|
RESECT FEMUR/KNEE TUMOR
|
Facility
|
OP
|
$4,298.00
|
|
|
Service Code
|
CPT 27365
|
| Hospital Charge Code |
6127365
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,074.50 |
| Max. Negotiated Rate |
$4,083.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,578.80
|
| Rate for Payer: Cash Price |
$2,578.80
|
| Rate for Payer: Cigna Commercial |
$3,653.30
|
| Rate for Payer: First Health Commercial |
$3,868.20
|
| Rate for Payer: First Health Workers Compensation |
$1,659.46
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,868.20
|
| Rate for Payer: GEHA Commercial |
$3,438.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,868.20
|
| Rate for Payer: Humana ChoiceCare |
$1,117.48
|
| Rate for Payer: Multiplan All |
$3,911.18
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,578.80
|
| Rate for Payer: OMNI Networks Commercial |
$3,008.60
|
| Rate for Payer: One Health Plan PPO/POS |
$3,868.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,083.10
|
| Rate for Payer: Three Rivers Provider Network All |
$3,223.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,782.24
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,074.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,997.14
|
| Rate for Payer: Zelis Auto |
$1,719.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,149.00
|
| Rate for Payer: Zelis Worker's Compensation |
$1,173.35
|
|
|
RESECT FEMUR/KNEE TUMOR
|
Facility
|
IP
|
$4,298.00
|
|
|
Service Code
|
CPT 27365
|
| Hospital Charge Code |
6127365
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,173.35 |
| Max. Negotiated Rate |
$4,083.10 |
| Rate for Payer: Cash Price |
$2,578.80
|
| Rate for Payer: Cigna Commercial |
$3,653.30
|
| Rate for Payer: First Health Commercial |
$3,868.20
|
| Rate for Payer: First Health Workers Compensation |
$1,659.46
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,868.20
|
| Rate for Payer: GEHA Commercial |
$3,008.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,868.20
|
| Rate for Payer: Multiplan All |
$3,911.18
|
| Rate for Payer: OMNI Networks Commercial |
$3,008.60
|
| Rate for Payer: One Health Plan PPO/POS |
$3,868.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,083.10
|
| Rate for Payer: Three Rivers Provider Network All |
$3,223.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,997.14
|
| Rate for Payer: Zelis Auto |
$1,719.20
|
| Rate for Payer: Zelis Worker's Compensation |
$1,173.35
|
|
|
RESECT FIBULA TUMOR
|
Facility
|
OP
|
$3,188.00
|
|
|
Service Code
|
CPT 27646
|
| Hospital Charge Code |
6127646
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$797.00 |
| Max. Negotiated Rate |
$3,028.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,912.80
|
| Rate for Payer: Cash Price |
$1,912.80
|
| Rate for Payer: Cigna Commercial |
$2,709.80
|
| Rate for Payer: First Health Commercial |
$2,869.20
|
| Rate for Payer: First Health Workers Compensation |
$1,230.89
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,869.20
|
| Rate for Payer: GEHA Commercial |
$2,550.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,869.20
|
| Rate for Payer: Humana ChoiceCare |
$828.88
|
| Rate for Payer: Multiplan All |
$2,901.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,912.80
|
| Rate for Payer: OMNI Networks Commercial |
$2,231.60
|
| Rate for Payer: One Health Plan PPO/POS |
$2,869.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,028.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,391.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,805.44
|
| Rate for Payer: United Healthcare Managed Medicaid |
$797.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,964.84
|
| Rate for Payer: Zelis Auto |
$1,275.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,594.00
|
| Rate for Payer: Zelis Worker's Compensation |
$870.32
|
|
|
RESECT FIBULA TUMOR
|
Facility
|
IP
|
$3,188.00
|
|
|
Service Code
|
CPT 27646
|
| Hospital Charge Code |
6127646
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$870.32 |
| Max. Negotiated Rate |
$3,028.60 |
| Rate for Payer: Cash Price |
$1,912.80
|
| Rate for Payer: Cigna Commercial |
$2,709.80
|
| Rate for Payer: First Health Commercial |
$2,869.20
|
| Rate for Payer: First Health Workers Compensation |
$1,230.89
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,869.20
|
| Rate for Payer: GEHA Commercial |
$2,231.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,869.20
|
| Rate for Payer: Multiplan All |
$2,901.08
|
| Rate for Payer: OMNI Networks Commercial |
$2,231.60
|
| Rate for Payer: One Health Plan PPO/POS |
