|
BIOPSY OF NECK/CHEST
|
Facility
|
IP
|
$726.12
|
|
|
Service Code
|
CPT 21550
|
| Hospital Charge Code |
7221550
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$198.23 |
| Max. Negotiated Rate |
$689.81 |
| Rate for Payer: Cash Price |
$435.67
|
| Rate for Payer: Cigna Commercial |
$617.20
|
| Rate for Payer: First Health Commercial |
$653.51
|
| Rate for Payer: First Health Workers Compensation |
$280.35
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$653.51
|
| Rate for Payer: GEHA Commercial |
$508.28
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$653.51
|
| Rate for Payer: Multiplan All |
$660.77
|
| Rate for Payer: OMNI Networks Commercial |
$508.28
|
| Rate for Payer: One Health Plan PPO/POS |
$653.51
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$689.81
|
| Rate for Payer: Three Rivers Provider Network All |
$544.59
|
| Rate for Payer: United Payors & United Providers UP&UP |
$675.29
|
| Rate for Payer: Zelis Auto |
$290.45
|
| Rate for Payer: Zelis Worker's Compensation |
$198.23
|
|
|
BIOPSY OF NECK/CHEST
|
Facility
|
IP
|
$483.00
|
|
|
Service Code
|
CPT 21550
|
| Hospital Charge Code |
6121550
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$131.86 |
| Max. Negotiated Rate |
$458.85 |
| Rate for Payer: Cash Price |
$289.80
|
| Rate for Payer: Cigna Commercial |
$410.55
|
| Rate for Payer: First Health Commercial |
$434.70
|
| Rate for Payer: First Health Workers Compensation |
$186.49
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$434.70
|
| Rate for Payer: GEHA Commercial |
$338.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$434.70
|
| Rate for Payer: Multiplan All |
$439.53
|
| Rate for Payer: OMNI Networks Commercial |
$338.10
|
| Rate for Payer: One Health Plan PPO/POS |
$434.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$458.85
|
| Rate for Payer: Three Rivers Provider Network All |
$362.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$449.19
|
| Rate for Payer: Zelis Auto |
$193.20
|
| Rate for Payer: Zelis Worker's Compensation |
$131.86
|
|
|
BIOPSY OF NECK/CHEST
|
Facility
|
OP
|
$726.12
|
|
|
Service Code
|
CPT 21550
|
| Hospital Charge Code |
7221550
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$198.23 |
| Max. Negotiated Rate |
$3,139.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,769.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$435.67
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,769.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,401.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,569.98
|
| Rate for Payer: Cash Price |
$435.67
|
| Rate for Payer: Cash Price |
$435.67
|
| Rate for Payer: Cigna Commercial |
$617.20
|
| Rate for Payer: First Health Commercial |
$653.51
|
| Rate for Payer: First Health Workers Compensation |
$280.35
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$653.51
|
| Rate for Payer: GEHA Commercial |
$580.90
|
| Rate for Payer: GEHA Medicare |
$1,569.98
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$653.51
|
| Rate for Payer: Humana ChoiceCare |
$1,726.98
|
| Rate for Payer: Humana Medicare Advantage |
$1,569.98
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,637.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,430.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,569.98
|
| Rate for Payer: Multiplan All |
$660.77
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,668.97
|
| Rate for Payer: OMNI Networks Commercial |
$508.28
|
| Rate for Payer: One Health Plan PPO/POS |
$653.51
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,651.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,430.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,569.98
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$689.81
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,139.96
|
| Rate for Payer: Three Rivers Provider Network All |
$544.59
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,538.58
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,430.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,569.98
|
| Rate for Payer: United Payors & United Providers UP&UP |
$675.29
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,569.98
|
| Rate for Payer: Zelis Auto |
$290.45
|
| Rate for Payer: Zelis Medicare |
$1,334.48
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,883.98
|
| Rate for Payer: Zelis Worker's Compensation |
$198.23
|
|
|
BIOPSY OF NECK/CHEST
|
Facility
|
OP
|
$483.00
|
|
|
Service Code
|
CPT 21550
|
| Hospital Charge Code |
6121550
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$131.86 |
| Max. Negotiated Rate |
$3,139.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,769.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$289.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,769.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,401.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,569.98
|
| Rate for Payer: Cash Price |
$289.80
|
| Rate for Payer: Cash Price |
$289.80
|
| Rate for Payer: Cigna Commercial |
$410.55
|
| Rate for Payer: First Health Commercial |
$434.70
|
| Rate for Payer: First Health Workers Compensation |
$186.49
