|
REPAIR DURA
|
Facility
|
OP
|
$2,759.00
|
|
|
Service Code
|
CPT 61618
|
| Hospital Charge Code |
6161618
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$689.75 |
| Max. Negotiated Rate |
$2,621.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,655.40
|
| Rate for Payer: Cash Price |
$1,655.40
|
| Rate for Payer: Cigna Commercial |
$2,345.15
|
| Rate for Payer: First Health Commercial |
$2,483.10
|
| Rate for Payer: First Health Workers Compensation |
$1,065.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,483.10
|
| Rate for Payer: GEHA Commercial |
$2,207.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,483.10
|
| Rate for Payer: Humana ChoiceCare |
$717.34
|
| Rate for Payer: Multiplan All |
$2,510.69
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,655.40
|
| Rate for Payer: OMNI Networks Commercial |
$1,931.30
|
| Rate for Payer: One Health Plan PPO/POS |
$2,483.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,621.05
|
| Rate for Payer: Three Rivers Provider Network All |
$2,069.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,427.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$689.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,565.87
|
| Rate for Payer: Zelis Auto |
$1,103.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,379.50
|
| Rate for Payer: Zelis Worker's Compensation |
$753.21
|
|
|
REPAIR DURA
|
Facility
|
IP
|
$2,759.00
|
|
|
Service Code
|
CPT 61618
|
| Hospital Charge Code |
6161618
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$753.21 |
| Max. Negotiated Rate |
$2,621.05 |
| Rate for Payer: Cash Price |
$1,655.40
|
| Rate for Payer: Cigna Commercial |
$2,345.15
|
| Rate for Payer: First Health Commercial |
$2,483.10
|
| Rate for Payer: First Health Workers Compensation |
$1,065.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,483.10
|
| Rate for Payer: GEHA Commercial |
$1,931.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,483.10
|
| Rate for Payer: Multiplan All |
$2,510.69
|
| Rate for Payer: OMNI Networks Commercial |
$1,931.30
|
| Rate for Payer: One Health Plan PPO/POS |
$2,483.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,621.05
|
| Rate for Payer: Three Rivers Provider Network All |
$2,069.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,565.87
|
| Rate for Payer: Zelis Auto |
$1,103.60
|
| Rate for Payer: Zelis Worker's Compensation |
$753.21
|
|
|
REPAIR DURA
|
Facility
|
IP
|
$3,053.00
|
|
|
Service Code
|
CPT 61619
|
| Hospital Charge Code |
6161619
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$833.47 |
| Max. Negotiated Rate |
$2,900.35 |
| Rate for Payer: Cash Price |
$1,831.80
|
| Rate for Payer: Cigna Commercial |
$2,595.05
|
| Rate for Payer: First Health Commercial |
$2,747.70
|
| Rate for Payer: First Health Workers Compensation |
$1,178.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,747.70
|
| Rate for Payer: GEHA Commercial |
$2,137.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,747.70
|
| Rate for Payer: Multiplan All |
$2,778.23
|
| Rate for Payer: OMNI Networks Commercial |
$2,137.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2,747.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,900.35
|
| Rate for Payer: Three Rivers Provider Network All |
$2,289.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,839.29
|
| Rate for Payer: Zelis Auto |
$1,221.20
|
| Rate for Payer: Zelis Worker's Compensation |
$833.47
|
|
|
REPAIR DURA
|
Facility
|
OP
|
$3,053.00
|
|
|
Service Code
|
CPT 61619
|
| Hospital Charge Code |
6161619
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$763.25 |
| Max. Negotiated Rate |
$2,900.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,831.80
|
| Rate for Payer: Cash Price |
$1,831.80
|
| Rate for Payer: Cigna Commercial |
$2,595.05
|
| Rate for Payer: First Health Commercial |
$2,747.70
|
| Rate for Payer: First Health Workers Compensation |
$1,178.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,747.70
|
| Rate for Payer: GEHA Commercial |
$2,442.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,747.70
|
| Rate for Payer: Humana ChoiceCare |
$793.78
|
| Rate for Payer: Multiplan All |
$2,778.23
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,831.80
|
| Rate for Payer: OMNI Networks Commercial |
$2,137.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2,747.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,900.35
|
| Rate for Payer: Three Rivers Provider Network All |
$2,289.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,686.64
