|
REPAIR BLOOD VESSEL LESION
|
Facility
|
IP
|
$1,665.00
|
|
|
Service Code
|
CPT 35206
|
| Hospital Charge Code |
6135206
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$454.55 |
| Max. Negotiated Rate |
$1,581.75 |
| Rate for Payer: Cash Price |
$999.00
|
| Rate for Payer: Cigna Commercial |
$1,415.25
|
| Rate for Payer: First Health Commercial |
$1,498.50
|
| Rate for Payer: First Health Workers Compensation |
$642.86
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,498.50
|
| Rate for Payer: GEHA Commercial |
$1,165.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,498.50
|
| Rate for Payer: Multiplan All |
$1,515.15
|
| Rate for Payer: OMNI Networks Commercial |
$1,165.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,498.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,581.75
|
| Rate for Payer: Three Rivers Provider Network All |
$1,248.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,548.45
|
| Rate for Payer: Zelis Auto |
$666.00
|
| Rate for Payer: Zelis Worker's Compensation |
$454.55
|
|
|
REPAIR BLOOD VESSEL LESION
|
Facility
|
OP
|
$1,796.00
|
|
|
Service Code
|
CPT 35226
|
| Hospital Charge Code |
6135226
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$490.31 |
| Max. Negotiated Rate |
$1,706.20 |
| 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 |
$1,077.60
|
| 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 |
$668.09
|
| Rate for Payer: Cash Price |
$1,077.60
|
| Rate for Payer: Cash Price |
$1,077.60
|
| Rate for Payer: Cigna Commercial |
$1,526.60
|
| Rate for Payer: First Health Commercial |
$1,616.40
|
| Rate for Payer: First Health Workers Compensation |
$693.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,616.40
|
| Rate for Payer: GEHA Commercial |
$1,436.80
|
| Rate for Payer: GEHA Medicare |
$668.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,616.40
|
| 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 |
$670.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$668.09
|
| Rate for Payer: Multiplan All |
$1,634.36
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,135.75
|
| Rate for Payer: OMNI Networks Commercial |
$1,257.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,616.40
|
| 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 |
$668.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,706.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,336.18
|
| Rate for Payer: Three Rivers Provider Network All |
$1,347.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$654.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$670.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$668.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,670.28
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$668.09
|
| Rate for Payer: Zelis Auto |
$718.40
|
| Rate for Payer: Zelis Medicare |
$567.88
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$801.71
|
| Rate for Payer: Zelis Worker's Compensation |
$490.31
|
|
|
REPAIR BLOOD VESSEL LESION
|
Facility
|
IP
|
$1,796.00
|
|
|
Service Code
|
CPT 35226
|
| Hospital Charge Code |
6135226
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$490.31 |
| Max. Negotiated Rate |
$1,706.20 |
| Rate for Payer: Cash Price |
$1,077.60
|
| Rate for Payer: Cigna Commercial |
$1,526.60
|
| Rate for Payer: First Health Commercial |
$1,616.40
|
| Rate for Payer: First Health Workers Compensation |
$693.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,616.40
|
| Rate for Payer: GEHA Commercial |
$1,257.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,616.40
|
| Rate for Payer: Multiplan All |
$1,634.36
|
| Rate for Payer: OMNI Networks Commercial |
$1,257.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,616.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,706.20
|
| Rate for Payer: Three Rivers Provider Network All |
$1,347.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,670.28
|
| Rate for Payer: Zelis Auto |
$718.40
|
| Rate for Payer: Zelis Worker's Compensation |
$490.31
|
|
|
REPAIR BLOOD VESSEL LESION
|
Facility
|
OP
|
$3,122.00
|
|
|
Service Code
|
CPT 35221
|
| Hospital Charge Code |
6135221
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$780.50 |
| Max. Negotiated Rate |
$2,965.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,873.20
|
| Rate for Payer: Cash Price |
$1,873.20
|
| Rate for Payer: Cigna Commercial |
$2,653.70
|
| Rate for Payer: First Health Commercial |
$2,809.80
|
| Rate for Payer: First Health Workers Compensation |
$1,205.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,809.80
|
| Rate for Payer: GEHA Commercial |
$2,497.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,809.80
|
| Rate for Payer: Humana ChoiceCare |
$811.72
|
