|
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 STOMACH
|
Facility
|
IP
|
$1,757.00
|
|
|
Service Code
|
CPT 43605
|
| Hospital Charge Code |
6143605
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$479.66 |
| Max. Negotiated Rate |
$1,669.15 |
| Rate for Payer: Cash Price |
$1,054.20
|
| Rate for Payer: Cigna Commercial |
$1,493.45
|
| Rate for Payer: First Health Commercial |
$1,581.30
|
| Rate for Payer: First Health Workers Compensation |
$678.38
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,581.30
|
| Rate for Payer: GEHA Commercial |
$1,229.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,581.30
|
| Rate for Payer: Multiplan All |
$1,598.87
|
| Rate for Payer: OMNI Networks Commercial |
$1,229.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,581.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,669.15
|
| Rate for Payer: Three Rivers Provider Network All |
$1,317.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,634.01
|
| Rate for Payer: Zelis Auto |
$702.80
|
| Rate for Payer: Zelis Worker's Compensation |
$479.66
|
|
|
BIOPSY OF STOMACH
|
Facility
|
OP
|
$1,757.00
|
|
|
Service Code
|
CPT 43605
|
| Hospital Charge Code |
6143605
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$439.25 |
| Max. Negotiated Rate |
$1,669.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,054.20
|
| Rate for Payer: Cash Price |
$1,054.20
|
| Rate for Payer: Cigna Commercial |
$1,493.45
|
| Rate for Payer: First Health Commercial |
$1,581.30
|
| Rate for Payer: First Health Workers Compensation |
$678.38
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,581.30
|
| Rate for Payer: GEHA Commercial |
$1,405.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,581.30
|
| Rate for Payer: Humana ChoiceCare |
$456.82
|
| Rate for Payer: Multiplan All |
$1,598.87
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,054.20
|
| Rate for Payer: OMNI Networks Commercial |
$1,229.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,581.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,669.15
|
| Rate for Payer: Three Rivers Provider Network All |
$1,317.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,546.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$439.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,634.01
|
| Rate for Payer: Zelis Auto |
$702.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$878.50
|
| Rate for Payer: Zelis Worker's Compensation |
$479.66
|
|
|
BIOPSY OF TESTIS
|
Facility
|
OP
|
$230.00
|
|
|
Service Code
|
CPT 54500
|
| Hospital Charge Code |
6154500
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$62.79 |
| Max. Negotiated Rate |
$5,435.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,567.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$138.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,567.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,241.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,717.63
|
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cigna Commercial |
$195.50
|
| Rate for Payer: First Health Commercial |
$207.00
|
| Rate for Payer: First Health Workers Compensation |
$88.80
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$207.00
|
| Rate for Payer: GEHA Commercial |
$184.00
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$207.00
|
| Rate for Payer: Humana ChoiceCare |
$2,989.39
|
| Rate for Payer: Humana Medicare Advantage |
$2,717.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,565.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,266.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,717.63
|
| Rate for Payer: Multiplan All |
$209.30
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$161.00
|
| Rate for Payer: One Health Plan PPO/POS |
$207.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,462.73
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,266.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,717.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$218.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$172.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,663.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,266.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,717.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$213.90
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$92.00
|
| Rate for Payer: Zelis Medicare |
$2,309.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,261.16
|
| Rate for Payer: Zelis Worker's Compensation |
$62.79
|
|
|
BIOPSY OF TESTIS
|
Facility
|
IP
|
$230.00
|
|
|
Service Code
|
CPT 54500
|
| Hospital Charge Code |
6154500
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$62.79 |
| Max. Negotiated Rate |
$218.50 |
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cigna Commercial |
$195.50
|
| Rate for Payer: First Health Commercial |
$207.00
|
| Rate for Payer: First Health Workers Compensation |
$88.80
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$207.00
|
| Rate for Payer: GEHA Commercial |
$161.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$207.00
