|
REPAIR, EXTENSOR TENDON, LEG; PRIMARY, WITHOUT GRAFT, EACH TENDON
|
Facility
|
OP
|
$13,566.52
|
|
|
Service Code
|
CPT 27664
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,544.86 |
| Max. Negotiated Rate |
$13,566.52 |
| 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 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 |
$6,783.26
|
| Rate for Payer: First Health Workers Compensation |
$8,730.06
|
| Rate for Payer: GEHA Medicare |
$6,783.26
|
| Rate for Payer: Humana ChoiceCare |
$7,461.59
|
| Rate for Payer: Humana Medicare Advantage |
$6,783.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,395.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,596.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,783.26
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,531.54
|
| 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 |
$6,783.26
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,566.52
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,647.59
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,596.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,783.26
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,783.26
|
| Rate for Payer: Zelis Medicare |
$5,765.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,139.91
|
| Rate for Payer: Zelis Worker's Compensation |
$6,172.77
|
|
|
REPAIR EXTRA TOE(S)
|
Facility
|
IP
|
$800.00
|
|
|
Service Code
|
CPT 28344
|
| Hospital Charge Code |
6128344
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$218.40 |
| Max. Negotiated Rate |
$760.00 |
| Rate for Payer: Cash Price |
$480.00
|
| Rate for Payer: Cigna Commercial |
$680.00
|
| Rate for Payer: First Health Commercial |
$720.00
|
| Rate for Payer: First Health Workers Compensation |
$308.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$720.00
|
| Rate for Payer: GEHA Commercial |
$560.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$720.00
|
| Rate for Payer: Multiplan All |
$728.00
|
| Rate for Payer: OMNI Networks Commercial |
$560.00
|
| Rate for Payer: One Health Plan PPO/POS |
$720.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$760.00
|
| Rate for Payer: Three Rivers Provider Network All |
$600.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$744.00
|
| Rate for Payer: Zelis Auto |
$320.00
|
| Rate for Payer: Zelis Worker's Compensation |
$218.40
|
|
|
REPAIR EXTRA TOE(S)
|
Facility
|
OP
|
$800.00
|
|
|
Service Code
|
CPT 28344
|
| Hospital Charge Code |
6128344
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$218.40 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,208.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$480.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,208.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,749.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$480.00
|
| Rate for Payer: Cash Price |
$480.00
|
| Rate for Payer: Cigna Commercial |
$680.00
|
| Rate for Payer: First Health Commercial |
$720.00
|
| Rate for Payer: First Health Workers Compensation |
$308.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$720.00
|
| Rate for Payer: GEHA Commercial |
$640.00
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$720.00
|
| 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 |
$1,785.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$728.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$560.00
|
| Rate for Payer: One Health Plan PPO/POS |
$720.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,061.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,785.30
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$760.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$600.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,785.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$744.00
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$320.00
|
| 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 |
$218.40
|
|
|
REPAIR EYELID WOUND
|
Facility
|
IP
|
$887.00
|
|
|
Service Code
|
CPT 67935
|
| Hospital Charge Code |
6167935
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$242.15 |
| Max. Negotiated Rate |
$842.65 |
| Rate for Payer: Cash Price |
$532.20
|
| Rate for Payer: Cigna Commercial |
$753.95
|
| Rate for Payer: First Health Commercial |
$798.30
|
| Rate for Payer: First Health Workers Compensation |
$342.47
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$798.30
|
| Rate for Payer: GEHA Commercial |
$620.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$798.30
|
| Rate for Payer: Multiplan All |
$807.17
|
| Rate for Payer: OMNI Networks Commercial |
$620.90
|
| Rate for Payer: One Health Plan PPO/POS |
$798.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$842.65
|
| Rate for Payer: Three Rivers Provider Network All |
$665.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$824.91
|
| Rate for Payer: Zelis Auto |
$354.80
|
| Rate for Payer: Zelis Worker's Compensation |
$242.15
|
|
|
REPAIR EYELID WOUND
|
Facility
|
OP
|
$887.00
|
|
|
Service Code
|
CPT 67935
|
| Hospital Charge Code |
6167935
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$242.15 |
| Max. Negotiated Rate |
$4,430.48 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,835.94
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$532.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,835.94
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,454.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,215.24
|
| Rate for Payer: Cash Price |
$532.20
|
| Rate for Payer: Cash Price |
$532.20
|
| Rate for Payer: Cigna Commercial |
$753.95
|
| Rate for Payer: First Health Commercial |
$798.30
|
| Rate for Payer: First Health Workers Compensation |