| Rate for Payer: Multiplan All |
$2,841.02
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,873.20
|
| Rate for Payer: OMNI Networks Commercial |
$2,185.40
|
| Rate for Payer: One Health Plan PPO/POS |
$2,809.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,965.90
|
| Rate for Payer: Three Rivers Provider Network All |
$2,341.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,747.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$780.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,903.46
|
| Rate for Payer: Zelis Auto |
$1,248.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,561.00
|
| Rate for Payer: Zelis Worker's Compensation |
$852.31
|
|
|
REPAIR BLOOD VESSEL LESION
|
Facility
|
IP
|
$3,122.00
|
|
|
Service Code
|
CPT 35221
|
| Hospital Charge Code |
6135221
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$852.31 |
| Max. Negotiated Rate |
$2,965.90 |
| Rate for Payer: Cash Price |
$1,873.20
|
| Rate for Payer: Cigna Commercial |
$2,653.70
|
| Rate for Payer: First Health Commercial |
$2,809.80
|
| Rate for Payer: First Health Workers Compensation |
$1,205.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,809.80
|
| Rate for Payer: GEHA Commercial |
$2,185.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,809.80
|
| Rate for Payer: Multiplan All |
$2,841.02
|
| Rate for Payer: OMNI Networks Commercial |
$2,185.40
|
| Rate for Payer: One Health Plan PPO/POS |
$2,809.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,965.90
|
| Rate for Payer: Three Rivers Provider Network All |
$2,341.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,903.46
|
| Rate for Payer: Zelis Auto |
$1,248.80
|
| Rate for Payer: Zelis Worker's Compensation |
$852.31
|
|
|
REPAIR BLOOD VESSEL LESION
|
Facility
|
OP
|
$1,665.00
|
|
|
Service Code
|
CPT 35206
|
| Hospital Charge Code |
6135206
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$454.55 |
| Max. Negotiated Rate |
$5,977.36 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,599.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$999.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,599.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,851.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,988.68
|
| Rate for Payer: Cash Price |
$999.00
|
| Rate for Payer: Cash Price |
$999.00
|
| Rate for Payer: Cigna Commercial |
$1,415.25
|
| Rate for Payer: First Health Commercial |
$1,498.50
|
| Rate for Payer: First Health Workers Compensation |
$642.86
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,498.50
|
| Rate for Payer: GEHA Commercial |
$1,332.00
|
| Rate for Payer: GEHA Medicare |
$2,988.68
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,498.50
|
| 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 |
$2,909.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,988.68
|
| Rate for Payer: Multiplan All |
$1,515.15
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,080.76
|
| Rate for Payer: OMNI Networks Commercial |
$1,165.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,498.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$3,359.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,909.32
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,988.68
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,581.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,977.36
|
| Rate for Payer: Three Rivers Provider Network All |
$1,248.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,928.91
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,909.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,988.68
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,548.45
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,988.68
|
| Rate for Payer: Zelis Auto |
$666.00
|
| 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 |
$454.55
|
|
|
REPAIR BOWEL-BLADDER FISTULA
|
Facility
|
OP
|
$2,788.00
|
|
|
Service Code
|
CPT 44660
|
| Hospital Charge Code |
6144660
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$697.00 |
| Max. Negotiated Rate |
$2,648.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,672.80
|
| Rate for Payer: Cash Price |
$1,672.80
|
| Rate for Payer: Cigna Commercial |
$2,369.80
|
| Rate for Payer: First Health Commercial |
$2,509.20
|
| Rate for Payer: First Health Workers Compensation |
$1,076.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,509.20
|
| Rate for Payer: GEHA Commercial |
$2,230.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,509.20
|
| Rate for Payer: Humana ChoiceCare |
$724.88
|
| Rate for Payer: Multiplan All |
$2,537.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,672.80
|
| Rate for Payer: OMNI Networks Commercial |
$1,951.60
|
| Rate for Payer: One Health Plan PPO/POS |
