|
REMOVAL OF THYROID
|
Facility
|
IP
|
$2,209.00
|
|
|
Service Code
|
CPT 60271
|
| Hospital Charge Code |
6160271
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$603.06 |
| Max. Negotiated Rate |
$2,098.55 |
| Rate for Payer: Cash Price |
$1,325.40
|
| Rate for Payer: Cigna Commercial |
$1,877.65
|
| Rate for Payer: First Health Commercial |
$1,988.10
|
| Rate for Payer: First Health Workers Compensation |
$852.89
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,988.10
|
| Rate for Payer: GEHA Commercial |
$1,546.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,988.10
|
| Rate for Payer: Multiplan All |
$2,010.19
|
| Rate for Payer: OMNI Networks Commercial |
$1,546.30
|
| Rate for Payer: One Health Plan PPO/POS |
$1,988.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,098.55
|
| Rate for Payer: Three Rivers Provider Network All |
$1,656.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,054.37
|
| Rate for Payer: Zelis Auto |
$883.60
|
| Rate for Payer: Zelis Worker's Compensation |
$603.06
|
|
|
REMOVAL OF THYROID
|
Facility
|
IP
|
$1,918.00
|
|
|
Service Code
|
CPT 60240
|
| Hospital Charge Code |
6160240
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$523.61 |
| Max. Negotiated Rate |
$1,822.10 |
| Rate for Payer: Cash Price |
$1,150.80
|
| Rate for Payer: Cigna Commercial |
$1,630.30
|
| Rate for Payer: First Health Commercial |
$1,726.20
|
| Rate for Payer: First Health Workers Compensation |
$740.54
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,726.20
|
| Rate for Payer: GEHA Commercial |
$1,342.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,726.20
|
| Rate for Payer: Multiplan All |
$1,745.38
|
| Rate for Payer: OMNI Networks Commercial |
$1,342.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,726.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,822.10
|
| Rate for Payer: Three Rivers Provider Network All |
$1,438.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,783.74
|
| Rate for Payer: Zelis Auto |
$767.20
|
| Rate for Payer: Zelis Worker's Compensation |
$523.61
|
|
|
REMOVAL OF THYROID
|
Facility
|
OP
|
$2,863.00
|
|
|
Service Code
|
CPT 60270
|
| Hospital Charge Code |
6160270
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$715.75 |
| Max. Negotiated Rate |
$2,719.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,717.80
|
| Rate for Payer: Cash Price |
$1,717.80
|
| Rate for Payer: Cigna Commercial |
$2,433.55
|
| Rate for Payer: First Health Commercial |
$2,576.70
|
| Rate for Payer: First Health Workers Compensation |
$1,105.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,576.70
|
| Rate for Payer: GEHA Commercial |
$2,290.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,576.70
|
| Rate for Payer: Humana ChoiceCare |
$744.38
|
| Rate for Payer: Multiplan All |
$2,605.33
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,717.80
|
| Rate for Payer: OMNI Networks Commercial |
$2,004.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2,576.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,719.85
|
| Rate for Payer: Three Rivers Provider Network All |
$2,147.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,519.44
|
| Rate for Payer: United Healthcare Managed Medicaid |
$715.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,662.59
|
| Rate for Payer: Zelis Auto |
$1,145.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,431.50
|
| Rate for Payer: Zelis Worker's Compensation |
$781.60
|
|
|
REMOVAL OF TOE
|
Facility
|
OP
|
$716.00
|
|
|
Service Code
|
CPT 28150
|
| Hospital Charge Code |
6128150
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$195.47 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,208.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$429.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,208.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,749.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cigna Commercial |
$608.60
|
| Rate for Payer: First Health Commercial |
$644.40
|
| Rate for Payer: First Health Workers Compensation |
$276.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$644.40
|
| Rate for Payer: GEHA Commercial |
$572.80
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$644.40
|
| 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 |
$1,785.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$651.56
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$501.20
|
| Rate for Payer: One Health Plan PPO/POS |
$644.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,061.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,785.30
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$680.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$537.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,785.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$665.88
