|
REPAIR OF BOWEL LESION
|
Facility
|
IP
|
$2,749.00
|
|
|
Service Code
|
CPT 44605
|
| Hospital Charge Code |
6144605
|
|
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 OF BOWEL LESION
|
Facility
|
OP
|
$2,749.00
|
|
|
Service Code
|
CPT 44605
|
| Hospital Charge Code |
6144605
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$687.25 |
| Max. Negotiated Rate |
$2,611.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$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: Great West Healthcare (Cigna) Commercial |
$2,474.10
|
| Rate for Payer: Humana ChoiceCare |
$714.74
|
| Rate for Payer: Multiplan All |
$2,501.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,649.40
|
| 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: TriWest Veterans Administration/VAPC3 |
$2,419.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$687.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,556.57
|
| Rate for Payer: Zelis Auto |
$1,099.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,374.50
|
| Rate for Payer: Zelis Worker's Compensation |
$750.48
|
|
|
REPAIR OF BOWEL POUCH
|
Facility
|
OP
|
$1,630.00
|
|
|
Service Code
|
CPT 57270
|
| Hospital Charge Code |
6157270
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$407.50 |
| Max. Negotiated Rate |
$1,548.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$978.00
|
| Rate for Payer: Cash Price |
$978.00
|
| Rate for Payer: Cigna Commercial |
$1,385.50
|
| Rate for Payer: First Health Commercial |
$1,467.00
|
| Rate for Payer: First Health Workers Compensation |
$629.34
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,467.00
|
| Rate for Payer: GEHA Commercial |
$1,304.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,467.00
|
| Rate for Payer: Humana ChoiceCare |
$423.80
|
| Rate for Payer: Multiplan All |
$1,483.30
|
| Rate for Payer: New Mexico Health Connections Medicare |
$978.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,141.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,467.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,548.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,222.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,434.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$407.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,515.90
|
| Rate for Payer: Zelis Auto |
$652.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$815.00
|
| Rate for Payer: Zelis Worker's Compensation |
$444.99
|
|
|
REPAIR OF BOWEL POUCH
|
Facility
|
IP
|
$1,630.00
|
|
|
Service Code
|
CPT 57270
|
| Hospital Charge Code |
6157270
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$444.99 |
| Max. Negotiated Rate |
$1,548.50 |
| Rate for Payer: Cash Price |
$978.00
|
| Rate for Payer: Cigna Commercial |
$1,385.50
|
| Rate for Payer: First Health Commercial |
$1,467.00
|
| Rate for Payer: First Health Workers Compensation |
$629.34
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,467.00
|
| Rate for Payer: GEHA Commercial |
$1,141.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,467.00
|
| Rate for Payer: Multiplan All |
$1,483.30
|
| Rate for Payer: OMNI Networks Commercial |
$1,141.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,467.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,548.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,222.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,515.90
|
| Rate for Payer: Zelis Auto |
$652.00
|
| Rate for Payer: Zelis Worker's Compensation |
$444.99
|
|
|
REPAIR OF CIRCUMCISION
|
Facility
|
IP
|
$557.00
|
|
|
Service Code
|
CPT 54163
|
| Hospital Charge Code |
6154163
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$152.06 |
| Max. Negotiated Rate |
$529.15 |
| Rate for Payer: Cash Price |
$334.20
|
| Rate for Payer: Cigna Commercial |
$473.45
|
| Rate for Payer: First Health Commercial |
$501.30
|
| Rate for Payer: First Health Workers Compensation |
$215.06
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$501.30
|
| Rate for Payer: GEHA Commercial |
$389.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$501.30
|
| Rate for Payer: Multiplan All |
$506.87
|
| Rate for Payer: OMNI Networks Commercial |
$389.90
|
| Rate for Payer: One Health Plan PPO/POS |
$501.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$529.15
|
| Rate for Payer: Three Rivers Provider Network All |
$417.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$518.01
|
| Rate for Payer: Zelis Auto |
$222.80
|
| Rate for Payer: Zelis Worker's Compensation |
$152.06
|
|
|
REPAIR OF CIRCUMCISION
|
Facility
|
OP
|
$557.00
|
|
|
Service Code
|
CPT 54163
|
| Hospital Charge Code |
6154163
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$152.06 |
| Max. Negotiated Rate |
$3,890.28 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,354.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$334.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,354.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,865.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,945.14