|
| Rate for Payer: United Healthcare Managed Medicaid |
$763.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,839.29
|
| Rate for Payer: Zelis Auto |
$1,221.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,526.50
|
| Rate for Payer: Zelis Worker's Compensation |
$833.47
|
|
|
REPAIR EARDRUM STRUCTURES
|
Facility
|
IP
|
$2,503.00
|
|
|
Service Code
|
CPT 69635
|
| Hospital Charge Code |
6169635
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$683.32 |
| Max. Negotiated Rate |
$2,377.85 |
| Rate for Payer: Cash Price |
$1,501.80
|
| Rate for Payer: Cigna Commercial |
$2,127.55
|
| Rate for Payer: First Health Commercial |
$2,252.70
|
| Rate for Payer: First Health Workers Compensation |
$966.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,252.70
|
| Rate for Payer: GEHA Commercial |
$1,752.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,252.70
|
| Rate for Payer: Multiplan All |
$2,277.73
|
| Rate for Payer: OMNI Networks Commercial |
$1,752.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2,252.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,377.85
|
| Rate for Payer: Three Rivers Provider Network All |
$1,877.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,327.79
|
| Rate for Payer: Zelis Auto |
$1,001.20
|
| Rate for Payer: Zelis Worker's Compensation |
$683.32
|
|
|
REPAIR EARDRUM STRUCTURES
|
Facility
|
OP
|
$2,503.00
|
|
|
Service Code
|
CPT 69635
|
| Hospital Charge Code |
6169635
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$683.32 |
| Max. Negotiated Rate |
$11,234.32 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,345.94
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,501.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,345.94
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,442.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,617.16
|
| Rate for Payer: Cash Price |
$1,501.80
|
| Rate for Payer: Cash Price |
$1,501.80
|
| Rate for Payer: Cigna Commercial |
$2,127.55
|
| Rate for Payer: First Health Commercial |
$2,252.70
|
| Rate for Payer: First Health Workers Compensation |
$966.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,252.70
|
| Rate for Payer: GEHA Commercial |
$2,002.40
|
| Rate for Payer: GEHA Medicare |
$5,617.16
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,252.70
|
| Rate for Payer: Humana ChoiceCare |
$6,178.88
|
| Rate for Payer: Humana Medicare Advantage |
$5,617.16
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$9,436.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,512.96
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,617.16
|
| Rate for Payer: Multiplan All |
$2,277.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$9,549.17
|
| Rate for Payer: OMNI Networks Commercial |
$1,752.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2,252.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,056.21
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,512.96
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,617.16
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,377.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,234.32
|
| Rate for Payer: Three Rivers Provider Network All |
$1,877.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,504.82
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,512.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,617.16
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,327.79
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,617.16
|
| Rate for Payer: Zelis Auto |
$1,001.20
|
| Rate for Payer: Zelis Medicare |
$4,774.59
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,740.59
|
| Rate for Payer: Zelis Worker's Compensation |
$683.32
|
|
|
REPAIR ELBOW DEB/ATTCH OPEN
|
Facility
|
IP
|
$1,346.00
|
|
|
Service Code
|
CPT 24359
|
| Hospital Charge Code |
6124359
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$367.46 |
| Max. Negotiated Rate |
$1,278.70 |
| Rate for Payer: Cash Price |
$807.60
|
| Rate for Payer: Cigna Commercial |
$1,144.10
|
| Rate for Payer: First Health Commercial |
$1,211.40
|
| Rate for Payer: First Health Workers Compensation |
$519.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,211.40
|
| Rate for Payer: GEHA Commercial |
$942.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,211.40
|
| Rate for Payer: Multiplan All |
$1,224.86
|
| Rate for Payer: OMNI Networks Commercial |
$942.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,211.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,278.70