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$286.40
|
| 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 |
$195.47
|
|
|
REMOVAL OF TOE
|
Facility
|
IP
|
$716.00
|
|
|
Service Code
|
CPT 28150
|
| Hospital Charge Code |
6128150
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$195.47 |
| Max. Negotiated Rate |
$680.20 |
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cigna Commercial |
$608.60
|
| Rate for Payer: First Health Commercial |
$644.40
|
| Rate for Payer: First Health Workers Compensation |
$276.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$644.40
|
| Rate for Payer: GEHA Commercial |
$501.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$644.40
|
| Rate for Payer: Multiplan All |
$651.56
|
| Rate for Payer: OMNI Networks Commercial |
$501.20
|
| Rate for Payer: One Health Plan PPO/POS |
$644.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$680.20
|
| Rate for Payer: Three Rivers Provider Network All |
$537.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$665.88
|
| Rate for Payer: Zelis Auto |
$286.40
|
| Rate for Payer: Zelis Worker's Compensation |
$195.47
|
|
|
REMOVAL OF TOE LESIONS
|
Facility
|
OP
|
$682.00
|
|
|
Service Code
|
CPT 28092
|
| Hospital Charge Code |
6128092
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$186.19 |
| Max. Negotiated Rate |
$3,039.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,208.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$409.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,208.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,749.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,519.65
|
| Rate for Payer: Cash Price |
$409.20
|
| Rate for Payer: Cash Price |
$409.20
|
| Rate for Payer: Cigna Commercial |
$579.70
|
| Rate for Payer: First Health Commercial |
$613.80
|
| Rate for Payer: First Health Workers Compensation |
$263.32
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$613.80
|
| Rate for Payer: GEHA Commercial |
$545.60
|
| Rate for Payer: GEHA Medicare |
$1,519.65
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$613.80
|
| Rate for Payer: Humana ChoiceCare |
$1,671.62
|
| Rate for Payer: Humana Medicare Advantage |
$1,519.65
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,553.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,785.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,519.65
|
| Rate for Payer: Multiplan All |
$620.62
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,583.41
|
| Rate for Payer: OMNI Networks Commercial |
$477.40
|
| Rate for Payer: One Health Plan PPO/POS |
$613.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,061.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,785.30
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,519.65
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$647.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,039.30
|
| Rate for Payer: Three Rivers Provider Network All |
$511.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,489.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,785.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,519.65
|
| Rate for Payer: United Payors & United Providers UP&UP |
$634.26
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,519.65
|
| Rate for Payer: Zelis Auto |
$272.80
|
| Rate for Payer: Zelis Medicare |
$1,291.70
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,823.58
|
| Rate for Payer: Zelis Worker's Compensation |
$186.19
|
|
|
REMOVAL OF TOE LESIONS
|
Facility
|
OP
|
$733.00
|
|
|
Service Code
|
CPT 28108
|
| Hospital Charge Code |
6128108
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$200.11 |
| Max. Negotiated Rate |
$3,039.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,208.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$439.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,208.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,749.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,519.65
|
| Rate for Payer: Cash Price |
$439.80
|
| Rate for Payer: Cash Price |
$439.80
|
| Rate for Payer: Cigna Commercial |
$623.05
|
| Rate for Payer: First Health Commercial |
$659.70
|
| Rate for Payer: First Health Workers Compensation |
$283.01
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$659.70
|
| Rate for Payer: GEHA Commercial |
$586.40
|
| Rate for Payer: GEHA Medicare |
$1,519.65
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$659.70
|
| Rate for Payer: Humana ChoiceCare |
$1,671.62
|
| Rate for Payer: Humana Medicare Advantage |
$1,519.65
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,553.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,785.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,519.65
|
| Rate for Payer: Multiplan All |
$667.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,583.41
|
| Rate for Payer: OMNI Networks Commercial |