|
| Rate for Payer: Multiplan All |
$209.30
|
| Rate for Payer: OMNI Networks Commercial |
$161.00
|
| Rate for Payer: One Health Plan PPO/POS |
$207.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$218.50
|
| Rate for Payer: Three Rivers Provider Network All |
$172.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$213.90
|
| Rate for Payer: Zelis Auto |
$92.00
|
| Rate for Payer: Zelis Worker's Compensation |
$62.79
|
|
|
BIOPSY OF TESTIS
|
Facility
|
IP
|
$539.00
|
|
|
Service Code
|
CPT 54505
|
| Hospital Charge Code |
6154505
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$147.15 |
| Max. Negotiated Rate |
$512.05 |
| Rate for Payer: Cash Price |
$323.40
|
| Rate for Payer: Cigna Commercial |
$458.15
|
| Rate for Payer: First Health Commercial |
$485.10
|
| Rate for Payer: First Health Workers Compensation |
$208.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$485.10
|
| Rate for Payer: GEHA Commercial |
$377.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$485.10
|
| Rate for Payer: Multiplan All |
$490.49
|
| Rate for Payer: OMNI Networks Commercial |
$377.30
|
| Rate for Payer: One Health Plan PPO/POS |
$485.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$512.05
|
| Rate for Payer: Three Rivers Provider Network All |
$404.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$501.27
|
| Rate for Payer: Zelis Auto |
$215.60
|
| Rate for Payer: Zelis Worker's Compensation |
$147.15
|
|
|
BIOPSY OF TESTIS
|
Facility
|
OP
|
$539.00
|
|
|
Service Code
|
CPT 54505
|
| Hospital Charge Code |
6154505
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$147.15 |
| Max. Negotiated Rate |
$6,549.86 |
| 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 |
$323.40
|
| 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 |
$3,274.93
|
| Rate for Payer: Cash Price |
$323.40
|
| Rate for Payer: Cash Price |
$323.40
|
| Rate for Payer: Cigna Commercial |
$458.15
|
| Rate for Payer: First Health Commercial |
$485.10
|
| Rate for Payer: First Health Workers Compensation |
$208.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$485.10
|
| Rate for Payer: GEHA Commercial |
$431.20
|
| Rate for Payer: GEHA Medicare |
$3,274.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$485.10
|
| Rate for Payer: Humana ChoiceCare |
$3,602.42
|
| Rate for Payer: Humana Medicare Advantage |
$3,274.93
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,501.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,902.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,274.93
|
| Rate for Payer: Multiplan All |
$490.49
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,567.38
|
| Rate for Payer: OMNI Networks Commercial |
$377.30
|
| Rate for Payer: One Health Plan PPO/POS |
$485.10
|
| 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 |
$3,274.93
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$512.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,549.86
|
| Rate for Payer: Three Rivers Provider Network All |
$404.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,209.43
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,902.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,274.93
|
| Rate for Payer: United Payors & United Providers UP&UP |
$501.27
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,274.93
|
| Rate for Payer: Zelis Auto |
$215.60
|
| Rate for Payer: Zelis Medicare |
$2,783.69
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,929.92
|
| Rate for Payer: Zelis Worker's Compensation |
$147.15
|
|
|
BIOPSY OF THROAT
|
Facility
|
IP
|
$345.00
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
6142800
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$94.19 |
| Max. Negotiated Rate |
$327.75 |
| Rate for Payer: Cash Price |
$207.00
|
| Rate for Payer: Cigna Commercial |
$293.25
|
| Rate for Payer: First Health Commercial |
$310.50
|
| Rate for Payer: First Health Workers Compensation |
$133.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$310.50
|
| Rate for Payer: GEHA Commercial |
$241.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$310.50
|
| Rate for Payer: Multiplan All |
$313.95
|
| Rate for Payer: OMNI Networks Commercial |
$241.50
|
| Rate for Payer: One Health Plan PPO/POS |
$310.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$327.75
|
| Rate for Payer: Three Rivers Provider Network All |
$258.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$320.85
|
| Rate for Payer: Zelis Auto |
$138.00
|
| Rate for Payer: Zelis Worker's Compensation |
$94.19
|
|
|
BIOPSY OF THROAT
|
Facility
|
OP
|
$345.00
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
6142800
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$94.19 |
| Max. Negotiated Rate |
$2,813.06 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,737.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$207.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,737.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,376.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,406.53
|
| Rate for Payer: Cash Price |
$207.00
