|
RESECT LEG/ANKLE TUM < 5 CM
|
Facility
|
OP
|
$2,120.00
|
|
|
Service Code
|
CPT 27615
|
| Hospital Charge Code |
6127615
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$578.76 |
| 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 |
$1,272.00
|
| 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 |
$1,272.00
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cigna Commercial |
$1,802.00
|
| Rate for Payer: First Health Commercial |
$1,908.00
|
| Rate for Payer: First Health Workers Compensation |
$818.53
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,908.00
|
| Rate for Payer: GEHA Commercial |
$1,696.00
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,908.00
|
| 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 |
$1,430.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,717.63
|
| Rate for Payer: Multiplan All |
$1,929.20
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$1,484.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,908.00
|
| 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 |
$2,014.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$1,590.00
|
| 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 |
$1,971.60
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$848.00
|
| 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 |
$578.76
|
|
|
RESECT LEG/ANKLE TUM < 5 CM
|
Facility
|
IP
|
$2,120.00
|
|
|
Service Code
|
CPT 27615
|
| Hospital Charge Code |
6127615
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$578.76 |
| Max. Negotiated Rate |
$2,014.00 |
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cigna Commercial |
$1,802.00
|
| Rate for Payer: First Health Commercial |
$1,908.00
|
| Rate for Payer: First Health Workers Compensation |
$818.53
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,908.00
|
| Rate for Payer: GEHA Commercial |
$1,484.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,908.00
|
| Rate for Payer: Multiplan All |
$1,929.20
|
| Rate for Payer: OMNI Networks Commercial |
$1,484.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,908.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,014.00
|
| Rate for Payer: Three Rivers Provider Network All |
$1,590.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,971.60
|
| Rate for Payer: Zelis Auto |
$848.00
|
| Rate for Payer: Zelis Worker's Compensation |
$578.76
|
|
|
RESECT LEG/ANKLE TUM 5 CM/>
|
Facility
|
IP
|
$2,638.00
|
|
|
Service Code
|
CPT 27616
|
| Hospital Charge Code |
6127616
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$720.17 |
| Max. Negotiated Rate |
$2,506.10 |
| Rate for Payer: Cash Price |
$1,582.80
|
| Rate for Payer: Cigna Commercial |
$2,242.30
|
| Rate for Payer: First Health Commercial |
$2,374.20
|
| Rate for Payer: First Health Workers Compensation |
$1,018.53
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,374.20
|
| Rate for Payer: GEHA Commercial |
$1,846.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,374.20
|
| Rate for Payer: Multiplan All |
$2,400.58
|
| Rate for Payer: OMNI Networks Commercial |
$1,846.60
|
| Rate for Payer: One Health Plan PPO/POS |
$2,374.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,506.10
|
| Rate for Payer: Three Rivers Provider Network All |
$1,978.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,453.34
|
| Rate for Payer: Zelis Auto |
$1,055.20
|
| Rate for Payer: Zelis Worker's Compensation |
$720.17
|
|
|
RESECT LEG/ANKLE TUM 5 CM/>
|
Facility
|
OP
|
$2,638.00
|
|
|
Service Code
|
CPT 27616
|
| Hospital Charge Code |
6127616
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$720.17 |
| 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 |
$1,582.80
|
| 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 |
$1,582.80
|
| Rate for Payer: Cash Price |
$1,582.80
|
| Rate for Payer: Cigna Commercial |
$2,242.30
|
| Rate for Payer: First Health Commercial |
$2,374.20
|
| Rate for Payer: First Health Workers Compensation |
$1,018.53
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,374.20
|
| Rate for Payer: GEHA Commercial |
$2,110.40
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,374.20
|
| 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 |
$2,400.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$1,846.60
|
| Rate for Payer: One Health Plan PPO/POS |
$2,374.20
|
| 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 |
$2,506.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$1,978.50
|
| 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 |
$2,453.34
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$1,055.20
|
| 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 |
$720.17
|
|
|
RESECT MEDIASTINAL CYST
|
Facility
|
OP
|
$1,862.00
|
|
|
Service Code
