|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
7599218
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$244.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$33.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$122.37
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$44.00
|
| Rate for Payer: GEHA Medicare |
$122.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Humana ChoiceCare |
$134.61
|
| Rate for Payer: Humana Medicare Advantage |
$122.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$205.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$122.37
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$208.03
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$122.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$244.74
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$119.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$122.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$122.37
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Medicare |
$104.01
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$146.84
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
9400096
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$52.25 |
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$38.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
IP
|
$320.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
1999220
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$87.36 |
| Max. Negotiated Rate |
$304.00 |
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cigna Commercial |
$272.00
|
| Rate for Payer: First Health Commercial |
$288.00
|
| Rate for Payer: First Health Workers Compensation |
$123.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$288.00
|
| Rate for Payer: GEHA Commercial |
$224.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$288.00
|
| Rate for Payer: Multiplan All |
$291.20
|
| Rate for Payer: OMNI Networks Commercial |
$224.00
|
| Rate for Payer: One Health Plan PPO/POS |
$288.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$304.00
|
| Rate for Payer: Three Rivers Provider Network All |
$240.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$297.60
|
| Rate for Payer: Zelis Auto |
$128.00
|
| Rate for Payer: Zelis Worker's Compensation |
$87.36
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
21500017
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$52.25 |
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$38.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
OP
|
$320.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
1999220
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$304.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$192.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$122.37
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cigna Commercial |
$272.00
|
| Rate for Payer: First Health Commercial |
$288.00
|
| Rate for Payer: First Health Workers Compensation |
$123.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$288.00
|
| Rate for Payer: GEHA Commercial |
$256.00
|
| Rate for Payer: GEHA Medicare |
$122.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$288.00
|
| Rate for Payer: Humana ChoiceCare |
$134.61
|
| Rate for Payer: Humana Medicare Advantage |
$122.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$205.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$122.37
|
| Rate for Payer: Multiplan All |
$291.20
|
| Rate for Payer: New Mexico Health Connections Medicare |
$208.03
|
| Rate for Payer: OMNI Networks Commercial |
$224.00
|
| Rate for Payer: One Health Plan PPO/POS |
$288.00
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$122.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$304.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$244.74
|
| Rate for Payer: Three Rivers Provider Network All |
$240.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$119.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$80.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$122.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$297.60
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$122.37
|
| Rate for Payer: Zelis Auto |
$128.00
|
| Rate for Payer: Zelis Medicare |
$104.01
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$146.84
|
| Rate for Payer: Zelis Worker's Compensation |
$87.36
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
8000007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$52.25 |
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$38.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
8300070
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$52.25 |
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$38.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
8900029
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$244.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$33.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$122.37
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$44.00
|
| Rate for Payer: GEHA Medicare |
$122.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Humana ChoiceCare |
$134.61
|
| Rate for Payer: Humana Medicare Advantage |
$122.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$205.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$122.37
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$208.03
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$122.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$244.74
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$119.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$122.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$122.37
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Medicare |
$104.01
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$146.84
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
21000003
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$52.25 |
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$38.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
9399218
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$244.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$33.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$122.37
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$44.00
|
| Rate for Payer: GEHA Medicare |
$122.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Humana ChoiceCare |
$134.61
|
| Rate for Payer: Humana Medicare Advantage |
$122.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$205.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$122.37
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$208.03
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$122.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$244.74
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$119.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$122.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$122.37
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Medicare |
$104.01
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$146.84
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
9799218
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$244.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$33.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$122.37
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$44.00
|
| Rate for Payer: GEHA Medicare |
$122.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Humana ChoiceCare |
$134.61
|
| Rate for Payer: Humana Medicare Advantage |
$122.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$205.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$122.37
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$208.03
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$122.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$244.74
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$119.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$122.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$122.37
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Medicare |
$104.01
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$146.84
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
9200029
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$244.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$33.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$122.37
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$44.00
|
| Rate for Payer: GEHA Medicare |
$122.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Humana ChoiceCare |
$134.61
|
| Rate for Payer: Humana Medicare Advantage |
$122.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$205.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$122.37
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$208.03
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$122.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$244.74
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$119.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$122.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$122.37
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Medicare |
$104.01
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$146.84
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
11099218
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.38 |
| Max. Negotiated Rate |
$52.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$16.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$16.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18.09
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$33.00
|
| Rate for Payer: Cimarron Advantage Cimarron Advantage PPO |
$25.33
|
| Rate for Payer: First Health Workers Compensation |
$33.13
|
| Rate for Payer: GEHA Commercial |
$18.09
|
| Rate for Payer: GEHA Medicare |
$18.09
|
| Rate for Payer: Health Net Federal Services Government |
$18.09
|
| Rate for Payer: HealthSmart Commercial |