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$434.70
|
| Rate for Payer: GEHA Commercial |
$386.40
|
| Rate for Payer: GEHA Medicare |
$1,569.98
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$434.70
|
| Rate for Payer: Humana ChoiceCare |
$1,726.98
|
| Rate for Payer: Humana Medicare Advantage |
$1,569.98
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,637.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,430.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,569.98
|
| Rate for Payer: Multiplan All |
$439.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,668.97
|
| Rate for Payer: OMNI Networks Commercial |
$338.10
|
| Rate for Payer: One Health Plan PPO/POS |
$434.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,651.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,430.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,569.98
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$458.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,139.96
|
| Rate for Payer: Three Rivers Provider Network All |
$362.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,538.58
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,430.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,569.98
|
| Rate for Payer: United Payors & United Providers UP&UP |
$449.19
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,569.98
|
| Rate for Payer: Zelis Auto |
$193.20
|
| Rate for Payer: Zelis Medicare |
$1,334.48
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,883.98
|
| Rate for Payer: Zelis Worker's Compensation |
$131.86
|
|
|
BIOPSY OF NERVE
|
Facility
|
OP
|
$607.00
|
|
|
Service Code
|
CPT 64795
|
| Hospital Charge Code |
6164795
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$165.71 |
| Max. Negotiated Rate |
$3,784.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,892.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$364.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,892.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,499.44
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,892.20
|
| Rate for Payer: Cash Price |
$364.20
|
| Rate for Payer: Cash Price |
$364.20
|
| Rate for Payer: Cigna Commercial |
$515.95
|
| Rate for Payer: First Health Commercial |
$546.30
|
| Rate for Payer: First Health Workers Compensation |
$234.36
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$546.30
|
| Rate for Payer: GEHA Commercial |
$485.60
|
| Rate for Payer: GEHA Medicare |
$1,892.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$546.30
|
| Rate for Payer: Humana ChoiceCare |
$2,081.42
|
| Rate for Payer: Humana Medicare Advantage |
$1,892.20
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$3,178.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,529.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,892.20
|
| Rate for Payer: Multiplan All |
$552.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,216.74
|
| Rate for Payer: OMNI Networks Commercial |
$424.90
|
| Rate for Payer: One Health Plan PPO/POS |
$546.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,766.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,529.98
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,892.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$576.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,784.40
|
| Rate for Payer: Three Rivers Provider Network All |
$455.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,854.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,529.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,892.20
|
| Rate for Payer: United Payors & United Providers UP&UP |
$564.51
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,892.20
|
| Rate for Payer: Zelis Auto |
$242.80
|
| Rate for Payer: Zelis Medicare |
$1,608.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,270.64
|
| Rate for Payer: Zelis Worker's Compensation |
$165.71
|
|
|
BIOPSY OF NERVE
|
Facility
|
IP
|
$607.00
|
|
|
Service Code
|
CPT 64795
|
| Hospital Charge Code |
6164795
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$165.71 |
| Max. Negotiated Rate |
$576.65 |
| Rate for Payer: Cash Price |
$364.20
|
| Rate for Payer: Cigna Commercial |
$515.95
|
| Rate for Payer: First Health Commercial |
$546.30
|
| Rate for Payer: First Health Workers Compensation |
$234.36
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$546.30
|
| Rate for Payer: GEHA Commercial |
$424.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$546.30
|
| Rate for Payer: Multiplan All |
$552.37
|
| Rate for Payer: OMNI Networks Commercial |
$424.90
|
| Rate for Payer: One Health Plan PPO/POS |
$546.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$576.65
|
| Rate for Payer: Three Rivers Provider Network All |
$455.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$564.51
|
| Rate for Payer: Zelis Auto |
$242.80
|
| Rate for Payer: Zelis Worker's Compensation |
$165.71
|
|
|
BIOPSY OF PANCREAS OPEN
|
Facility
|
IP
|
$1,862.00
|
|
|
Service Code
|
CPT 48100
|
| Hospital Charge Code |
6148100
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$508.33 |
| Max. Negotiated Rate |
$1,768.90 |
| Rate for Payer: Cash Price |