$2,869.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,028.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,391.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,964.84
|
| Rate for Payer: Zelis Auto |
$1,275.20
|
| Rate for Payer: Zelis Worker's Compensation |
$870.32
|
|
|
RESECT FOOT/TOE TUMOR < 3 CM
|
Facility
|
IP
|
$1,503.00
|
|
|
Service Code
|
CPT 28046
|
| Hospital Charge Code |
6128046
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$410.32 |
| Max. Negotiated Rate |
$1,427.85 |
| Rate for Payer: Cash Price |
$901.80
|
| Rate for Payer: Cigna Commercial |
$1,277.55
|
| Rate for Payer: First Health Commercial |
$1,352.70
|
| Rate for Payer: First Health Workers Compensation |
$580.31
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,352.70
|
| Rate for Payer: GEHA Commercial |
$1,052.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,352.70
|
| Rate for Payer: Multiplan All |
$1,367.73
|
| Rate for Payer: OMNI Networks Commercial |
$1,052.10
|
| Rate for Payer: One Health Plan PPO/POS |
$1,352.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,427.85
|
| Rate for Payer: Three Rivers Provider Network All |
$1,127.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,397.79
|
| Rate for Payer: Zelis Auto |
$601.20
|
| Rate for Payer: Zelis Worker's Compensation |
$410.32
|
|
|
RESECT FOOT/TOE TUMOR < 3 CM
|
Facility
|
OP
|
$1,503.00
|
|
|
Service Code
|
CPT 28046
|
| Hospital Charge Code |
6128046
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$410.32 |
| Max. Negotiated Rate |
$5,435.26 |
| 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 |
$901.80
|
| 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 |
$2,717.63
|
| Rate for Payer: Cash Price |
$901.80
|
| Rate for Payer: Cash Price |
$901.80
|
| Rate for Payer: Cigna Commercial |
$1,277.55
|
| Rate for Payer: First Health Commercial |
$1,352.70
|
| Rate for Payer: First Health Workers Compensation |
$580.31
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,352.70
|
| Rate for Payer: GEHA Commercial |
$1,202.40
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,352.70
|
| 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 |
$1,430.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,717.63
|
| Rate for Payer: Multiplan All |
$1,367.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$1,052.10
|
| Rate for Payer: One Health Plan PPO/POS |
$1,352.70
|
| 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 |
$2,717.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,427.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$1,127.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,663.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,430.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,717.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,397.79
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$601.20
|
| 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 |
$410.32
|
|
|
RESECT FOOT/TOE TUMOR > 3 CM
|
Facility
|
IP
|
$2,216.00
|
|
|
Service Code
|
CPT 28047
|
| Hospital Charge Code |
6128047
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$604.97 |
| Max. Negotiated Rate |
$2,105.20 |
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cigna Commercial |
$1,883.60
|
| Rate for Payer: First Health Commercial |
$1,994.40
|
| Rate for Payer: First Health Workers Compensation |
$855.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,994.40
|
| Rate for Payer: GEHA Commercial |
$1,551.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,994.40
|
| Rate for Payer: Multiplan All |
$2,016.56
|
| Rate for Payer: OMNI Networks Commercial |
$1,551.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,994.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,105.20
|
| Rate for Payer: Three Rivers Provider Network All |
$1,662.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,060.88
|
| Rate for Payer: Zelis Auto |
$886.40
|
| Rate for Payer: Zelis Worker's Compensation |
$604.97
|
|
|
RESECT FOOT/TOE TUMOR > 3 CM
|
Facility
|
OP
|
$2,216.00
|
|
|
Service Code
|
CPT 28047
|
| Hospital Charge Code |
6128047
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$604.97 |
| Max. Negotiated Rate |
$5,435.26 |
| 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 |
$1,329.60
|
| 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 |
$2,717.63
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cigna Commercial |
$1,883.60
|
| Rate for Payer: First Health Commercial |
$1,994.40
|
| Rate for Payer: First Health Workers Compensation |
$855.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,994.40
|
| Rate for Payer: GEHA Commercial |