$2,509.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,648.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,091.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,453.44
|
| Rate for Payer: United Healthcare Managed Medicaid |
$697.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,592.84
|
| Rate for Payer: Zelis Auto |
$1,115.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,394.00
|
| Rate for Payer: Zelis Worker's Compensation |
$761.12
|
|
|
REPAIR BOWEL-BLADDER FISTULA
|
Facility
|
IP
|
$2,788.00
|
|
|
Service Code
|
CPT 44660
|
| Hospital Charge Code |
6144660
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$761.12 |
| Max. Negotiated Rate |
$2,648.60 |
| Rate for Payer: Cash Price |
$1,672.80
|
| Rate for Payer: Cigna Commercial |
$2,369.80
|
| Rate for Payer: First Health Commercial |
$2,509.20
|
| Rate for Payer: First Health Workers Compensation |
$1,076.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,509.20
|
| Rate for Payer: GEHA Commercial |
$1,951.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,509.20
|
| Rate for Payer: Multiplan All |
$2,537.08
|
| Rate for Payer: OMNI Networks Commercial |
$1,951.60
|
| Rate for Payer: One Health Plan PPO/POS |
$2,509.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,648.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,091.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,592.84
|
| Rate for Payer: Zelis Auto |
$1,115.20
|
| Rate for Payer: Zelis Worker's Compensation |
$761.12
|
|
|
REPAIR BOWEL-BLADDER FISTULA
|
Facility
|
OP
|
$3,265.00
|
|
|
Service Code
|
CPT 44661
|
| Hospital Charge Code |
6144661
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$816.25 |
| Max. Negotiated Rate |
$3,101.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,959.00
|
| Rate for Payer: Cash Price |
$1,959.00
|
| Rate for Payer: Cigna Commercial |
$2,775.25
|
| Rate for Payer: First Health Commercial |
$2,938.50
|
| Rate for Payer: First Health Workers Compensation |
$1,260.62
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,938.50
|
| Rate for Payer: GEHA Commercial |
$2,612.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,938.50
|
| Rate for Payer: Humana ChoiceCare |
$848.90
|
| Rate for Payer: Multiplan All |
$2,971.15
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,959.00
|
| Rate for Payer: OMNI Networks Commercial |
$2,285.50
|
| Rate for Payer: One Health Plan PPO/POS |
$2,938.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,101.75
|
| Rate for Payer: Three Rivers Provider Network All |
$2,448.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,873.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$816.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,036.45
|
| Rate for Payer: Zelis Auto |
$1,306.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,632.50
|
| Rate for Payer: Zelis Worker's Compensation |
$891.35
|
|
|
REPAIR BOWEL-BLADDER FISTULA
|
Facility
|
IP
|
$3,265.00
|
|
|
Service Code
|
CPT 44661
|
| Hospital Charge Code |
6144661
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$891.35 |
| Max. Negotiated Rate |
$3,101.75 |
| Rate for Payer: Cash Price |
$1,959.00
|
| Rate for Payer: Cigna Commercial |
$2,775.25
|
| Rate for Payer: First Health Commercial |
$2,938.50
|
| Rate for Payer: First Health Workers Compensation |
$1,260.62
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,938.50
|
| Rate for Payer: GEHA Commercial |
$2,285.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,938.50
|
| Rate for Payer: Multiplan All |
$2,971.15
|
| Rate for Payer: OMNI Networks Commercial |
$2,285.50
|
| Rate for Payer: One Health Plan PPO/POS |
$2,938.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,101.75
|
| Rate for Payer: Three Rivers Provider Network All |
$2,448.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,036.45
|
| Rate for Payer: Zelis Auto |
$1,306.00
|
| Rate for Payer: Zelis Worker's Compensation |
$891.35
|
|
|
REPAIR BOWEL FISTULA
|
Facility
|
OP
|
$3,055.00
|
|
|
Service Code
|
CPT 44650
|
| Hospital Charge Code |
6144650
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$763.75 |
| Max. Negotiated Rate |
$2,902.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,833.00
|
| Rate for Payer: Cash Price |
$1,833.00
|
| Rate for Payer: Cigna Commercial |
$2,596.75
|
| Rate for Payer: First Health Commercial |
$2,749.50
|
| Rate for Payer: First Health Workers Compensation |
$1,179.54
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,749.50
|
| Rate for Payer: GEHA Commercial |
$2,444.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,749.50
|
| Rate for Payer: Humana ChoiceCare |
$794.30
|
| Rate for Payer: Multiplan All |