$1,117.20
|
| Rate for Payer: Cigna Commercial |
$1,582.70
|
| Rate for Payer: First Health Commercial |
$1,675.80
|
| Rate for Payer: First Health Workers Compensation |
$718.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,675.80
|
| Rate for Payer: GEHA Commercial |
$1,303.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,675.80
|
| Rate for Payer: Multiplan All |
$1,694.42
|
| Rate for Payer: OMNI Networks Commercial |
$1,303.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,675.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,768.90
|
| Rate for Payer: Three Rivers Provider Network All |
$1,396.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,731.66
|
| Rate for Payer: Zelis Auto |
$744.80
|
| Rate for Payer: Zelis Worker's Compensation |
$508.33
|
|
|
BIOPSY OF PANCREAS OPEN
|
Facility
|
OP
|
$1,862.00
|
|
|
Service Code
|
CPT 48100
|
| Hospital Charge Code |
6148100
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$465.50 |
| Max. Negotiated Rate |
$1,768.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,117.20
|
| Rate for Payer: Cash Price |
$1,117.20
|
| Rate for Payer: Cigna Commercial |
$1,582.70
|
| Rate for Payer: First Health Commercial |
$1,675.80
|
| Rate for Payer: First Health Workers Compensation |
$718.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,675.80
|
| Rate for Payer: GEHA Commercial |
$1,489.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,675.80
|
| Rate for Payer: Humana ChoiceCare |
$484.12
|
| Rate for Payer: Multiplan All |
$1,694.42
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,117.20
|
| Rate for Payer: OMNI Networks Commercial |
$1,303.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,675.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,768.90
|
| Rate for Payer: Three Rivers Provider Network All |
$1,396.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,638.56
|
| Rate for Payer: United Healthcare Managed Medicaid |
$465.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,731.66
|
| Rate for Payer: Zelis Auto |
$744.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$931.00
|
| Rate for Payer: Zelis Worker's Compensation |
$508.33
|
|
|
BIOPSY OF PENIS
|
Facility
|
IP
|
$387.00
|
|
|
Service Code
|
CPT 54100
|
| Hospital Charge Code |
6154100
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$105.65 |
| Max. Negotiated Rate |
$367.65 |
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Cigna Commercial |
$328.95
|
| Rate for Payer: First Health Commercial |
$348.30
|
| Rate for Payer: First Health Workers Compensation |
$149.42
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$348.30
|
| Rate for Payer: GEHA Commercial |
$270.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$348.30
|
| Rate for Payer: Multiplan All |
$352.17
|
| Rate for Payer: OMNI Networks Commercial |
$270.90
|
| Rate for Payer: One Health Plan PPO/POS |
$348.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$367.65
|
| Rate for Payer: Three Rivers Provider Network All |
$290.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$359.91
|
| Rate for Payer: Zelis Auto |
$154.80
|
| Rate for Payer: Zelis Worker's Compensation |
$105.65
|
|
|
BIOPSY OF PENIS
|
Facility
|
OP
|
$546.00
|
|
|
Service Code
|
CPT 54105
|
| Hospital Charge Code |
6154105
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$149.06 |
| Max. Negotiated Rate |
$5,546.54 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,364.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$327.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,364.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,873.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,773.27
|
| Rate for Payer: Cash Price |
$327.60
|
| Rate for Payer: Cash Price |
$327.60
|
| Rate for Payer: Cigna Commercial |
$464.10
|
| Rate for Payer: First Health Commercial |
$491.40
|
| Rate for Payer: First Health Workers Compensation |
$210.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$491.40
|
| Rate for Payer: GEHA Commercial |
$436.80
|
| Rate for Payer: GEHA Medicare |
$2,773.27
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$491.40
|
| Rate for Payer: Humana ChoiceCare |
$3,050.60
|
| Rate for Payer: Humana Medicare Advantage |
$2,773.27
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,659.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,911.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,773.27
|
| Rate for Payer: Multiplan All |
$496.86
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,714.56
|
| Rate for Payer: OMNI Networks Commercial |
$382.20
|
| Rate for Payer: One Health Plan PPO/POS |
$491.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,207.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,911.49
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,773.27
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$518.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,546.54
|
| Rate for Payer: Three Rivers Provider Network All |
$409.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,717.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,911.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,773.27