$513.10
|
| Rate for Payer: One Health Plan PPO/POS |
$659.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,061.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,785.30
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,519.65
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$696.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,039.30
|
| Rate for Payer: Three Rivers Provider Network All |
$549.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,489.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,785.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,519.65
|
| Rate for Payer: United Payors & United Providers UP&UP |
$681.69
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,519.65
|
| Rate for Payer: Zelis Auto |
$293.20
|
| Rate for Payer: Zelis Medicare |
$1,291.70
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,823.58
|
| Rate for Payer: Zelis Worker's Compensation |
$200.11
|
|
|
REMOVAL OF TOE LESIONS
|
Facility
|
IP
|
$682.00
|
|
|
Service Code
|
CPT 28092
|
| Hospital Charge Code |
6128092
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$186.19 |
| Max. Negotiated Rate |
$647.90 |
| Rate for Payer: Cash Price |
$409.20
|
| Rate for Payer: Cigna Commercial |
$579.70
|
| Rate for Payer: First Health Commercial |
$613.80
|
| Rate for Payer: First Health Workers Compensation |
$263.32
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$613.80
|
| Rate for Payer: GEHA Commercial |
$477.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$613.80
|
| Rate for Payer: Multiplan All |
$620.62
|
| Rate for Payer: OMNI Networks Commercial |
$477.40
|
| Rate for Payer: One Health Plan PPO/POS |
$613.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$647.90
|
| Rate for Payer: Three Rivers Provider Network All |
$511.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$634.26
|
| Rate for Payer: Zelis Auto |
$272.80
|
| Rate for Payer: Zelis Worker's Compensation |
$186.19
|
|
|
REMOVAL OF TOE LESIONS
|
Facility
|
IP
|
$733.00
|
|
|
Service Code
|
CPT 28108
|
| Hospital Charge Code |
6128108
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$200.11 |
| Max. Negotiated Rate |
$696.35 |
| Rate for Payer: Cash Price |
$439.80
|
| Rate for Payer: Cigna Commercial |
$623.05
|
| Rate for Payer: First Health Commercial |
$659.70
|
| Rate for Payer: First Health Workers Compensation |
$283.01
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$659.70
|
| Rate for Payer: GEHA Commercial |
$513.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$659.70
|
| Rate for Payer: Multiplan All |
$667.03
|
| Rate for Payer: OMNI Networks Commercial |
$513.10
|
| Rate for Payer: One Health Plan PPO/POS |
$659.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$696.35
|
| Rate for Payer: Three Rivers Provider Network All |
$549.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$681.69
|
| Rate for Payer: Zelis Auto |
$293.20
|
| Rate for Payer: Zelis Worker's Compensation |
$200.11
|
|
|
REMOVAL OF TONGUE
|
Facility
|
OP
|
$4,561.00
|
|
|
Service Code
|
CPT 41140
|
| Hospital Charge Code |
6141140
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,140.25 |
| Max. Negotiated Rate |
$4,332.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,736.60
|
| Rate for Payer: Cash Price |
$2,736.60
|
| Rate for Payer: Cigna Commercial |
$3,876.85
|
| Rate for Payer: First Health Commercial |
$4,104.90
|
| Rate for Payer: First Health Workers Compensation |
$1,761.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,104.90
|
| Rate for Payer: GEHA Commercial |
$3,648.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,104.90
|
| Rate for Payer: Humana ChoiceCare |
$1,185.86
|
| Rate for Payer: Multiplan All |
$4,150.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,736.60
|
| Rate for Payer: OMNI Networks Commercial |
$3,192.70
|
| Rate for Payer: One Health Plan PPO/POS |
$4,104.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,332.95
|
| Rate for Payer: Three Rivers Provider Network All |
$3,420.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4,013.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,140.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,241.73
|
| Rate for Payer: Zelis Auto |
$1,824.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,280.50
|
| Rate for Payer: Zelis Worker's Compensation |
$1,245.15
|
|
|
REMOVAL OF TONGUE
|
Facility
|
IP
|
$4,561.00
|
|
|
Service Code
|
CPT 41140
|
| Hospital Charge Code |
6141140
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,245.15 |
| Max. Negotiated Rate |
$4,332.95 |
| Rate for Payer: Cash Price |
$2,736.60
|
| Rate for Payer: Cigna Commercial |
$3,876.85
|
| Rate for Payer: First Health Commercial |
$4,104.90
|
| Rate for Payer: First Health Workers Compensation |
$1,761.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,104.90