$2,780.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,833.00
|
| Rate for Payer: OMNI Networks Commercial |
$2,138.50
|
| Rate for Payer: One Health Plan PPO/POS |
$2,749.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,902.25
|
| Rate for Payer: Three Rivers Provider Network All |
$2,291.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,688.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$763.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,841.15
|
| Rate for Payer: Zelis Auto |
$1,222.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,527.50
|
| Rate for Payer: Zelis Worker's Compensation |
$834.01
|
|
|
REPAIR BOWEL FISTULA
|
Facility
|
IP
|
$3,055.00
|
|
|
Service Code
|
CPT 44650
|
| Hospital Charge Code |
6144650
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$834.01 |
| Max. Negotiated Rate |
$2,902.25 |
| Rate for Payer: Cash Price |
$1,833.00
|
| Rate for Payer: Cigna Commercial |
$2,596.75
|
| Rate for Payer: First Health Commercial |
$2,749.50
|
| Rate for Payer: First Health Workers Compensation |
$1,179.54
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,749.50
|
| Rate for Payer: GEHA Commercial |
$2,138.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,749.50
|
| Rate for Payer: Multiplan All |
$2,780.05
|
| Rate for Payer: OMNI Networks Commercial |
$2,138.50
|
| Rate for Payer: One Health Plan PPO/POS |
$2,749.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,902.25
|
| Rate for Payer: Three Rivers Provider Network All |
$2,291.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,841.15
|
| Rate for Payer: Zelis Auto |
$1,222.00
|
| Rate for Payer: Zelis Worker's Compensation |
$834.01
|
|
|
REPAIR BOWEL OPENING
|
Facility
|
IP
|
$2,135.00
|
|
|
Service Code
|
CPT 44625
|
| Hospital Charge Code |
6144625
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$582.86 |
| Max. Negotiated Rate |
$2,028.25 |
| Rate for Payer: Cash Price |
$1,281.00
|
| Rate for Payer: Cigna Commercial |
$1,814.75
|
| Rate for Payer: First Health Commercial |
$1,921.50
|
| Rate for Payer: First Health Workers Compensation |
$824.32
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,921.50
|
| Rate for Payer: GEHA Commercial |
$1,494.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,921.50
|
| Rate for Payer: Multiplan All |
$1,942.85
|
| Rate for Payer: OMNI Networks Commercial |
$1,494.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,921.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,028.25
|
| Rate for Payer: Three Rivers Provider Network All |
$1,601.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,985.55
|
| Rate for Payer: Zelis Auto |
$854.00
|
| Rate for Payer: Zelis Worker's Compensation |
$582.86
|
|
|
REPAIR BOWEL OPENING
|
Facility
|
IP
|
$1,822.00
|
|
|
Service Code
|
CPT 44620
|
| Hospital Charge Code |
6144620
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$497.41 |
| Max. Negotiated Rate |
$1,730.90 |
| Rate for Payer: Cash Price |
$1,093.20
|
| Rate for Payer: Cigna Commercial |
$1,548.70
|
| Rate for Payer: First Health Commercial |
$1,639.80
|
| Rate for Payer: First Health Workers Compensation |
$703.47
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,639.80
|
| Rate for Payer: GEHA Commercial |
$1,275.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,639.80
|
| Rate for Payer: Multiplan All |
$1,658.02
|
| Rate for Payer: OMNI Networks Commercial |
$1,275.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,639.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,730.90
|
| Rate for Payer: Three Rivers Provider Network All |
$1,366.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,694.46
|
| Rate for Payer: Zelis Auto |
$728.80
|
| Rate for Payer: Zelis Worker's Compensation |
$497.41
|
|
|
REPAIR BOWEL OPENING
|
Facility
|
OP
|
$1,822.00
|
|
|
Service Code
|
CPT 44620
|
| Hospital Charge Code |
6144620
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$455.50 |
| Max. Negotiated Rate |
$1,730.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,093.20
|
| Rate for Payer: Cash Price |
$1,093.20
|
| Rate for Payer: Cigna Commercial |
$1,548.70
|
| Rate for Payer: First Health Commercial |
$1,639.80
|
| Rate for Payer: First Health Workers Compensation |
$703.47
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,639.80
|
| Rate for Payer: GEHA Commercial |
$1,457.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,639.80
|
| Rate for Payer: Humana ChoiceCare |
$473.72
|
| Rate for Payer: Multiplan All |
$1,658.02
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,093.20
|
| Rate for Payer: OMNI Networks Commercial |
$1,275.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,639.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,730.90