|
| Rate for Payer: Cash Price |
$207.00
|
| Rate for Payer: Cigna Commercial |
$293.25
|
| Rate for Payer: First Health Commercial |
$310.50
|
| Rate for Payer: First Health Workers Compensation |
$133.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$310.50
|
| Rate for Payer: GEHA Commercial |
$276.00
|
| Rate for Payer: GEHA Medicare |
$1,406.53
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$310.50
|
| 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 |
$1,404.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,406.53
|
| Rate for Payer: Multiplan All |
$313.95
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,391.10
|
| Rate for Payer: OMNI Networks Commercial |
$241.50
|
| Rate for Payer: One Health Plan PPO/POS |
$310.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,622.00
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,404.77
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,406.53
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$327.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,813.06
|
| Rate for Payer: Three Rivers Provider Network All |
$258.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,378.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,404.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,406.53
|
| Rate for Payer: United Payors & United Providers UP&UP |
$320.85
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,406.53
|
| Rate for Payer: Zelis Auto |
$138.00
|
| 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 |
$94.19
|
|
|
BIOPSY OF TOE JOINT LINING
|
Facility
|
OP
|
$620.00
|
|
|
Service Code
|
CPT 28054
|
| Hospital Charge Code |
6128054
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$169.26 |
| 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 |
$372.00
|
| 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 |
$372.00
|
| Rate for Payer: Cash Price |
$372.00
|
| Rate for Payer: Cigna Commercial |
$527.00
|
| Rate for Payer: First Health Commercial |
$558.00
|
| Rate for Payer: First Health Workers Compensation |
$239.38
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$558.00
|
| Rate for Payer: GEHA Commercial |
$496.00
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$558.00
|
| 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 |
$564.20
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$434.00
|
| Rate for Payer: One Health Plan PPO/POS |
$558.00
|
| 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 |
$589.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$465.00
|
| 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 |
$576.60
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$248.00
|
| 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 |
$169.26
|
|
|
BIOPSY OF TOE JOINT LINING
|
Facility
|
IP
|
$620.00
|
|
|
Service Code
|
CPT 28054
|
| Hospital Charge Code |
6128054
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$169.26 |
| Max. Negotiated Rate |
$589.00 |
| Rate for Payer: Cash Price |
$372.00
|
| Rate for Payer: Cigna Commercial |
$527.00
|
| Rate for Payer: First Health Commercial |
$558.00
|
| Rate for Payer: First Health Workers Compensation |
$239.38
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$558.00
|
| Rate for Payer: GEHA Commercial |
$434.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$558.00
|
| Rate for Payer: Multiplan All |
$564.20
|
| Rate for Payer: OMNI Networks Commercial |
$434.00
|
| Rate for Payer: One Health Plan PPO/POS |
$558.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$589.00
|
| Rate for Payer: Three Rivers Provider Network All |
$465.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$576.60
|
| Rate for Payer: Zelis Auto |
$248.00
|
| Rate for Payer: Zelis Worker's Compensation |
$169.26
|
|
|
BIOPSY OF TONGUE
|
Facility
|
IP
|
$347.00
|
|
|
Service Code
|
CPT 41105
|
| Hospital Charge Code |
6141105
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$94.73 |
| Max. Negotiated Rate |
$329.65 |
| Rate for Payer: Cash Price |
$208.20
|
| Rate for Payer: Cigna Commercial |
$294.95
|
| Rate for Payer: First Health Commercial |
$312.30
|
| Rate for Payer: First Health Workers Compensation |
$133.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$312.30
|
| Rate for Payer: GEHA Commercial |
$242.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$312.30
|
| Rate for Payer: Multiplan All |
$315.77
|
| Rate for Payer: OMNI Networks Commercial |
$242.90
|
| Rate for Payer: One Health Plan PPO/POS |
$312.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$329.65
|
| Rate for Payer: Three Rivers Provider Network All |
$260.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$322.71
|
| Rate for Payer: Zelis Auto |
$138.80
|
| Rate for Payer: Zelis Worker's Compensation |
$94.73
|
|
|
BIOPSY OF TONGUE
|
Facility
|
OP
|
$347.00
|
|
|
Service Code
|
CPT 41105
|
| Hospital Charge Code |
6141105
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$94.73 |
| Max. Negotiated Rate |