|
CPT 39200
|
| Hospital Charge Code |
6139200
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$465.50 |
| Max. Negotiated Rate |
$1,768.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,117.20
|
| Rate for Payer: Cash Price |
$1,117.20
|
| Rate for Payer: Cigna Commercial |
$1,582.70
|
| Rate for Payer: First Health Commercial |
$1,675.80
|
| Rate for Payer: First Health Workers Compensation |
$718.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,675.80
|
| Rate for Payer: GEHA Commercial |
$1,489.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,675.80
|
| Rate for Payer: Humana ChoiceCare |
$484.12
|
| Rate for Payer: Multiplan All |
$1,694.42
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,117.20
|
| Rate for Payer: OMNI Networks Commercial |
$1,303.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,675.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,768.90
|
| Rate for Payer: Three Rivers Provider Network All |
$1,396.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,638.56
|
| Rate for Payer: United Healthcare Managed Medicaid |
$465.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,731.66
|
| Rate for Payer: Zelis Auto |
$744.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$931.00
|
| Rate for Payer: Zelis Worker's Compensation |
$508.33
|
|
|
RESECT MEDIASTINAL CYST
|
Facility
|
IP
|
$1,862.00
|
|
|
Service Code
|
CPT 39200
|
| Hospital Charge Code |
6139200
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$508.33 |
| Max. Negotiated Rate |
$1,768.90 |
| Rate for Payer: Cash Price |
$1,117.20
|
| Rate for Payer: Cigna Commercial |
$1,582.70
|
| Rate for Payer: First Health Commercial |
$1,675.80
|
| Rate for Payer: First Health Workers Compensation |
$718.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,675.80
|
| Rate for Payer: GEHA Commercial |
$1,303.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,675.80
|
| Rate for Payer: Multiplan All |
$1,694.42
|
| Rate for Payer: OMNI Networks Commercial |
$1,303.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,675.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,768.90
|
| Rate for Payer: Three Rivers Provider Network All |
$1,396.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,731.66
|
| Rate for Payer: Zelis Auto |
$744.80
|
| Rate for Payer: Zelis Worker's Compensation |
$508.33
|
|
|
RESECT MEDIASTINAL TUMOR
|
Facility
|
IP
|
$2,401.00
|
|
|
Service Code
|
CPT 39220
|
| Hospital Charge Code |
6139220
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$655.47 |
| Max. Negotiated Rate |
$2,280.95 |
| Rate for Payer: Cash Price |
$1,440.60
|
| Rate for Payer: Cigna Commercial |
$2,040.85
|
| Rate for Payer: First Health Commercial |
$2,160.90
|
| Rate for Payer: First Health Workers Compensation |
$927.03
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,160.90
|
| Rate for Payer: GEHA Commercial |
$1,680.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,160.90
|
| Rate for Payer: Multiplan All |
$2,184.91
|
| Rate for Payer: OMNI Networks Commercial |
$1,680.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,160.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,280.95
|
| Rate for Payer: Three Rivers Provider Network All |
$1,800.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,232.93
|
| Rate for Payer: Zelis Auto |
$960.40
|
| Rate for Payer: Zelis Worker's Compensation |
$655.47
|
|
|
RESECT MEDIASTINAL TUMOR
|
Facility
|
OP
|
$2,401.00
|
|
|
Service Code
|
CPT 39220
|
| Hospital Charge Code |
6139220
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$600.25 |
| Max. Negotiated Rate |
$2,280.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,440.60
|
| Rate for Payer: Cash Price |
$1,440.60
|
| Rate for Payer: Cigna Commercial |
$2,040.85
|
| Rate for Payer: First Health Commercial |
$2,160.90
|
| Rate for Payer: First Health Workers Compensation |
$927.03
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,160.90
|
| Rate for Payer: GEHA Commercial |
$1,920.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,160.90
|
| Rate for Payer: Humana ChoiceCare |
$624.26
|
| Rate for Payer: Multiplan All |
$2,184.91
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,440.60
|
| Rate for Payer: OMNI Networks Commercial |
$1,680.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,160.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,280.95
|
| Rate for Payer: Three Rivers Provider Network All |
$1,800.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,112.88
|
| Rate for Payer: United Healthcare Managed Medicaid |
$600.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,232.93
|
| Rate for Payer: Zelis Auto |
$960.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,200.50