$342.47
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$798.30
|
| Rate for Payer: GEHA Commercial |
$709.60
|
| Rate for Payer: GEHA Medicare |
$2,215.24
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$798.30
|
| Rate for Payer: Humana ChoiceCare |
$2,436.76
|
| Rate for Payer: Humana Medicare Advantage |
$2,215.24
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$3,721.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,484.05
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,215.24
|
| Rate for Payer: Multiplan All |
$807.17
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,765.91
|
| Rate for Payer: OMNI Networks Commercial |
$620.90
|
| Rate for Payer: One Health Plan PPO/POS |
$798.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,713.54
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,484.05
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,215.24
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$842.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$4,430.48
|
| Rate for Payer: Three Rivers Provider Network All |
$665.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,170.94
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,484.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,215.24
|
| Rate for Payer: United Payors & United Providers UP&UP |
$824.91
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,215.24
|
| Rate for Payer: Zelis Auto |
$354.80
|
| Rate for Payer: Zelis Medicare |
$1,882.95
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,658.29
|
| Rate for Payer: Zelis Worker's Compensation |
$242.15
|
|
|
REPAIR FIBULA NONUNION
|
Facility
|
OP
|
$1,997.00
|
|
|
Service Code
|
CPT 27726
|
| Hospital Charge Code |
6127726
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$545.18 |
| Max. Negotiated Rate |
$13,566.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,597.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,198.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,597.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,641.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,783.26
|
| Rate for Payer: Cash Price |
$1,198.20
|
| Rate for Payer: Cash Price |
$1,198.20
|
| Rate for Payer: Cigna Commercial |
$1,697.45
|
| Rate for Payer: First Health Commercial |
$1,797.30
|
| Rate for Payer: First Health Workers Compensation |
$771.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,797.30
|
| Rate for Payer: GEHA Commercial |
$1,597.60
|
| Rate for Payer: GEHA Medicare |
$6,783.26
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,797.30
|
| Rate for Payer: Humana ChoiceCare |
$7,461.59
|
| Rate for Payer: Humana Medicare Advantage |
$6,783.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,395.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,716.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,783.26
|
| Rate for Payer: Multiplan All |
$1,817.27
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,531.54
|
| Rate for Payer: OMNI Networks Commercial |
$1,397.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,797.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,290.72
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,716.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,783.26
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,897.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,566.52
|
| Rate for Payer: Three Rivers Provider Network All |
$1,497.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,647.59
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,716.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,783.26
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,857.21
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,783.26
|
| Rate for Payer: Zelis Auto |
$798.80
|
| Rate for Payer: Zelis Medicare |
$5,765.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,139.91
|
| Rate for Payer: Zelis Worker's Compensation |
$545.18
|
|
|
REPAIR FIBULA NONUNION
|
Facility
|
IP
|
$1,997.00
|
|
|
Service Code
|
CPT 27726
|
| Hospital Charge Code |
6127726
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$545.18 |
| Max. Negotiated Rate |
$1,897.15 |
| Rate for Payer: Cash Price |
$1,198.20
|
| Rate for Payer: Cigna Commercial |
$1,697.45
|
| Rate for Payer: First Health Commercial |
$1,797.30
|
| Rate for Payer: First Health Workers Compensation |
$771.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,797.30
|
| Rate for Payer: GEHA Commercial |
$1,397.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,797.30
|
| Rate for Payer: Multiplan All |
$1,817.27
|
| Rate for Payer: OMNI Networks Commercial |
$1,397.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,797.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,897.15
|
| Rate for Payer: Three Rivers Provider Network All |
$1,497.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,857.21
|
| Rate for Payer: Zelis Auto |
$798.80
|
| Rate for Payer: Zelis Worker's Compensation |
$545.18
|
|
|
REPAIR FINGER DEFORMITY
|
Facility
|
OP
|
$2,749.00
|
|
|
Service Code
|
CPT 26590
|
| Hospital Charge Code |
6126590
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$750.48 |
| 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 |
$1,649.40
|
| 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 |
$1,649.40
|
| Rate for Payer: Cash Price |
$1,649.40
|
| Rate for Payer: Cigna Commercial |
$2,336.65
|
| Rate for Payer: First Health Commercial |
$2,474.10
|
| Rate for Payer: First Health Workers Compensation |
$1,061.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,474.10
|
| Rate for Payer: GEHA Commercial |
$2,199.20
|