|
| Rate for Payer: GEHA Commercial |
$3,192.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,104.90
|
| Rate for Payer: Multiplan All |
$4,150.51
|
| Rate for Payer: OMNI Networks Commercial |
$3,192.70
|
| Rate for Payer: One Health Plan PPO/POS |
$4,104.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,332.95
|
| Rate for Payer: Three Rivers Provider Network All |
$3,420.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,241.73
|
| Rate for Payer: Zelis Auto |
$1,824.40
|
| Rate for Payer: Zelis Worker's Compensation |
$1,245.15
|
|
|
REMOVAL OF TONSILS
|
Facility
|
OP
|
$648.00
|
|
|
Service Code
|
CPT 42826
|
| Hospital Charge Code |
6142826
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$176.90 |
| Max. Negotiated Rate |
$6,158.84 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,524.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$388.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,524.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,999.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,079.42
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cigna Commercial |
$550.80
|
| Rate for Payer: First Health Commercial |
$583.20
|
| Rate for Payer: First Health Workers Compensation |
$250.19
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$583.20
|
| Rate for Payer: GEHA Commercial |
$518.40
|
| Rate for Payer: GEHA Medicare |
$3,079.42
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$583.20
|
| Rate for Payer: Humana ChoiceCare |
$3,387.36
|
| Rate for Payer: Humana Medicare Advantage |
$3,079.42
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,173.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,040.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,079.42
|
| Rate for Payer: Multiplan All |
$589.68
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,235.01
|
| Rate for Payer: OMNI Networks Commercial |
$453.60
|
| Rate for Payer: One Health Plan PPO/POS |
$583.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,355.78
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,040.27
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,079.42
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$615.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,158.84
|
| Rate for Payer: Three Rivers Provider Network All |
$486.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,017.83
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,040.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,079.42
|
| Rate for Payer: United Payors & United Providers UP&UP |
$602.64
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,079.42
|
| Rate for Payer: Zelis Auto |
$259.20
|
| Rate for Payer: Zelis Medicare |
$2,617.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,695.30
|
| Rate for Payer: Zelis Worker's Compensation |
$176.90
|
|
|
REMOVAL OF TONSILS
|
Facility
|
OP
|
$675.00
|
|
|
Service Code
|
CPT 42825
|
| Hospital Charge Code |
6142825
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$184.28 |
| Max. Negotiated Rate |
$11,234.32 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,524.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$405.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,524.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,999.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,617.16
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Cigna Commercial |
$573.75
|
| Rate for Payer: First Health Commercial |
$607.50
|
| Rate for Payer: First Health Workers Compensation |
$260.62
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$607.50
|
| Rate for Payer: GEHA Commercial |
$540.00
|
| Rate for Payer: GEHA Medicare |
$5,617.16
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$607.50
|
| Rate for Payer: Humana ChoiceCare |
$6,178.88
|
| Rate for Payer: Humana Medicare Advantage |
$5,617.16
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$9,436.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,040.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,617.16
|
| Rate for Payer: Multiplan All |
$614.25
|
| Rate for Payer: New Mexico Health Connections Medicare |
$9,549.17
|
| Rate for Payer: OMNI Networks Commercial |
$472.50
|
| Rate for Payer: One Health Plan PPO/POS |
$607.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,355.78
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,040.27
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,617.16
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$641.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,234.32
|
| Rate for Payer: Three Rivers Provider Network All |
$506.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,504.82
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,040.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,617.16
|