|
| Rate for Payer: Zelis Worker's Compensation |
$655.47
|
|
|
RESECT METATARSAL TUMOR
|
Facility
|
OP
|
$1,572.00
|
|
|
Service Code
|
CPT 28173
|
| Hospital Charge Code |
6128173
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$429.16 |
| 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 |
$943.20
|
| 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 |
$943.20
|
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Cigna Commercial |
$1,336.20
|
| Rate for Payer: First Health Commercial |
$1,414.80
|
| Rate for Payer: First Health Workers Compensation |
$606.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,414.80
|
| Rate for Payer: GEHA Commercial |
$1,257.60
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,414.80
|
| Rate for Payer: Humana ChoiceCare |
$3,388.98
|
| Rate for Payer: Humana Medicare Advantage |
$3,080.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,175.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,785.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$1,430.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$1,100.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,414.80
|
| 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 |
$1,493.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$1,179.00
|
| 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 |
$1,461.96
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$628.80
|
| 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 |
$429.16
|
|
|
RESECT METATARSAL TUMOR
|
Facility
|
IP
|
$1,572.00
|
|
|
Service Code
|
CPT 28173
|
| Hospital Charge Code |
6128173
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$429.16 |
| Max. Negotiated Rate |
$1,493.40 |
| Rate for Payer: Cash Price |
$943.20
|
| Rate for Payer: Cigna Commercial |
$1,336.20
|
| Rate for Payer: First Health Commercial |
$1,414.80
|
| Rate for Payer: First Health Workers Compensation |
$606.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,414.80
|
| Rate for Payer: GEHA Commercial |
$1,100.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,414.80
|
| Rate for Payer: Multiplan All |
$1,430.52
|
| Rate for Payer: OMNI Networks Commercial |
$1,100.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,414.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,493.40
|
| Rate for Payer: Three Rivers Provider Network All |
$1,179.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,461.96
|
| Rate for Payer: Zelis Auto |
$628.80
|
| Rate for Payer: Zelis Worker's Compensation |
$429.16
|
|
|
RESECT NECK TUM < 5 CM
|
Facility
|
IP
|
$1,988.00
|
|
|
Service Code
|
CPT 21557
|
| Hospital Charge Code |
6121557
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$542.72 |
| Max. Negotiated Rate |
$1,888.60 |
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: Cigna Commercial |
$1,689.80
|
| Rate for Payer: First Health Commercial |
$1,789.20
|
| Rate for Payer: First Health Workers Compensation |
$767.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,789.20
|
| Rate for Payer: GEHA Commercial |
$1,391.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,789.20
|
| Rate for Payer: Multiplan All |
$1,809.08
|
| Rate for Payer: OMNI Networks Commercial |
$1,391.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,789.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,888.60
|
| Rate for Payer: Three Rivers Provider Network All |
$1,491.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,848.84
|
| Rate for Payer: Zelis Auto |
$795.20
|
| Rate for Payer: Zelis Worker's Compensation |
$542.72
|
|
|
RESECT NECK TUM < 5 CM
|
Facility
|
OP
|
$1,988.00
|
|
|
Service Code
|
CPT 21557
|
| Hospital Charge Code |
6121557
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$542.72 |
| 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 |
$1,192.80
|
| 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 |
$1,192.80
|
| Rate for Payer: Cash Price |
$1,192.80
|
| Rate for Payer: Cigna Commercial |
$1,689.80
|
| Rate for Payer: First Health Commercial |
$1,789.20
|
| Rate for Payer: First Health Workers Compensation |
$767.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,789.20
|
| Rate for Payer: GEHA Commercial |
$1,590.40
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,789.20
|
| 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 |
$1,809.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$1,391.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,789.20
|
| 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 |
$1,888.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$1,491.00
|
| 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 |
$1,848.84
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$795.20