| Rate for Payer: GEHA Medicare |
$1,519.65
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,474.10
|
| 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 |
$2,501.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,583.41
|
| Rate for Payer: OMNI Networks Commercial |
$1,924.30
|
| Rate for Payer: One Health Plan PPO/POS |
$2,474.10
|
| 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 |
$2,611.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,039.30
|
| Rate for Payer: Three Rivers Provider Network All |
$2,061.75
|
| 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 |
$2,556.57
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,519.65
|
| Rate for Payer: Zelis Auto |
$1,099.60
|
| 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 |
$750.48
|
|
|
REPAIR FINGER DEFORMITY
|
Facility
|
IP
|
$2,749.00
|
|
|
Service Code
|
CPT 26590
|
| Hospital Charge Code |
6126590
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$750.48 |
| Max. Negotiated Rate |
$2,611.55 |
| Rate for Payer: Cash Price |
$1,649.40
|
| Rate for Payer: Cigna Commercial |
$2,336.65
|
| Rate for Payer: First Health Commercial |
$2,474.10
|
| Rate for Payer: First Health Workers Compensation |
$1,061.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,474.10
|
| Rate for Payer: GEHA Commercial |
$1,924.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,474.10
|
| Rate for Payer: Multiplan All |
$2,501.59
|
| Rate for Payer: OMNI Networks Commercial |
$1,924.30
|
| Rate for Payer: One Health Plan PPO/POS |
$2,474.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,611.55
|
| Rate for Payer: Three Rivers Provider Network All |
$2,061.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,556.57
|
| Rate for Payer: Zelis Auto |
$1,099.60
|
| Rate for Payer: Zelis Worker's Compensation |
$750.48
|
|
|
REPAIR FINGER/HAND TENDON
|
Facility
|
IP
|
$1,395.00
|
|
|
Service Code
|
CPT 26350
|
| Hospital Charge Code |
6126350
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$380.83 |
| Max. Negotiated Rate |
$1,325.25 |
| Rate for Payer: Cash Price |
$837.00
|
| Rate for Payer: Cigna Commercial |
$1,185.75
|
| Rate for Payer: First Health Commercial |
$1,255.50
|
| Rate for Payer: First Health Workers Compensation |
$538.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,255.50
|
| Rate for Payer: GEHA Commercial |
$976.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,255.50
|
| Rate for Payer: Multiplan All |
$1,269.45
|
| Rate for Payer: OMNI Networks Commercial |
$976.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,255.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,325.25
|
| Rate for Payer: Three Rivers Provider Network All |
$1,046.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,297.35
|
| Rate for Payer: Zelis Auto |
$558.00
|
| Rate for Payer: Zelis Worker's Compensation |
$380.83
|
|
|
REPAIR FINGER/HAND TENDON
|
Facility
|
OP
|
$1,015.00
|
|
|
Service Code
|
CPT 26426
|
| Hospital Charge Code |
6126426
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$277.10 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,855.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$609.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,855.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,261.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$609.00
|
| Rate for Payer: Cash Price |
$609.00
|
| Rate for Payer: Cigna Commercial |
$862.75
|
| Rate for Payer: First Health Commercial |
$913.50
|
| Rate for Payer: First Health Workers Compensation |
$391.89
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$913.50
|
| Rate for Payer: GEHA Commercial |
$812.00
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$913.50
|
| 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 |
$2,307.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$923.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$710.50
|
| Rate for Payer: One Health Plan PPO/POS |
$913.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,664.73
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,307.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$964.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$761.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,307.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$943.95
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$406.00
|
| 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 |
$277.10
|
|
|
REPAIR FINGER/HAND TENDON
|
Facility
|
OP
|
$1,490.00
|
|
|
Service Code
|
CPT 26370
|
| Hospital Charge Code |
6126370
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$406.77 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,855.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$894.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,855.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,261.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$894.00
|
| Rate for Payer: Cash Price |
$894.00
|
| Rate for Payer: Cigna Commercial |
$1,266.50
|
| Rate for Payer: First Health Commercial |
$1,341.00
|
| Rate for Payer: First Health Workers Compensation |
$575.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,341.00
|
| Rate for Payer: GEHA Commercial |
$1,192.00
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,341.00
|
| 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 |
$2,307.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$1,355.90
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$1,043.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,341.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,664.73
