|
REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONI
|
Facility
|
IP
|
$410.00
|
|
|
Service Code
|
CPT 33286
|
| Hospital Charge Code |
9000024
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$111.93 |
| Max. Negotiated Rate |
$389.50 |
| Rate for Payer: Cash Price |
$246.00
|
| Rate for Payer: Cigna Commercial |
$348.50
|
| Rate for Payer: First Health Commercial |
$369.00
|
| Rate for Payer: First Health Workers Compensation |
$158.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$369.00
|
| Rate for Payer: GEHA Commercial |
$287.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$369.00
|
| Rate for Payer: Multiplan All |
$373.10
|
| Rate for Payer: OMNI Networks Commercial |
$287.00
|
| Rate for Payer: One Health Plan PPO/POS |
$369.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$389.50
|
| Rate for Payer: Three Rivers Provider Network All |
$307.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$381.30
|
| Rate for Payer: Zelis Auto |
$164.00
|
| Rate for Payer: Zelis Worker's Compensation |
$111.93
|
|
|
REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONI
|
Facility
|
OP
|
$410.00
|
|
|
Service Code
|
CPT 33286
|
| Hospital Charge Code |
9000024
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$111.93 |
| Max. Negotiated Rate |
$1,336.18 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$869.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$246.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$869.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$688.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$668.09
|
| Rate for Payer: Cash Price |
$246.00
|
| Rate for Payer: Cash Price |
$246.00
|
| Rate for Payer: Cigna Commercial |
$348.50
|
| Rate for Payer: First Health Commercial |
$369.00
|
| Rate for Payer: First Health Workers Compensation |
$158.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$369.00
|
| Rate for Payer: GEHA Commercial |
$328.00
|
| Rate for Payer: GEHA Medicare |
$668.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$369.00
|
| Rate for Payer: Humana ChoiceCare |
$734.90
|
| Rate for Payer: Humana Medicare Advantage |
$668.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,122.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$702.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$668.09
|
| Rate for Payer: Multiplan All |
$373.10
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,135.75
|
| Rate for Payer: OMNI Networks Commercial |
$287.00
|
| Rate for Payer: One Health Plan PPO/POS |
$369.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$811.08
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$702.45
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$668.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$389.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,336.18
|
| Rate for Payer: Three Rivers Provider Network All |
$307.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$654.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$702.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$668.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$381.30
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$668.09
|
| Rate for Payer: Zelis Auto |
$164.00
|
| Rate for Payer: Zelis Medicare |
$567.88
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$801.71
|
| Rate for Payer: Zelis Worker's Compensation |
$111.93
|
|
|
REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONI
|
Facility
|
OP
|
$282.00
|
|
|
Service Code
|
CPT 33286
|
| Hospital Charge Code |
8699249
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$76.99 |
| Max. Negotiated Rate |
$1,336.18 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$869.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$169.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$869.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$688.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$668.09
|
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Cigna Commercial |
$239.70
|
| Rate for Payer: First Health Commercial |
$253.80
|
| Rate for Payer: First Health Workers Compensation |
$108.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$253.80
|
| Rate for Payer: GEHA Commercial |
$225.60
|
| Rate for Payer: GEHA Medicare |
$668.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$253.80
|
| Rate for Payer: Humana ChoiceCare |
$734.90
|
| Rate for Payer: Humana Medicare Advantage |
$668.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,122.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$702.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$668.09
|
| Rate for Payer: Multiplan All |