$6,158.84 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,737.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$208.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,737.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,376.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,079.42
|
| Rate for Payer: Cash Price |
$208.20
|
| Rate for Payer: Cash Price |
$208.20
|
| Rate for Payer: Cigna Commercial |
$294.95
|
| Rate for Payer: First Health Commercial |
$312.30
|
| Rate for Payer: First Health Workers Compensation |
$133.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$312.30
|
| Rate for Payer: GEHA Commercial |
$277.60
|
| Rate for Payer: GEHA Medicare |
$3,079.42
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$312.30
|
| 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 |
$1,404.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,079.42
|
| Rate for Payer: Multiplan All |
$315.77
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,235.01
|
| Rate for Payer: OMNI Networks Commercial |
$242.90
|
| Rate for Payer: One Health Plan PPO/POS |
$312.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,622.00
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,404.77
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,079.42
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$329.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,158.84
|
| Rate for Payer: Three Rivers Provider Network All |
$260.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,017.83
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,404.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,079.42
|
| Rate for Payer: United Payors & United Providers UP&UP |
$322.71
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,079.42
|
| Rate for Payer: Zelis Auto |
$138.80
|
| 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 |
$94.73
|
|
|
BIOPSY OF UPPER NOSE/THROAT
|
Facility
|
OP
|
$347.00
|
|
|
Service Code
|
CPT 42804
|
| Hospital Charge Code |
6142804
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$94.73 |
| Max. Negotiated Rate |
$6,158.84 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,737.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$208.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,737.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,376.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,079.42
|
| Rate for Payer: Cash Price |
$208.20
|
| Rate for Payer: Cash Price |
$208.20
|
| Rate for Payer: Cigna Commercial |
$294.95
|
| Rate for Payer: First Health Commercial |
$312.30
|
| Rate for Payer: First Health Workers Compensation |
$133.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$312.30
|
| Rate for Payer: GEHA Commercial |
$277.60
|
| Rate for Payer: GEHA Medicare |
$3,079.42
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$312.30
|
| 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 |
$1,404.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,079.42
|
| Rate for Payer: Multiplan All |
$315.77
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,235.01
|
| Rate for Payer: OMNI Networks Commercial |
$242.90
|
| Rate for Payer: One Health Plan PPO/POS |
$312.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,622.00
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,404.77
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,079.42
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$329.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,158.84
|
| Rate for Payer: Three Rivers Provider Network All |
$260.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,017.83
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,404.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,079.42
|
| Rate for Payer: United Payors & United Providers UP&UP |
$322.71
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,079.42
|
| Rate for Payer: Zelis Auto |
$138.80
|
| 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 |
$94.73
|
|
|
BIOPSY OF UPPER NOSE/THROAT
|
Facility
|
IP
|
$347.00
|
|
|
Service Code
|
CPT 42804
|
| Hospital Charge Code |
6142804
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$94.73 |
| Max. Negotiated Rate |
$329.65 |
| Rate for Payer: Cash Price |
$208.20
|
| Rate for Payer: Cigna Commercial |
$294.95
|
| Rate for Payer: First Health Commercial |
$312.30
|
| Rate for Payer: First Health Workers Compensation |
$133.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$312.30
|
| Rate for Payer: GEHA Commercial |
$242.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$312.30
|
| Rate for Payer: Multiplan All |
$315.77
|
| Rate for Payer: OMNI Networks Commercial |
$242.90
|
| Rate for Payer: One Health Plan PPO/POS |
$312.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$329.65
|
| Rate for Payer: Three Rivers Provider Network All |
$260.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$322.71
|
| Rate for Payer: Zelis Auto |
$138.80
|
| Rate for Payer: Zelis Worker's Compensation |
$94.73
|
|
|
BIOPSY OF UPPER NOSE/THROAT
|
Facility
|
IP
|
$407.00
|
|
|
Service Code
|
CPT 42806
|
| Hospital Charge Code |
6142806
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$111.11 |