|
| Rate for Payer: United Payors & United Providers UP&UP |
$507.78
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,773.27
|
| Rate for Payer: Zelis Auto |
$218.40
|
| Rate for Payer: Zelis Medicare |
$2,357.28
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,327.92
|
| Rate for Payer: Zelis Worker's Compensation |
$149.06
|
|
|
BIOPSY OF PENIS
|
Facility
|
OP
|
$387.00
|
|
|
Service Code
|
CPT 54100
|
| Hospital Charge Code |
6154100
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$105.65 |
| Max. Negotiated Rate |
$3,139.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,769.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$232.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,769.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,401.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,569.98
|
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Cigna Commercial |
$328.95
|
| Rate for Payer: First Health Commercial |
$348.30
|
| Rate for Payer: First Health Workers Compensation |
$149.42
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$348.30
|
| Rate for Payer: GEHA Commercial |
$309.60
|
| Rate for Payer: GEHA Medicare |
$1,569.98
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$348.30
|
| Rate for Payer: Humana ChoiceCare |
$1,726.98
|
| Rate for Payer: Humana Medicare Advantage |
$1,569.98
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,637.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,430.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,569.98
|
| Rate for Payer: Multiplan All |
$352.17
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,668.97
|
| Rate for Payer: OMNI Networks Commercial |
$270.90
|
| Rate for Payer: One Health Plan PPO/POS |
$348.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,651.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,430.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,569.98
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$367.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,139.96
|
| Rate for Payer: Three Rivers Provider Network All |
$290.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,538.58
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,430.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,569.98
|
| Rate for Payer: United Payors & United Providers UP&UP |
$359.91
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,569.98
|
| Rate for Payer: Zelis Auto |
$154.80
|
| Rate for Payer: Zelis Medicare |
$1,334.48
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,883.98
|
| Rate for Payer: Zelis Worker's Compensation |
$105.65
|
|
|
BIOPSY OF PENIS
|
Facility
|
IP
|
$546.00
|
|
|
Service Code
|
CPT 54105
|
| Hospital Charge Code |
6154105
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$149.06 |
| Max. Negotiated Rate |
$518.70 |
| Rate for Payer: Cash Price |
$327.60
|
| Rate for Payer: Cigna Commercial |
$464.10
|
| Rate for Payer: First Health Commercial |
$491.40
|
| Rate for Payer: First Health Workers Compensation |
$210.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$491.40
|
| Rate for Payer: GEHA Commercial |
$382.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$491.40
|
| Rate for Payer: Multiplan All |
$496.86
|
| Rate for Payer: OMNI Networks Commercial |
$382.20
|
| Rate for Payer: One Health Plan PPO/POS |
$491.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$518.70
|
| Rate for Payer: Three Rivers Provider Network All |
$409.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$507.78
|
| Rate for Payer: Zelis Auto |
$218.40
|
| Rate for Payer: Zelis Worker's Compensation |
$149.06
|
|
|
BIOPSY OF PROSTATE
|
Facility
|
IP
|
$684.00
|
|
|
Service Code
|
CPT 55705
|
| Hospital Charge Code |
6155705
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$186.73 |
| Max. Negotiated Rate |
$649.80 |
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cigna Commercial |
$581.40
|
| Rate for Payer: First Health Commercial |
$615.60
|
| Rate for Payer: First Health Workers Compensation |
$264.09
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$615.60
|
| Rate for Payer: GEHA Commercial |
$478.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$615.60
|
| Rate for Payer: Multiplan All |
$622.44
|
| Rate for Payer: OMNI Networks Commercial |
$478.80
|
| Rate for Payer: One Health Plan PPO/POS |
$615.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$649.80
|
| Rate for Payer: Three Rivers Provider Network All |
$513.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$636.12
|
| Rate for Payer: Zelis Auto |
$273.60
|
| Rate for Payer: Zelis Worker's Compensation |
$186.73
|
|
|
BIOPSY OF PROSTATE
|
Facility
|
OP
|
$684.00
|
|
|
Service Code
|
CPT 55705
|
| Hospital Charge Code |
6155705
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$186.73 |
| Max. Negotiated Rate |
$6,683.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,256.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$410.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,256.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$995.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,341.98