$256.62
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,135.75
|
| Rate for Payer: OMNI Networks Commercial |
$197.40
|
| Rate for Payer: One Health Plan PPO/POS |
$253.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$811.08
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$702.45
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$668.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$267.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,336.18
|
| Rate for Payer: Three Rivers Provider Network All |
$211.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$654.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$702.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$668.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$262.26
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$668.09
|
| Rate for Payer: Zelis Auto |
$112.80
|
| Rate for Payer: Zelis Medicare |
$567.88
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$801.71
|
| Rate for Payer: Zelis Worker's Compensation |
$76.99
|
|
|
REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONI
|
Facility
|
IP
|
$4,828.00
|
|
|
Service Code
|
CPT 33286
|
| Hospital Charge Code |
4210023
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,318.04 |
| Max. Negotiated Rate |
$4,586.60 |
| Rate for Payer: Cash Price |
$2,896.80
|
| Rate for Payer: Cigna Commercial |
$4,103.80
|
| Rate for Payer: First Health Commercial |
$4,345.20
|
| Rate for Payer: First Health Workers Compensation |
$1,864.09
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,345.20
|
| Rate for Payer: GEHA Commercial |
$3,379.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,345.20
|
| Rate for Payer: Multiplan All |
$4,393.48
|
| Rate for Payer: OMNI Networks Commercial |
$3,379.60
|
| Rate for Payer: One Health Plan PPO/POS |
$4,345.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,586.60
|
| Rate for Payer: Three Rivers Provider Network All |
$3,621.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,490.04
|
| Rate for Payer: Zelis Auto |
$1,931.20
|
| Rate for Payer: Zelis Worker's Compensation |
$1,318.04
|
|
|
REMOVAL SUTURES / STAPLES LOCAL ANESTH
|
Facility
|
OP
|
$31.44
|
|
|
Service Code
|
CPT 15853
|
| Hospital Charge Code |
8215853
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.86 |
| Max. Negotiated Rate |
$29.87 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$18.86
|
| Rate for Payer: Cash Price |
$18.86
|
| Rate for Payer: Cigna Commercial |
$26.72
|
| Rate for Payer: First Health Commercial |
$28.30
|
| Rate for Payer: First Health Workers Compensation |
$12.14
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$28.30
|
| Rate for Payer: GEHA Commercial |
$25.15
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$28.30
|
| Rate for Payer: Humana ChoiceCare |
$8.17
|
| Rate for Payer: Multiplan All |
$28.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$18.86
|
| Rate for Payer: OMNI Networks Commercial |
$22.01
|
| Rate for Payer: One Health Plan PPO/POS |
$28.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$29.87
|
| Rate for Payer: Three Rivers Provider Network All |
$23.58
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$27.67
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7.86
|
| Rate for Payer: United Payors & United Providers UP&UP |
$29.24
|
| Rate for Payer: Zelis Auto |
$12.58
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$15.72
|
| Rate for Payer: Zelis Worker's Compensation |
$8.58
|
|
|
REMOVAL SUTURES / STAPLES LOCAL ANESTH
|
Facility
|
IP
|
$31.44
|
|
|
Service Code
|
CPT 15853
|
| Hospital Charge Code |
8215853
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$8.58 |
| Max. Negotiated Rate |
$29.87 |
| Rate for Payer: Cash Price |
$18.86
|
| Rate for Payer: Cigna Commercial |
$26.72
|
| Rate for Payer: First Health Commercial |
$28.30
|
| Rate for Payer: First Health Workers Compensation |
$12.14
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$28.30
|
| Rate for Payer: GEHA Commercial |
$22.01
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$28.30
|
| Rate for Payer: Multiplan All |
$28.61
|
| Rate for Payer: OMNI Networks Commercial |
$22.01
|
| Rate for Payer: One Health Plan PPO/POS |
$28.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$29.87
|
| Rate for Payer: Three Rivers Provider Network All |
$23.58
|
| Rate for Payer: United Payors & United Providers UP&UP |
$29.24
|
| Rate for Payer: Zelis Auto |
$12.58
|
| Rate for Payer: Zelis Worker's Compensation |
$8.58
|
|
|
REMOVAL SWEAT GLAND LESION
|
Facility
|
IP
|
$644.00
|
|
|
Service Code
|
CPT 11450
|
| Hospital Charge Code |
6111450