$1,772.80
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,994.40
|
| 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 |
$1,911.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,717.63
|
| Rate for Payer: Multiplan All |
$2,016.56
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$1,551.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,994.40
|
| 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 |
$2,717.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,105.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$1,662.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,663.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,911.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,717.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,060.88
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$886.40
|
| 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 |
$604.97
|
|
|
RESECT FORARM/WRIST TUM 3CM>
|
Facility
|
IP
|
$2,409.00
|
|
|
Service Code
|
CPT 25078
|
| Hospital Charge Code |
6125078
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$657.66 |
| Max. Negotiated Rate |
$2,288.55 |
| Rate for Payer: Cash Price |
$1,445.40
|
| Rate for Payer: Cigna Commercial |
$2,047.65
|
| Rate for Payer: First Health Commercial |
$2,168.10
|
| Rate for Payer: First Health Workers Compensation |
$930.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,168.10
|
| Rate for Payer: GEHA Commercial |
$1,686.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,168.10
|
| Rate for Payer: Multiplan All |
$2,192.19
|
| Rate for Payer: OMNI Networks Commercial |
$1,686.30
|
| Rate for Payer: One Health Plan PPO/POS |
$2,168.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,288.55
|
| Rate for Payer: Three Rivers Provider Network All |
$1,806.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,240.37
|
| Rate for Payer: Zelis Auto |
$963.60
|
| Rate for Payer: Zelis Worker's Compensation |
$657.66
|
|
|
RESECT FORARM/WRIST TUM 3CM>
|
Facility
|
OP
|
$2,409.00
|
|
|
Service Code
|
CPT 25078
|
| Hospital Charge Code |
6125078
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$657.66 |
| Max. Negotiated Rate |
$5,435.26 |
| 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 |
$1,445.40
|
| 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 |
$2,717.63
|
| Rate for Payer: Cash Price |
$1,445.40
|
| Rate for Payer: Cash Price |
$1,445.40
|
| Rate for Payer: Cigna Commercial |
$2,047.65
|
| Rate for Payer: First Health Commercial |
$2,168.10
|
| Rate for Payer: First Health Workers Compensation |
$930.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,168.10
|
| Rate for Payer: GEHA Commercial |
$1,927.20
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,168.10
|
| 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 |
$1,911.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,717.63
|
| Rate for Payer: Multiplan All |
$2,192.19
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$1,686.30
|
| Rate for Payer: One Health Plan PPO/POS |
$2,168.10
|
| 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 |
$2,717.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,288.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$1,806.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,663.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,911.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,717.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,240.37
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$963.60
|
| 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 |
$657.66
|
|
|
RESECT FOREARM/WRIST TUM<3CM
|
Facility
|
OP
|
$1,826.00
|
|
|
Service Code
|
CPT 25077
|
| Hospital Charge Code |
6125077
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$498.50 |
| Max. Negotiated Rate |
$5,435.26 |
| 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 |
$1,095.60
|
| 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 |
$2,717.63
|
| Rate for Payer: Cash Price |
$1,095.60
|
| Rate for Payer: Cash Price |
$1,095.60
|
| Rate for Payer: Cigna Commercial |
$1,552.10
|
| Rate for Payer: First Health Commercial |
$1,643.40
|
| Rate for Payer: First Health Workers Compensation |
$705.02
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,643.40
|
| Rate for Payer: GEHA Commercial |
$1,460.80
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,643.40
|
| 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 |
$1,430.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,717.63
|
| Rate for Payer: Multiplan All |
$1,661.66