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cash Price |
$410.40
|
| Rate for Payer: Cigna Commercial |
$581.40
|
| Rate for Payer: First Health Commercial |
$615.60
|
| Rate for Payer: First Health Workers Compensation |
$264.09
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$615.60
|
| Rate for Payer: GEHA Commercial |
$547.20
|
| Rate for Payer: GEHA Medicare |
$3,341.98
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$615.60
|
| Rate for Payer: Humana ChoiceCare |
$3,676.18
|
| Rate for Payer: Humana Medicare Advantage |
$3,341.98
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,614.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,016.00
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,341.98
|
| Rate for Payer: Multiplan All |
$622.44
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,681.37
|
| Rate for Payer: OMNI Networks Commercial |
$478.80
|
| Rate for Payer: One Health Plan PPO/POS |
$615.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,173.12
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,016.00
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,341.98
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$649.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,683.96
|
| Rate for Payer: Three Rivers Provider Network All |
$513.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,275.14
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,016.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,341.98
|
| Rate for Payer: United Payors & United Providers UP&UP |
$636.12
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,341.98
|
| Rate for Payer: Zelis Auto |
$273.60
|
| Rate for Payer: Zelis Medicare |
$2,840.68
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,010.38
|
| Rate for Payer: Zelis Worker's Compensation |
$186.73
|
|
|
BIOPSY OF RECTUM
|
Facility
|
IP
|
$768.00
|
|
|
Service Code
|
CPT 45100
|
| Hospital Charge Code |
6145100
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$209.66 |
| Max. Negotiated Rate |
$729.60 |
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cigna Commercial |
$652.80
|
| Rate for Payer: First Health Commercial |
$691.20
|
| Rate for Payer: First Health Workers Compensation |
$296.52
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$691.20
|
| Rate for Payer: GEHA Commercial |
$537.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$691.20
|
| Rate for Payer: Multiplan All |
$698.88
|
| Rate for Payer: OMNI Networks Commercial |
$537.60
|
| Rate for Payer: One Health Plan PPO/POS |
$691.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$729.60
|
| Rate for Payer: Three Rivers Provider Network All |
$576.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$714.24
|
| Rate for Payer: Zelis Auto |
$307.20
|
| Rate for Payer: Zelis Worker's Compensation |
$209.66
|
|
|
BIOPSY OF RECTUM
|
Facility
|
OP
|
$768.00
|
|
|
Service Code
|
CPT 45100
|
| Hospital Charge Code |
6145100
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$209.66 |
| Max. Negotiated Rate |
$5,314.64 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,423.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$460.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,423.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,919.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,657.32
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cigna Commercial |
$652.80
|
| Rate for Payer: First Health Commercial |
$691.20
|
| Rate for Payer: First Health Workers Compensation |
$296.52
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$691.20
|
| Rate for Payer: GEHA Commercial |
$614.40
|
| Rate for Payer: GEHA Medicare |
$2,657.32
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$691.20
|
| Rate for Payer: Humana ChoiceCare |
$2,923.05
|
| Rate for Payer: Humana Medicare Advantage |
$2,657.32
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,464.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,959.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,657.32
|
| Rate for Payer: Multiplan All |
$698.88
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,517.44
|
| Rate for Payer: OMNI Networks Commercial |
$537.60
|
| Rate for Payer: One Health Plan PPO/POS |
$691.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,262.04
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,959.08
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,657.32
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$729.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,314.64
|
| Rate for Payer: Three Rivers Provider Network All |
$576.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,604.17
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,959.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,657.32
|
| Rate for Payer: United Payors & United Providers UP&UP |
$714.24
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,657.32
|
| Rate for Payer: Zelis Auto |
$307.20
|
| Rate for Payer: Zelis Medicare |
$2,258.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,188.78
|
| Rate for Payer: Zelis Worker's Compensation |
$209.66
|
|
|