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$175.81 |
| Max. Negotiated Rate |
$611.80 |
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Cigna Commercial |
$547.40
|
| Rate for Payer: First Health Commercial |
$579.60
|
| Rate for Payer: First Health Workers Compensation |
$248.65
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$579.60
|
| Rate for Payer: GEHA Commercial |
$450.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$579.60
|
| Rate for Payer: Multiplan All |
$586.04
|
| Rate for Payer: OMNI Networks Commercial |
$450.80
|
| Rate for Payer: One Health Plan PPO/POS |
$579.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$611.80
|
| Rate for Payer: Three Rivers Provider Network All |
$483.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$598.92
|
| Rate for Payer: Zelis Auto |
$257.60
|
| Rate for Payer: Zelis Worker's Compensation |
$175.81
|
|
|
REMOVAL SWEAT GLAND LESION
|
Facility
|
OP
|
$833.00
|
|
|
Service Code
|
CPT 11463
|
| Hospital Charge Code |
6111463
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$227.41 |
| 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 |
$499.80
|
| 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 |
$499.80
|
| Rate for Payer: Cash Price |
$499.80
|
| Rate for Payer: Cigna Commercial |
$708.05
|
| Rate for Payer: First Health Commercial |
$749.70
|
| Rate for Payer: First Health Workers Compensation |
$321.62
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$749.70
|
| Rate for Payer: GEHA Commercial |
$666.40
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$749.70
|
| 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 |
$758.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$583.10
|
| Rate for Payer: One Health Plan PPO/POS |
$749.70
|
| 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 |
$791.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$624.75
|
| 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 |
$774.69
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$333.20
|
| 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 |
$227.41
|
|
|
REMOVAL SWEAT GLAND LESION
|
Facility
|
OP
|
$719.00
|
|
|
Service Code
|
CPT 11470
|
| Hospital Charge Code |
6111470
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$196.29 |
| 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 |
$431.40
|
| 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 |
$431.40
|
| Rate for Payer: Cash Price |
$431.40
|
| Rate for Payer: Cigna Commercial |
$611.15
|
| Rate for Payer: First Health Commercial |
$647.10
|
| Rate for Payer: First Health Workers Compensation |
$277.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$647.10
|
| Rate for Payer: GEHA Commercial |
$575.20
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$647.10
|
| 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 |
$654.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$503.30
|
| Rate for Payer: One Health Plan PPO/POS |
$647.10
|
| 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 |
$683.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$539.25
|
| 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 |
$668.67
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$287.60
|
| 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 |
$196.29
|
|
|
REMOVAL SWEAT GLAND LESION
|
Facility
|
IP
|
$893.00
|
|
|
Service Code
|
CPT 11471
|
| Hospital Charge Code |
6111471
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$243.79 |
| Max. Negotiated Rate |
$848.35 |
| Rate for Payer: Cash Price |
$535.80
|
| Rate for Payer: Cigna Commercial |
$759.05
|
| Rate for Payer: First Health Commercial |
$803.70
|
| Rate for Payer: First Health Workers Compensation |
$344.79
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$803.70
|
| Rate for Payer: GEHA Commercial |
$625.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$803.70
|
| Rate for Payer: Multiplan All |
$812.63
|
| Rate for Payer: OMNI Networks Commercial |
$625.10
|
| Rate for Payer: One Health Plan PPO/POS |
$803.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$848.35
|
| Rate for Payer: Three Rivers Provider Network All |
$669.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$830.49
|
| Rate for Payer: Zelis Auto |
$357.20
|
| Rate for Payer: Zelis Worker's Compensation |
$243.79
|
|
|
REMOVAL SWEAT GLAND LESION
|
Facility
|
IP
|
$833.00
|
|
|
Service Code
|
CPT 11463
|
| Hospital Charge Code |
6111463
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$227.41 |
| Max. Negotiated Rate |
$791.35 |
| Rate for Payer: Cash Price |
$499.80
|
| Rate for Payer: Cigna Commercial |
$708.05
|
| Rate for Payer: First Health Commercial |
$749.70
|