|
| 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 |
$542.72
|
|
|
RESECT NECK TUM 5 CM/>
|
Facility
|
OP
|
$2,806.00
|
|
|
Service Code
|
CPT 21558
|
| Hospital Charge Code |
6121558
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$766.04 |
| 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 |
$1,683.60
|
| 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 |
$1,683.60
|
| Rate for Payer: Cash Price |
$1,683.60
|
| Rate for Payer: Cigna Commercial |
$2,385.10
|
| Rate for Payer: First Health Commercial |
$2,525.40
|
| Rate for Payer: First Health Workers Compensation |
$1,083.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,525.40
|
| Rate for Payer: GEHA Commercial |
$2,244.80
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,525.40
|
| 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 |
$2,553.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$1,964.20
|
| Rate for Payer: One Health Plan PPO/POS |
$2,525.40
|
| 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 |
$2,665.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$2,104.50
|
| 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 |
$2,609.58
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$1,122.40
|
| 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 |
$766.04
|
|
|
RESECT NECK TUM 5 CM/>
|
Facility
|
IP
|
$2,806.00
|
|
|
Service Code
|
CPT 21558
|
| Hospital Charge Code |
6121558
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$766.04 |
| Max. Negotiated Rate |
$2,665.70 |
| Rate for Payer: Cash Price |
$1,683.60
|
| Rate for Payer: Cigna Commercial |
$2,385.10
|
| Rate for Payer: First Health Commercial |
$2,525.40
|
| Rate for Payer: First Health Workers Compensation |
$1,083.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,525.40
|
| Rate for Payer: GEHA Commercial |
$1,964.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,525.40
|
| Rate for Payer: Multiplan All |
$2,553.46
|
| Rate for Payer: OMNI Networks Commercial |
$1,964.20
|
| Rate for Payer: One Health Plan PPO/POS |
$2,525.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,665.70
|
| Rate for Payer: Three Rivers Provider Network All |
$2,104.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,609.58
|
| Rate for Payer: Zelis Auto |
$1,122.40
|
| Rate for Payer: Zelis Worker's Compensation |
$766.04
|
|
|
RESECT PHALANX OF TOE TUMOR
|
Facility
|
IP
|
$1,001.00
|
|
|
Service Code
|
CPT 28175
|
| Hospital Charge Code |
6128175
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$273.27 |
| Max. Negotiated Rate |
$950.95 |
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$850.85
|
| Rate for Payer: First Health Commercial |
$900.90
|
| Rate for Payer: First Health Workers Compensation |
$386.49
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$900.90
|
| Rate for Payer: GEHA Commercial |
$700.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$900.90
|
| Rate for Payer: Multiplan All |
$910.91
|
| Rate for Payer: OMNI Networks Commercial |
$700.70
|
| Rate for Payer: One Health Plan PPO/POS |
$900.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$950.95
|
| Rate for Payer: Three Rivers Provider Network All |
$750.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$930.93
|
| Rate for Payer: Zelis Auto |
$400.40
|
| Rate for Payer: Zelis Worker's Compensation |
$273.27
|
|
|
RESECT PHALANX OF TOE TUMOR
|
Facility
|
OP
|
$1,001.00
|
|
|
Service Code
|
CPT 28175
|
| Hospital Charge Code |
6128175
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$273.27 |
| Max. Negotiated Rate |
$3,039.30 |
| 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 |
$600.60
|
| 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 |
$1,519.65
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cash Price |
$600.60
|
| Rate for Payer: Cigna Commercial |
$850.85
|
| Rate for Payer: First Health Commercial |
$900.90
|
| Rate for Payer: First Health Workers Compensation |
$386.49
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$900.90
|
| Rate for Payer: GEHA Commercial |
$800.80
|
| Rate for Payer: GEHA Medicare |
$1,519.65
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$900.90
|
| Rate for Payer: Humana ChoiceCare |
$1,671.62
|
| Rate for Payer: Humana Medicare Advantage |
$1,519.65
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,553.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,785.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,519.65
|
| Rate for Payer: Multiplan All |
$910.91
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,583.41
|
| Rate for Payer: OMNI Networks Commercial |
$700.70
|
| Rate for Payer: One Health Plan PPO/POS |
$900.90
|
| 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 |