|
| Rate for Payer: Cash Price |
$334.20
|
| Rate for Payer: Cash Price |
$334.20
|
| Rate for Payer: Cigna Commercial |
$473.45
|
| Rate for Payer: First Health Commercial |
$501.30
|
| Rate for Payer: First Health Workers Compensation |
$215.06
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$501.30
|
| Rate for Payer: GEHA Commercial |
$445.60
|
| Rate for Payer: GEHA Medicare |
$1,945.14
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$501.30
|
| Rate for Payer: Humana ChoiceCare |
$2,139.65
|
| Rate for Payer: Humana Medicare Advantage |
$1,945.14
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$3,267.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,902.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,945.14
|
| Rate for Payer: Multiplan All |
$506.87
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,306.74
|
| Rate for Payer: OMNI Networks Commercial |
$389.90
|
| Rate for Payer: One Health Plan PPO/POS |
$501.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,197.26
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,902.98
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,945.14
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$529.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,890.28
|
| Rate for Payer: Three Rivers Provider Network All |
$417.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,906.24
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,902.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,945.14
|
| Rate for Payer: United Payors & United Providers UP&UP |
$518.01
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,945.14
|
| Rate for Payer: Zelis Auto |
$222.80
|
| Rate for Payer: Zelis Medicare |
$1,653.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,334.17
|
| Rate for Payer: Zelis Worker's Compensation |
$152.06
|
|
|
REPAIR OF CLOACAL ANOMALY
|
Facility
|
IP
|
$7,597.00
|
|
|
Service Code
|
CPT 46746
|
| Hospital Charge Code |
6146746
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$2,073.98 |
| Max. Negotiated Rate |
$7,217.15 |
| Rate for Payer: Cash Price |
$4,558.20
|
| Rate for Payer: Cigna Commercial |
$6,457.45
|
| Rate for Payer: First Health Commercial |
$6,837.30
|
| Rate for Payer: First Health Workers Compensation |
$2,933.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6,837.30
|
| Rate for Payer: GEHA Commercial |
$5,317.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6,837.30
|
| Rate for Payer: Multiplan All |
$6,913.27
|
| Rate for Payer: OMNI Networks Commercial |
$5,317.90
|
| Rate for Payer: One Health Plan PPO/POS |
$6,837.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$7,217.15
|
| Rate for Payer: Three Rivers Provider Network All |
$5,697.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$7,065.21
|
| Rate for Payer: Zelis Auto |
$3,038.80
|
| Rate for Payer: Zelis Worker's Compensation |
$2,073.98
|
|
|
REPAIR OF CLOACAL ANOMALY
|
Facility
|
OP
|
$8,254.00
|
|
|
Service Code
|
CPT 46748
|
| Hospital Charge Code |
6146748
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$2,063.50 |
| Max. Negotiated Rate |
$7,841.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,952.40
|
| Rate for Payer: Cash Price |
$4,952.40
|
| Rate for Payer: Cigna Commercial |
$7,015.90
|
| Rate for Payer: First Health Commercial |
$7,428.60
|
| Rate for Payer: First Health Workers Compensation |
$3,186.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$7,428.60
|
| Rate for Payer: GEHA Commercial |
$6,603.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$7,428.60
|
| Rate for Payer: Humana ChoiceCare |
$2,146.04
|
| Rate for Payer: Multiplan All |
$7,511.14
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,952.40
|
| Rate for Payer: OMNI Networks Commercial |
$5,777.80
|
| Rate for Payer: One Health Plan PPO/POS |
$7,428.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$7,841.30
|
| Rate for Payer: Three Rivers Provider Network All |
$6,190.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7,263.52
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,063.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$7,676.22
|
| Rate for Payer: Zelis Auto |
$3,301.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,127.00
|
| Rate for Payer: Zelis Worker's Compensation |
$2,253.34
|
|
|
REPAIR OF CLOACAL ANOMALY
|
Facility
|
IP
|
$7,433.00
|
|
|
Service Code
|
CPT 46744
|
| Hospital Charge Code |
6146744
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$2,029.21 |
| Max. Negotiated Rate |
$7,061.35 |
| Rate for Payer: Cash Price |
$4,459.80
|
| Rate for Payer: Cigna Commercial |
$6,318.05
|
| Rate for Payer: First Health Commercial |
$6,689.70
|
| Rate for Payer: First Health Workers Compensation |