| Max. Negotiated Rate |
$386.65 |
| Rate for Payer: Cash Price |
$244.20
|
| Rate for Payer: Cigna Commercial |
$345.95
|
| Rate for Payer: First Health Commercial |
$366.30
|
| Rate for Payer: First Health Workers Compensation |
$157.14
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$366.30
|
| Rate for Payer: GEHA Commercial |
$284.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$366.30
|
| Rate for Payer: Multiplan All |
$370.37
|
| Rate for Payer: OMNI Networks Commercial |
$284.90
|
| Rate for Payer: One Health Plan PPO/POS |
$366.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$386.65
|
| Rate for Payer: Three Rivers Provider Network All |
$305.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$378.51
|
| Rate for Payer: Zelis Auto |
$162.80
|
| Rate for Payer: Zelis Worker's Compensation |
$111.11
|
|
|
BIOPSY OF UPPER NOSE/THROAT
|
Facility
|
OP
|
$407.00
|
|
|
Service Code
|
CPT 42806
|
| Hospital Charge Code |
6142806
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$111.11 |
| 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 |
$244.20
|
| 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 |
$244.20
|
| Rate for Payer: Cash Price |
$244.20
|
| Rate for Payer: Cigna Commercial |
$345.95
|
| Rate for Payer: First Health Commercial |
$366.30
|
| Rate for Payer: First Health Workers Compensation |
$157.14
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$366.30
|
| Rate for Payer: GEHA Commercial |
$325.60
|
| Rate for Payer: GEHA Medicare |
$3,079.42
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$366.30
|
| 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 |
$370.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,235.01
|
| Rate for Payer: OMNI Networks Commercial |
$284.90
|
| Rate for Payer: One Health Plan PPO/POS |
$366.30
|
| 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 |
$386.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,158.84
|
| Rate for Payer: Three Rivers Provider Network All |
$305.25
|
| 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 |
$378.51
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,079.42
|
| Rate for Payer: Zelis Auto |
$162.80
|
| 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 |
$111.11
|
|
|
BIOPSY OF URETHRA
|
Facility
|
OP
|
$442.00
|
|
|
Service Code
|
CPT 53200
|
| Hospital Charge Code |
6153200
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$120.67 |
| Max. Negotiated Rate |
$3,890.28 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,056.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$265.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,056.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,628.99
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,945.14
|
| Rate for Payer: Cash Price |
$265.20
|
| Rate for Payer: Cash Price |
$265.20
|
| Rate for Payer: Cigna Commercial |
$375.70
|
| Rate for Payer: First Health Commercial |
$397.80
|
| Rate for Payer: First Health Workers Compensation |
$170.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$397.80
|
| Rate for Payer: GEHA Commercial |
$353.60
|
| Rate for Payer: GEHA Medicare |
$1,945.14
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$397.80
|
| 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 |
$1,662.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,945.14
|
| Rate for Payer: Multiplan All |
$402.22
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,306.74
|
| Rate for Payer: OMNI Networks Commercial |
$309.40
|
| Rate for Payer: One Health Plan PPO/POS |
$397.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,919.20
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,662.17
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,945.14
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$419.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,890.28
|
| Rate for Payer: Three Rivers Provider Network All |
$331.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,906.24
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,662.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,945.14
|
| Rate for Payer: United Payors & United Providers UP&UP |
$411.06
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,945.14
|
| Rate for Payer: Zelis Auto |
$176.80
|
| 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 |
$120.67
|
|
|
BIOPSY OF URETHRA
|
Facility
|
IP
|
$442.00
|
|
|
Service Code
|
CPT 53200
|
| Hospital Charge Code |
6153200
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$120.67 |
| Max. Negotiated Rate |
$419.90 |
| Rate for Payer: Cash Price |
$265.20
|
| Rate for Payer: Cigna Commercial |
$375.70
|
| Rate for Payer: First Health Commercial |
$397.80
|
| Rate for Payer: First Health Workers Compensation |
$170.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$397.80
|
| Rate for Payer: GEHA Commercial |
$309.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$397.80
|
| Rate for Payer: Multiplan All |
$402.22
|
| Rate for Payer: OMNI Networks Commercial |
$309.40
|
| Rate for Payer: One Health Plan PPO/POS |