BIOPSY OF SACROILIAC JOINT
|
Facility
|
IP
|
$972.00
|
|
|
Service Code
|
CPT 27050
|
| Hospital Charge Code |
6127050
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$265.36 |
| Max. Negotiated Rate |
$923.40 |
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cigna Commercial |
$826.20
|
| Rate for Payer: First Health Commercial |
$874.80
|
| Rate for Payer: First Health Workers Compensation |
$375.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$874.80
|
| Rate for Payer: GEHA Commercial |
$680.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$874.80
|
| Rate for Payer: Multiplan All |
$884.52
|
| Rate for Payer: OMNI Networks Commercial |
$680.40
|
| Rate for Payer: One Health Plan PPO/POS |
$874.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$923.40
|
| Rate for Payer: Three Rivers Provider Network All |
$729.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$903.96
|
| Rate for Payer: Zelis Auto |
$388.80
|
| Rate for Payer: Zelis Worker's Compensation |
$265.36
|
|
|
BIOPSY OF SACROILIAC JOINT
|
Facility
|
OP
|
$972.00
|
|
|
Service Code
|
CPT 27050
|
| Hospital Charge Code |
6127050
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$265.36 |
| Max. Negotiated Rate |
$3,101.54 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,225.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$583.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,225.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,763.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,550.77
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cigna Commercial |
$826.20
|
| Rate for Payer: First Health Commercial |
$874.80
|
| Rate for Payer: First Health Workers Compensation |
$375.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$874.80
|
| Rate for Payer: GEHA Commercial |
$777.60
|
| Rate for Payer: GEHA Medicare |
$1,550.77
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$874.80
|
| Rate for Payer: Humana ChoiceCare |
$1,705.85
|
| Rate for Payer: Humana Medicare Advantage |
$1,550.77
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,605.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,799.28
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,550.77
|
| Rate for Payer: Multiplan All |
$884.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,636.31
|
| Rate for Payer: OMNI Networks Commercial |
$680.40
|
| Rate for Payer: One Health Plan PPO/POS |
$874.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,077.52
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,799.28
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,550.77
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$923.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,101.54
|
| Rate for Payer: Three Rivers Provider Network All |
$729.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,519.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,799.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,550.77
|
| Rate for Payer: United Payors & United Providers UP&UP |
$903.96
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,550.77
|
| Rate for Payer: Zelis Auto |
$388.80
|
| Rate for Payer: Zelis Medicare |
$1,318.15
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,860.92
|
| Rate for Payer: Zelis Worker's Compensation |
$265.36
|
|
|
BIOPSY OF SALIVARY GLAND
|
Facility
|
OP
|
$171.00
|
|
|
Service Code
|
CPT 42400
|
| Hospital Charge Code |
6142400
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$46.68 |
| Max. Negotiated Rate |
$1,363.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$790.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$102.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$790.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$625.93
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$681.76
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Cigna Commercial |
$145.35
|
| Rate for Payer: First Health Commercial |
$153.90
|
| Rate for Payer: First Health Workers Compensation |
$66.02
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$153.90
|
| Rate for Payer: GEHA Commercial |
$136.80
|
| Rate for Payer: GEHA Medicare |
$681.76
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$153.90
|
| Rate for Payer: Humana ChoiceCare |
$749.94
|
| Rate for Payer: Humana Medicare Advantage |
$681.76
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,145.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$638.67
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$681.76
|
| Rate for Payer: Multiplan All |
$155.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,158.99
|
| Rate for Payer: OMNI Networks Commercial |
$119.70
|
| Rate for Payer: One Health Plan PPO/POS |
$153.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$737.44
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$638.67
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$681.76
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$162.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,363.52
|
| Rate for Payer: Three Rivers Provider Network All |
$128.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$668.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$638.67