|
| Rate for Payer: Three Rivers Provider Network All |
$1,366.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,603.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$455.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,694.46
|
| Rate for Payer: Zelis Auto |
$728.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$911.00
|
| Rate for Payer: Zelis Worker's Compensation |
$497.41
|
|
|
REPAIR BOWEL OPENING
|
Facility
|
OP
|
$2,135.00
|
|
|
Service Code
|
CPT 44625
|
| Hospital Charge Code |
6144625
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$533.75 |
| Max. Negotiated Rate |
$2,028.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,281.00
|
| Rate for Payer: Cash Price |
$1,281.00
|
| Rate for Payer: Cigna Commercial |
$1,814.75
|
| Rate for Payer: First Health Commercial |
$1,921.50
|
| Rate for Payer: First Health Workers Compensation |
$824.32
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,921.50
|
| Rate for Payer: GEHA Commercial |
$1,708.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,921.50
|
| Rate for Payer: Humana ChoiceCare |
$555.10
|
| Rate for Payer: Multiplan All |
$1,942.85
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,281.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,494.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,921.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,028.25
|
| Rate for Payer: Three Rivers Provider Network All |
$1,601.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,878.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$533.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,985.55
|
| Rate for Payer: Zelis Auto |
$854.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,067.50
|
| Rate for Payer: Zelis Worker's Compensation |
$582.86
|
|
|
REPAIR BOWEL OPENING
|
Facility
|
OP
|
$3,383.00
|
|
|
Service Code
|
CPT 44626
|
| Hospital Charge Code |
6144626
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$845.75 |
| Max. Negotiated Rate |
$3,213.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,029.80
|
| Rate for Payer: Cash Price |
$2,029.80
|
| Rate for Payer: Cigna Commercial |
$2,875.55
|
| Rate for Payer: First Health Commercial |
$3,044.70
|
| Rate for Payer: First Health Workers Compensation |
$1,306.18
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,044.70
|
| Rate for Payer: GEHA Commercial |
$2,706.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,044.70
|
| Rate for Payer: Humana ChoiceCare |
$879.58
|
| Rate for Payer: Multiplan All |
$3,078.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,029.80
|
| Rate for Payer: OMNI Networks Commercial |
$2,368.10
|
| Rate for Payer: One Health Plan PPO/POS |
$3,044.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,213.85
|
| Rate for Payer: Three Rivers Provider Network All |
$2,537.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,977.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$845.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,146.19
|
| Rate for Payer: Zelis Auto |
$1,353.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,691.50
|
| Rate for Payer: Zelis Worker's Compensation |
$923.56
|
|
|
REPAIR BOWEL OPENING
|
Facility
|
IP
|
$3,383.00
|
|
|
Service Code
|
CPT 44626
|
| Hospital Charge Code |
6144626
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$923.56 |
| Max. Negotiated Rate |
$3,213.85 |
| Rate for Payer: Cash Price |
$2,029.80
|
| Rate for Payer: Cigna Commercial |
$2,875.55
|
| Rate for Payer: First Health Commercial |
$3,044.70
|
| Rate for Payer: First Health Workers Compensation |
$1,306.18
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,044.70
|
| Rate for Payer: GEHA Commercial |
$2,368.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,044.70
|
| Rate for Payer: Multiplan All |
$3,078.53
|
| Rate for Payer: OMNI Networks Commercial |
$2,368.10
|
| Rate for Payer: One Health Plan PPO/POS |
$3,044.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,213.85
|
| Rate for Payer: Three Rivers Provider Network All |
$2,537.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,146.19
|
| Rate for Payer: Zelis Auto |
$1,353.20
|
| Rate for Payer: Zelis Worker's Compensation |
$923.56
|
|
|
REPAIR BOWEL-SKIN FISTULA
|
Facility
|
OP
|
$2,956.00
|
|
|
Service Code
|
CPT 44640
|
| Hospital Charge Code |
6144640
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$739.00 |
| Max. Negotiated Rate |
$2,808.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,773.60
|
| Rate for Payer: Cash Price |
$1,773.60
|
| Rate for Payer: Cigna Commercial |
$2,512.60
|
| Rate for Payer: First Health Commercial |
$2,660.40
|
| Rate for Payer: First Health Workers Compensation |
$1,141.31