$397.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$419.90
|
| Rate for Payer: Three Rivers Provider Network All |
$331.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$411.06
|
| Rate for Payer: Zelis Auto |
$176.80
|
| Rate for Payer: Zelis Worker's Compensation |
$120.67
|
|
|
BIOPSY OF VAGINA
|
Facility
|
IP
|
$207.00
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
6157100
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$56.51 |
| Max. Negotiated Rate |
$196.65 |
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$175.95
|
| Rate for Payer: First Health Commercial |
$186.30
|
| Rate for Payer: First Health Workers Compensation |
$79.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$186.30
|
| Rate for Payer: GEHA Commercial |
$144.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$186.30
|
| Rate for Payer: Multiplan All |
$188.37
|
| Rate for Payer: OMNI Networks Commercial |
$144.90
|
| Rate for Payer: One Health Plan PPO/POS |
$186.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$196.65
|
| Rate for Payer: Three Rivers Provider Network All |
$155.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$192.51
|
| Rate for Payer: Zelis Auto |
$82.80
|
| Rate for Payer: Zelis Worker's Compensation |
$56.51
|
|
|
BIOPSY OF VAGINA
|
Facility
|
IP
|
$383.00
|
|
|
Service Code
|
CPT 57105
|
| Hospital Charge Code |
6157105
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$104.56 |
| Max. Negotiated Rate |
$363.85 |
| Rate for Payer: Cash Price |
$229.80
|
| Rate for Payer: Cigna Commercial |
$325.55
|
| Rate for Payer: First Health Commercial |
$344.70
|
| Rate for Payer: First Health Workers Compensation |
$147.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$344.70
|
| Rate for Payer: GEHA Commercial |
$268.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$344.70
|
| Rate for Payer: Multiplan All |
$348.53
|
| Rate for Payer: OMNI Networks Commercial |
$268.10
|
| Rate for Payer: One Health Plan PPO/POS |
$344.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$363.85
|
| Rate for Payer: Three Rivers Provider Network All |
$287.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$356.19
|
| Rate for Payer: Zelis Auto |
$153.20
|
| Rate for Payer: Zelis Worker's Compensation |
$104.56
|
|
|
BIOPSY OF VAGINA
|
Facility
|
OP
|
$207.00
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
6157100
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$56.51 |
| Max. Negotiated Rate |
$1,653.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$687.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$687.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$544.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$826.80
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cigna Commercial |
$175.95
|
| Rate for Payer: First Health Commercial |
$186.30
|
| Rate for Payer: First Health Workers Compensation |
$79.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$186.30
|
| Rate for Payer: GEHA Commercial |
$165.60
|
| Rate for Payer: GEHA Medicare |
$826.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$186.30
|
| Rate for Payer: Humana ChoiceCare |
$909.48
|
| Rate for Payer: Humana Medicare Advantage |
$826.80
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,389.02
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$555.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$826.80
|
| Rate for Payer: Multiplan All |
$188.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,405.56
|
| Rate for Payer: OMNI Networks Commercial |
$144.90
|
| Rate for Payer: One Health Plan PPO/POS |
$186.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$641.23
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$555.35
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$826.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$196.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,653.60
|
| Rate for Payer: Three Rivers Provider Network All |
$155.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$810.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$555.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$826.80
|
| Rate for Payer: United Payors & United Providers UP&UP |
$192.51
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$826.80
|
| Rate for Payer: Zelis Auto |
$82.80
|
| Rate for Payer: Zelis Medicare |
$702.78
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$992.16
|
| Rate for Payer: Zelis Worker's Compensation |
$56.51
|
|
|
BIOPSY OF VAGINA
|
Facility
|
OP
|
$383.00
|
|
|
Service Code
|
CPT 57105
|
| Hospital Charge Code |
6157105
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$104.56 |
| Max. Negotiated Rate |
$6,038.18 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,026.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$229.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,026.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,605.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,019.09
|
| Rate for Payer: Cash Price |
$229.80
|
| Rate for Payer: Cash Price |
$229.80
|