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$1,278.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,643.40
|
| 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 |
$2,717.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,734.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$1,369.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,663.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,430.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,717.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,698.18
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$730.40
|
| 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 |
$498.50
|
|
|
RESECT FOREARM/WRIST TUM<3CM
|
Facility
|
IP
|
$1,826.00
|
|
|
Service Code
|
CPT 25077
|
| Hospital Charge Code |
6125077
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$498.50 |
| Max. Negotiated Rate |
$1,734.70 |
| Rate for Payer: Cash Price |
$1,095.60
|
| Rate for Payer: Cigna Commercial |
$1,552.10
|
| Rate for Payer: First Health Commercial |
$1,643.40
|
| Rate for Payer: First Health Workers Compensation |
$705.02
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,643.40
|
| Rate for Payer: GEHA Commercial |
$1,278.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,643.40
|
| Rate for Payer: Multiplan All |
$1,661.66
|
| Rate for Payer: OMNI Networks Commercial |
$1,278.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,643.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,734.70
|
| Rate for Payer: Three Rivers Provider Network All |
$1,369.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,698.18
|
| Rate for Payer: Zelis Auto |
$730.40
|
| Rate for Payer: Zelis Worker's Compensation |
$498.50
|
|
|
RESECT HIP/PELV TUM < 5 CM
|
Facility
|
IP
|
$2,807.00
|
|
|
Service Code
|
CPT 27049
|
| Hospital Charge Code |
6127049
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$766.31 |
| Max. Negotiated Rate |
$2,666.65 |
| Rate for Payer: Cash Price |
$1,684.20
|
| Rate for Payer: Cigna Commercial |
$2,385.95
|
| Rate for Payer: First Health Commercial |
$2,526.30
|
| Rate for Payer: First Health Workers Compensation |
$1,083.78
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,526.30
|
| Rate for Payer: GEHA Commercial |
$1,964.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,526.30
|
| Rate for Payer: Multiplan All |
$2,554.37
|
| Rate for Payer: OMNI Networks Commercial |
$1,964.90
|
| Rate for Payer: One Health Plan PPO/POS |
$2,526.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,666.65
|
| Rate for Payer: Three Rivers Provider Network All |
$2,105.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,610.51
|
| Rate for Payer: Zelis Auto |
$1,122.80
|
| Rate for Payer: Zelis Worker's Compensation |
$766.31
|
|
|
RESECT HIP/PELV TUM < 5 CM
|
Facility
|
OP
|
$2,807.00
|
|
|
Service Code
|
CPT 27049
|
| Hospital Charge Code |
6127049
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$766.31 |
| Max. Negotiated Rate |
$5,435.26 |
| 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 |
$1,684.20
|
| 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 |
$2,717.63
|
| Rate for Payer: Cash Price |
$1,684.20
|
| Rate for Payer: Cash Price |
$1,684.20
|
| Rate for Payer: Cigna Commercial |
$2,385.95
|
| Rate for Payer: First Health Commercial |
$2,526.30
|
| Rate for Payer: First Health Workers Compensation |
$1,083.78
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,526.30
|
| Rate for Payer: GEHA Commercial |
$2,245.60
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,526.30
|
| 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 |
$1,430.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,717.63
|
| Rate for Payer: Multiplan All |
$2,554.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$1,964.90
|
| Rate for Payer: One Health Plan PPO/POS |
$2,526.30
|
| 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 |
$2,717.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,666.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$2,105.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,663.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,430.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,717.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,610.51
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$1,122.80
|
| 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 |
$766.31
|
|
|
RESECT HIP/PELV TUM 5 CM/>
|
Facility
|
OP
|
$3,791.00
|
|
|
Service Code
|
CPT 27059
|
| Hospital Charge Code |
6127059
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,034.94 |
| Max. Negotiated Rate |
$5,435.26 |
