Three Rivers Provider Network All |
$1,104.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,647.59
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,806.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,783.26
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,369.89
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,783.26
|
| Rate for Payer: Zelis Auto |
$589.20
|
| Rate for Payer: Zelis Medicare |
$5,765.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,139.91
|
| Rate for Payer: Zelis Worker's Compensation |
$402.13
|
|
|
REINFORCE RADIUS AND ULNA
|
Facility
|
IP
|
$1,857.00
|
|
|
Service Code
|
CPT 25492
|
| Hospital Charge Code |
6125492
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$506.96 |
| Max. Negotiated Rate |
$1,764.15 |
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Cigna Commercial |
$1,578.45
|
| Rate for Payer: First Health Commercial |
$1,671.30
|
| Rate for Payer: First Health Workers Compensation |
$716.99
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,671.30
|
| Rate for Payer: GEHA Commercial |
$1,299.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,671.30
|
| Rate for Payer: Multiplan All |
$1,689.87
|
| Rate for Payer: OMNI Networks Commercial |
$1,299.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,671.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,764.15
|
| Rate for Payer: Three Rivers Provider Network All |
$1,392.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,727.01
|
| Rate for Payer: Zelis Auto |
$742.80
|
| Rate for Payer: Zelis Worker's Compensation |
$506.96
|
|
|
REINFORCE RADIUS AND ULNA
|
Facility
|
OP
|
$1,857.00
|
|
|
Service Code
|
CPT 25492
|
| Hospital Charge Code |
6125492
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$506.96 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,709.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,114.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,709.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,730.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Cigna Commercial |
$1,578.45
|
| Rate for Payer: First Health Commercial |
$1,671.30
|
| Rate for Payer: First Health Workers Compensation |
$716.99
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,671.30
|
| Rate for Payer: GEHA Commercial |
$1,485.60
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,671.30
|
| Rate for Payer: Humana ChoiceCare |
$3,388.98
|
| Rate for Payer: Humana Medicare Advantage |
$3,080.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,175.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,806.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$1,689.87
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$1,299.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,671.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,395.55
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,806.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,764.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$1,392.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,806.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,727.01
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$742.80
|
| Rate for Payer: Zelis Medicare |
$2,618.76
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,697.07
|
| Rate for Payer: Zelis Worker's Compensation |
$506.96
|
|