| Rate for Payer: Cigna Commercial |
$325.55
|
| Rate for Payer: First Health Commercial |
$344.70
|
| Rate for Payer: First Health Workers Compensation |
$147.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$344.70
|
| Rate for Payer: GEHA Commercial |
$306.40
|
| Rate for Payer: GEHA Medicare |
$3,019.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$344.70
|
| Rate for Payer: Humana ChoiceCare |
$3,321.00
|
| Rate for Payer: Humana Medicare Advantage |
$3,019.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,072.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,638.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,019.09
|
| Rate for Payer: Multiplan All |
$348.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,132.45
|
| Rate for Payer: OMNI Networks Commercial |
$268.10
|
| Rate for Payer: One Health Plan PPO/POS |
$344.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,891.64
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,638.29
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,019.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$363.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,038.18
|
| Rate for Payer: Three Rivers Provider Network All |
$287.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,958.71
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,638.29
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,019.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$356.19
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,019.09
|
| Rate for Payer: Zelis Auto |
$153.20
|
| Rate for Payer: Zelis Medicare |
$2,566.23
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,622.91
|
| Rate for Payer: Zelis Worker's Compensation |
$104.56
|
|
|
BIOPSY OF VAGINA
|
Facility
|
IP
|
$300.12
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
23557100
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$81.93 |
| Max. Negotiated Rate |
$285.11 |
| Rate for Payer: Cash Price |
$180.07
|
| Rate for Payer: Cigna Commercial |
$255.10
|
| Rate for Payer: First Health Commercial |
$270.11
|
| Rate for Payer: First Health Workers Compensation |
$115.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$270.11
|
| Rate for Payer: GEHA Commercial |
$210.08
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$270.11
|
| Rate for Payer: Multiplan All |
$273.11
|
| Rate for Payer: OMNI Networks Commercial |
$210.08
|
| Rate for Payer: One Health Plan PPO/POS |
$270.11
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$285.11
|
| Rate for Payer: Three Rivers Provider Network All |
$225.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$279.11
|
| Rate for Payer: Zelis Auto |
$120.05
|
| Rate for Payer: Zelis Worker's Compensation |
$81.93
|
|
|
BIOPSY OF VAGINA
|
Facility
|
OP
|
$300.12
|
|
|
Service Code
|
CPT 57100
|
| Hospital Charge Code |
23557100
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$81.93 |
| Max. Negotiated Rate |
$1,653.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$687.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$180.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$687.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$544.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$826.80
|
| Rate for Payer: Cash Price |
$180.07
|
| Rate for Payer: Cash Price |
$180.07
|
| Rate for Payer: Cigna Commercial |
$255.10
|
| Rate for Payer: First Health Commercial |
$270.11
|
| Rate for Payer: First Health Workers Compensation |
$115.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$270.11
|
| Rate for Payer: GEHA Commercial |
$240.10
|
| Rate for Payer: GEHA Medicare |
$826.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$270.11
|
| Rate for Payer: Humana ChoiceCare |
$909.48
|
| Rate for Payer: Humana Medicare Advantage |
$826.80
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,389.02
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$555.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$826.80
|
| Rate for Payer: Multiplan All |
$273.11
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,405.56
|
| Rate for Payer: OMNI Networks Commercial |
$210.08
|
| Rate for Payer: One Health Plan PPO/POS |
$270.11
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$641.23
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$555.35
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$826.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$285.11
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,653.60
|
| Rate for Payer: Three Rivers Provider Network All |
$225.09
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$810.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$555.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$826.80
|
| Rate for Payer: United Payors & United Providers UP&UP |
$279.11
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$826.80
|
| Rate for Payer: Zelis Auto |
$120.05
|
| Rate for Payer: Zelis Medicare |
$702.78
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$992.16
|
| Rate for Payer: Zelis Worker's Compensation |
$81.93
|
|