| Rate for Payer: First Health Workers Compensation |
$321.62
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$749.70
|
| Rate for Payer: GEHA Commercial |
$583.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$749.70
|
| Rate for Payer: Multiplan All |
$758.03
|
| Rate for Payer: OMNI Networks Commercial |
$583.10
|
| Rate for Payer: One Health Plan PPO/POS |
$749.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$791.35
|
| Rate for Payer: Three Rivers Provider Network All |
$624.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$774.69
|
| Rate for Payer: Zelis Auto |
$333.20
|
| Rate for Payer: Zelis Worker's Compensation |
$227.41
|
|
|
REMOVAL SWEAT GLAND LESION
|
Facility
|
OP
|
$893.00
|
|
|
Service Code
|
CPT 11471
|
| Hospital Charge Code |
6111471
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$243.79 |
| 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 |
$535.80
|
| 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 |
$535.80
|
| Rate for Payer: Cash Price |
$535.80
|
| Rate for Payer: Cigna Commercial |
$759.05
|
| Rate for Payer: First Health Commercial |
$803.70
|
| Rate for Payer: First Health Workers Compensation |
$344.79
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$803.70
|
| Rate for Payer: GEHA Commercial |
$714.40
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$803.70
|
| 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 |
$812.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$625.10
|
| Rate for Payer: One Health Plan PPO/POS |
$803.70
|
| 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 |
$848.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$669.75
|
| 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 |
$830.49
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$357.20
|
| 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 |
$243.79
|
|
|
REMOVAL SWEAT GLAND LESION
|
Facility
|
OP
|
$644.00
|
|
|
Service Code
|
CPT 11450
|
| Hospital Charge Code |
6111450
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$175.81 |
| 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 |
$386.40
|
| 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 |
$386.40
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Cigna Commercial |
$547.40
|
| Rate for Payer: First Health Commercial |
$579.60
|
| Rate for Payer: First Health Workers Compensation |
$248.65
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$579.60
|
| Rate for Payer: GEHA Commercial |
$515.20
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$579.60
|
| 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 |
$586.04
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$450.80
|
| Rate for Payer: One Health Plan PPO/POS |
$579.60
|
| 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 |
$611.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$483.00
|
| 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 |
$598.92
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$257.60
|
| 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 |
$175.81
|
|
|
REMOVAL SWEAT GLAND LESION
|
Facility
|
IP
|
$832.00
|
|
|
Service Code
|
CPT 11451
|
| Hospital Charge Code |
6111451
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$227.14 |
| Max. Negotiated Rate |
$790.40 |
| Rate for Payer: Cash Price |
$499.20
|
| Rate for Payer: Cigna Commercial |
$707.20
|
| Rate for Payer: First Health Commercial |
$748.80
|
| Rate for Payer: First Health Workers Compensation |
$321.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$748.80
|
| Rate for Payer: GEHA Commercial |
$582.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$748.80
|
| Rate for Payer: Multiplan All |
$757.12
|
| Rate for Payer: OMNI Networks Commercial |
$582.40
|
| Rate for Payer: One Health Plan PPO/POS |
$748.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$790.40
|
| Rate for Payer: Three Rivers Provider Network All |
$624.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$773.76
|
| Rate for Payer: Zelis Auto |
$332.80
|
| Rate for Payer: Zelis Worker's Compensation |
$227.14
|
|
|
REMOVAL SWEAT GLAND LESION
|
Facility
|
OP
|
$832.00
|
|
|
Service Code
|
CPT 11451
|
| Hospital Charge Code |
6111451
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$227.14 |
| 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 |
$499.20
|
| 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 |
$499.20
|
| Rate for Payer: Cash Price |
$499.20
|
| Rate for Payer: Cigna Commercial |
$707.20
|
| Rate for Payer: First Health Commercial |
$748.80
|
| Rate for Payer: First Health Workers Compensation |
$321.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$748.80
|
