|
BIOPSY EXTERNAL EAR
|
Facility
|
IP
|
$1,374.00
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
21669100
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$375.10 |
| Max. Negotiated Rate |
$1,305.30 |
| Rate for Payer: Cash Price |
$824.40
|
| Rate for Payer: Cigna Commercial |
$1,167.90
|
| Rate for Payer: First Health Commercial |
$1,236.60
|
| Rate for Payer: First Health Workers Compensation |
$530.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,236.60
|
| Rate for Payer: GEHA Commercial |
$961.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,236.60
|
| Rate for Payer: Multiplan All |
$1,250.34
|
| Rate for Payer: OMNI Networks Commercial |
$961.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,236.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,305.30
|
| Rate for Payer: Three Rivers Provider Network All |
$1,030.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,277.82
|
| Rate for Payer: Zelis Auto |
$549.60
|
| Rate for Payer: Zelis Worker's Compensation |
$375.10
|
|
|
BIOPSY EXTERNAL EAR
|
Facility
|
IP
|
$258.63
|
|
|
Service Code
|
CPT 69100
|
| Hospital Charge Code |
8511102
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$70.61 |
| Max. Negotiated Rate |
$245.70 |
| Rate for Payer: Cash Price |
$155.18
|
| Rate for Payer: Cigna Commercial |
$219.84
|
| Rate for Payer: First Health Commercial |
$232.77
|
| Rate for Payer: First Health Workers Compensation |
$99.86
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$232.77
|
| Rate for Payer: GEHA Commercial |
$181.04
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$232.77
|
| Rate for Payer: Multiplan All |
$235.35
|
| Rate for Payer: OMNI Networks Commercial |
$181.04
|
| Rate for Payer: One Health Plan PPO/POS |
$232.77
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$245.70
|
| Rate for Payer: Three Rivers Provider Network All |
$193.97
|
| Rate for Payer: United Payors & United Providers UP&UP |
$240.53
|
| Rate for Payer: Zelis Auto |
$103.45
|
| Rate for Payer: Zelis Worker's Compensation |
$70.61
|
|
|
BIOPSY EYELID & LID MARGIN
|
Facility
|
OP
|
$220.00
|
|
|
Service Code
|
CPT 67810
|
| Hospital Charge Code |
6167810
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$60.06 |
| Max. Negotiated Rate |
$567.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$326.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$132.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$326.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$258.46
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$283.85
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cigna Commercial |
$187.00
|
| Rate for Payer: First Health Commercial |
$198.00
|
| Rate for Payer: First Health Workers Compensation |
$84.94
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$198.00
|
| Rate for Payer: GEHA Commercial |
$176.00
|
| Rate for Payer: GEHA Medicare |
$283.85
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$198.00
|
| Rate for Payer: Humana ChoiceCare |
$312.24
|
| Rate for Payer: Humana Medicare Advantage |
$283.85
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$476.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$263.72
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$283.85
|
| Rate for Payer: Multiplan All |
$200.20
|
| Rate for Payer: New Mexico Health Connections Medicare |
$482.55
|
| Rate for Payer: OMNI Networks Commercial |
$154.00
|
| Rate for Payer: One Health Plan PPO/POS |
$198.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$304.50
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$263.72
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$283.85
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$209.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$567.70
|
| Rate for Payer: Three Rivers Provider Network All |
$165.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$278.17
|
| Rate for Payer: United Healthcare Managed Medicaid |
$263.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$283.85
|
| Rate for Payer: United Payors & United Providers UP&UP |
$204.60
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$283.85
|
| Rate for Payer: Zelis Auto |
$88.00
|
| Rate for Payer: Zelis Medicare |
$241.27
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$340.62
|
| Rate for Payer: Zelis Worker's Compensation |
$60.06
|
|
|
BIOPSY EYELID & LID MARGIN
|
Facility
|
IP
|
$220.00
|
|
|
Service Code
|
CPT 67810
|
| Hospital Charge Code |
6167810
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$60.06 |
| Max. Negotiated Rate |
$209.00 |
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cigna Commercial |
$187.00
|
| Rate for Payer: First Health Commercial |
$198.00
|
| Rate for Payer: First Health Workers Compensation |
$84.94
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$198.00
|
| Rate for Payer: GEHA Commercial |
$154.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$198.00
|
| Rate for Payer: Multiplan All |
$200.20
|
| Rate for Payer: OMNI Networks Commercial |
$154.00
|
| Rate for Payer: One Health Plan PPO/POS |
$198.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$209.00
|
| Rate for Payer: Three Rivers Provider Network All |
$165.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$204.60
|
| Rate for Payer: Zelis Auto |