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,307.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,415.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$1,117.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,307.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,385.70
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$596.00
|
| 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 |
$406.77
|
|
|
REPAIR FINGER/HAND TENDON
|
Facility
|
IP
|
$1,743.00
|
|
|
Service Code
|
CPT 26357
|
| Hospital Charge Code |
6126357
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$475.84 |
| Max. Negotiated Rate |
$1,655.85 |
| Rate for Payer: Cash Price |
$1,045.80
|
| Rate for Payer: Cigna Commercial |
$1,481.55
|
| Rate for Payer: First Health Commercial |
$1,568.70
|
| Rate for Payer: First Health Workers Compensation |
$672.97
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,568.70
|
| Rate for Payer: GEHA Commercial |
$1,220.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,568.70
|
| Rate for Payer: Multiplan All |
$1,586.13
|
| Rate for Payer: OMNI Networks Commercial |
$1,220.10
|
| Rate for Payer: One Health Plan PPO/POS |
$1,568.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,655.85
|
| Rate for Payer: Three Rivers Provider Network All |
$1,307.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,620.99
|
| Rate for Payer: Zelis Auto |
$697.20
|
| Rate for Payer: Zelis Worker's Compensation |
$475.84
|
|
|
REPAIR FINGER/HAND TENDON
|
Facility
|
OP
|
$1,743.00
|
|
|
Service Code
|
CPT 26357
|
| Hospital Charge Code |
6126357
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$475.84 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,855.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,045.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,855.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,261.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$1,045.80
|
| Rate for Payer: Cash Price |
$1,045.80
|
| Rate for Payer: Cigna Commercial |
$1,481.55
|
| Rate for Payer: First Health Commercial |
$1,568.70
|
| Rate for Payer: First Health Workers Compensation |
$672.97
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,568.70
|
| Rate for Payer: GEHA Commercial |
$1,394.40
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,568.70
|
| 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 |
$2,307.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$1,586.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$1,220.10
|
| Rate for Payer: One Health Plan PPO/POS |
$1,568.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,664.73
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,307.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,655.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$1,307.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,307.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,620.99
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$697.20
|
| 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 |
$475.84
|
|
|
REPAIR FINGER/HAND TENDON
|
Facility
|
OP
|
$1,672.00
|
|
|
Service Code
|
CPT 26373
|
| Hospital Charge Code |
6126373
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$456.46 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,855.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,003.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,855.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,261.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$1,003.20
|
| Rate for Payer: Cash Price |
$1,003.20
|
| Rate for Payer: Cigna Commercial |
$1,421.20
|
| Rate for Payer: First Health Commercial |
$1,504.80
|
| Rate for Payer: First Health Workers Compensation |
$645.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,504.80
|
| Rate for Payer: GEHA Commercial |
$1,337.60
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,504.80
|
| 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 |
$2,307.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$1,521.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$1,170.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,504.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,664.73
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,307.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,588.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$1,254.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,307.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,554.96
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$668.80
|
| 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 |
$456.46
|
|
|
REPAIR FINGER/HAND TENDON
|
Facility
|
IP
|
$1,015.00
|
|
|
Service Code
|
CPT 26426
|
| Hospital Charge Code |
6126426
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$277.10 |
| Max. Negotiated Rate |
$964.25 |
| Rate for Payer: Cash Price |
$609.00
|
| Rate for Payer: Cigna Commercial |
$862.75
|
| Rate for Payer: First Health Commercial |
$913.50
|
| Rate for Payer: First Health Workers Compensation |
$391.89
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$913.50
|
| Rate for Payer: GEHA Commercial |
$710.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$913.50
|
| Rate for Payer: Multiplan All |
$923.65
|
| Rate for Payer: OMNI Networks Commercial |
$710.50
|
| Rate for Payer: One Health Plan PPO/POS |
$913.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$964.25
|
| Rate for Payer: Three Rivers Provider Network All |
$761.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$943.95
|
| Rate for Payer: Zelis Auto |
$406.00
|
| Rate for Payer: Zelis Worker's Compensation |
$277.10
|
|
|
REPAIR FINGER/HAND TENDON
|
Facility
|
IP
|
$1,672.00
|
|
|
Service Code
|
CPT 26373