$2,869.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6,689.70
|
| Rate for Payer: GEHA Commercial |
$5,203.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6,689.70
|
| Rate for Payer: Multiplan All |
$6,764.03
|
| Rate for Payer: OMNI Networks Commercial |
$5,203.10
|
| Rate for Payer: One Health Plan PPO/POS |
$6,689.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$7,061.35
|
| Rate for Payer: Three Rivers Provider Network All |
$5,574.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$6,912.69
|
| Rate for Payer: Zelis Auto |
$2,973.20
|
| Rate for Payer: Zelis Worker's Compensation |
$2,029.21
|
|
|
REPAIR OF CLOACAL ANOMALY
|
Facility
|
OP
|
$7,433.00
|
|
|
Service Code
|
CPT 46744
|
| Hospital Charge Code |
6146744
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,858.25 |
| Max. Negotiated Rate |
$7,061.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,459.80
|
| Rate for Payer: Cash Price |
$4,459.80
|
| Rate for Payer: Cigna Commercial |
$6,318.05
|
| Rate for Payer: First Health Commercial |
$6,689.70
|
| Rate for Payer: First Health Workers Compensation |
$2,869.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6,689.70
|
| Rate for Payer: GEHA Commercial |
$5,946.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6,689.70
|
| Rate for Payer: Humana ChoiceCare |
$1,932.58
|
| Rate for Payer: Multiplan All |
$6,764.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,459.80
|
| Rate for Payer: OMNI Networks Commercial |
$5,203.10
|
| Rate for Payer: One Health Plan PPO/POS |
$6,689.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$7,061.35
|
| Rate for Payer: Three Rivers Provider Network All |
$5,574.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,541.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,858.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$6,912.69
|
| Rate for Payer: Zelis Auto |
$2,973.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,716.50
|
| Rate for Payer: Zelis Worker's Compensation |
$2,029.21
|
|
|
REPAIR OF CLOACAL ANOMALY
|
Facility
|
IP
|
$8,254.00
|
|
|
Service Code
|
CPT 46748
|
| Hospital Charge Code |
6146748
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$2,253.34 |
| Max. Negotiated Rate |
$7,841.30 |
| Rate for Payer: Cash Price |
$4,952.40
|
| Rate for Payer: Cigna Commercial |
$7,015.90
|
| Rate for Payer: First Health Commercial |
$7,428.60
|
| Rate for Payer: First Health Workers Compensation |
$3,186.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$7,428.60
|
| Rate for Payer: GEHA Commercial |
$5,777.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$7,428.60
|
| Rate for Payer: Multiplan All |
$7,511.14
|
| Rate for Payer: OMNI Networks Commercial |
$5,777.80
|
| Rate for Payer: One Health Plan PPO/POS |
$7,428.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$7,841.30
|
| Rate for Payer: Three Rivers Provider Network All |
$6,190.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$7,676.22
|
| Rate for Payer: Zelis Auto |
$3,301.60
|
| Rate for Payer: Zelis Worker's Compensation |
$2,253.34
|
|
|
REPAIR OF CLOACAL ANOMALY
|
Facility
|
OP
|
$7,597.00
|
|
|
Service Code
|
CPT 46746
|
| Hospital Charge Code |
6146746
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,899.25 |
| Max. Negotiated Rate |
$7,217.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,558.20
|
| Rate for Payer: Cash Price |
$4,558.20
|
| Rate for Payer: Cigna Commercial |
$6,457.45
|
| Rate for Payer: First Health Commercial |
$6,837.30
|
| Rate for Payer: First Health Workers Compensation |
$2,933.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6,837.30
|
| Rate for Payer: GEHA Commercial |
$6,077.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6,837.30
|
| Rate for Payer: Humana ChoiceCare |
$1,975.22
|
| Rate for Payer: Multiplan All |
$6,913.27
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,558.20
|
| Rate for Payer: OMNI Networks Commercial |
$5,317.90
|
| Rate for Payer: One Health Plan PPO/POS |
$6,837.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$7,217.15
|
| Rate for Payer: Three Rivers Provider Network All |
$5,697.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,685.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,899.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$7,065.21
|
| Rate for Payer: Zelis Auto |
$3,038.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,798.50
|
| Rate for Payer: Zelis Worker's Compensation |
$2,073.98
|
|
|
REPAIR OF DIGIT NERVE
|
Facility
|
OP
|
$1,399.00
|
|
|
Service Code
|
CPT 64831
|
| Hospital Charge Code |
6164831
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$381.93 |
| Max. Negotiated Rate |
$3,769.41 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,769.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$839.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,769.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,986.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,854.23