|
| Rate for Payer: Three Rivers Provider Network All |
$1,009.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,251.78
|
| Rate for Payer: Zelis Auto |
$538.40
|
| Rate for Payer: Zelis Worker's Compensation |
$367.46
|
|
|
REPAIR ELBOW DEB/ATTCH OPEN
|
Facility
|
OP
|
$1,346.00
|
|
|
Service Code
|
CPT 24359
|
| Hospital Charge Code |
6124359
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$367.46 |
| 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 |
$807.60
|
| 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 |
$807.60
|
| Rate for Payer: Cash Price |
$807.60
|
| Rate for Payer: Cigna Commercial |
$1,144.10
|
| Rate for Payer: First Health Commercial |
$1,211.40
|
| Rate for Payer: First Health Workers Compensation |
$519.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,211.40
|
| Rate for Payer: GEHA Commercial |
$1,076.80
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,211.40
|
| Rate for Payer: Humana ChoiceCare |
$3,388.98
|
| Rate for Payer: Humana Medicare Advantage |
$3,080.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,175.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,596.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$1,224.86
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$942.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,211.40
|
| 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 |
$1,278.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$1,009.50
|
| 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 |
$1,251.78
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$538.40
|
| 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 |
$367.46
|
|
|
REPAIR ELBOW PERC
|
Facility
|
IP
|
$869.00
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
6124357
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$237.24 |
| Max. Negotiated Rate |
$825.55 |
| Rate for Payer: Cash Price |
$521.40
|
| Rate for Payer: Cigna Commercial |
$738.65
|
| Rate for Payer: First Health Commercial |
$782.10
|
| Rate for Payer: First Health Workers Compensation |
$335.52
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$782.10
|
| Rate for Payer: GEHA Commercial |
$608.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$782.10
|
| Rate for Payer: Multiplan All |
$790.79
|
| Rate for Payer: OMNI Networks Commercial |
$608.30
|
| Rate for Payer: One Health Plan PPO/POS |
$782.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$825.55
|
| Rate for Payer: Three Rivers Provider Network All |
$651.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$808.17
|
| Rate for Payer: Zelis Auto |
$347.60
|
| Rate for Payer: Zelis Worker's Compensation |
$237.24
|
|
|
REPAIR ELBOW PERC
|
Facility
|
OP
|
$869.00
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
6124357
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$237.24 |
| 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 |
$521.40
|
| 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 |
$521.40
|
| Rate for Payer: Cash Price |
$521.40
|
| Rate for Payer: Cigna Commercial |
$738.65
|
| Rate for Payer: First Health Commercial |
$782.10
|
| Rate for Payer: First Health Workers Compensation |
$335.52
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$782.10
|
| Rate for Payer: GEHA Commercial |
$695.20
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$782.10
|
| 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 |
$790.79
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$608.30
|
| Rate for Payer: One Health Plan PPO/POS |
$782.10
|
| 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 |
$825.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$651.75
|
| 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 |
$808.17
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$347.60
|
| 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 |
$237.24
|
|
|
REPAIR ELBOW W/DEB OPEN
|
Facility
|
IP
|
$1,061.00
|
|
|
Service Code
|
CPT 24358
|
| Hospital Charge Code |
6124358
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$289.65 |
| Max. Negotiated Rate |
$1,007.95 |
| Rate for Payer: Cash Price |
$636.60
|
| Rate for Payer: Cigna Commercial |
$901.85
|
| Rate for Payer: First Health Commercial |
$954.90
|
| Rate for Payer: First Health Workers Compensation |
$409.65
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$954.90
|
| Rate for Payer: GEHA Commercial |
$742.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$954.90
|