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,660.40
|
| Rate for Payer: GEHA Commercial |
$2,364.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,660.40
|
| Rate for Payer: Humana ChoiceCare |
$768.56
|
| Rate for Payer: Multiplan All |
$2,689.96
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,773.60
|
| Rate for Payer: OMNI Networks Commercial |
$2,069.20
|
| Rate for Payer: One Health Plan PPO/POS |
$2,660.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,808.20
|
| Rate for Payer: Three Rivers Provider Network All |
$2,217.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,601.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$739.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,749.08
|
| Rate for Payer: Zelis Auto |
$1,182.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,478.00
|
| Rate for Payer: Zelis Worker's Compensation |
$806.99
|
|
|
REPAIR BOWEL-SKIN FISTULA
|
Facility
|
IP
|
$2,956.00
|
|
|
Service Code
|
CPT 44640
|
| Hospital Charge Code |
6144640
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$806.99 |
| Max. Negotiated Rate |
$2,808.20 |
| Rate for Payer: Cash Price |
$1,773.60
|
| Rate for Payer: Cigna Commercial |
$2,512.60
|
| Rate for Payer: First Health Commercial |
$2,660.40
|
| Rate for Payer: First Health Workers Compensation |
$1,141.31
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,660.40
|
| Rate for Payer: GEHA Commercial |
$2,069.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,660.40
|
| Rate for Payer: Multiplan All |
$2,689.96
|
| Rate for Payer: OMNI Networks Commercial |
$2,069.20
|
| Rate for Payer: One Health Plan PPO/POS |
$2,660.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,808.20
|
| Rate for Payer: Three Rivers Provider Network All |
$2,217.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,749.08
|
| Rate for Payer: Zelis Auto |
$1,182.40
|
| Rate for Payer: Zelis Worker's Compensation |
$806.99
|
|
|
REPAIR CARPAL BONE SHORTEN
|
Facility
|
IP
|
$1,598.00
|
|
|
Service Code
|
CPT 25394
|
| Hospital Charge Code |
6125394
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$436.25 |
| Max. Negotiated Rate |
$1,518.10 |
| Rate for Payer: Cash Price |
$958.80
|
| Rate for Payer: Cigna Commercial |
$1,358.30
|
| Rate for Payer: First Health Commercial |
$1,438.20
|
| Rate for Payer: First Health Workers Compensation |
$616.99
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,438.20
|
| Rate for Payer: GEHA Commercial |
$1,118.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,438.20
|
| Rate for Payer: Multiplan All |
$1,454.18
|
| Rate for Payer: OMNI Networks Commercial |
$1,118.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,438.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,518.10
|
| Rate for Payer: Three Rivers Provider Network All |
$1,198.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,486.14
|
| Rate for Payer: Zelis Auto |
$639.20
|
| Rate for Payer: Zelis Worker's Compensation |
$436.25
|
|
|
REPAIR CARPAL BONE SHORTEN
|
Facility
|
OP
|
$1,598.00
|
|
|
Service Code
|
CPT 25394
|
| Hospital Charge Code |
6125394
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$436.25 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,709.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$958.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,709.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,730.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$958.80
|
| Rate for Payer: Cash Price |
$958.80
|
| Rate for Payer: Cigna Commercial |
$1,358.30
|
| Rate for Payer: First Health Commercial |
$1,438.20
|
| Rate for Payer: First Health Workers Compensation |
$616.99
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,438.20
|
| Rate for Payer: GEHA Commercial |
$1,278.40
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,438.20
|
| 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 |
$3,806.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$1,454.18
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$1,118.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,438.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,395.55
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,806.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,518.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$1,198.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,806.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,486.14
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$639.20
|
| 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 |
$436.25
|
|
|
REPAIR CLITORIS
|
Facility
|
IP
|
$2,380.00
|
|
|
Service Code
|
CPT 56805
|
| Hospital Charge Code |
6156805
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$649.74 |