$25.33
|
| Rate for Payer: HealthSmart Worker's Compensation |
$31.79
|
| Rate for Payer: Humana ChoiceCare |
$19.90
|
| Rate for Payer: Humana Medicare Advantage |
$18.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18.09
|
| Rate for Payer: Multiplan All |
$41.25
|
| Rate for Payer: National Preferred Provider Network Commercial |
$52.25
|
| Rate for Payer: National Preferred Provider Network Worker's Compensation |
$33.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18.99
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22.46
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$39.26
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.09
|
| Rate for Payer: Zelis Medicare |
$15.38
|
| Rate for Payer: Zelis Worker's Compensation |
$23.42
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
12099218
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.38 |
| Max. Negotiated Rate |
$52.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$16.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$16.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18.09
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$33.00
|
| Rate for Payer: Cimarron Advantage Cimarron Advantage PPO |
$25.33
|
| Rate for Payer: First Health Workers Compensation |
$33.13
|
| Rate for Payer: GEHA Commercial |
$18.09
|
| Rate for Payer: GEHA Medicare |
$18.09
|
| Rate for Payer: Health Net Federal Services Government |
$18.09
|
| Rate for Payer: HealthSmart Commercial |
$25.33
|
| Rate for Payer: HealthSmart Worker's Compensation |
$31.79
|
| Rate for Payer: Humana ChoiceCare |
$19.90
|
| Rate for Payer: Humana Medicare Advantage |
$18.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$25.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18.09
|
| Rate for Payer: Multiplan All |
$41.25
|
| Rate for Payer: National Preferred Provider Network Commercial |
$52.25
|
| Rate for Payer: National Preferred Provider Network Worker's Compensation |
$33.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18.99
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$22.46
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$17.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$39.26
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$17.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.09
|
| Rate for Payer: Zelis Medicare |
$15.38
|
| Rate for Payer: Zelis Worker's Compensation |
$23.42
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
25500017
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$244.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$33.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$122.37
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$44.00
|
| Rate for Payer: GEHA Medicare |
$122.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Humana ChoiceCare |
$134.61
|
| Rate for Payer: Humana Medicare Advantage |
$122.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$205.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$122.37
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$208.03
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$122.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$244.74
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$119.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$122.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$122.37
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Medicare |
$104.01
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$146.84
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
9600008
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$52.25 |
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$38.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
8250028
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$244.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$33.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$122.37
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$44.00
|
| Rate for Payer: GEHA Medicare |
$122.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Humana ChoiceCare |
$134.61
|
| Rate for Payer: Humana Medicare Advantage |
$122.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$205.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$122.37
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$208.03
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$122.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$244.74
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$119.92
|
| Rate for Payer: United Healthcare Commercial |
$46.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$122.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$122.37
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Medicare |
$104.01
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$146.84
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
7999248
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$52.25 |
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$38.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
8700007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$52.25 |
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$38.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
8900029
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$52.25 |
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$38.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
8499220
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$244.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$33.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$122.37
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$44.00
|
| Rate for Payer: GEHA Medicare |
$122.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Humana ChoiceCare |
$134.61
|
| Rate for Payer: Humana Medicare Advantage |
$122.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$205.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$122.37
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$208.03
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$80.00
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$122.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$244.74
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$119.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$122.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$122.37
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Medicare |
$104.01
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$146.84
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
9000028
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$15.02 |
| Max. Negotiated Rate |
$52.25 |
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$38.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
8800031
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$244.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$33.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$122.37
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$44.00
|
| Rate for Payer: GEHA Medicare |
$122.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Humana ChoiceCare |
$134.61
|
| Rate for Payer: Humana Medicare Advantage |
$122.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$205.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$122.37
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$208.03
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$122.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$244.74
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$119.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$122.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$122.37
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Medicare |
$104.01
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$146.84
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
IP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
8800031
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$52.25 |
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$38.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: Zelis Auto |
$22.00
|
|
|
REM MNTR PHYSIOL PARAM 1ST SET UP PT EDU
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
9400096
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$244.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$33.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$122.37
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cigna Commercial |
$46.75
|
| Rate for Payer: First Health Commercial |
$49.50
|
| Rate for Payer: First Health Workers Compensation |
$21.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$49.50
|
| Rate for Payer: GEHA Commercial |
$44.00
|
| Rate for Payer: GEHA Medicare |
$122.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$49.50
|
| Rate for Payer: Humana ChoiceCare |
$134.61
|
| Rate for Payer: Humana Medicare Advantage |
$122.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$205.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$122.37
|
| Rate for Payer: Multiplan All |
$50.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$208.03
|
| Rate for Payer: OMNI Networks Commercial |
$38.50
|
| Rate for Payer: One Health Plan PPO/POS |
$49.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$122.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$52.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$244.74
|
| Rate for Payer: Three Rivers Provider Network All |
$41.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$119.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$122.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$51.15
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$122.37
|
| Rate for Payer: Zelis Auto |
$22.00
|
| Rate for Payer: Zelis Medicare |
$104.01
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$146.84
|
| Rate for Payer: Zelis Worker's Compensation |
$15.02
|
|