|
| Rate for Payer: United Healthcare Medicare Advantage |
$681.76
|
| Rate for Payer: United Payors & United Providers UP&UP |
$159.03
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$681.76
|
| Rate for Payer: Zelis Auto |
$68.40
|
| Rate for Payer: Zelis Medicare |
$579.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$818.11
|
| Rate for Payer: Zelis Worker's Compensation |
$46.68
|
|
|
BIOPSY OF SALIVARY GLAND
|
Facility
|
IP
|
$171.00
|
|
|
Service Code
|
CPT 42400
|
| Hospital Charge Code |
6142400
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$46.68 |
| Max. Negotiated Rate |
$162.45 |
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Cigna Commercial |
$145.35
|
| Rate for Payer: First Health Commercial |
$153.90
|
| Rate for Payer: First Health Workers Compensation |
$66.02
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$153.90
|
| Rate for Payer: GEHA Commercial |
$119.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$153.90
|
| Rate for Payer: Multiplan All |
$155.61
|
| Rate for Payer: OMNI Networks Commercial |
$119.70
|
| Rate for Payer: One Health Plan PPO/POS |
$153.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$162.45
|
| Rate for Payer: Three Rivers Provider Network All |
$128.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$159.03
|
| Rate for Payer: Zelis Auto |
$68.40
|
| Rate for Payer: Zelis Worker's Compensation |
$46.68
|
|
|
BIOPSY OF SHOULDER JOINT
|
Facility
|
IP
|
$1,014.00
|
|
|
Service Code
|
CPT 23100
|
| Hospital Charge Code |
6123100
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$276.82 |
| Max. Negotiated Rate |
$963.30 |
| Rate for Payer: Cash Price |
$608.40
|
| Rate for Payer: Cigna Commercial |
$861.90
|
| Rate for Payer: First Health Commercial |
$912.60
|
| Rate for Payer: First Health Workers Compensation |
$391.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$912.60
|
| Rate for Payer: GEHA Commercial |
$709.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$912.60
|
| Rate for Payer: Multiplan All |
$922.74
|
| Rate for Payer: OMNI Networks Commercial |
$709.80
|
| Rate for Payer: One Health Plan PPO/POS |
$912.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$963.30
|
| Rate for Payer: Three Rivers Provider Network All |
$760.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$943.02
|
| Rate for Payer: Zelis Auto |
$405.60
|
| Rate for Payer: Zelis Worker's Compensation |
$276.82
|
|
|
BIOPSY OF SHOULDER JOINT
|
Facility
|
OP
|
$1,014.00
|
|
|
Service Code
|
CPT 23100
|
| Hospital Charge Code |
6123100
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$276.82 |
| Max. Negotiated Rate |
$6,287.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,225.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$608.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,225.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,763.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,143.96
|
| Rate for Payer: Cash Price |
$608.40
|
| Rate for Payer: Cash Price |
$608.40
|
| Rate for Payer: Cigna Commercial |
$861.90
|
| Rate for Payer: First Health Commercial |
$912.60
|
| Rate for Payer: First Health Workers Compensation |
$391.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$912.60
|
| Rate for Payer: GEHA Commercial |
$811.20
|
| Rate for Payer: GEHA Medicare |
$3,143.96
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$912.60
|
| Rate for Payer: Humana ChoiceCare |
$3,458.36
|
| Rate for Payer: Humana Medicare Advantage |
$3,143.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,281.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,799.28
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,143.96
|
| Rate for Payer: Multiplan All |
$922.74
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,344.73
|
| Rate for Payer: OMNI Networks Commercial |
$709.80
|
| Rate for Payer: One Health Plan PPO/POS |
$912.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,077.52
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,799.28
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,143.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$963.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,287.92
|
| Rate for Payer: Three Rivers Provider Network All |
$760.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,081.08
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,799.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,143.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$943.02
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,143.96
|
| Rate for Payer: Zelis Auto |
$405.60
|
| Rate for Payer: Zelis Medicare |
$2,672.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,772.75
|
| Rate for Payer: Zelis Worker's Compensation |
$276.82
|
|
|
BIOPSY OF SOFT TISSUES
|
Facility
|
OP
|
$513.00
|
|
|
Service Code
|
CPT 27040
|
| Hospital Charge Code |
6127040
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$140.05 |
| Max. Negotiated Rate |
$3,139.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$307.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$657.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,569.98
