|
BIOFDBK TRNG PERINL MUSC ANORECT/URO SPH
|
Facility
|
IP
|
$260.00
|
|
|
Service Code
|
CPT 90911
|
| Hospital Charge Code |
8499250
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$70.98 |
| Max. Negotiated Rate |
$247.00 |
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cigna Commercial |
$221.00
|
| Rate for Payer: First Health Commercial |
$234.00
|
| Rate for Payer: First Health Workers Compensation |
$100.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$234.00
|
| Rate for Payer: GEHA Commercial |
$182.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$234.00
|
| Rate for Payer: Multiplan All |
$236.60
|
| Rate for Payer: OMNI Networks Commercial |
$182.00
|
| Rate for Payer: One Health Plan PPO/POS |
$234.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$247.00
|
| Rate for Payer: Three Rivers Provider Network All |
$195.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$241.80
|
| Rate for Payer: Zelis Auto |
$104.00
|
| Rate for Payer: Zelis Worker's Compensation |
$70.98
|
|
|
BIOFDBK TRNG PERINL MUSC ANORECT/URO SPH
|
Facility
|
OP
|
$260.00
|
|
|
Service Code
|
CPT 90911
|
| Hospital Charge Code |
8499250
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$247.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$156.00
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cigna Commercial |
$221.00
|
| Rate for Payer: First Health Commercial |
$234.00
|
| Rate for Payer: First Health Workers Compensation |
$100.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$234.00
|
| Rate for Payer: GEHA Commercial |
$208.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$234.00
|
| Rate for Payer: Humana ChoiceCare |
$67.60
|
| Rate for Payer: Multiplan All |
$236.60
|
| Rate for Payer: New Mexico Health Connections Medicare |
$156.00
|
| Rate for Payer: OMNI Networks Commercial |
$182.00
|
| Rate for Payer: One Health Plan PPO/POS |
$234.00
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$80.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$247.00
|
| Rate for Payer: Three Rivers Provider Network All |
$195.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$228.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$65.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$241.80
|
| Rate for Payer: Zelis Auto |
$104.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$130.00
|
| Rate for Payer: Zelis Worker's Compensation |
$70.98
|
|
|
BIOFEEDBACK TRAINING ANY MODALITY
|
Facility
|
IP
|
$111.66
|
|
|
Service Code
|
CPT 90901
|
| Hospital Charge Code |
23590901
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$106.08 |
| Rate for Payer: Cash Price |
$67.00
|
| Rate for Payer: Cigna Commercial |
$94.91
|
| Rate for Payer: First Health Commercial |
$100.49
|
| Rate for Payer: First Health Workers Compensation |
$43.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$100.49
|
| Rate for Payer: GEHA Commercial |
$78.16
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$100.49
|
| Rate for Payer: Multiplan All |
$101.61
|
| Rate for Payer: OMNI Networks Commercial |
$78.16
|
| Rate for Payer: One Health Plan PPO/POS |
$100.49
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$106.08
|
| Rate for Payer: Three Rivers Provider Network All |
$83.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$103.84
|
| Rate for Payer: Zelis Auto |
$44.66
|
| Rate for Payer: Zelis Worker's Compensation |
$30.48
|
|
|
BIOFEEDBACK TRAINING ANY MODALITY
|
Facility
|
OP
|
$119.00
|
|
|
Service Code
|
CPT 90901
|
| Hospital Charge Code |
9599252
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$29.75 |
| Max. Negotiated Rate |
$113.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$71.40
|
| Rate for Payer: Cash Price |
$71.40
|
| Rate for Payer: Cigna Commercial |
$101.15
|
| Rate for Payer: First Health Commercial |
$107.10
|
| Rate for Payer: First Health Workers Compensation |
$45.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$107.10
|
| Rate for Payer: GEHA Commercial |
$95.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$107.10
|
| Rate for Payer: Humana ChoiceCare |
$30.94
|
| Rate for Payer: Multiplan All |
$108.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$71.40
|
| Rate for Payer: OMNI Networks Commercial |
$83.30
|
| Rate for Payer: One Health Plan PPO/POS |
$107.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$113.05
|
| Rate for Payer: Three Rivers Provider Network All |
$89.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$104.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$29.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$110.67
|
| Rate for Payer: Zelis Auto |
$47.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$59.50
|
| Rate for Payer: Zelis Worker's Compensation |
$32.49
|
|
|
BIOFEEDBACK TRAINING ANY MODALITY
|
Facility
|
IP
|
$119.00
|
|
|
Service Code
|
CPT 90901
|
| Hospital Charge Code |
8499249
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$32.49 |
| Max. Negotiated Rate |
$113.05 |
| Rate for Payer: Cash Price |
$71.40
|
| Rate for Payer: Cigna Commercial |
$101.15
|
| Rate for Payer: First Health Commercial |
$107.10
|
| Rate for Payer: First Health Workers Compensation |
$45.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$107.10
|
| Rate for Payer: GEHA Commercial |