| 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 |
$2,274.60
|
| 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 |
$2,717.63
|
| Rate for Payer: Cash Price |
$2,274.60
|
| Rate for Payer: Cash Price |
$2,274.60
|
| Rate for Payer: Cigna Commercial |
$3,222.35
|
| Rate for Payer: First Health Commercial |
$3,411.90
|
| Rate for Payer: First Health Workers Compensation |
$1,463.71
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,411.90
|
| Rate for Payer: GEHA Commercial |
$3,032.80
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,411.90
|
| 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 |
$1,911.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,717.63
|
| Rate for Payer: Multiplan All |
$3,449.81
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$2,653.70
|
| Rate for Payer: One Health Plan PPO/POS |
$3,411.90
|
| 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 |
$2,717.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,601.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$2,843.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,663.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,911.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,717.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,525.63
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$1,516.40
|
| 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 |
$1,034.94
|
|
|
RESECT HIP/PELV TUM 5 CM/>
|
Facility
|
IP
|
$3,791.00
|
|
|
Service Code
|
CPT 27059
|
| Hospital Charge Code |
6127059
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,034.94 |
| Max. Negotiated Rate |
$3,601.45 |
| Rate for Payer: Cash Price |
$2,274.60
|
| Rate for Payer: Cigna Commercial |
$3,222.35
|
| Rate for Payer: First Health Commercial |
$3,411.90
|
| Rate for Payer: First Health Workers Compensation |
$1,463.71
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,411.90
|
| Rate for Payer: GEHA Commercial |
$2,653.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,411.90
|
| Rate for Payer: Multiplan All |
$3,449.81
|
| Rate for Payer: OMNI Networks Commercial |
$2,653.70
|
| Rate for Payer: One Health Plan PPO/POS |
$3,411.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,601.45
|
| Rate for Payer: Three Rivers Provider Network All |
$2,843.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,525.63
|
| Rate for Payer: Zelis Auto |
$1,516.40
|
| Rate for Payer: Zelis Worker's Compensation |
$1,034.94
|
|
|
RESECT HIP TUM INCL ACETABUL
|
Facility
|
OP
|
$5,259.00
|
|
|
Service Code
|
CPT 27076
|
| Hospital Charge Code |
6127076
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,314.75 |
| Max. Negotiated Rate |
$4,996.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,155.40
|
| Rate for Payer: Cash Price |
$3,155.40
|
| Rate for Payer: Cigna Commercial |
$4,470.15
|
| Rate for Payer: First Health Commercial |
$4,733.10
|
| Rate for Payer: First Health Workers Compensation |
$2,030.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,733.10
|
| Rate for Payer: GEHA Commercial |
$4,207.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,733.10
|
| Rate for Payer: Humana ChoiceCare |
$1,367.34
|
| Rate for Payer: Multiplan All |
$4,785.69
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,155.40
|
| Rate for Payer: OMNI Networks Commercial |
$3,681.30
|
| Rate for Payer: One Health Plan PPO/POS |
$4,733.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,996.05
|
| Rate for Payer: Three Rivers Provider Network All |
$3,944.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4,627.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,314.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,890.87
|
| Rate for Payer: Zelis Auto |
$2,103.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,629.50
|
| Rate for Payer: Zelis Worker's Compensation |
$1,435.71
|
|
|
RESECT HIP TUM INCL ACETABUL
|
Facility
|
IP
|
$5,259.00
|
|
|
Service Code
|
CPT 27076
|
| Hospital Charge Code |
6127076
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,435.71 |
| Max. Negotiated Rate |
$4,996.05 |
| Rate for Payer: Cash Price |
$3,155.40
|
| Rate for Payer: Cigna Commercial |
$4,470.15
|
| Rate for Payer: First Health Commercial |
$4,733.10
|
| Rate for Payer: First Health Workers Compensation |
$2,030.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,733.10
|
| Rate for Payer: GEHA Commercial |
$3,681.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,733.10
|
| Rate for Payer: Multiplan All |
$4,785.69
|
| Rate for Payer: OMNI Networks Commercial |
$3,681.30
|
| Rate for Payer: One Health Plan PPO/POS |