|
| Rate for Payer: Cash Price |
$839.40
|
| Rate for Payer: Cash Price |
$839.40
|
| Rate for Payer: Cigna Commercial |
$1,189.15
|
| Rate for Payer: First Health Commercial |
$1,259.10
|
| Rate for Payer: First Health Workers Compensation |
$540.15
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,259.10
|
| Rate for Payer: GEHA Commercial |
$1,119.20
|
| Rate for Payer: GEHA Medicare |
$1,854.23
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,259.10
|
| Rate for Payer: Humana ChoiceCare |
$2,039.65
|
| Rate for Payer: Humana Medicare Advantage |
$1,854.23
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$3,115.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,046.94
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,854.23
|
| Rate for Payer: Multiplan All |
$1,273.09
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,152.19
|
| Rate for Payer: OMNI Networks Commercial |
$979.30
|
| Rate for Payer: One Health Plan PPO/POS |
$1,259.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$3,518.12
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,046.94
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,854.23
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,329.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,708.46
|
| Rate for Payer: Three Rivers Provider Network All |
$1,049.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,817.15
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,046.94
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,854.23
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,301.07
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,854.23
|
| Rate for Payer: Zelis Auto |
$559.60
|
| Rate for Payer: Zelis Medicare |
$1,576.10
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,225.08
|
| Rate for Payer: Zelis Worker's Compensation |
$381.93
|
|
|
REPAIR OF DIGIT NERVE
|
Facility
|
IP
|
$1,399.00
|
|
|
Service Code
|
CPT 64831
|
| Hospital Charge Code |
6164831
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$381.93 |
| Max. Negotiated Rate |
$1,329.05 |
| Rate for Payer: Cash Price |
$839.40
|
| Rate for Payer: Cigna Commercial |
$1,189.15
|
| Rate for Payer: First Health Commercial |
$1,259.10
|
| Rate for Payer: First Health Workers Compensation |
$540.15
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,259.10
|
| Rate for Payer: GEHA Commercial |
$979.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,259.10
|
| Rate for Payer: Multiplan All |
$1,273.09
|
| Rate for Payer: OMNI Networks Commercial |
$979.30
|
| Rate for Payer: One Health Plan PPO/POS |
$1,259.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,329.05
|
| Rate for Payer: Three Rivers Provider Network All |
$1,049.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,301.07
|
| Rate for Payer: Zelis Auto |
$559.60
|
| Rate for Payer: Zelis Worker's Compensation |
$381.93
|
|
|
REPAIR OF EARDRUM
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
CPT 69610
|
| Hospital Charge Code |
6169610
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$204.75 |
| Max. Negotiated Rate |
$712.50 |
| Rate for Payer: Cash Price |
$450.00
|
| Rate for Payer: Cigna Commercial |
$637.50
|
| Rate for Payer: First Health Commercial |
$675.00
|
| Rate for Payer: First Health Workers Compensation |
$289.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$675.00
|
| Rate for Payer: GEHA Commercial |
$525.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$675.00
|
| Rate for Payer: Multiplan All |
$682.50
|
| Rate for Payer: OMNI Networks Commercial |
$525.00
|
| Rate for Payer: One Health Plan PPO/POS |
$675.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$712.50
|
| Rate for Payer: Three Rivers Provider Network All |
$562.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$697.50
|
| Rate for Payer: Zelis Auto |
$300.00
|
| Rate for Payer: Zelis Worker's Compensation |
$204.75
|
|
|
REPAIR OF EARDRUM
|
Facility
|
OP
|
$996.00
|
|
|
Service Code
|
CPT 69620
|
| Hospital Charge Code |
6169620
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$271.91 |
| Max. Negotiated Rate |
$6,158.84 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,524.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$597.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,524.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,999.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,079.42
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cigna Commercial |
$846.60
|
| Rate for Payer: First Health Commercial |
$896.40
|
| Rate for Payer: First Health Workers Compensation |
$384.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$896.40
|
| Rate for Payer: GEHA Commercial |
$796.80
|
| Rate for Payer: GEHA Medicare |
$3,079.42
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$896.40