$88.00
|
| Rate for Payer: Zelis Worker's Compensation |
$60.06
|
|
|
BIOPSY FINGER JOINT LINING
|
Facility
|
OP
|
$808.00
|
|
|
Service Code
|
CPT 26110
|
| Hospital Charge Code |
6126110
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$220.58 |
| Max. Negotiated Rate |
$3,039.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,723.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$484.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,723.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,365.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,519.65
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cigna Commercial |
$686.80
|
| Rate for Payer: First Health Commercial |
$727.20
|
| Rate for Payer: First Health Workers Compensation |
$311.97
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$727.20
|
| Rate for Payer: GEHA Commercial |
$646.40
|
| Rate for Payer: GEHA Medicare |
$1,519.65
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$727.20
|
| 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 |
$1,392.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,519.65
|
| Rate for Payer: Multiplan All |
$735.28
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,583.41
|
| Rate for Payer: OMNI Networks Commercial |
$565.60
|
| Rate for Payer: One Health Plan PPO/POS |
$727.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,608.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,392.84
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,519.65
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$767.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,039.30
|
| Rate for Payer: Three Rivers Provider Network All |
$606.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,489.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,392.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,519.65
|
| Rate for Payer: United Payors & United Providers UP&UP |
$751.44
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,519.65
|
| Rate for Payer: Zelis Auto |
$323.20
|
| 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 |
$220.58
|
|
|
BIOPSY FINGER JOINT LINING
|
Facility
|
IP
|
$808.00
|
|
|
Service Code
|
CPT 26110
|
| Hospital Charge Code |
6126110
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$220.58 |
| Max. Negotiated Rate |
$767.60 |
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cigna Commercial |
$686.80
|
| Rate for Payer: First Health Commercial |
$727.20
|
| Rate for Payer: First Health Workers Compensation |
$311.97
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$727.20
|
| Rate for Payer: GEHA Commercial |
$565.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$727.20
|
| Rate for Payer: Multiplan All |
$735.28
|
| Rate for Payer: OMNI Networks Commercial |
$565.60
|
| Rate for Payer: One Health Plan PPO/POS |
$727.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$767.60
|
| Rate for Payer: Three Rivers Provider Network All |
$606.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$751.44
|
| Rate for Payer: Zelis Auto |
$323.20
|
| Rate for Payer: Zelis Worker's Compensation |
$220.58
|
|
|
BIOPSY FINGER JOINT LINING
|
Facility
|
OP
|
$838.00
|
|
|
Service Code
|
CPT 26105
|
| Hospital Charge Code |
6126105
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$228.77 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,723.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$502.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,723.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,365.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$502.80
|
| Rate for Payer: Cash Price |
$502.80
|
| Rate for Payer: Cigna Commercial |
$712.30
|
| Rate for Payer: First Health Commercial |
$754.20
|
| Rate for Payer: First Health Workers Compensation |
$323.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$754.20
|
| Rate for Payer: GEHA Commercial |
$670.40
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$754.20
|
| 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 |
$1,392.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$762.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$586.60
|
| Rate for Payer: One Health Plan PPO/POS |
$754.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,608.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,392.84
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$796.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$628.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,392.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$779.34
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$335.20
|
| 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 |
$228.77
|
|
|
BIOPSY FINGER JOINT LINING
|
Facility
|
IP
|
$838.00
|
|
|
Service Code
|
CPT 26105
|
| Hospital Charge Code |
6126105
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$228.77 |
| Max. Negotiated Rate |
$796.10 |
| Rate for Payer: Cash Price |
$502.80
|
| Rate for Payer: Cigna Commercial |
$712.30
|
| Rate for Payer: First Health Commercial |
$754.20
|
| Rate for Payer: First Health Workers Compensation |
$323.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$754.20
|
| Rate for Payer: GEHA Commercial |
$586.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$754.20
|
| Rate for Payer: Multiplan All |