$83.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$107.10
|
| Rate for Payer: Multiplan All |
$108.29
|
| Rate for Payer: OMNI Networks Commercial |
$83.30
|
| Rate for Payer: One Health Plan PPO/POS |
$107.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$113.05
|
| Rate for Payer: Three Rivers Provider Network All |
$89.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$110.67
|
| Rate for Payer: Zelis Auto |
$47.60
|
| Rate for Payer: Zelis Worker's Compensation |
$32.49
|
|
|
BIOFEEDBACK TRAINING ANY MODALITY
|
Facility
|
IP
|
$119.00
|
|
|
Service Code
|
CPT 90901
|
| Hospital Charge Code |
9599252
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$32.49 |
| Max. Negotiated Rate |
$113.05 |
| Rate for Payer: Cash Price |
$71.40
|
| Rate for Payer: Cigna Commercial |
$101.15
|
| Rate for Payer: First Health Commercial |
$107.10
|
| Rate for Payer: First Health Workers Compensation |
$45.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$107.10
|
| Rate for Payer: GEHA Commercial |
$83.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$107.10
|
| Rate for Payer: Multiplan All |
$108.29
|
| Rate for Payer: OMNI Networks Commercial |
$83.30
|
| Rate for Payer: One Health Plan PPO/POS |
$107.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$113.05
|
| Rate for Payer: Three Rivers Provider Network All |
$89.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$110.67
|
| Rate for Payer: Zelis Auto |
$47.60
|
| Rate for Payer: Zelis Worker's Compensation |
$32.49
|
|
|
BIOFEEDBACK TRAINING ANY MODALITY
|
Facility
|
OP
|
$111.66
|
|
|
Service Code
|
CPT 90901
|
| Hospital Charge Code |
23590901
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$27.91 |
| Max. Negotiated Rate |
$106.08 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$67.00
|
| Rate for Payer: Cash Price |
$67.00
|
| Rate for Payer: Cigna Commercial |
$94.91
|
| Rate for Payer: First Health Commercial |
$100.49
|
| Rate for Payer: First Health Workers Compensation |
$43.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$100.49
|
| Rate for Payer: GEHA Commercial |
$89.33
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$100.49
|
| Rate for Payer: Humana ChoiceCare |
$29.03
|
| Rate for Payer: Multiplan All |
$101.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$67.00
|
| Rate for Payer: OMNI Networks Commercial |
$78.16
|
| Rate for Payer: One Health Plan PPO/POS |
$100.49
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$106.08
|
| Rate for Payer: Three Rivers Provider Network All |
$83.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$98.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$27.91
|
| Rate for Payer: United Payors & United Providers UP&UP |
$103.84
|
| Rate for Payer: Zelis Auto |
$44.66
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$55.83
|
| Rate for Payer: Zelis Worker's Compensation |
$30.48
|
|
|
BIOFEEDBACK TRAINING ANY MODALITY
|
Facility
|
OP
|
$119.00
|
|
|
Service Code
|
CPT 90901
|
| Hospital Charge Code |
8499249
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$29.75 |
| Max. Negotiated Rate |
$113.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$71.40
|
| Rate for Payer: Cash Price |
$71.40
|
| Rate for Payer: Cash Price |
$71.40
|
| Rate for Payer: Cigna Commercial |
$101.15
|
| Rate for Payer: First Health Commercial |
$107.10
|
| Rate for Payer: First Health Workers Compensation |
$45.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$107.10
|
| Rate for Payer: GEHA Commercial |
$95.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$107.10
|
| Rate for Payer: Humana ChoiceCare |
$30.94
|
| Rate for Payer: Multiplan All |
$108.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$71.40
|
| Rate for Payer: OMNI Networks Commercial |
$83.30
|
| Rate for Payer: One Health Plan PPO/POS |
$107.10
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$80.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$113.05
|
| Rate for Payer: Three Rivers Provider Network All |
$89.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$104.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$29.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$110.67
|
| Rate for Payer: Zelis Auto |
$47.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$59.50
|
| Rate for Payer: Zelis Worker's Compensation |
$32.49
|
|
|
BIOPSY ABDOMINAL MASS
|
Facility
|
OP
|
$268.00
|
|
|
Service Code
|
CPT 49180
|
| Hospital Charge Code |
6149180
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$73.16 |
| Max. Negotiated Rate |
$3,076.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$977.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$160.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$977.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$774.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,538.48
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cigna Commercial |
$227.80
|
| Rate for Payer: First Health Commercial |
$241.20
|
| Rate for Payer: First Health Workers Compensation |
$103.47
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$241.20
|
| Rate for Payer: GEHA Commercial |
$214.40
|
| Rate for Payer: GEHA Medicare |
$1,538.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$241.20
|
| Rate for Payer: Humana ChoiceCare |
$1,692.33
|
| Rate for Payer: Humana Medicare Advantage |