| Rate for Payer: Multiplan All |
$965.51
|
| Rate for Payer: OMNI Networks Commercial |
$742.70
|
| Rate for Payer: One Health Plan PPO/POS |
$954.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,007.95
|
| Rate for Payer: Three Rivers Provider Network All |
$795.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$986.73
|
| Rate for Payer: Zelis Auto |
$424.40
|
| Rate for Payer: Zelis Worker's Compensation |
$289.65
|
|
|
REPAIR ELBOW W/DEB OPEN
|
Facility
|
OP
|
$1,061.00
|
|
|
Service Code
|
CPT 24358
|
| Hospital Charge Code |
6124358
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$289.65 |
| 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 |
$636.60
|
| 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 |
$636.60
|
| Rate for Payer: Cash Price |
$636.60
|
| Rate for Payer: Cigna Commercial |
$901.85
|
| Rate for Payer: First Health Commercial |
$954.90
|
| Rate for Payer: First Health Workers Compensation |
$409.65
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$954.90
|
| Rate for Payer: GEHA Commercial |
$848.80
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$954.90
|
| 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 |
$965.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$742.70
|
| Rate for Payer: One Health Plan PPO/POS |
$954.90
|
| 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 |
$1,007.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$795.75
|
| 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 |
$986.73
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$424.40
|
| 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 |
$289.65
|
|
|
REPAIR ESOPHAGUS AND FISTULA
|
Facility
|
IP
|
$2,287.00
|
|
|
Service Code
|
CPT 43305
|
| Hospital Charge Code |
6143305
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$624.35 |
| Max. Negotiated Rate |
$2,172.65 |
| Rate for Payer: Cash Price |
$1,372.20
|
| Rate for Payer: Cigna Commercial |
$1,943.95
|
| Rate for Payer: First Health Commercial |
$2,058.30
|
| Rate for Payer: First Health Workers Compensation |
$883.01
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,058.30
|
| Rate for Payer: GEHA Commercial |
$1,600.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,058.30
|
| Rate for Payer: Multiplan All |
$2,081.17
|
| Rate for Payer: OMNI Networks Commercial |
$1,600.90
|
| Rate for Payer: One Health Plan PPO/POS |
$2,058.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,172.65
|
| Rate for Payer: Three Rivers Provider Network All |
$1,715.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,126.91
|
| Rate for Payer: Zelis Auto |
$914.80
|
| Rate for Payer: Zelis Worker's Compensation |
$624.35
|
|
|
REPAIR ESOPHAGUS AND FISTULA
|
Facility
|
OP
|
$3,438.00
|
|
|
Service Code
|
CPT 43312
|
| Hospital Charge Code |
6143312
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$859.50 |
| Max. Negotiated Rate |
$3,266.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,062.80
|
| Rate for Payer: Cash Price |
$2,062.80
|
| Rate for Payer: Cigna Commercial |
$2,922.30
|
| Rate for Payer: First Health Commercial |
$3,094.20
|
| Rate for Payer: First Health Workers Compensation |
$1,327.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,094.20
|
| Rate for Payer: GEHA Commercial |
$2,750.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,094.20
|
| Rate for Payer: Humana ChoiceCare |
$893.88
|
| Rate for Payer: Multiplan All |
$3,128.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,062.80
|
| Rate for Payer: OMNI Networks Commercial |
$2,406.60
|
| Rate for Payer: One Health Plan PPO/POS |
$3,094.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,266.10
|
| Rate for Payer: Three Rivers Provider Network All |
$2,578.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,025.44
|
| Rate for Payer: United Healthcare Managed Medicaid |
$859.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,197.34
|
| Rate for Payer: Zelis Auto |
$1,375.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,719.00
|
| Rate for Payer: Zelis Worker's Compensation |
$938.57
|
|
|
REPAIR ESOPHAGUS AND FISTULA
|
Facility
|
IP
|
$3,438.00
|
|
|
Service Code
|
CPT 43312
|
| Hospital Charge Code |
6143312
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$938.57 |
| Max. Negotiated Rate |
$3,266.10 |
| Rate for Payer: Cash Price |
$2,062.80
|
| Rate for Payer: Cigna Commercial |
$2,922.30
|
| Rate for Payer: First Health Commercial |
$3,094.20
|
| Rate for Payer: First Health Workers Compensation |