$762.58
|
| Rate for Payer: OMNI Networks Commercial |
$586.60
|
| Rate for Payer: One Health Plan PPO/POS |
$754.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$796.10
|
| Rate for Payer: Three Rivers Provider Network All |
$628.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$779.34
|
| Rate for Payer: Zelis Auto |
$335.20
|
| Rate for Payer: Zelis Worker's Compensation |
$228.77
|
|
|
BIOPSY FOREARM SOFT TISSUES
|
Facility
|
IP
|
$496.00
|
|
|
Service Code
|
CPT 25065
|
| Hospital Charge Code |
6125065
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$135.41 |
| Max. Negotiated Rate |
$471.20 |
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cigna Commercial |
$421.60
|
| Rate for Payer: First Health Commercial |
$446.40
|
| Rate for Payer: First Health Workers Compensation |
$191.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$446.40
|
| Rate for Payer: GEHA Commercial |
$347.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$446.40
|
| Rate for Payer: Multiplan All |
$451.36
|
| Rate for Payer: OMNI Networks Commercial |
$347.20
|
| Rate for Payer: One Health Plan PPO/POS |
$446.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$471.20
|
| Rate for Payer: Three Rivers Provider Network All |
$372.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$461.28
|
| Rate for Payer: Zelis Auto |
$198.40
|
| Rate for Payer: Zelis Worker's Compensation |
$135.41
|
|
|
BIOPSY FOREARM SOFT TISSUES
|
Facility
|
OP
|
$908.00
|
|
|
Service Code
|
CPT 25066
|
| Hospital Charge Code |
6125066
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$247.88 |
| 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 |
$544.80
|
| 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 |
$544.80
|
| Rate for Payer: Cash Price |
$544.80
|
| Rate for Payer: Cigna Commercial |
$771.80
|
| Rate for Payer: First Health Commercial |
$817.20
|
| Rate for Payer: First Health Workers Compensation |
$350.58
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$817.20
|
| Rate for Payer: GEHA Commercial |
$726.40
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$817.20
|
| 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 |
$826.28
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$635.60
|
| Rate for Payer: One Health Plan PPO/POS |
$817.20
|
| 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 |
$862.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$681.00
|
| 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 |
$844.44
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$363.20
|
| 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 |
$247.88
|
|
|
BIOPSY FOREARM SOFT TISSUES
|
Facility
|
OP
|
$496.00
|
|
|
Service Code
|
CPT 25065
|
| Hospital Charge Code |
6125065
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$135.41 |
| 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 |
$297.60
|
| 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 |
$297.60
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cigna Commercial |
$421.60
|
| Rate for Payer: First Health Commercial |
$446.40
|
| Rate for Payer: First Health Workers Compensation |
$191.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$446.40
|
| Rate for Payer: GEHA Commercial |
$396.80
|
| Rate for Payer: GEHA Medicare |
$1,538.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$446.40
|
| 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 |
$451.36
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,615.42
|
| Rate for Payer: OMNI Networks Commercial |
$347.20
|
| Rate for Payer: One Health Plan PPO/POS |
$446.40
|
| 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 |
$471.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,076.96
|
| Rate for Payer: Three Rivers Provider Network All |
$372.00
|
| 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 |
$461.28
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,538.48
|
| Rate for Payer: Zelis Auto |
$198.40
|
| 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 |
$135.41
|
|
|
BIOPSY FOREARM SOFT TISSUES
|
Facility
|
IP
|
$908.00
|
|
|
Service Code
|
CPT 25066
|
| Hospital Charge Code |
6125066
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$247.88 |
| Max. Negotiated Rate |
$862.60 |
| Rate for Payer: Cash Price |
$544.80
|
| Rate for Payer: Cigna Commercial |
$771.80
|
| Rate for Payer: First Health Commercial |
$817.20
|
| Rate for Payer: First Health Workers Compensation |
$350.58
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$817.20
|
| Rate for Payer: GEHA Commercial |
$635.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$817.20
|
| Rate for Payer: Multiplan All |
$826.28
|
| Rate for Payer: OMNI Networks Commercial |
$635.60
|
| Rate for Payer: One Health Plan PPO/POS |
$817.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$862.60
|
| Rate for Payer: Three Rivers Provider Network All |
$681.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$844.44
|
| Rate for Payer: Zelis Auto |
$363.20
|
| Rate for Payer: Zelis Worker's Compensation |
$247.88
|
|
|
BIOPSY HAND JOINT LINING
|
Facility
|
IP
|
$840.00
|
|
|
Service Code
|
CPT 26100
|
| Hospital Charge Code |
6126100
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$229.32 |
| Max. Negotiated Rate |
$798.00 |
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cigna Commercial |