$1,538.48
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,584.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$790.05
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,538.48
|
| Rate for Payer: Multiplan All |
$243.88
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,615.42
|
| Rate for Payer: OMNI Networks Commercial |
$187.60
|
| Rate for Payer: One Health Plan PPO/POS |
$241.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$912.23
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$790.05
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,538.48
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$254.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,076.96
|
| Rate for Payer: Three Rivers Provider Network All |
$201.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,507.71
|
| Rate for Payer: United Healthcare Managed Medicaid |
$790.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,538.48
|
| Rate for Payer: United Payors & United Providers UP&UP |
$249.24
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,538.48
|
| Rate for Payer: Zelis Auto |
$107.20
|
| Rate for Payer: Zelis Medicare |
$1,307.71
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,846.18
|
| Rate for Payer: Zelis Worker's Compensation |
$73.16
|
|
|
BIOPSY ABDOMINAL MASS
|
Facility
|
IP
|
$268.00
|
|
|
Service Code
|
CPT 49180
|
| Hospital Charge Code |
6149180
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$73.16 |
| Max. Negotiated Rate |
$254.60 |
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cigna Commercial |
$227.80
|
| Rate for Payer: First Health Commercial |
$241.20
|
| Rate for Payer: First Health Workers Compensation |
$103.47
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$241.20
|
| Rate for Payer: GEHA Commercial |
$187.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$241.20
|
| Rate for Payer: Multiplan All |
$243.88
|
| Rate for Payer: OMNI Networks Commercial |
$187.60
|
| Rate for Payer: One Health Plan PPO/POS |
$241.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$254.60
|
| Rate for Payer: Three Rivers Provider Network All |
$201.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$249.24
|
| Rate for Payer: Zelis Auto |
$107.20
|
| Rate for Payer: Zelis Worker's Compensation |
$73.16
|
|
|
BIOPSY ARM/ELBOW SOFT TISSUE
|
Facility
|
OP
|
$512.00
|
|
|
Service Code
|
CPT 24065
|
| Hospital Charge Code |
6124065
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$139.78 |
| Max. Negotiated Rate |
$3,076.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,769.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$307.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,769.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,401.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,538.48
|
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Cigna Commercial |
$435.20
|
| Rate for Payer: First Health Commercial |
$460.80
|
| Rate for Payer: First Health Workers Compensation |
$197.68
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$460.80
|
| Rate for Payer: GEHA Commercial |
$409.60
|
| Rate for Payer: GEHA Medicare |
$1,538.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$460.80
|
| Rate for Payer: Humana ChoiceCare |
$1,692.33
|
| Rate for Payer: Humana Medicare Advantage |
$1,538.48
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,584.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,430.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,538.48
|
| Rate for Payer: Multiplan All |
$465.92
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,615.42
|
| Rate for Payer: OMNI Networks Commercial |
$358.40
|
| Rate for Payer: One Health Plan PPO/POS |
$460.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,651.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,430.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,538.48
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$486.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,076.96
|
| Rate for Payer: Three Rivers Provider Network All |
$384.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,507.71
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,430.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,538.48
|
| Rate for Payer: United Payors & United Providers UP&UP |
$476.16
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,538.48
|
| Rate for Payer: Zelis Auto |
$204.80
|
| Rate for Payer: Zelis Medicare |
$1,307.71
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,846.18
|
| Rate for Payer: Zelis Worker's Compensation |
$139.78
|
|
|
BIOPSY ARM/ELBOW SOFT TISSUE
|
Facility
|
IP
|
$851.00
|
|
|
Service Code
|
CPT 24066
|
| Hospital Charge Code |
6124066
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$232.32 |
| Max. Negotiated Rate |
$808.45 |
| Rate for Payer: Cash Price |
$510.60
|
| Rate for Payer: Cigna Commercial |
$723.35
|
| Rate for Payer: First Health Commercial |
$765.90
|
| Rate for Payer: First Health Workers Compensation |
$328.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$765.90
|
| Rate for Payer: GEHA Commercial |
$595.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$765.90
|
| Rate for Payer: Multiplan All |
$774.41
|
| Rate for Payer: OMNI Networks Commercial |
$595.70
|