| Max. Negotiated Rate |
$2,261.00 |
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cigna Commercial |
$2,023.00
|
| Rate for Payer: First Health Commercial |
$2,142.00
|
| Rate for Payer: First Health Workers Compensation |
$918.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,142.00
|
| Rate for Payer: GEHA Commercial |
$1,666.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,142.00
|
| Rate for Payer: Multiplan All |
$2,165.80
|
| Rate for Payer: OMNI Networks Commercial |
$1,666.00
|
| Rate for Payer: One Health Plan PPO/POS |
$2,142.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,261.00
|
| Rate for Payer: Three Rivers Provider Network All |
$1,785.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,213.40
|
| Rate for Payer: Zelis Auto |
$952.00
|
| Rate for Payer: Zelis Worker's Compensation |
$649.74
|
|
|
REPAIR CLITORIS
|
Facility
|
OP
|
$2,380.00
|
|
|
Service Code
|
CPT 56805
|
| Hospital Charge Code |
6156805
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$649.74 |
| Max. Negotiated Rate |
$6,038.18 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,026.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,428.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,026.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,605.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,019.09
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cigna Commercial |
$2,023.00
|
| Rate for Payer: First Health Commercial |
$2,142.00
|
| Rate for Payer: First Health Workers Compensation |
$918.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,142.00
|
| Rate for Payer: GEHA Commercial |
$1,904.00
|
| Rate for Payer: GEHA Medicare |
$3,019.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,142.00
|
| Rate for Payer: Humana ChoiceCare |
$3,321.00
|
| Rate for Payer: Humana Medicare Advantage |
$3,019.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,072.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,638.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,019.09
|
| Rate for Payer: Multiplan All |
$2,165.80
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,132.45
|
| Rate for Payer: OMNI Networks Commercial |
$1,666.00
|
| Rate for Payer: One Health Plan PPO/POS |
$2,142.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,891.64
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,638.29
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,019.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,261.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,038.18
|
| Rate for Payer: Three Rivers Provider Network All |
$1,785.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,958.71
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,638.29
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,019.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,213.40
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,019.09
|
| Rate for Payer: Zelis Auto |
$952.00
|
| Rate for Payer: Zelis Medicare |
$2,566.23
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,622.91
|
| Rate for Payer: Zelis Worker's Compensation |
$649.74
|
|
|
REPAIR COMP F/C/C/M/N/AX/G/H/F 1.1-2.5CM
|
Facility
|
OP
|
$641.00
|
|
|
Service Code
|
CPT 13131
|
| Hospital Charge Code |
6113131
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$174.99 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$318.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$384.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$318.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$252.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$384.60
|
| Rate for Payer: Cash Price |
$384.60
|
| Rate for Payer: Cigna Commercial |
$544.85
|
| Rate for Payer: First Health Commercial |
$576.90
|
| Rate for Payer: First Health Workers Compensation |
$247.49
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$576.90
|
| Rate for Payer: GEHA Commercial |
$512.80
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$576.90
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$257.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$583.31
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$448.70
|
| Rate for Payer: One Health Plan PPO/POS |
$576.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$297.33
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$257.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$608.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$480.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$257.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$596.13
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$256.40
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$174.99
|
|