$714.00
|
| Rate for Payer: First Health Commercial |
$756.00
|
| Rate for Payer: First Health Workers Compensation |
$324.32
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$756.00
|
| Rate for Payer: GEHA Commercial |
$588.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$756.00
|
| Rate for Payer: Multiplan All |
$764.40
|
| Rate for Payer: OMNI Networks Commercial |
$588.00
|
| Rate for Payer: One Health Plan PPO/POS |
$756.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$798.00
|
| Rate for Payer: Three Rivers Provider Network All |
$630.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$781.20
|
| Rate for Payer: Zelis Auto |
$336.00
|
| Rate for Payer: Zelis Worker's Compensation |
$229.32
|
|
|
BIOPSY HAND JOINT LINING
|
Facility
|
OP
|
$840.00
|
|
|
Service Code
|
CPT 26100
|
| Hospital Charge Code |
6126100
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$229.32 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,723.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$504.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,723.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,365.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cigna Commercial |
$714.00
|
| Rate for Payer: First Health Commercial |
$756.00
|
| Rate for Payer: First Health Workers Compensation |
$324.32
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$756.00
|
| Rate for Payer: GEHA Commercial |
$672.00
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$756.00
|
| 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 |
$1,392.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$764.40
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$588.00
|
| Rate for Payer: One Health Plan PPO/POS |
$756.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,608.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,392.84
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$798.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$630.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,392.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$781.20
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$336.00
|
| 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 |
$229.32
|
|
|
BIOPSY KNEE JOINT LINING
|
Facility
|
IP
|
$851.00
|
|
|
Service Code
|
CPT 27330
|
| Hospital Charge Code |
6127330
|
|
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 KNEE JOINT LINING
|
Facility
|
OP
|
$851.00
|
|
|
Service Code
|
CPT 27330
|
| Hospital Charge Code |
6127330
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$232.32 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,212.40
|
| 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 |
$3,212.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,544.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| 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 |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$765.90
|
| 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 |
$2,596.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$774.41
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| 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 |
$2,998.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,596.69
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$808.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$638.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,596.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$791.43
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$340.40
|
| 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 |
$232.32
|
|
|
BIOPSY LIVER NEEDLE PERCUTANEOUS
|
Facility
|
IP
|
$321.00
|
|
|
Service Code
|
CPT 47000
|
| Hospital Charge Code |
6147000
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$87.63 |
| Max. Negotiated Rate |
$304.95 |
| Rate for Payer: Cash Price |
$192.60
|
| Rate for Payer: Cigna Commercial |
$272.85
|
| Rate for Payer: First Health Commercial |
$288.90
|
| Rate for Payer: First Health Workers Compensation |
$123.94
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$288.90
|
| Rate for Payer: GEHA Commercial |
$224.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$288.90
|
| Rate for Payer: Multiplan All |
$292.11
|
| Rate for Payer: OMNI Networks Commercial |
$224.70
|
| Rate for Payer: One Health Plan PPO/POS |
$288.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$304.95
|
| Rate for Payer: Three Rivers Provider Network All |
$240.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$298.53
|
| Rate for Payer: Zelis Auto |
$128.40
|
| Rate for Payer: Zelis Worker's Compensation |
$87.63
|
|
|
BIOPSY LIVER NEEDLE PERCUTANEOUS
|
Facility
|
OP
|
$321.00
|
|
|
Service Code
|
CPT 47000
|
| Hospital Charge Code |
6147000
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$87.63 |
| 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 |
$192.60
|
| 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 |
$192.60
|
| Rate for Payer: Cash Price |
$192.60
|
| Rate for Payer: Cigna Commercial |
$272.85
|
| Rate for Payer: First Health Commercial |
$288.90
|
| Rate for Payer: First Health Workers Compensation |
$123.94
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$288.90
|
| Rate for Payer: GEHA Commercial |
$256.80
|