| Rate for Payer: One Health Plan PPO/POS |
$765.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$808.45
|
| Rate for Payer: Three Rivers Provider Network All |
$638.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$791.43
|
| Rate for Payer: Zelis Auto |
$340.40
|
| Rate for Payer: Zelis Worker's Compensation |
$232.32
|
|
|
BIOPSY ARM/ELBOW SOFT TISSUE
|
Facility
|
IP
|
$512.00
|
|
|
Service Code
|
CPT 24065
|
| Hospital Charge Code |
6124065
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$139.78 |
| Max. Negotiated Rate |
$486.40 |
| Rate for Payer: Cash Price |
$307.20
|
| Rate for Payer: Cigna Commercial |
$435.20
|
| Rate for Payer: First Health Commercial |
$460.80
|
| Rate for Payer: First Health Workers Compensation |
$197.68
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$460.80
|
| Rate for Payer: GEHA Commercial |
$358.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$460.80
|
| Rate for Payer: Multiplan All |
$465.92
|
| Rate for Payer: OMNI Networks Commercial |
$358.40
|
| Rate for Payer: One Health Plan PPO/POS |
$460.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$486.40
|
| Rate for Payer: Three Rivers Provider Network All |
$384.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$476.16
|
| Rate for Payer: Zelis Auto |
$204.80
|
| Rate for Payer: Zelis Worker's Compensation |
$139.78
|
|
|
BIOPSY ARM/ELBOW SOFT TISSUE
|
Facility
|
OP
|
$851.00
|
|
|
Service Code
|
CPT 24066
|
| Hospital Charge Code |
6124066
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$232.32 |
| Max. Negotiated Rate |
$5,435.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,769.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$510.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,769.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,401.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,717.63
|
| Rate for Payer: Cash Price |
$510.60
|
| Rate for Payer: Cash Price |
$510.60
|
| Rate for Payer: Cigna Commercial |
$723.35
|
| Rate for Payer: First Health Commercial |
$765.90
|
| Rate for Payer: First Health Workers Compensation |
$328.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$765.90
|
| Rate for Payer: GEHA Commercial |
$680.80
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$765.90
|
| Rate for Payer: Humana ChoiceCare |
$2,989.39
|
| Rate for Payer: Humana Medicare Advantage |
$2,717.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,565.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,430.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,717.63
|
| Rate for Payer: Multiplan All |
$774.41
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$595.70
|
| Rate for Payer: One Health Plan PPO/POS |
$765.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,651.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,430.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,717.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$808.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$638.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,663.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,430.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,717.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$791.43
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$340.40
|
| Rate for Payer: Zelis Medicare |
$2,309.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,261.16
|
| Rate for Payer: Zelis Worker's Compensation |
$232.32
|
|
|
BIOPSY, BONE, OPEN; DEEP
|
Facility
|
IP
|
$7,544.07
|
|
|
Service Code
|
CPT 20245
|
| Hospital Charge Code |
220245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,059.53 |
| Max. Negotiated Rate |
$7,166.87 |
| Rate for Payer: Cash Price |
$4,526.44
|
| Rate for Payer: Cigna Commercial |
$6,412.46
|
| Rate for Payer: First Health Commercial |
$6,789.66
|
| Rate for Payer: First Health Workers Compensation |
$2,912.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6,789.66
|
| Rate for Payer: GEHA Commercial |
$5,280.85
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6,789.66
|
| Rate for Payer: Multiplan All |
$6,865.10
|
| Rate for Payer: OMNI Networks Commercial |
$5,280.85
|
| Rate for Payer: One Health Plan PPO/POS |
$6,789.66
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$7,166.87
|
| Rate for Payer: Three Rivers Provider Network All |
$5,658.05
|
| Rate for Payer: United Payors & United Providers UP&UP |
$7,015.99
|
| Rate for Payer: Zelis Auto |
$3,017.63
|
| Rate for Payer: Zelis Worker's Compensation |
$2,059.53
|
|
|
BIOPSY BONE OPEN SUPERFICIAL
|
Facility
|
OP
|
$7,148.00
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
1900048
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,873.34 |
| Max. Negotiated Rate |
$6,790.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,364.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,288.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,364.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,873.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,717.63
|
| Rate for Payer: Cash Price |
$4,288.80
|
| Rate for Payer: Cash Price |
$4,288.80
|
| Rate for Payer: Cigna Commercial |
$6,075.80
|
| Rate for Payer: First Health Commercial |
$6,433.20
|
| Rate for Payer: First Health Workers Compensation |
$2,759.84
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6,433.20