$1,327.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,094.20
|
| Rate for Payer: GEHA Commercial |
$2,406.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,094.20
|
| Rate for Payer: Multiplan All |
$3,128.58
|
| Rate for Payer: OMNI Networks Commercial |
$2,406.60
|
| Rate for Payer: One Health Plan PPO/POS |
$3,094.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,266.10
|
| Rate for Payer: Three Rivers Provider Network All |
$2,578.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,197.34
|
| Rate for Payer: Zelis Auto |
$1,375.20
|
| Rate for Payer: Zelis Worker's Compensation |
$938.57
|
|
|
REPAIR ESOPHAGUS AND FISTULA
|
Facility
|
OP
|
$2,287.00
|
|
|
Service Code
|
CPT 43305
|
| Hospital Charge Code |
6143305
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$571.75 |
| Max. Negotiated Rate |
$2,172.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,372.20
|
| Rate for Payer: Cash Price |
$1,372.20
|
| Rate for Payer: Cigna Commercial |
$1,943.95
|
| Rate for Payer: First Health Commercial |
$2,058.30
|
| Rate for Payer: First Health Workers Compensation |
$883.01
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,058.30
|
| Rate for Payer: GEHA Commercial |
$1,829.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,058.30
|
| Rate for Payer: Humana ChoiceCare |
$594.62
|
| Rate for Payer: Multiplan All |
$2,081.17
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,372.20
|
| Rate for Payer: OMNI Networks Commercial |
$1,600.90
|
| Rate for Payer: One Health Plan PPO/POS |
$2,058.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,172.65
|
| Rate for Payer: Three Rivers Provider Network All |
$1,715.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,012.56
|
| Rate for Payer: United Healthcare Managed Medicaid |
$571.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,126.91
|
| Rate for Payer: Zelis Auto |
$914.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,143.50
|
| Rate for Payer: Zelis Worker's Compensation |
$624.35
|
|
|
REPAIR ESOPHAGUS OPENING
|
Facility
|
IP
|
$2,114.00
|
|
|
Service Code
|
CPT 43420
|
| Hospital Charge Code |
6143420
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$577.12 |
| Max. Negotiated Rate |
$2,008.30 |
| Rate for Payer: Cash Price |
$1,268.40
|
| Rate for Payer: Cigna Commercial |
$1,796.90
|
| Rate for Payer: First Health Commercial |
$1,902.60
|
| Rate for Payer: First Health Workers Compensation |
$816.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,902.60
|
| Rate for Payer: GEHA Commercial |
$1,479.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,902.60
|
| Rate for Payer: Multiplan All |
$1,923.74
|
| Rate for Payer: OMNI Networks Commercial |
$1,479.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,902.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,008.30
|
| Rate for Payer: Three Rivers Provider Network All |
$1,585.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,966.02
|
| Rate for Payer: Zelis Auto |
$845.60
|
| Rate for Payer: Zelis Worker's Compensation |
$577.12
|
|
|
REPAIR ESOPHAGUS OPENING
|
Facility
|
OP
|
$3,043.00
|
|
|
Service Code
|
CPT 43425
|
| Hospital Charge Code |
6143425
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$760.75 |
| Max. Negotiated Rate |
$2,890.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,825.80
|
| Rate for Payer: Cash Price |
$1,825.80
|
| Rate for Payer: Cigna Commercial |
$2,586.55
|
| Rate for Payer: First Health Commercial |
$2,738.70
|
| Rate for Payer: First Health Workers Compensation |
$1,174.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,738.70
|
| Rate for Payer: GEHA Commercial |
$2,434.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,738.70
|
| Rate for Payer: Humana ChoiceCare |
$791.18
|
| Rate for Payer: Multiplan All |
$2,769.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,825.80
|
| Rate for Payer: OMNI Networks Commercial |
$2,130.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2,738.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,890.85
|
| Rate for Payer: Three Rivers Provider Network All |
$2,282.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,677.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$760.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,829.99
|
| Rate for Payer: Zelis Auto |
$1,217.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,521.50
|
| Rate for Payer: Zelis Worker's Compensation |
$830.74
|
|
|
REPAIR ESOPHAGUS OPENING
|
Facility
|
IP
|
$3,043.00
|
|
|