| Rate for Payer: GEHA Medicare |
$1,538.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$288.90
|
| 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 |
$292.11
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,615.42
|
| Rate for Payer: OMNI Networks Commercial |
$224.70
|
| Rate for Payer: One Health Plan PPO/POS |
$288.90
|
| 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 |
$304.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,076.96
|
| Rate for Payer: Three Rivers Provider Network All |
$240.75
|
| 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 |
$298.53
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,538.48
|
| Rate for Payer: Zelis Auto |
$128.40
|
| 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 |
$87.63
|
|
|
BIOPSY LOWER LEG SOFT TISSUE
|
Facility
|
IP
|
$828.00
|
|
|
Service Code
|
CPT 27614
|
| Hospital Charge Code |
6127614
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$226.04 |
| Max. Negotiated Rate |
$786.60 |
| Rate for Payer: Cash Price |
$496.80
|
| Rate for Payer: Cigna Commercial |
$703.80
|
| Rate for Payer: First Health Commercial |
$745.20
|
| Rate for Payer: First Health Workers Compensation |
$319.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$745.20
|
| Rate for Payer: GEHA Commercial |
$579.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$745.20
|
| Rate for Payer: Multiplan All |
$753.48
|
| Rate for Payer: OMNI Networks Commercial |
$579.60
|
| Rate for Payer: One Health Plan PPO/POS |
$745.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$786.60
|
| Rate for Payer: Three Rivers Provider Network All |
$621.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$770.04
|
| Rate for Payer: Zelis Auto |
$331.20
|
| Rate for Payer: Zelis Worker's Compensation |
$226.04
|
|
|
BIOPSY LOWER LEG SOFT TISSUE
|
Facility
|
OP
|
$496.00
|
|
|
Service Code
|
CPT 27613
|
| Hospital Charge Code |
6127613
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$135.41 |
| 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 |
$297.60
|
| 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 |
$297.60
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cigna Commercial |
$421.60
|
| Rate for Payer: First Health Commercial |
$446.40
|
| Rate for Payer: First Health Workers Compensation |
$191.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$446.40
|
| Rate for Payer: GEHA Commercial |
$396.80
|
| Rate for Payer: GEHA Medicare |
$1,538.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$446.40
|
| 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 |
$451.36
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,615.42
|
| Rate for Payer: OMNI Networks Commercial |
$347.20
|
| Rate for Payer: One Health Plan PPO/POS |
$446.40
|
| 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 |
$471.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,076.96
|
| Rate for Payer: Three Rivers Provider Network All |
$372.00
|
| 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 |
$461.28
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,538.48
|
| Rate for Payer: Zelis Auto |
$198.40
|
| 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 |
$135.41
|
|
|
BIOPSY LOWER LEG SOFT TISSUE
|
Facility
|
IP
|
$496.00
|
|
|
Service Code
|
CPT 27613
|
| Hospital Charge Code |
6127613
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$135.41 |
| Max. Negotiated Rate |
$471.20 |
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cigna Commercial |
$421.60
|
| Rate for Payer: First Health Commercial |
$446.40
|
| Rate for Payer: First Health Workers Compensation |
$191.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$446.40
|
| Rate for Payer: GEHA Commercial |
$347.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$446.40
|
| Rate for Payer: Multiplan All |
$451.36
|
| Rate for Payer: OMNI Networks Commercial |
$347.20
|
| Rate for Payer: One Health Plan PPO/POS |
$446.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$471.20
|
| Rate for Payer: Three Rivers Provider Network All |
$372.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$461.28
|
| Rate for Payer: Zelis Auto |
$198.40
|
| Rate for Payer: Zelis Worker's Compensation |
$135.41
|
|
|
BIOPSY LOWER LEG SOFT TISSUE
|
Facility
|
OP
|
$828.00
|
|
|
Service Code
|
CPT 27614
|
| Hospital Charge Code |
6127614
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$226.04 |
| 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 |
$496.80
|
| 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 |
$496.80
|
| Rate for Payer: Cash Price |
$496.80
|
| Rate for Payer: Cigna Commercial |
$703.80
|
| Rate for Payer: First Health Commercial |
$745.20
|
| Rate for Payer: First Health Workers Compensation |
$319.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$745.20
|
| Rate for Payer: GEHA Commercial |
$662.40
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$745.20
|
| 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 |
$753.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$579.60
|
| Rate for Payer: One Health Plan PPO/POS |
$745.20
|
| 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 |
$786.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$621.00
|
| 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 |
$770.04
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$331.20