$4,733.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,996.05
|
| Rate for Payer: Three Rivers Provider Network All |
$3,944.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,890.87
|
| Rate for Payer: Zelis Auto |
$2,103.60
|
| Rate for Payer: Zelis Worker's Compensation |
$1,435.71
|
|
|
RESECT HIP TUMOR
|
Facility
|
OP
|
$4,352.00
|
|
|
Service Code
|
CPT 27075
|
| Hospital Charge Code |
6127075
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,088.00 |
| Max. Negotiated Rate |
$4,134.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,611.20
|
| Rate for Payer: Cash Price |
$2,611.20
|
| Rate for Payer: Cigna Commercial |
$3,699.20
|
| Rate for Payer: First Health Commercial |
$3,916.80
|
| Rate for Payer: First Health Workers Compensation |
$1,680.31
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,916.80
|
| Rate for Payer: GEHA Commercial |
$3,481.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,916.80
|
| Rate for Payer: Humana ChoiceCare |
$1,131.52
|
| Rate for Payer: Multiplan All |
$3,960.32
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,611.20
|
| Rate for Payer: OMNI Networks Commercial |
$3,046.40
|
| Rate for Payer: One Health Plan PPO/POS |
$3,916.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,134.40
|
| Rate for Payer: Three Rivers Provider Network All |
$3,264.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,829.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,088.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,047.36
|
| Rate for Payer: Zelis Auto |
$1,740.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,176.00
|
| Rate for Payer: Zelis Worker's Compensation |
$1,188.10
|
|
|
RESECT HIP TUMOR
|
Facility
|
IP
|
$4,352.00
|
|
|
Service Code
|
CPT 27075
|
| Hospital Charge Code |
6127075
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,188.10 |
| Max. Negotiated Rate |
$4,134.40 |
| Rate for Payer: Cash Price |
$2,611.20
|
| Rate for Payer: Cigna Commercial |
$3,699.20
|
| Rate for Payer: First Health Commercial |
$3,916.80
|
| Rate for Payer: First Health Workers Compensation |
$1,680.31
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,916.80
|
| Rate for Payer: GEHA Commercial |
$3,046.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,916.80
|
| Rate for Payer: Multiplan All |
$3,960.32
|
| Rate for Payer: OMNI Networks Commercial |
$3,046.40
|
| Rate for Payer: One Health Plan PPO/POS |
$3,916.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,134.40
|
| Rate for Payer: Three Rivers Provider Network All |
$3,264.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,047.36
|
| Rate for Payer: Zelis Auto |
$1,740.80
|
| Rate for Payer: Zelis Worker's Compensation |
$1,188.10
|
|
|
RESECT HIP TUM W/INNOM BONE
|
Facility
|
OP
|
$5,916.00
|
|
|
Service Code
|
CPT 27077
|
| Hospital Charge Code |
6127077
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,479.00 |
| Max. Negotiated Rate |
$5,620.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,549.60
|
| Rate for Payer: Cash Price |
$3,549.60
|
| Rate for Payer: Cigna Commercial |
$5,028.60
|
| Rate for Payer: First Health Commercial |
$5,324.40
|
| Rate for Payer: First Health Workers Compensation |
$2,284.17
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$5,324.40
|
| Rate for Payer: GEHA Commercial |
$4,732.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$5,324.40
|
| Rate for Payer: Humana ChoiceCare |
$1,538.16
|
| Rate for Payer: Multiplan All |
$5,383.56
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,549.60
|
| Rate for Payer: OMNI Networks Commercial |
$4,141.20
|
| Rate for Payer: One Health Plan PPO/POS |
$5,324.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,620.20
|
| Rate for Payer: Three Rivers Provider Network All |
$4,437.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,206.08
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,479.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5,501.88
|
| Rate for Payer: Zelis Auto |
$2,366.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,958.00
|
| Rate for Payer: Zelis Worker's Compensation |
$1,615.07
|
|
|
RESECT HIP TUM W/INNOM BONE
|
Facility
|
IP
|
$5,916.00
|
|
|
Service Code
|
CPT 27077
|
| Hospital Charge Code |
6127077
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,615.07 |
| Max. Negotiated Rate |
$5,620.20 |
| Rate for Payer: Cash Price |
$3,549.60
|
| Rate for Payer: Cigna Commercial |
$5,028.60
|
| Rate for Payer: First Health Commercial |
$5,324.40
|
| Rate for Payer: First Health Workers Compensation |
$2,284.17
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$5,324.40