|
| Rate for Payer: Cash Price |
$307.80
|
| Rate for Payer: Cash Price |
$307.80
|
| Rate for Payer: Cigna Commercial |
$436.05
|
| Rate for Payer: First Health Commercial |
$461.70
|
| Rate for Payer: First Health Workers Compensation |
$198.07
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$461.70
|
| Rate for Payer: GEHA Commercial |
$410.40
|
| Rate for Payer: GEHA Medicare |
$1,569.98
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$461.70
|
| Rate for Payer: Humana ChoiceCare |
$1,726.98
|
| Rate for Payer: Humana Medicare Advantage |
$1,569.98
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,637.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$670.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,569.98
|
| Rate for Payer: Multiplan All |
$466.83
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,668.97
|
| Rate for Payer: OMNI Networks Commercial |
$359.10
|
| Rate for Payer: One Health Plan PPO/POS |
$461.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$774.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$670.42
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,569.98
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$487.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,139.96
|
| Rate for Payer: Three Rivers Provider Network All |
$384.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,538.58
|
| Rate for Payer: United Healthcare Managed Medicaid |
$670.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,569.98
|
| Rate for Payer: United Payors & United Providers UP&UP |
$477.09
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,569.98
|
| Rate for Payer: Zelis Auto |
$205.20
|
| Rate for Payer: Zelis Medicare |
$1,334.48
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,883.98
|
| Rate for Payer: Zelis Worker's Compensation |
$140.05
|
|
|
BIOPSY OF SOFT TISSUES
|
Facility
|
IP
|
$1,418.00
|
|
|
Service Code
|
CPT 27041
|
| Hospital Charge Code |
6127041
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$387.11 |
| Max. Negotiated Rate |
$1,347.10 |
| Rate for Payer: Cash Price |
$850.80
|
| Rate for Payer: Cigna Commercial |
$1,205.30
|
| Rate for Payer: First Health Commercial |
$1,276.20
|
| Rate for Payer: First Health Workers Compensation |
$547.49
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,276.20
|
| Rate for Payer: GEHA Commercial |
$992.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,276.20
|
| Rate for Payer: Multiplan All |
$1,290.38
|
| Rate for Payer: OMNI Networks Commercial |
$992.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,276.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,347.10
|
| Rate for Payer: Three Rivers Provider Network All |
$1,063.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,318.74
|
| Rate for Payer: Zelis Auto |
$567.20
|
| Rate for Payer: Zelis Worker's Compensation |
$387.11
|
|
|
BIOPSY OF SOFT TISSUES
|
Facility
|
OP
|
$1,418.00
|
|
|
Service Code
|
CPT 27041
|
| Hospital Charge Code |
6127041
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$387.11 |
| Max. Negotiated Rate |
$3,139.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$850.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$657.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,569.98
|
| Rate for Payer: Cash Price |
$850.80
|
| Rate for Payer: Cash Price |
$850.80
|
| Rate for Payer: Cigna Commercial |
$1,205.30
|
| Rate for Payer: First Health Commercial |
$1,276.20
|
| Rate for Payer: First Health Workers Compensation |
$547.49
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,276.20
|
| Rate for Payer: GEHA Commercial |
$1,134.40
|
| Rate for Payer: GEHA Medicare |
$1,569.98
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,276.20
|
| Rate for Payer: Humana ChoiceCare |
$1,726.98
|
| Rate for Payer: Humana Medicare Advantage |
$1,569.98
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,637.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$670.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,569.98
|
| Rate for Payer: Multiplan All |
$1,290.38
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,668.97
|
| Rate for Payer: OMNI Networks Commercial |
$992.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,276.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$774.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$670.42
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,569.98
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,347.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,139.96
|
| Rate for Payer: Three Rivers Provider Network All |
$1,063.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,538.58
|
| Rate for Payer: United Healthcare Managed Medicaid |
$670.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,569.98
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,318.74
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,569.98
|
| Rate for Payer: Zelis Auto |
$567.20
|
| Rate for Payer: Zelis Medicare |
$1,334.48
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,883.98
|
| Rate for Payer: Zelis Worker's Compensation |
$387.11
|
|