| Rate for Payer: United Payors & United Providers UP&UP |
$627.75
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,617.16
|
| Rate for Payer: Zelis Auto |
$270.00
|
| Rate for Payer: Zelis Medicare |
$4,774.59
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,740.59
|
| Rate for Payer: Zelis Worker's Compensation |
$184.28
|
|
|
REMOVAL OF TONSILS
|
Facility
|
IP
|
$675.00
|
|
|
Service Code
|
CPT 42825
|
| Hospital Charge Code |
6142825
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$184.28 |
| Max. Negotiated Rate |
$641.25 |
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Cigna Commercial |
$573.75
|
| Rate for Payer: First Health Commercial |
$607.50
|
| Rate for Payer: First Health Workers Compensation |
$260.62
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$607.50
|
| Rate for Payer: GEHA Commercial |
$472.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$607.50
|
| Rate for Payer: Multiplan All |
$614.25
|
| Rate for Payer: OMNI Networks Commercial |
$472.50
|
| Rate for Payer: One Health Plan PPO/POS |
$607.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$641.25
|
| Rate for Payer: Three Rivers Provider Network All |
$506.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$627.75
|
| Rate for Payer: Zelis Auto |
$270.00
|
| Rate for Payer: Zelis Worker's Compensation |
$184.28
|
|
|
REMOVAL OF TONSILS
|
Facility
|
IP
|
$648.00
|
|
|
Service Code
|
CPT 42826
|
| Hospital Charge Code |
6142826
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$176.90 |
| Max. Negotiated Rate |
$615.60 |
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cigna Commercial |
$550.80
|
| Rate for Payer: First Health Commercial |
$583.20
|
| Rate for Payer: First Health Workers Compensation |
$250.19
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$583.20
|
| Rate for Payer: GEHA Commercial |
$453.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$583.20
|
| Rate for Payer: Multiplan All |
$589.68
|
| Rate for Payer: OMNI Networks Commercial |
$453.60
|
| Rate for Payer: One Health Plan PPO/POS |
$583.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$615.60
|
| Rate for Payer: Three Rivers Provider Network All |
$486.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$602.64
|
| Rate for Payer: Zelis Auto |
$259.20
|
| Rate for Payer: Zelis Worker's Compensation |
$176.90
|
|
|
REMOVAL OF TUNNELED INTRAPERITONEAL CATHETER
|
Facility
|
OP
|
$5,977.36
|
|
|
Service Code
|
CPT 49422
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,872.08 |
| Max. Negotiated Rate |
$5,977.36 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,363.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,363.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,872.08
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,988.68
|
| Rate for Payer: First Health Workers Compensation |
$3,846.43
|
| Rate for Payer: GEHA Medicare |
$2,988.68
|
| Rate for Payer: Humana ChoiceCare |
$3,287.55
|
| Rate for Payer: Humana Medicare Advantage |
$2,988.68
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,020.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,910.21
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,988.68
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,080.76
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,205.60
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,910.21
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,988.68
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,977.36
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,928.91
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,910.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,988.68
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,988.68
|
| Rate for Payer: Zelis Medicare |
$2,540.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,586.42
|
| Rate for Payer: Zelis Worker's Compensation |
$2,719.70
|
|
|
REMOVAL OF UPPER JAW
|
Facility
|
OP
|
$4,256.00
|
|
|
Service Code
|
CPT 31230
|
| Hospital Charge Code |
6131230
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,064.00 |
| Max. Negotiated Rate |
$4,043.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,553.60
|
| Rate for Payer: Cash Price |
$2,553.60
|
| Rate for Payer: Cigna Commercial |
$3,617.60
|
| Rate for Payer: First Health Commercial |
$3,830.40
|
| Rate for Payer: First Health Workers Compensation |
$1,643.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,830.40
|
| Rate for Payer: GEHA Commercial |
$3,404.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,830.40
|
| Rate for Payer: Humana ChoiceCare |
$1,106.56
|
| Rate for Payer: Multiplan All |
$3,872.96
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,553.60
|
| Rate for Payer: OMNI Networks Commercial |
$2,979.20
|
| Rate for Payer: One Health Plan PPO/POS |