|
| Rate for Payer: GEHA Commercial |
$4,141.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$5,324.40
|
| Rate for Payer: Multiplan All |
$5,383.56
|
| Rate for Payer: OMNI Networks Commercial |
$4,141.20
|
| Rate for Payer: One Health Plan PPO/POS |
$5,324.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,620.20
|
| Rate for Payer: Three Rivers Provider Network All |
$4,437.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5,501.88
|
| Rate for Payer: Zelis Auto |
$2,366.40
|
| Rate for Payer: Zelis Worker's Compensation |
$1,615.07
|
|
|
RESECT INFERIOR TURBINATE
|
Facility
|
OP
|
$874.00
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
6130140
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$238.60 |
| 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 |
$524.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,524.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,999.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,079.42
|
| Rate for Payer: Cash Price |
$524.40
|
| Rate for Payer: Cash Price |
$524.40
|
| Rate for Payer: Cigna Commercial |
$742.90
|
| Rate for Payer: First Health Commercial |
$786.60
|
| Rate for Payer: First Health Workers Compensation |
$337.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$786.60
|
| Rate for Payer: GEHA Commercial |
$699.20
|
| Rate for Payer: GEHA Medicare |
$3,079.42
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$786.60
|
| Rate for Payer: Humana ChoiceCare |
$3,387.36
|
| Rate for Payer: Humana Medicare Advantage |
$3,079.42
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,173.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,040.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,079.42
|
| Rate for Payer: Multiplan All |
$795.34
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,235.01
|
| Rate for Payer: OMNI Networks Commercial |
$611.80
|
| Rate for Payer: One Health Plan PPO/POS |
$786.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,355.78
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,040.27
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,079.42
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$830.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,158.84
|
| Rate for Payer: Three Rivers Provider Network All |
$655.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,017.83
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,040.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,079.42
|
| Rate for Payer: United Payors & United Providers UP&UP |
$812.82
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,079.42
|
| Rate for Payer: Zelis Auto |
$349.60
|
| Rate for Payer: Zelis Medicare |
$2,617.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,695.30
|
| Rate for Payer: Zelis Worker's Compensation |
$238.60
|
|
|
RESECT INFERIOR TURBINATE
|
Facility
|
IP
|
$874.00
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
6130140
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$238.60 |
| Max. Negotiated Rate |
$830.30 |
| Rate for Payer: Cash Price |
$524.40
|
| Rate for Payer: Cigna Commercial |
$742.90
|
| Rate for Payer: First Health Commercial |
$786.60
|
| Rate for Payer: First Health Workers Compensation |
$337.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$786.60
|
| Rate for Payer: GEHA Commercial |
$611.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$786.60
|
| Rate for Payer: Multiplan All |
$795.34
|
| Rate for Payer: OMNI Networks Commercial |
$611.80
|
| Rate for Payer: One Health Plan PPO/POS |
$786.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$830.30
|
| Rate for Payer: Three Rivers Provider Network All |
$655.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$812.82
|
| Rate for Payer: Zelis Auto |
$349.60
|
| Rate for Payer: Zelis Worker's Compensation |
$238.60
|
|
|
RESECTION, PARTIAL OR COMPLETE, PHALANGEAL BASE, EACH TOE
|
Facility
|
OP
|
$6,161.78
|
|
|
Service Code
|
CPT 28126
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,749.66 |
| 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 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: First Health Workers Compensation |
$3,965.11
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| 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: New Mexico Health Connections Medicare |
$5,237.51
|
| 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 Worker's Compensation |
$6,161.78
|
| 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: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| 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 |
$2,803.61
|
|