Service Code
|
CPT 43425
|
| Hospital Charge Code |
6143425
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$830.74 |
| Max. Negotiated Rate |
$2,890.85 |
| Rate for Payer: Cash Price |
$1,825.80
|
| Rate for Payer: Cigna Commercial |
$2,586.55
|
| Rate for Payer: First Health Commercial |
$2,738.70
|
| Rate for Payer: First Health Workers Compensation |
$1,174.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,738.70
|
| Rate for Payer: GEHA Commercial |
$2,130.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,738.70
|
| Rate for Payer: Multiplan All |
$2,769.13
|
| Rate for Payer: OMNI Networks Commercial |
$2,130.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2,738.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,890.85
|
| Rate for Payer: Three Rivers Provider Network All |
$2,282.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,829.99
|
| Rate for Payer: Zelis Auto |
$1,217.20
|
| Rate for Payer: Zelis Worker's Compensation |
$830.74
|
|
|
REPAIR ESOPHAGUS OPENING
|
Facility
|
OP
|
$2,114.00
|
|
|
Service Code
|
CPT 43420
|
| Hospital Charge Code |
6143420
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$577.12 |
| Max. Negotiated Rate |
$6,158.84 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,524.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,268.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,524.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,999.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,079.42
|
| Rate for Payer: Cash Price |
$1,268.40
|
| Rate for Payer: Cash Price |
$1,268.40
|
| Rate for Payer: Cigna Commercial |
$1,796.90
|
| Rate for Payer: First Health Commercial |
$1,902.60
|
| Rate for Payer: First Health Workers Compensation |
$816.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,902.60
|
| Rate for Payer: GEHA Commercial |
$1,691.20
|
| Rate for Payer: GEHA Medicare |
$3,079.42
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,902.60
|
| Rate for Payer: Humana ChoiceCare |
$3,387.36
|
| Rate for Payer: Humana Medicare Advantage |
$3,079.42
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,173.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,040.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,079.42
|
| Rate for Payer: Multiplan All |
$1,923.74
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,235.01
|
| Rate for Payer: OMNI Networks Commercial |
$1,479.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,902.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,355.78
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,040.27
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,079.42
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,008.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,158.84
|
| Rate for Payer: Three Rivers Provider Network All |
$1,585.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,017.83
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,040.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,079.42
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,966.02
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,079.42
|
| Rate for Payer: Zelis Auto |
$845.60
|
| Rate for Payer: Zelis Medicare |
$2,617.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,695.30
|
| Rate for Payer: Zelis Worker's Compensation |
$577.12
|
|
|
REPAIR ESOPHAGUS WOUND
|
Facility
|
OP
|
$2,206.00
|
|
|
Service Code
|
CPT 43410
|
| Hospital Charge Code |
6143410
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$551.50 |
| Max. Negotiated Rate |
$2,095.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,323.60
|
| Rate for Payer: Cash Price |
$1,323.60
|
| Rate for Payer: Cigna Commercial |
$1,875.10
|
| Rate for Payer: First Health Commercial |
$1,985.40
|
| Rate for Payer: First Health Workers Compensation |
$851.74
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,985.40
|
| Rate for Payer: GEHA Commercial |
$1,764.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,985.40
|
| Rate for Payer: Humana ChoiceCare |
$573.56
|
| Rate for Payer: Multiplan All |
$2,007.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,323.60
|
| Rate for Payer: OMNI Networks Commercial |
$1,544.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,985.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,095.70
|
| Rate for Payer: Three Rivers Provider Network All |
$1,654.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,941.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$551.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,051.58