$3,830.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,043.20
|
| Rate for Payer: Three Rivers Provider Network All |
$3,192.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,745.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,064.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,958.08
|
| Rate for Payer: Zelis Auto |
$1,702.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,128.00
|
| Rate for Payer: Zelis Worker's Compensation |
$1,161.89
|
|
|
REMOVAL OF UPPER JAW
|
Facility
|
IP
|
$4,256.00
|
|
|
Service Code
|
CPT 31230
|
| Hospital Charge Code |
6131230
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,161.89 |
| Max. Negotiated Rate |
$4,043.20 |
| Rate for Payer: Cash Price |
$2,553.60
|
| Rate for Payer: Cigna Commercial |
$3,617.60
|
| Rate for Payer: First Health Commercial |
$3,830.40
|
| Rate for Payer: First Health Workers Compensation |
$1,643.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,830.40
|
| Rate for Payer: GEHA Commercial |
$2,979.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,830.40
|
| Rate for Payer: Multiplan All |
$3,872.96
|
| Rate for Payer: OMNI Networks Commercial |
$2,979.20
|
| Rate for Payer: One Health Plan PPO/POS |
$3,830.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,043.20
|
| Rate for Payer: Three Rivers Provider Network All |
$3,192.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,958.08
|
| Rate for Payer: Zelis Auto |
$1,702.40
|
| Rate for Payer: Zelis Worker's Compensation |
$1,161.89
|
|
|
REMOVAL OF UPPER JAW
|
Facility
|
IP
|
$3,822.00
|
|
|
Service Code
|
CPT 31225
|
| Hospital Charge Code |
6131225
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,043.41 |
| Max. Negotiated Rate |
$3,630.90 |
| Rate for Payer: Cash Price |
$2,293.20
|
| Rate for Payer: Cigna Commercial |
$3,248.70
|
| Rate for Payer: First Health Commercial |
$3,439.80
|
| Rate for Payer: First Health Workers Compensation |
$1,475.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,439.80
|
| Rate for Payer: GEHA Commercial |
$2,675.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,439.80
|
| Rate for Payer: Multiplan All |
$3,478.02
|
| Rate for Payer: OMNI Networks Commercial |
$2,675.40
|
| Rate for Payer: One Health Plan PPO/POS |
$3,439.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,630.90
|
| Rate for Payer: Three Rivers Provider Network All |
$2,866.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,554.46
|
| Rate for Payer: Zelis Auto |
$1,528.80
|
| Rate for Payer: Zelis Worker's Compensation |
$1,043.41
|
|
|
REMOVAL OF UPPER JAW
|
Facility
|
OP
|
$3,822.00
|
|
|
Service Code
|
CPT 31225
|
| Hospital Charge Code |
6131225
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$955.50 |
| Max. Negotiated Rate |
$3,630.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,293.20
|
| Rate for Payer: Cash Price |
$2,293.20
|
| Rate for Payer: Cigna Commercial |
$3,248.70
|
| Rate for Payer: First Health Commercial |
$3,439.80
|
| Rate for Payer: First Health Workers Compensation |
$1,475.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,439.80
|
| Rate for Payer: GEHA Commercial |
$3,057.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,439.80
|
| Rate for Payer: Humana ChoiceCare |
$993.72
|
| Rate for Payer: Multiplan All |
$3,478.02
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,293.20
|
| Rate for Payer: OMNI Networks Commercial |
$2,675.40
|
| Rate for Payer: One Health Plan PPO/POS |
$3,439.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,630.90
|
| Rate for Payer: Three Rivers Provider Network All |
$2,866.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,363.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$955.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,554.46
|
| Rate for Payer: Zelis Auto |
$1,528.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,911.00
|
| Rate for Payer: Zelis Worker's Compensation |
$1,043.41
|
|
|
REMOVAL OF URETER
|
Facility
|
OP
|
$2,139.00
|
|
|
Service Code
|
CPT 50650
|
| Hospital Charge Code |
6150650
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$534.75 |
| Max. Negotiated Rate |
$2,032.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cigna Commercial |
$1,818.15
|
| Rate for Payer: First Health Commercial |
$1,925.10
|
| Rate for Payer: First Health Workers Compensation |
$825.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,925.10
|
| Rate for Payer: GEHA Commercial |
$1,711.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,925.10
|
| Rate for Payer: Humana ChoiceCare |
$556.14
|
| Rate for Payer: Multiplan All |
$1,946.49
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,283.40
|
| Rate for Payer: OMNI Networks Commercial |
$1,497.30
|
| Rate for Payer: One Health Plan PPO/POS |
$1,925.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,032.05
|
| Rate for Payer: Three Rivers Provider Network All |