| Rate for Payer: GEHA Commercial |
$665.60
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$748.80
|
| 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 |
$757.12
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$582.40
|
| Rate for Payer: One Health Plan PPO/POS |
$748.80
|
| 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 |
$790.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$624.00
|
| 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 |
$773.76
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$332.80
|
| 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 |
$227.14
|
|
|
REMOVAL SWEAT GLAND LESION
|
Facility
|
IP
|
$612.00
|
|
|
Service Code
|
CPT 11462
|
| Hospital Charge Code |
6111462
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$167.08 |
| Max. Negotiated Rate |
$581.40 |
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cigna Commercial |
$520.20
|
| Rate for Payer: First Health Commercial |
$550.80
|
| Rate for Payer: First Health Workers Compensation |
$236.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$550.80
|
| Rate for Payer: GEHA Commercial |
$428.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$550.80
|
| Rate for Payer: Multiplan All |
$556.92
|
| Rate for Payer: OMNI Networks Commercial |
$428.40
|
| Rate for Payer: One Health Plan PPO/POS |
$550.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$581.40
|
| Rate for Payer: Three Rivers Provider Network All |
$459.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$569.16
|
| Rate for Payer: Zelis Auto |
$244.80
|
| Rate for Payer: Zelis Worker's Compensation |
$167.08
|
|
|
REMOVAL SWEAT GLAND LESION
|
Facility
|
OP
|
$612.00
|
|
|
Service Code
|
CPT 11462
|
| Hospital Charge Code |
6111462
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$167.08 |
| 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 |
$367.20
|
| 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 |
$367.20
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cigna Commercial |
$520.20
|
| Rate for Payer: First Health Commercial |
$550.80
|
| Rate for Payer: First Health Workers Compensation |
$236.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$550.80
|
| Rate for Payer: GEHA Commercial |
$489.60
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$550.80
|
| 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 |
$556.92
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$428.40
|
| Rate for Payer: One Health Plan PPO/POS |
$550.80
|
| 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 |
$581.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$459.00
|
| 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 |
$569.16
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$244.80
|
| 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 |
$167.08
|
|
|
REMOVAL SWEAT GLAND LESION
|
Facility
|
IP
|
$719.00
|
|
|
Service Code
|
CPT 11470
|
| Hospital Charge Code |
6111470
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$196.29 |
| Max. Negotiated Rate |
$683.05 |
| Rate for Payer: Cash Price |
$431.40
|
| Rate for Payer: Cigna Commercial |
$611.15
|
| Rate for Payer: First Health Commercial |
$647.10
|
| Rate for Payer: First Health Workers Compensation |
$277.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$647.10
|
| Rate for Payer: GEHA Commercial |
$503.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$647.10
|
| Rate for Payer: Multiplan All |
$654.29
|
| Rate for Payer: OMNI Networks Commercial |
$503.30
|
| Rate for Payer: One Health Plan PPO/POS |
$647.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$683.05
|
| Rate for Payer: Three Rivers Provider Network All |
$539.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$668.67
|
| Rate for Payer: Zelis Auto |
$287.60
|
| Rate for Payer: Zelis Worker's Compensation |
$196.29
|
|
|
REMOVE ABDOMINAL LYMPH NODES
|
Facility
|
OP
|
$709.00
|
|
|
Service Code
|
CPT 38747
|
| Hospital Charge Code |
6138747
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$177.25 |
| Max. Negotiated Rate |
$673.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$425.40
|
| Rate for Payer: Cash Price |
$425.40
|
| Rate for Payer: Cigna Commercial |
$602.65
|
| Rate for Payer: First Health Commercial |
$638.10
|
| Rate for Payer: First Health Workers Compensation |
$273.74
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$638.10
|
| Rate for Payer: GEHA Commercial |
$567.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$638.10
|
| Rate for Payer: Humana ChoiceCare |
$184.34
|
| Rate for Payer: Multiplan All |
$645.19
|
| Rate for Payer: New Mexico Health Connections Medicare |
$425.40
|