|
| Rate for Payer: Humana ChoiceCare |
$3,387.36
|
| Rate for Payer: Humana Medicare Advantage |
$3,079.42
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,173.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,040.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,079.42
|
| Rate for Payer: Multiplan All |
$906.36
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,235.01
|
| Rate for Payer: OMNI Networks Commercial |
$697.20
|
| Rate for Payer: One Health Plan PPO/POS |
$896.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,355.78
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,040.27
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,079.42
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$946.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,158.84
|
| Rate for Payer: Three Rivers Provider Network All |
$747.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,017.83
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,040.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,079.42
|
| Rate for Payer: United Payors & United Providers UP&UP |
$926.28
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,079.42
|
| Rate for Payer: Zelis Auto |
$398.40
|
| Rate for Payer: Zelis Medicare |
$2,617.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,695.30
|
| Rate for Payer: Zelis Worker's Compensation |
$271.91
|
|
|
REPAIR OF EARDRUM
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
CPT 69610
|
| Hospital Charge Code |
6169610
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$204.75 |
| Max. Negotiated Rate |
$2,813.06 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,524.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$450.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,524.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,999.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,406.53
|
| Rate for Payer: Cash Price |
$450.00
|
| Rate for Payer: Cash Price |
$450.00
|
| Rate for Payer: Cigna Commercial |
$637.50
|
| Rate for Payer: First Health Commercial |
$675.00
|
| Rate for Payer: First Health Workers Compensation |
$289.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$675.00
|
| Rate for Payer: GEHA Commercial |
$600.00
|
| Rate for Payer: GEHA Medicare |
$1,406.53
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$675.00
|
| Rate for Payer: Humana ChoiceCare |
$1,547.18
|
| Rate for Payer: Humana Medicare Advantage |
$1,406.53
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,362.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,040.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,406.53
|
| Rate for Payer: Multiplan All |
$682.50
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,391.10
|
| Rate for Payer: OMNI Networks Commercial |
$525.00
|
| Rate for Payer: One Health Plan PPO/POS |
$675.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,355.78
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,040.27
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,406.53
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$712.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,813.06
|
| Rate for Payer: Three Rivers Provider Network All |
$562.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,378.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,040.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,406.53
|
| Rate for Payer: United Payors & United Providers UP&UP |
$697.50
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,406.53
|
| Rate for Payer: Zelis Auto |
$300.00
|
| Rate for Payer: Zelis Medicare |
$1,195.55
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,687.84
|
| Rate for Payer: Zelis Worker's Compensation |
$204.75
|
|
|
REPAIR OF EARDRUM
|
Facility
|
IP
|
$996.00
|
|
|
Service Code
|
CPT 69620
|
| Hospital Charge Code |
6169620
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$271.91 |
| Max. Negotiated Rate |
$946.20 |
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Cigna Commercial |
$846.60
|
| Rate for Payer: First Health Commercial |
$896.40
|
| Rate for Payer: First Health Workers Compensation |
$384.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$896.40
|
| Rate for Payer: GEHA Commercial |
$697.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$896.40
|
| Rate for Payer: Multiplan All |
$906.36
|
| Rate for Payer: OMNI Networks Commercial |
$697.20
|
| Rate for Payer: One Health Plan PPO/POS |
$896.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$946.20
|
| Rate for Payer: Three Rivers Provider Network All |
$747.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$926.28
|
| Rate for Payer: Zelis Auto |
$398.40
|
| Rate for Payer: Zelis Worker's Compensation |
$271.91
|
|
|
REPAIR OF ESOPHAGUS
|
Facility
|
OP
|
$3,158.00
|
|
|
Service Code
|
CPT 43310
|
| Hospital Charge Code |
6143310
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$789.50 |