|
| Rate for Payer: Zelis Auto |
$882.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,103.00
|
| Rate for Payer: Zelis Worker's Compensation |
$602.24
|
|
|
REPAIR ESOPHAGUS WOUND
|
Facility
|
OP
|
$5,454.00
|
|
|
Service Code
|
CPT 43415
|
| Hospital Charge Code |
6143415
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,363.50 |
| Max. Negotiated Rate |
$5,181.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,272.40
|
| Rate for Payer: Cash Price |
$3,272.40
|
| Rate for Payer: Cigna Commercial |
$4,635.90
|
| Rate for Payer: First Health Commercial |
$4,908.60
|
| Rate for Payer: First Health Workers Compensation |
$2,105.79
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,908.60
|
| Rate for Payer: GEHA Commercial |
$4,363.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,908.60
|
| Rate for Payer: Humana ChoiceCare |
$1,418.04
|
| Rate for Payer: Multiplan All |
$4,963.14
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,272.40
|
| Rate for Payer: OMNI Networks Commercial |
$3,817.80
|
| Rate for Payer: One Health Plan PPO/POS |
$4,908.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,181.30
|
| Rate for Payer: Three Rivers Provider Network All |
$4,090.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4,799.52
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,363.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5,072.22
|
| Rate for Payer: Zelis Auto |
$2,181.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,727.00
|
| Rate for Payer: Zelis Worker's Compensation |
$1,488.94
|
|
|
REPAIR ESOPHAGUS WOUND
|
Facility
|
IP
|
$2,206.00
|
|
|
Service Code
|
CPT 43410
|
| Hospital Charge Code |
6143410
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$602.24 |
| Max. Negotiated Rate |
$2,095.70 |
| Rate for Payer: Cash Price |
$1,323.60
|
| Rate for Payer: Cigna Commercial |
$1,875.10
|
| Rate for Payer: First Health Commercial |
$1,985.40
|
| Rate for Payer: First Health Workers Compensation |
$851.74
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,985.40
|
| Rate for Payer: GEHA Commercial |
$1,544.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,985.40
|
| Rate for Payer: Multiplan All |
$2,007.46
|
| Rate for Payer: OMNI Networks Commercial |
$1,544.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,985.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,095.70
|
| Rate for Payer: Three Rivers Provider Network All |
$1,654.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,051.58
|
| Rate for Payer: Zelis Auto |
$882.40
|
| Rate for Payer: Zelis Worker's Compensation |
$602.24
|
|
|
REPAIR ESOPHAGUS WOUND
|
Facility
|
IP
|
$5,454.00
|
|
|
Service Code
|
CPT 43415
|
| Hospital Charge Code |
6143415
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,488.94 |
| Max. Negotiated Rate |
$5,181.30 |
| Rate for Payer: Cash Price |
$3,272.40
|
| Rate for Payer: Cigna Commercial |
$4,635.90
|
| Rate for Payer: First Health Commercial |
$4,908.60
|
| Rate for Payer: First Health Workers Compensation |
$2,105.79
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,908.60
|
| Rate for Payer: GEHA Commercial |
$3,817.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,908.60
|
| Rate for Payer: Multiplan All |
$4,963.14
|
| Rate for Payer: OMNI Networks Commercial |
$3,817.80
|
| Rate for Payer: One Health Plan PPO/POS |
$4,908.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,181.30
|
| Rate for Payer: Three Rivers Provider Network All |
$4,090.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5,072.22
|
| Rate for Payer: Zelis Auto |
$2,181.60
|
| Rate for Payer: Zelis Worker's Compensation |
$1,488.94
|
|
|
REPAIR, EXTENSOR TENDON, FINGER, PRIMARY OR SECONDARY; WITHOUT FREE GRAFT, EACH TENDON
|
Facility
|
OP
|
$3,039.30
|
|
|
Service Code
|
CPT 26418
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,291.70 |
| 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 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: First Health Workers Compensation |
$1,955.79
|
| Rate for Payer: GEHA Medicare |
$1,519.65
|
| 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: New Mexico Health Connections Medicare |
$2,583.41
|
| 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 Worker's Compensation |
$3,039.30
|
| 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: VistaCare Hospice Medicaid/Medicare |
$1,519.65
|
| 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 |
$1,382.88
|
|