|
| Rate for Payer: GEHA Commercial |
$5,718.40
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6,433.20
|
| Rate for Payer: Humana ChoiceCare |
$2,989.39
|
| Rate for Payer: Humana Medicare Advantage |
$2,717.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,565.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,911.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,717.63
|
| Rate for Payer: Multiplan All |
$6,504.68
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$5,003.60
|
| Rate for Payer: One Health Plan PPO/POS |
$6,433.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,207.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,911.49
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,717.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$6,790.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$5,361.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,663.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,911.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,717.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$6,647.64
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$2,859.20
|
| Rate for Payer: Zelis Medicare |
$2,309.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,261.16
|
| Rate for Payer: Zelis Worker's Compensation |
$1,951.40
|
|
|
BIOPSY BONE OPEN SUPERFICIAL
|
Facility
|
OP
|
$471.00
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
6120240
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$128.58 |
| Max. Negotiated Rate |
$5,435.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,364.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$282.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,364.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,873.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,717.63
|
| Rate for Payer: Cash Price |
$282.60
|
| Rate for Payer: Cash Price |
$282.60
|
| Rate for Payer: Cigna Commercial |
$400.35
|
| Rate for Payer: First Health Commercial |
$423.90
|
| Rate for Payer: First Health Workers Compensation |
$181.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$423.90
|
| Rate for Payer: GEHA Commercial |
$376.80
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$423.90
|
| Rate for Payer: Humana ChoiceCare |
$2,989.39
|
| Rate for Payer: Humana Medicare Advantage |
$2,717.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,565.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,911.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,717.63
|
| Rate for Payer: Multiplan All |
$428.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$329.70
|
| Rate for Payer: One Health Plan PPO/POS |
$423.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,207.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,911.49
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,717.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$447.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$353.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,663.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,911.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,717.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$438.03
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$188.40
|
| Rate for Payer: Zelis Medicare |
$2,309.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,261.16
|
| Rate for Payer: Zelis Worker's Compensation |
$128.58
|
|
|
BIOPSY BONE OPEN SUPERFICIAL
|
Facility
|
IP
|
$471.00
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
6120240
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$128.58 |
| Max. Negotiated Rate |
$447.45 |
| Rate for Payer: Cash Price |
$282.60
|
| Rate for Payer: Cigna Commercial |
$400.35
|
| Rate for Payer: First Health Commercial |
$423.90
|
| Rate for Payer: First Health Workers Compensation |
$181.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$423.90
|
| Rate for Payer: GEHA Commercial |
$329.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$423.90
|
| Rate for Payer: Multiplan All |
$428.61
|
| Rate for Payer: OMNI Networks Commercial |
$329.70
|
| Rate for Payer: One Health Plan PPO/POS |
$423.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$447.45
|
| Rate for Payer: Three Rivers Provider Network All |
$353.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$438.03
|
| Rate for Payer: Zelis Auto |
$188.40
|
| Rate for Payer: Zelis Worker's Compensation |
$128.58
|
|
|
BIOPSY BONE OPEN SUPERFICIAL
|
Facility
|
IP
|
$7,148.00
|
|
|
Service Code
|
CPT 20240
|
| Hospital Charge Code |
1900048
|
|
Hospital Revenue Code
|
982
|
| Min. Negotiated Rate |
$1,951.40 |
| Max. Negotiated Rate |
$6,790.60 |
| Rate for Payer: Cash Price |
$4,288.80
|
| Rate for Payer: Cigna Commercial |
$6,075.80
|
| Rate for Payer: First Health Commercial |
$6,433.20
|
| Rate for Payer: First Health Workers Compensation |
$2,759.84
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6,433.20
|
| Rate for Payer: GEHA Commercial |
$5,003.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6,433.20
|
| Rate for Payer: Multiplan All |
$6,504.68
|
| Rate for Payer: OMNI Networks Commercial |
$5,003.60
|
| Rate for Payer: One Health Plan PPO/POS |
$6,433.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$6,790.60
|