| Max. Negotiated Rate |
$3,000.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,894.80
|
| Rate for Payer: Cash Price |
$1,894.80
|
| Rate for Payer: Cigna Commercial |
$2,684.30
|
| Rate for Payer: First Health Commercial |
$2,842.20
|
| Rate for Payer: First Health Workers Compensation |
$1,219.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,842.20
|
| Rate for Payer: GEHA Commercial |
$2,526.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,842.20
|
| Rate for Payer: Humana ChoiceCare |
$821.08
|
| Rate for Payer: Multiplan All |
$2,873.78
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,894.80
|
| Rate for Payer: OMNI Networks Commercial |
$2,210.60
|
| Rate for Payer: One Health Plan PPO/POS |
$2,842.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,000.10
|
| Rate for Payer: Three Rivers Provider Network All |
$2,368.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,779.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$789.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,936.94
|
| Rate for Payer: Zelis Auto |
$1,263.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,579.00
|
| Rate for Payer: Zelis Worker's Compensation |
$862.13
|
|
|
REPAIR OF ESOPHAGUS
|
Facility
|
IP
|
$3,158.00
|
|
|
Service Code
|
CPT 43310
|
| Hospital Charge Code |
6143310
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$862.13 |
| Max. Negotiated Rate |
$3,000.10 |
| Rate for Payer: Cash Price |
$1,894.80
|
| Rate for Payer: Cigna Commercial |
$2,684.30
|
| Rate for Payer: First Health Commercial |
$2,842.20
|
| Rate for Payer: First Health Workers Compensation |
$1,219.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,842.20
|
| Rate for Payer: GEHA Commercial |
$2,210.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,842.20
|
| Rate for Payer: Multiplan All |
$2,873.78
|
| Rate for Payer: OMNI Networks Commercial |
$2,210.60
|
| Rate for Payer: One Health Plan PPO/POS |
$2,842.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,000.10
|
| Rate for Payer: Three Rivers Provider Network All |
$2,368.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,936.94
|
| Rate for Payer: Zelis Auto |
$1,263.20
|
| Rate for Payer: Zelis Worker's Compensation |
$862.13
|
|
|
REPAIR OF ESOPHAGUS
|
Facility
|
OP
|
$1,276.00
|
|
|
Service Code
|
CPT 43300
|
| Hospital Charge Code |
6143300
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$319.00 |
| Max. Negotiated Rate |
$1,212.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$765.60
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cigna Commercial |
$1,084.60
|
| Rate for Payer: First Health Commercial |
$1,148.40
|
| Rate for Payer: First Health Workers Compensation |
$492.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,148.40
|
| Rate for Payer: GEHA Commercial |
$1,020.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,148.40
|
| Rate for Payer: Humana ChoiceCare |
$331.76
|
| Rate for Payer: Multiplan All |
$1,161.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$765.60
|
| Rate for Payer: OMNI Networks Commercial |
$893.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,148.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,212.20
|
| Rate for Payer: Three Rivers Provider Network All |
$957.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,122.88
|
| Rate for Payer: United Healthcare Managed Medicaid |
$319.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,186.68
|
| Rate for Payer: Zelis Auto |
$510.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$638.00
|
| Rate for Payer: Zelis Worker's Compensation |
$348.35
|
|
|
REPAIR OF ESOPHAGUS
|
Facility
|
IP
|
$1,276.00
|
|
|
Service Code
|
CPT 43300
|
| Hospital Charge Code |
6143300
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$348.35 |
| Max. Negotiated Rate |
$1,212.20 |
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cigna Commercial |
$1,084.60
|
| Rate for Payer: First Health Commercial |
$1,148.40
|
| Rate for Payer: First Health Workers Compensation |
$492.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,148.40
|
| Rate for Payer: GEHA Commercial |
$893.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,148.40
|
| Rate for Payer: Multiplan All |
$1,161.16
|
| Rate for Payer: OMNI Networks Commercial |
$893.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,148.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,212.20
|
| Rate for Payer: Three Rivers Provider Network All |
$957.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,186.68
|
| Rate for Payer: Zelis Auto |
$510.40
|
| Rate for Payer: Zelis Worker's Compensation |
$348.35
|
|
|
REPAIR OF FIBULA EPIPHYSIS
|
Facility
|
IP
|
$827.00
|
|
|
Service Code
|
CPT 27732
|
| Hospital Charge Code |
6127732
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$225.77 |
| Max. Negotiated Rate |
$785.65 |
| Rate for Payer: Cash Price |