| Rate for Payer: OMNI Networks Commercial |
$496.30
|
| Rate for Payer: One Health Plan PPO/POS |
$638.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$673.55
|
| Rate for Payer: Three Rivers Provider Network All |
$531.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$623.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$177.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$659.37
|
| Rate for Payer: Zelis Auto |
$283.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$354.50
|
| Rate for Payer: Zelis Worker's Compensation |
$193.56
|
|
|
REMOVE ABDOMINAL LYMPH NODES
|
Facility
|
IP
|
$709.00
|
|
|
Service Code
|
CPT 38747
|
| Hospital Charge Code |
6138747
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$193.56 |
| Max. Negotiated Rate |
$673.55 |
| Rate for Payer: Cash Price |
$425.40
|
| Rate for Payer: Cigna Commercial |
$602.65
|
| Rate for Payer: First Health Commercial |
$638.10
|
| Rate for Payer: First Health Workers Compensation |
$273.74
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$638.10
|
| Rate for Payer: GEHA Commercial |
$496.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$638.10
|
| Rate for Payer: Multiplan All |
$645.19
|
| Rate for Payer: OMNI Networks Commercial |
$496.30
|
| Rate for Payer: One Health Plan PPO/POS |
$638.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$673.55
|
| Rate for Payer: Three Rivers Provider Network All |
$531.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$659.37
|
| Rate for Payer: Zelis Auto |
$283.60
|
| Rate for Payer: Zelis Worker's Compensation |
$193.56
|
|
|
REMOVE ANAL FIST 2 STAGE
|
Facility
|
OP
|
$842.00
|
|
|
Service Code
|
CPT 46285
|
| Hospital Charge Code |
6146285
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$229.87 |
| Max. Negotiated Rate |
$5,208.02 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,423.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$505.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,423.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,919.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,604.01
|
| Rate for Payer: Cash Price |
$505.20
|
| Rate for Payer: Cash Price |
$505.20
|
| Rate for Payer: Cigna Commercial |
$715.70
|
| Rate for Payer: First Health Commercial |
$757.80
|
| Rate for Payer: First Health Workers Compensation |
$325.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$757.80
|
| Rate for Payer: GEHA Commercial |
$673.60
|
| Rate for Payer: GEHA Medicare |
$2,604.01
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$757.80
|
| Rate for Payer: Humana ChoiceCare |
$2,864.41
|
| Rate for Payer: Humana Medicare Advantage |
$2,604.01
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,374.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,959.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,604.01
|
| Rate for Payer: Multiplan All |
$766.22
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,426.82
|
| Rate for Payer: OMNI Networks Commercial |
$589.40
|
| Rate for Payer: One Health Plan PPO/POS |
$757.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,262.04
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,959.08
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,604.01
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$799.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,208.02
|
| Rate for Payer: Three Rivers Provider Network All |
$631.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,551.93
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,959.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,604.01
|
| Rate for Payer: United Payors & United Providers UP&UP |
$783.06
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,604.01
|
| Rate for Payer: Zelis Auto |
$336.80
|
| Rate for Payer: Zelis Medicare |
$2,213.41
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,124.81
|
| Rate for Payer: Zelis Worker's Compensation |
$229.87
|
|
|
REMOVE ANAL FIST 2 STAGE
|
Facility
|
IP
|
$842.00
|
|
|
Service Code
|
CPT 46285
|
| Hospital Charge Code |
6146285
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$229.87 |
| Max. Negotiated Rate |
$799.90 |
| Rate for Payer: Cash Price |
$505.20
|
| Rate for Payer: Cigna Commercial |
$715.70
|
| Rate for Payer: First Health Commercial |
$757.80
|
| Rate for Payer: First Health Workers Compensation |
$325.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$757.80
|
| Rate for Payer: GEHA Commercial |
$589.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$757.80
|
| Rate for Payer: Multiplan All |
$766.22
|
| Rate for Payer: OMNI Networks Commercial |
$589.40
|
| Rate for Payer: One Health Plan PPO/POS |