$1,519.65
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$950.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,039.30
|
| Rate for Payer: Three Rivers Provider Network All |
$750.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,489.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,785.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,519.65
|
| Rate for Payer: United Payors & United Providers UP&UP |
$930.93
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,519.65
|
| Rate for Payer: Zelis Auto |
$400.40
|
| Rate for Payer: Zelis Medicare |
$1,291.70
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,823.58
|
| Rate for Payer: Zelis Worker's Compensation |
$273.27
|
|
|
RESECT PROX FINGER TUMOR
|
Facility
|
OP
|
$1,634.00
|
|
|
Service Code
|
CPT 26260
|
| Hospital Charge Code |
6126260
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$446.08 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,723.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$980.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,723.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,365.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$980.40
|
| Rate for Payer: Cash Price |
$980.40
|
| Rate for Payer: Cigna Commercial |
$1,388.90
|
| Rate for Payer: First Health Commercial |
$1,470.60
|
| Rate for Payer: First Health Workers Compensation |
$630.89
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,470.60
|
| Rate for Payer: GEHA Commercial |
$1,307.20
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,470.60
|
| Rate for Payer: Humana ChoiceCare |
$3,388.98
|
| Rate for Payer: Humana Medicare Advantage |
$3,080.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,175.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,392.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$1,486.94
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$1,143.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,470.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,608.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,392.84
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,552.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$1,225.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,392.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,519.62
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$653.60
|
| 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 |
$446.08
|
|
|
RESECT PROX FINGER TUMOR
|
Facility
|
IP
|
$1,634.00
|
|
|
Service Code
|
CPT 26260
|
| Hospital Charge Code |
6126260
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$446.08 |
| Max. Negotiated Rate |
$1,552.30 |
| Rate for Payer: Cash Price |
$980.40
|
| Rate for Payer: Cigna Commercial |
$1,388.90
|
| Rate for Payer: First Health Commercial |
$1,470.60
|
| Rate for Payer: First Health Workers Compensation |
$630.89
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,470.60
|
| Rate for Payer: GEHA Commercial |
$1,143.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,470.60
|
| Rate for Payer: Multiplan All |
$1,486.94
|
| Rate for Payer: OMNI Networks Commercial |
$1,143.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,470.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,552.30
|
| Rate for Payer: Three Rivers Provider Network All |
$1,225.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,519.62
|
| Rate for Payer: Zelis Auto |
$653.60
|
| Rate for Payer: Zelis Worker's Compensation |
$446.08
|
|
|
RESECT PROX HUMERUS TUMOR
|
Facility
|
IP
|
$4,023.00
|
|
|
Service Code
|
CPT 23220
|
| Hospital Charge Code |
6123220
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,098.28 |
| Max. Negotiated Rate |
$3,821.85 |
| Rate for Payer: Cash Price |
$2,413.80
|
| Rate for Payer: Cigna Commercial |
$3,419.55
|
| Rate for Payer: First Health Commercial |
$3,620.70
|
| Rate for Payer: First Health Workers Compensation |
$1,553.28
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,620.70
|
| Rate for Payer: GEHA Commercial |
$2,816.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,620.70
|
| Rate for Payer: Multiplan All |
$3,660.93
|
| Rate for Payer: OMNI Networks Commercial |
$2,816.10
|
| Rate for Payer: One Health Plan PPO/POS |
$3,620.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,821.85
|
| Rate for Payer: Three Rivers Provider Network All |
$3,017.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,741.39
|
| Rate for Payer: Zelis Auto |
$1,609.20
|
| Rate for Payer: Zelis Worker's Compensation |
$1,098.28
|
|
|
RESECT PROX HUMERUS TUMOR
|
Facility
|
OP
|
$4,023.00
|
|
|
Service Code
|
CPT 23220
|
| Hospital Charge Code |
6123220