|
| 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 |
$226.04
|
|
|
BIOPSY MUSCLE PERCUTANEOUS NEEDLE
|
Facility
|
OP
|
$690.00
|
|
|
Service Code
|
CPT 20206
|
| Hospital Charge Code |
8300020
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$188.37 |
| Max. Negotiated Rate |
$3,076.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$790.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$414.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$790.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$625.93
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,538.48
|
| Rate for Payer: Cash Price |
$414.00
|
| Rate for Payer: Cash Price |
$414.00
|
| Rate for Payer: Cigna Commercial |
$586.50
|
| Rate for Payer: First Health Commercial |
$621.00
|
| Rate for Payer: First Health Workers Compensation |
$266.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$621.00
|
| Rate for Payer: GEHA Commercial |
$552.00
|
| Rate for Payer: GEHA Medicare |
$1,538.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$621.00
|
| 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 |
$638.67
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,538.48
|
| Rate for Payer: Multiplan All |
$627.90
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,615.42
|
| Rate for Payer: OMNI Networks Commercial |
$483.00
|
| Rate for Payer: One Health Plan PPO/POS |
$621.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$737.44
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$638.67
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,538.48
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$655.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,076.96
|
| Rate for Payer: Three Rivers Provider Network All |
$517.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,507.71
|
| Rate for Payer: United Healthcare Managed Medicaid |
$638.67
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,538.48
|
| Rate for Payer: United Payors & United Providers UP&UP |
$641.70
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,538.48
|
| Rate for Payer: Zelis Auto |
$276.00
|
| 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 |
$188.37
|
|
|
BIOPSY MUSCLE PERCUTANEOUS NEEDLE
|
Facility
|
IP
|
$182.00
|
|
|
Service Code
|
CPT 20206
|
| Hospital Charge Code |
6120206
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$49.69 |
| Max. Negotiated Rate |
$172.90 |
| Rate for Payer: Cash Price |
$109.20
|
| Rate for Payer: Cigna Commercial |
$154.70
|
| Rate for Payer: First Health Commercial |
$163.80
|
| Rate for Payer: First Health Workers Compensation |
$70.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$163.80
|
| Rate for Payer: GEHA Commercial |
$127.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$163.80
|
| Rate for Payer: Multiplan All |
$165.62
|
| Rate for Payer: OMNI Networks Commercial |
$127.40
|
| Rate for Payer: One Health Plan PPO/POS |
$163.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$172.90
|
| Rate for Payer: Three Rivers Provider Network All |
$136.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$169.26
|
| Rate for Payer: Zelis Auto |
$72.80
|
| Rate for Payer: Zelis Worker's Compensation |
$49.69
|
|
|
BIOPSY MUSCLE PERCUTANEOUS NEEDLE
|
Facility
|
OP
|
$182.00
|
|
|
Service Code
|
CPT 20206
|
| Hospital Charge Code |
6120206
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$49.69 |
| Max. Negotiated Rate |
$3,076.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$790.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$109.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$790.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$625.93
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,538.48
|
| Rate for Payer: Cash Price |
$109.20
|
| Rate for Payer: Cash Price |
$109.20
|
| Rate for Payer: Cigna Commercial |
$154.70
|
| Rate for Payer: First Health Commercial |
$163.80
|
| Rate for Payer: First Health Workers Compensation |
$70.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$163.80
|
| Rate for Payer: GEHA Commercial |
$145.60
|
| Rate for Payer: GEHA Medicare |
$1,538.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$163.80
|
| 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 |
$638.67
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,538.48
|
| Rate for Payer: Multiplan All |
$165.62
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,615.42
|
| Rate for Payer: OMNI Networks Commercial |
$127.40
|
| Rate for Payer: One Health Plan PPO/POS |
$163.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$737.44
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$638.67
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,538.48
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$172.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,076.96
|
| Rate for Payer: Three Rivers Provider Network All |
$136.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,507.71
|
| Rate for Payer: United Healthcare Managed Medicaid |
$638.67
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,538.48
|
| Rate for Payer: United Payors & United Providers UP&UP |
$169.26
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,538.48
|
| Rate for Payer: Zelis Auto |
$72.80
|
| 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 |
$49.69
|
|