| Rate for Payer: Three Rivers Provider Network All |
$5,361.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$6,647.64
|
| Rate for Payer: Zelis Auto |
$2,859.20
|
| Rate for Payer: Zelis Worker's Compensation |
$1,951.40
|
|
|
BIOPSY, BONE, OPEN; SUPERFICIAL (EG, STERNUM, SPINOUS PROCESS, RIB, PATELLA, OLECRANON PROCESS, CALCANEUS, TARSAL, METATARSAL, CARPAL, METACARPAL, PHALANX)
|
Facility
|
OP
|
$5,435.26
|
|
|
Service Code
|
CPT 20240
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,873.34 |
| Max. Negotiated Rate |
$5,435.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,364.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,364.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,873.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,717.63
|
| Rate for Payer: First Health Workers Compensation |
$3,497.59
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Humana ChoiceCare |
$2,989.39
|
| Rate for Payer: Humana Medicare Advantage |
$2,717.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,565.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,911.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,717.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,207.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,911.49
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,717.63
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,663.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,911.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,717.63
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Medicare |
$2,309.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,261.16
|
| Rate for Payer: Zelis Worker's Compensation |
$2,473.04
|
|
|
BIOPSY BONE TROCAR/NEEDLE DEEP
|
Facility
|
OP
|
$333.00
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
6120225
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$90.91 |
| Max. Negotiated Rate |
$3,076.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,769.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$199.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,769.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,401.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,538.48
|
| Rate for Payer: Cash Price |
$199.80
|
| Rate for Payer: Cash Price |
$199.80
|
| Rate for Payer: Cigna Commercial |
$283.05
|
| Rate for Payer: First Health Commercial |
$299.70
|
| Rate for Payer: First Health Workers Compensation |
$128.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$299.70
|
| Rate for Payer: GEHA Commercial |
$266.40
|
| Rate for Payer: GEHA Medicare |
$1,538.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$299.70
|
| Rate for Payer: Humana ChoiceCare |
$1,692.33
|
| Rate for Payer: Humana Medicare Advantage |
$1,538.48
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,584.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,430.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,538.48
|
| Rate for Payer: Multiplan All |
$303.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,615.42
|
| Rate for Payer: OMNI Networks Commercial |
$233.10
|
| Rate for Payer: One Health Plan PPO/POS |
$299.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,651.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,430.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,538.48
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$316.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,076.96
|
| Rate for Payer: Three Rivers Provider Network All |
$249.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,507.71
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,430.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,538.48
|
| Rate for Payer: United Payors & United Providers UP&UP |
$309.69
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,538.48
|
| Rate for Payer: Zelis Auto |
$133.20
|
| Rate for Payer: Zelis Medicare |
$1,307.71
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,846.18
|
| Rate for Payer: Zelis Worker's Compensation |
$90.91
|
|
|
BIOPSY BONE TROCAR/NEEDLE DEEP
|
Facility
|
IP
|
$333.00
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
6120225
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$90.91 |
| Max. Negotiated Rate |
$316.35 |
| Rate for Payer: Cash Price |
$199.80
|
| Rate for Payer: Cigna Commercial |
$283.05
|
| Rate for Payer: First Health Commercial |
$299.70
|
| Rate for Payer: First Health Workers Compensation |
$128.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$299.70
|
| Rate for Payer: GEHA Commercial |
$233.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$299.70
|
| Rate for Payer: Multiplan All |
$303.03
|
| Rate for Payer: OMNI Networks Commercial |
$233.10
|
| Rate for Payer: One Health Plan PPO/POS |
$299.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$316.35
|
| Rate for Payer: Three Rivers Provider Network All |
$249.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$309.69
|
| Rate for Payer: Zelis Auto |
$133.20
|
| Rate for Payer: Zelis Worker's Compensation |
$90.91
|
|
|
BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL
|
Facility
|
IP
|
$499.00
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
20300101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$136.23 |
| Max. Negotiated Rate |
$474.05 |