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,005.75 |
| Max. Negotiated Rate |
$3,821.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,413.80
|
| Rate for Payer: Cash Price |
$2,413.80
|
| Rate for Payer: Cigna Commercial |
$3,419.55
|
| Rate for Payer: First Health Commercial |
$3,620.70
|
| Rate for Payer: First Health Workers Compensation |
$1,553.28
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,620.70
|
| Rate for Payer: GEHA Commercial |
$3,218.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,620.70
|
| Rate for Payer: Humana ChoiceCare |
$1,045.98
|
| Rate for Payer: Multiplan All |
$3,660.93
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,413.80
|
| Rate for Payer: OMNI Networks Commercial |
$2,816.10
|
| Rate for Payer: One Health Plan PPO/POS |
$3,620.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,821.85
|
| Rate for Payer: Three Rivers Provider Network All |
$3,017.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,540.24
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,005.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,741.39
|
| Rate for Payer: Zelis Auto |
$1,609.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,011.50
|
| Rate for Payer: Zelis Worker's Compensation |
$1,098.28
|
|
|
RESECT RADIUS TUMOR
|
Facility
|
OP
|
$2,722.00
|
|
|
Service Code
|
CPT 24152
|
| Hospital Charge Code |
6124152
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$743.11 |
| Max. Negotiated Rate |
$13,566.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,709.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,633.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,709.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,730.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,783.26
|
| Rate for Payer: Cash Price |
$1,633.20
|
| Rate for Payer: Cash Price |
$1,633.20
|
| Rate for Payer: Cigna Commercial |
$2,313.70
|
| Rate for Payer: First Health Commercial |
$2,449.80
|
| Rate for Payer: First Health Workers Compensation |
$1,050.96
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,449.80
|
| Rate for Payer: GEHA Commercial |
$2,177.60
|
| Rate for Payer: GEHA Medicare |
$6,783.26
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,449.80
|
| Rate for Payer: Humana ChoiceCare |
$7,461.59
|
| Rate for Payer: Humana Medicare Advantage |
$6,783.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,395.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,806.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,783.26
|
| Rate for Payer: Multiplan All |
$2,477.02
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,531.54
|
| Rate for Payer: OMNI Networks Commercial |
$1,905.40
|
| Rate for Payer: One Health Plan PPO/POS |
$2,449.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,395.55
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,806.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,783.26
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,585.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,566.52
|
| Rate for Payer: Three Rivers Provider Network All |
$2,041.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,647.59
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,806.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,783.26
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,531.46
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,783.26
|
| Rate for Payer: Zelis Auto |
$1,088.80
|
| Rate for Payer: Zelis Medicare |
$5,765.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,139.91
|
| Rate for Payer: Zelis Worker's Compensation |
$743.11
|
|
|
RESECT RADIUS TUMOR
|
Facility
|
IP
|
$2,722.00
|
|
|
Service Code
|
CPT 24152
|
| Hospital Charge Code |
6124152
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$743.11 |
| Max. Negotiated Rate |
$2,585.90 |
| Rate for Payer: Cash Price |
$1,633.20
|
| Rate for Payer: Cigna Commercial |
$2,313.70
|
| Rate for Payer: First Health Commercial |
$2,449.80
|
| Rate for Payer: First Health Workers Compensation |
$1,050.96
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,449.80
|
| Rate for Payer: GEHA Commercial |
$1,905.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,449.80
|
| Rate for Payer: Multiplan All |
$2,477.02
|
| Rate for Payer: OMNI Networks Commercial |
$1,905.40
|
| Rate for Payer: One Health Plan PPO/POS |
$2,449.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,585.90
|
| Rate for Payer: Three Rivers Provider Network All |
$2,041.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,531.46
|
| Rate for Payer: Zelis Auto |
$1,088.80
|
| Rate for Payer: Zelis Worker's Compensation |
$743.11
|
|
|
RESECT RADIUS/ULNAR TUMOR
|
Facility
|
IP
|
$3,062.00
|
|
|
Service Code