$1,604.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,882.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$534.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,989.27
|
| Rate for Payer: Zelis Auto |
$855.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,069.50
|
| Rate for Payer: Zelis Worker's Compensation |
$583.95
|
|
|
REMOVAL OF URETER
|
Facility
|
IP
|
$2,139.00
|
|
|
Service Code
|
CPT 50650
|
| Hospital Charge Code |
6150650
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$583.95 |
| Max. Negotiated Rate |
$2,032.05 |
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cigna Commercial |
$1,818.15
|
| Rate for Payer: First Health Commercial |
$1,925.10
|
| Rate for Payer: First Health Workers Compensation |
$825.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,925.10
|
| Rate for Payer: GEHA Commercial |
$1,497.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,925.10
|
| Rate for Payer: Multiplan All |
$1,946.49
|
| Rate for Payer: OMNI Networks Commercial |
$1,497.30
|
| Rate for Payer: One Health Plan PPO/POS |
$1,925.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,032.05
|
| Rate for Payer: Three Rivers Provider Network All |
$1,604.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,989.27
|
| Rate for Payer: Zelis Auto |
$855.60
|
| Rate for Payer: Zelis Worker's Compensation |
$583.95
|
|
|
REMOVAL OF URETER
|
Facility
|
IP
|
$2,376.00
|
|
|
Service Code
|
CPT 50660
|
| Hospital Charge Code |
6150660
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$648.65 |
| Max. Negotiated Rate |
$2,257.20 |
| Rate for Payer: Cash Price |
$1,425.60
|
| Rate for Payer: Cigna Commercial |
$2,019.60
|
| Rate for Payer: First Health Commercial |
$2,138.40
|
| Rate for Payer: First Health Workers Compensation |
$917.37
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,138.40
|
| Rate for Payer: GEHA Commercial |
$1,663.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,138.40
|
| Rate for Payer: Multiplan All |
$2,162.16
|
| Rate for Payer: OMNI Networks Commercial |
$1,663.20
|
| Rate for Payer: One Health Plan PPO/POS |
$2,138.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,257.20
|
| Rate for Payer: Three Rivers Provider Network All |
$1,782.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,209.68
|
| Rate for Payer: Zelis Auto |
$950.40
|
| Rate for Payer: Zelis Worker's Compensation |
$648.65
|
|
|
REMOVAL OF URETER
|
Facility
|
OP
|
$2,376.00
|
|
|
Service Code
|
CPT 50660
|
| Hospital Charge Code |
6150660
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$594.00 |
| Max. Negotiated Rate |
$2,257.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,425.60
|
| Rate for Payer: Cash Price |
$1,425.60
|
| Rate for Payer: Cigna Commercial |
$2,019.60
|
| Rate for Payer: First Health Commercial |
$2,138.40
|
| Rate for Payer: First Health Workers Compensation |
$917.37
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,138.40
|
| Rate for Payer: GEHA Commercial |
$1,900.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,138.40
|
| Rate for Payer: Humana ChoiceCare |
$617.76
|
| Rate for Payer: Multiplan All |
$2,162.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,425.60
|
| Rate for Payer: OMNI Networks Commercial |
$1,663.20
|
| Rate for Payer: One Health Plan PPO/POS |
$2,138.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,257.20
|
| Rate for Payer: Three Rivers Provider Network All |
$1,782.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,090.88
|
| Rate for Payer: United Healthcare Managed Medicaid |
$594.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,209.68
|
| Rate for Payer: Zelis Auto |
$950.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,188.00
|
| Rate for Payer: Zelis Worker's Compensation |
$648.65
|
|
|
REMOVAL OF URETER STONE
|
Facility
|
IP
|
$2,020.00
|
|
|
Service Code
|
CPT 50610
|
| Hospital Charge Code |
6150610
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$551.46 |
| Max. Negotiated Rate |
$1,919.00 |
| Rate for Payer: Cash Price |
$1,212.00
|
| Rate for Payer: Cigna Commercial |
$1,717.00
|
| Rate for Payer: First Health Commercial |
$1,818.00
|
| Rate for Payer: First Health Workers Compensation |
$779.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,818.00
|
| Rate for Payer: GEHA Commercial |
$1,414.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,818.00
|
| Rate for Payer: Multiplan All |
$1,838.20
|
| Rate for Payer: OMNI Networks Commercial |
$1,414.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,818.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,919.00
|
| Rate for Payer: Three Rivers Provider Network All |
$1,515.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,878.60
|
| Rate for Payer: Zelis Auto |
$808.00
|
| Rate for Payer: Zelis Worker's Compensation |
$551.46
|
|