| Rate for Payer: Cash Price |
$299.40
|
| Rate for Payer: Cigna Commercial |
$424.15
|
| Rate for Payer: First Health Commercial |
$449.10
|
| Rate for Payer: First Health Workers Compensation |
$192.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$449.10
|
| Rate for Payer: GEHA Commercial |
$349.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$449.10
|
| Rate for Payer: Multiplan All |
$454.09
|
| Rate for Payer: OMNI Networks Commercial |
$349.30
|
| Rate for Payer: One Health Plan PPO/POS |
$449.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$474.05
|
| Rate for Payer: Three Rivers Provider Network All |
$374.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$464.07
|
| Rate for Payer: Zelis Auto |
$199.60
|
| Rate for Payer: Zelis Worker's Compensation |
$136.23
|
|
|
BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL
|
Facility
|
OP
|
$3,567.00
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
1920220
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$657.03 |
| Max. Negotiated Rate |
$3,388.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,140.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$657.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,538.48
|
| Rate for Payer: Cash Price |
$2,140.20
|
| Rate for Payer: Cash Price |
$2,140.20
|
| Rate for Payer: Cigna Commercial |
$3,031.95
|
| Rate for Payer: First Health Commercial |
$3,210.30
|
| Rate for Payer: First Health Workers Compensation |
$1,377.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,210.30
|
| Rate for Payer: GEHA Commercial |
$2,853.60
|
| Rate for Payer: GEHA Medicare |
$1,538.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,210.30
|
| Rate for Payer: Humana ChoiceCare |
$1,692.33
|
| Rate for Payer: Humana Medicare Advantage |
$1,538.48
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,584.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$670.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,538.48
|
| Rate for Payer: Multiplan All |
$3,245.97
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,615.42
|
| Rate for Payer: OMNI Networks Commercial |
$2,496.90
|
| Rate for Payer: One Health Plan PPO/POS |
$3,210.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$774.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$670.42
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,538.48
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,388.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,076.96
|
| Rate for Payer: Three Rivers Provider Network All |
$2,675.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,507.71
|
| Rate for Payer: United Healthcare Managed Medicaid |
$670.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,538.48
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,317.31
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,538.48
|
| Rate for Payer: Zelis Auto |
$1,426.80
|
| Rate for Payer: Zelis Medicare |
$1,307.71
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,846.18
|
| Rate for Payer: Zelis Worker's Compensation |
$973.79
|
|
|
BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL
|
Facility
|
OP
|
$647.76
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
6120220
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$176.84 |
| Max. Negotiated Rate |
$3,076.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$388.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$657.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,538.48
|
| Rate for Payer: Cash Price |
$388.66
|
| Rate for Payer: Cash Price |
$388.66
|
| Rate for Payer: Cigna Commercial |
$550.60
|
| Rate for Payer: First Health Commercial |
$582.98
|
| Rate for Payer: First Health Workers Compensation |
$250.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$582.98
|
| Rate for Payer: GEHA Commercial |
$518.21
|
| Rate for Payer: GEHA Medicare |
$1,538.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$582.98
|
| Rate for Payer: Humana ChoiceCare |
$1,692.33
|
| Rate for Payer: Humana Medicare Advantage |
$1,538.48
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,584.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$670.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,538.48
|
| Rate for Payer: Multiplan All |
$589.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,615.42
|
| Rate for Payer: OMNI Networks Commercial |
$453.43
|
| Rate for Payer: One Health Plan PPO/POS |
$582.98
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$774.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$670.42
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,538.48
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$615.37
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,076.96
|
| Rate for Payer: Three Rivers Provider Network All |
$485.82
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,507.71
|
| Rate for Payer: United Healthcare Managed Medicaid |
$670.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,538.48
|
| Rate for Payer: United Payors & United Providers UP&UP |
$602.42
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,538.48
|
| Rate for Payer: Zelis Auto |
$259.10
|
| Rate for Payer: Zelis Medicare |
$1,307.71
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,846.18
|
| Rate for Payer: Zelis Worker's Compensation |
$176.84
|
|