|
| Hospital Charge Code |
6126373
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$456.46 |
| Max. Negotiated Rate |
$1,588.40 |
| Rate for Payer: Cash Price |
$1,003.20
|
| Rate for Payer: Cigna Commercial |
$1,421.20
|
| Rate for Payer: First Health Commercial |
$1,504.80
|
| Rate for Payer: First Health Workers Compensation |
$645.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,504.80
|
| Rate for Payer: GEHA Commercial |
$1,170.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,504.80
|
| Rate for Payer: Multiplan All |
$1,521.52
|
| Rate for Payer: OMNI Networks Commercial |
$1,170.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,504.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,588.40
|
| Rate for Payer: Three Rivers Provider Network All |
$1,254.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,554.96
|
| Rate for Payer: Zelis Auto |
$668.80
|
| Rate for Payer: Zelis Worker's Compensation |
$456.46
|
|
|
REPAIR FINGER/HAND TENDON
|
Facility
|
IP
|
$1,490.00
|
|
|
Service Code
|
CPT 26370
|
| Hospital Charge Code |
6126370
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$406.77 |
| Max. Negotiated Rate |
$1,415.50 |
| Rate for Payer: Cash Price |
$894.00
|
| Rate for Payer: Cigna Commercial |
$1,266.50
|
| Rate for Payer: First Health Commercial |
$1,341.00
|
| Rate for Payer: First Health Workers Compensation |
$575.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,341.00
|
| Rate for Payer: GEHA Commercial |
$1,043.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,341.00
|
| Rate for Payer: Multiplan All |
$1,355.90
|
| Rate for Payer: OMNI Networks Commercial |
$1,043.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,341.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,415.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,117.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,385.70
|
| Rate for Payer: Zelis Auto |
$596.00
|
| Rate for Payer: Zelis Worker's Compensation |
$406.77
|
|
|
REPAIR FINGER/HAND TENDON
|
Facility
|
OP
|
$1,395.00
|
|
|
Service Code
|
CPT 26350
|
| Hospital Charge Code |
6126350
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$380.83 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,855.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$837.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,855.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,261.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$837.00
|
| Rate for Payer: Cash Price |
$837.00
|
| Rate for Payer: Cigna Commercial |
$1,185.75
|
| Rate for Payer: First Health Commercial |
$1,255.50
|
| Rate for Payer: First Health Workers Compensation |
$538.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,255.50
|
| Rate for Payer: GEHA Commercial |
$1,116.00
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,255.50
|
| 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 |
$2,307.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$1,269.45
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$976.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,255.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,664.73
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,307.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,325.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$1,046.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,307.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,297.35
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$558.00
|
| 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 |
$380.83
|
|
|
REPAIR FINGER/HAND TENDON
|
Facility
|
OP
|
$1,758.00
|
|
|
Service Code
|
CPT 26356
|
| Hospital Charge Code |
6126356
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$479.93 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,855.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,054.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,855.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,261.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$1,054.80
|
| Rate for Payer: Cash Price |
$1,054.80
|
| Rate for Payer: Cigna Commercial |
$1,494.30
|
| Rate for Payer: First Health Commercial |
$1,582.20
|
| Rate for Payer: First Health Workers Compensation |
$678.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,582.20
|
| Rate for Payer: GEHA Commercial |
$1,406.40
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,582.20
|
| 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 |
$2,307.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$1,599.78
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$1,230.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,582.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,664.73
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,307.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,670.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$1,318.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,307.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,634.94
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$703.20
|
| 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 |
$479.93
|
|
|
REPAIR FINGER/HAND TENDON
|
Facility
|
IP
|
$1,758.00
|
|
|
Service Code
|
CPT 26356
|
| Hospital Charge Code |
6126356
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$479.93 |
| Max. Negotiated Rate |
$1,670.10 |
| Rate for Payer: Cash Price |
$1,054.80
|
| Rate for Payer: Cigna Commercial |
$1,494.30
|
| Rate for Payer: First Health Commercial |
$1,582.20
|
| Rate for Payer: First Health Workers Compensation |
$678.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,582.20
|