$496.20
|
| Rate for Payer: Cigna Commercial |
$702.95
|
| Rate for Payer: First Health Commercial |
$744.30
|
| Rate for Payer: First Health Workers Compensation |
$319.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$744.30
|
| Rate for Payer: GEHA Commercial |
$578.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$744.30
|
| Rate for Payer: Multiplan All |
$752.57
|
| Rate for Payer: OMNI Networks Commercial |
$578.90
|
| Rate for Payer: One Health Plan PPO/POS |
$744.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$785.65
|
| Rate for Payer: Three Rivers Provider Network All |
$620.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$769.11
|
| Rate for Payer: Zelis Auto |
$330.80
|
| Rate for Payer: Zelis Worker's Compensation |
$225.77
|
|
|
REPAIR OF FIBULA EPIPHYSIS
|
Facility
|
OP
|
$827.00
|
|
|
Service Code
|
CPT 27732
|
| Hospital Charge Code |
6127732
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$225.77 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,212.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$496.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,212.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,544.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$496.20
|
| Rate for Payer: Cash Price |
$496.20
|
| Rate for Payer: Cigna Commercial |
$702.95
|
| Rate for Payer: First Health Commercial |
$744.30
|
| Rate for Payer: First Health Workers Compensation |
$319.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$744.30
|
| Rate for Payer: GEHA Commercial |
$661.60
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$744.30
|
| Rate for Payer: Humana ChoiceCare |
$3,388.98
|
| Rate for Payer: Humana Medicare Advantage |
$3,080.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,175.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,596.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$752.57
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$578.90
|
| Rate for Payer: One Health Plan PPO/POS |
$744.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,998.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,596.69
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$785.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$620.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,596.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$769.11
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$330.80
|
| 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 |
$225.77
|
|
|
REPAIR OF FOOT BONES
|
Facility
|
OP
|
$1,773.99
|
|
|
Service Code
|
CPT 28320
|
| Hospital Charge Code |
6128320
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$484.30 |
| Max. Negotiated Rate |
$24,435.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,310.82
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,064.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,310.82
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,207.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,217.56
|
| Rate for Payer: Cash Price |
$1,064.39
|
| Rate for Payer: Cash Price |
$1,064.39
|
| Rate for Payer: Cigna Commercial |
$1,507.89
|
| Rate for Payer: First Health Commercial |
$1,596.59
|
| Rate for Payer: First Health Workers Compensation |
$684.94
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,596.59
|
| Rate for Payer: GEHA Commercial |
$1,419.19
|
| Rate for Payer: GEHA Medicare |
$12,217.56
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,596.59
|
| Rate for Payer: Humana ChoiceCare |
$13,439.32
|
| Rate for Payer: Humana Medicare Advantage |
$12,217.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,525.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,292.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,217.56
|
| Rate for Payer: Multiplan All |
$1,614.33
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,769.85
|
| Rate for Payer: OMNI Networks Commercial |
$1,241.79
|
| Rate for Payer: One Health Plan PPO/POS |
$1,596.59
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,956.77
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,292.92
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,217.56
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,685.29
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,435.12
|
| Rate for Payer: Three Rivers Provider Network All |
$1,330.49
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,973.21
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,292.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,217.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,649.81
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$12,217.56
|
| Rate for Payer: Zelis Auto |
$709.60
|
| Rate for Payer: Zelis Medicare |
$10,384.93
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,661.07
|
| Rate for Payer: Zelis Worker's Compensation |
$484.30
|
|