|
CPT 25170
|
| Hospital Charge Code |
6125170
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$835.93 |
| Max. Negotiated Rate |
$2,908.90 |
| Rate for Payer: Cash Price |
$1,837.20
|
| Rate for Payer: Cigna Commercial |
$2,602.70
|
| Rate for Payer: First Health Commercial |
$2,755.80
|
| Rate for Payer: First Health Workers Compensation |
$1,182.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,755.80
|
| Rate for Payer: GEHA Commercial |
$2,143.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,755.80
|
| Rate for Payer: Multiplan All |
$2,786.42
|
| Rate for Payer: OMNI Networks Commercial |
$2,143.40
|
| Rate for Payer: One Health Plan PPO/POS |
$2,755.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,908.90
|
| Rate for Payer: Three Rivers Provider Network All |
$2,296.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,847.66
|
| Rate for Payer: Zelis Auto |
$1,224.80
|
| Rate for Payer: Zelis Worker's Compensation |
$835.93
|
|
|
RESECT RADIUS/ULNAR TUMOR
|
Facility
|
OP
|
$3,062.00
|
|
|
Service Code
|
CPT 25170
|
| Hospital Charge Code |
6125170
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$835.93 |
| Max. Negotiated Rate |
$13,566.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,709.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,837.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,709.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,730.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,783.26
|
| Rate for Payer: Cash Price |
$1,837.20
|
| Rate for Payer: Cash Price |
$1,837.20
|
| Rate for Payer: Cigna Commercial |
$2,602.70
|
| Rate for Payer: First Health Commercial |
$2,755.80
|
| Rate for Payer: First Health Workers Compensation |
$1,182.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,755.80
|
| Rate for Payer: GEHA Commercial |
$2,449.60
|
| Rate for Payer: GEHA Medicare |
$6,783.26
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,755.80
|
| Rate for Payer: Humana ChoiceCare |
$7,461.59
|
| Rate for Payer: Humana Medicare Advantage |
$6,783.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,395.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,806.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,783.26
|
| Rate for Payer: Multiplan All |
$2,786.42
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,531.54
|
| Rate for Payer: OMNI Networks Commercial |
$2,143.40
|
| Rate for Payer: One Health Plan PPO/POS |
$2,755.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,395.55
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,806.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,783.26
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,908.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,566.52
|
| Rate for Payer: Three Rivers Provider Network All |
$2,296.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,647.59
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,806.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,783.26
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,847.66
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,783.26
|
| Rate for Payer: Zelis Auto |
$1,224.80
|
| Rate for Payer: Zelis Medicare |
$5,765.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,139.91
|
| Rate for Payer: Zelis Worker's Compensation |
$835.93
|
|
|
RESECT SCAPULA TUMOR
|
Facility
|
OP
|
$3,675.00
|
|
|
Service Code
|
CPT 23210
|
| Hospital Charge Code |
6123210
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$918.75 |
| Max. Negotiated Rate |
$3,491.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,205.00
|
| Rate for Payer: Cash Price |
$2,205.00
|
| Rate for Payer: Cigna Commercial |
$3,123.75
|
| Rate for Payer: First Health Commercial |
$3,307.50
|
| Rate for Payer: First Health Workers Compensation |
$1,418.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,307.50
|
| Rate for Payer: GEHA Commercial |
$2,940.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,307.50
|
| Rate for Payer: Humana ChoiceCare |
$955.50
|
| Rate for Payer: Multiplan All |
$3,344.25
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,205.00
|
| Rate for Payer: OMNI Networks Commercial |
$2,572.50
|
| Rate for Payer: One Health Plan PPO/POS |
$3,307.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,491.25
|
| Rate for Payer: Three Rivers Provider Network All |
$2,756.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,234.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$918.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,417.75
|
| Rate for Payer: Zelis Auto |
$1,470.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,837.50
|
| Rate for Payer: Zelis Worker's Compensation |
$1,003.27
|
|