| Rate for Payer: GEHA Commercial |
$1,230.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,582.20
|
| Rate for Payer: Multiplan All |
$1,599.78
|
| Rate for Payer: OMNI Networks Commercial |
$1,230.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,582.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,670.10
|
| Rate for Payer: Three Rivers Provider Network All |
$1,318.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,634.94
|
| Rate for Payer: Zelis Auto |
$703.20
|
| Rate for Payer: Zelis Worker's Compensation |
$479.93
|
|
|
REPAIR FINGER TENDON
|
Facility
|
OP
|
$975.00
|
|
|
Service Code
|
CPT 26432
|
| Hospital Charge Code |
6126432
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$266.18 |
| 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 |
$585.00
|
| 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 |
$1,519.65
|
| Rate for Payer: Cash Price |
$585.00
|
| Rate for Payer: Cash Price |
$585.00
|
| Rate for Payer: Cigna Commercial |
$828.75
|
| Rate for Payer: First Health Commercial |
$877.50
|
| Rate for Payer: First Health Workers Compensation |
$376.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$877.50
|
| Rate for Payer: GEHA Commercial |
$780.00
|
| Rate for Payer: GEHA Medicare |
$1,519.65
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$877.50
|
| 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 |
$887.25
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,583.41
|
| Rate for Payer: OMNI Networks Commercial |
$682.50
|
| Rate for Payer: One Health Plan PPO/POS |
$877.50
|
| 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 |
$926.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,039.30
|
| Rate for Payer: Three Rivers Provider Network All |
$731.25
|
| 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 |
$906.75
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,519.65
|
| Rate for Payer: Zelis Auto |
$390.00
|
| 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 |
$266.18
|
|
|
REPAIR FINGER TENDON
|
Facility
|
OP
|
$1,126.00
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
6126418
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$307.40 |
| 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 |
$675.60
|
| 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 |
$675.60
|
| Rate for Payer: Cash Price |
$675.60
|
| Rate for Payer: Cigna Commercial |
$957.10
|
| Rate for Payer: First Health Commercial |
$1,013.40
|
| Rate for Payer: First Health Workers Compensation |
$434.75
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,013.40
|
| Rate for Payer: GEHA Commercial |
$900.80
|
| Rate for Payer: GEHA Medicare |
$1,519.65
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,013.40
|
| 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 |
$1,024.66
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,583.41
|
| Rate for Payer: OMNI Networks Commercial |
$788.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,013.40
|
| 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 |
$1,069.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,039.30
|
| Rate for Payer: Three Rivers Provider Network All |
$844.50
|
| 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 |
$1,047.18
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,519.65
|
| Rate for Payer: Zelis Auto |
$450.40
|
| 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 |
$307.40
|
|
|
REPAIR FINGER TENDON
|
Facility
|
IP
|
$1,041.00
|
|
|
Service Code
|
CPT 26433
|
| Hospital Charge Code |
6126433
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$284.19 |
| Max. Negotiated Rate |
$988.95 |
| Rate for Payer: Cash Price |
$624.60
|
| Rate for Payer: Cigna Commercial |
$884.85
|
| Rate for Payer: First Health Commercial |
$936.90
|
| Rate for Payer: First Health Workers Compensation |
$401.93
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$936.90
|
| Rate for Payer: GEHA Commercial |
$728.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$936.90
|
| Rate for Payer: Multiplan All |
$947.31
|
| Rate for Payer: OMNI Networks Commercial |
$728.70
|
| Rate for Payer: One Health Plan PPO/POS |
$936.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$988.95
|
| Rate for Payer: Three Rivers Provider Network All |
$780.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$968.13
|
| Rate for Payer: Zelis Auto |
$416.40
|
| Rate for Payer: Zelis Worker's Compensation |
$284.19
|
|
|
REPAIR FINGER TENDON
|
Facility
|
OP
|
$1,041.00
|
|
|
Service Code
|
CPT 26433
|
| Hospital Charge Code |
6126433
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$284.19 |
| 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 |
$624.60
|
| 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 |
$624.60
|
| Rate for Payer: Cash Price |
$624.60
|
| Rate for Payer: Cigna Commercial |
$884.85
|
| Rate for Payer: First Health Commercial |
$936.90
|
| Rate for Payer: First Health Workers Compensation |
$401.93
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$936.90
|
| Rate for Payer: GEHA Commercial |
$832.80
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$936.90
|
| 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 |
$1,392.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$947.31
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$728.70
|
| Rate for Payer: One Health Plan PPO/POS |
$936.90
|
| 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 |
$988.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$780.75
|
| 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 |
$968.13
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$416.40
|
| 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 |
$284.19
|
|