$757.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$799.90
|
| Rate for Payer: Three Rivers Provider Network All |
$631.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$783.06
|
| Rate for Payer: Zelis Auto |
$336.80
|
| Rate for Payer: Zelis Worker's Compensation |
$229.87
|
|
|
REMOVE ANAL FIST COMPLEX
|
Facility
|
IP
|
$961.00
|
|
|
Service Code
|
CPT 46280
|
| Hospital Charge Code |
6146280
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$262.35 |
| Max. Negotiated Rate |
$912.95 |
| Rate for Payer: Cash Price |
$576.60
|
| Rate for Payer: Cigna Commercial |
$816.85
|
| Rate for Payer: First Health Commercial |
$864.90
|
| Rate for Payer: First Health Workers Compensation |
$371.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$864.90
|
| Rate for Payer: GEHA Commercial |
$672.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$864.90
|
| Rate for Payer: Multiplan All |
$874.51
|
| Rate for Payer: OMNI Networks Commercial |
$672.70
|
| Rate for Payer: One Health Plan PPO/POS |
$864.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$912.95
|
| Rate for Payer: Three Rivers Provider Network All |
$720.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$893.73
|
| Rate for Payer: Zelis Auto |
$384.40
|
| Rate for Payer: Zelis Worker's Compensation |
$262.35
|
|
|
REMOVE ANAL FIST COMPLEX
|
Facility
|
OP
|
$961.00
|
|
|
Service Code
|
CPT 46280
|
| Hospital Charge Code |
6146280
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$262.35 |
| Max. Negotiated Rate |
$5,208.02 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,423.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$576.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,423.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,919.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,604.01
|
| Rate for Payer: Cash Price |
$576.60
|
| Rate for Payer: Cash Price |
$576.60
|
| Rate for Payer: Cigna Commercial |
$816.85
|
| Rate for Payer: First Health Commercial |
$864.90
|
| Rate for Payer: First Health Workers Compensation |
$371.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$864.90
|
| Rate for Payer: GEHA Commercial |
$768.80
|
| Rate for Payer: GEHA Medicare |
$2,604.01
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$864.90
|
| Rate for Payer: Humana ChoiceCare |
$2,864.41
|
| Rate for Payer: Humana Medicare Advantage |
$2,604.01
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,374.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,959.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,604.01
|
| Rate for Payer: Multiplan All |
$874.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,426.82
|
| Rate for Payer: OMNI Networks Commercial |
$672.70
|
| Rate for Payer: One Health Plan PPO/POS |
$864.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,262.04
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,959.08
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,604.01
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$912.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,208.02
|
| Rate for Payer: Three Rivers Provider Network All |
$720.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,551.93
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,959.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,604.01
|
| Rate for Payer: United Payors & United Providers UP&UP |
$893.73
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,604.01
|
| Rate for Payer: Zelis Auto |
$384.40
|
| Rate for Payer: Zelis Medicare |
$2,213.41
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,124.81
|
| Rate for Payer: Zelis Worker's Compensation |
$262.35
|
|
|
REMOVE ANAL FIST INTER
|
Facility
|
IP
|
$846.00
|
|
|
Service Code
|
CPT 46275
|
| Hospital Charge Code |
6146275
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$230.96 |
| Max. Negotiated Rate |
$803.70 |
| Rate for Payer: Cash Price |
$507.60
|
| Rate for Payer: Cigna Commercial |
$719.10
|
| Rate for Payer: First Health Commercial |
$761.40
|
| Rate for Payer: First Health Workers Compensation |
$326.64
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$761.40
|
| Rate for Payer: GEHA Commercial |
$592.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$761.40
|
| Rate for Payer: Multiplan All |
$769.86
|
| Rate for Payer: OMNI Networks Commercial |
$592.20
|
| Rate for Payer: One Health Plan PPO/POS |
$761.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$803.70
|
| Rate for Payer: Three Rivers Provider Network All |
$634.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$786.78
|
| Rate for Payer: Zelis Auto |
$338.40
|
| Rate for Payer: Zelis Worker's Compensation |
$230.96
|
|
