|
BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP
|
Facility
|
OP
|
$815.00
|
|
|
Service Code
|
CPT 27324
|
| Hospital Charge Code |
8227324
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$222.50 |
| 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 |
$489.00
|
| 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 |
$489.00
|
| Rate for Payer: Cash Price |
$489.00
|
| Rate for Payer: Cigna Commercial |
$692.75
|
| Rate for Payer: First Health Commercial |
$733.50
|
| Rate for Payer: First Health Workers Compensation |
$314.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$733.50
|
| Rate for Payer: GEHA Commercial |
$652.00
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$733.50
|
| 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 |
$741.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$570.50
|
| Rate for Payer: One Health Plan PPO/POS |
$733.50
|
| 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 |
$774.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$611.25
|
| 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 |
$757.95
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$326.00
|
| 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 |
$222.50
|
|
|
BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP
|
Facility
|
OP
|
$815.00
|
|
|
Service Code
|
CPT 27324
|
| Hospital Charge Code |
8827324
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$222.50 |
| 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 |
$489.00
|
| 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 |
$489.00
|
| Rate for Payer: Cash Price |
$489.00
|
| Rate for Payer: Cigna Commercial |
$692.75
|
| Rate for Payer: First Health Commercial |
$733.50
|
| Rate for Payer: First Health Workers Compensation |
$314.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$733.50
|
| Rate for Payer: GEHA Commercial |
$652.00
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$733.50
|
| 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 |
$741.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$570.50
|
| Rate for Payer: One Health Plan PPO/POS |
$733.50
|
| 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 |
$774.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$611.25
|
| 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 |
$757.95
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$326.00
|
| 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 |
$222.50
|
|
|
BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP
|
Facility
|
IP
|
$815.00
|
|
|
Service Code
|
CPT 27324
|
| Hospital Charge Code |
8227324
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$222.50 |
| Max. Negotiated Rate |
$774.25 |
| Rate for Payer: Cash Price |
$489.00
|
| Rate for Payer: Cigna Commercial |
$692.75
|
| Rate for Payer: First Health Commercial |
$733.50
|
| Rate for Payer: First Health Workers Compensation |
$314.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$733.50
|
| Rate for Payer: GEHA Commercial |
$570.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$733.50
|
| Rate for Payer: Multiplan All |
$741.65
|
| Rate for Payer: OMNI Networks Commercial |
$570.50
|
| Rate for Payer: One Health Plan PPO/POS |
$733.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$774.25
|
| Rate for Payer: Three Rivers Provider Network All |
$611.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$757.95
|
| Rate for Payer: Zelis Auto |
$326.00
|
| Rate for Payer: Zelis Worker's Compensation |
$222.50
|
|
|
BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP
|
Facility
|
IP
|
$815.00
|
|
|
Service Code
|
CPT 27324
|
| Hospital Charge Code |
8827324
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$222.50 |
| Max. Negotiated Rate |
$774.25 |
| Rate for Payer: Cash Price |
$489.00
|
| Rate for Payer: Cigna Commercial |
$692.75
|
| Rate for Payer: First Health Commercial |
$733.50
|
| Rate for Payer: First Health Workers Compensation |
$314.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$733.50
|
| Rate for Payer: GEHA Commercial |
$570.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$733.50
|
| Rate for Payer: Multiplan All |
$741.65
|
| Rate for Payer: OMNI Networks Commercial |
$570.50
|
| Rate for Payer: One Health Plan PPO/POS |
$733.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$774.25
|
| Rate for Payer: Three Rivers Provider Network All |
$611.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$757.95
|
| Rate for Payer: Zelis Auto |
$326.00
|
| Rate for Payer: Zelis Worker's Compensation |
$222.50
|
|
|
BIOPSY THIGH SOFT TISSUES
|
Facility
|
IP
|
$815.00
|
|
|
Service Code
|
CPT 27324
|
| Hospital Charge Code |
6127324
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$222.50 |
| Max. Negotiated Rate |
$774.25 |
| Rate for Payer: Cash Price |
$489.00
|
| Rate for Payer: Cigna Commercial |
$692.75
|
| Rate for Payer: First Health Commercial |
$733.50
|
| Rate for Payer: First Health Workers Compensation |
$314.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$733.50
|
| Rate for Payer: GEHA Commercial |
$570.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$733.50
|
| Rate for Payer: Multiplan All |
$741.65
|
| Rate for Payer: OMNI Networks Commercial |
$570.50
|
| Rate for Payer: One Health Plan PPO/POS |
$733.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$774.25
|
| Rate for Payer: Three Rivers Provider Network All |
$611.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$757.95
|
| Rate for Payer: Zelis Auto |
$326.00
|
| Rate for Payer: Zelis Worker's Compensation |
$222.50
|
|
|
BIOPSY THIGH SOFT TISSUES
|
Facility
|
IP
|
$545.00
|
|
|
Service Code
|
CPT 27323
|
| Hospital Charge Code |
6127323
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$148.78 |
| Max. Negotiated Rate |
$517.75 |
| Rate for Payer: Cash Price |
$327.00
|
| Rate for Payer: Cigna Commercial |
$463.25
|
| Rate for Payer: First Health Commercial |
$490.50
|
| Rate for Payer: First Health Workers Compensation |
$210.42
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$490.50
|
| Rate for Payer: GEHA Commercial |
$381.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$490.50
|
| Rate for Payer: Multiplan All |
$495.95
|
| Rate for Payer: OMNI Networks Commercial |
$381.50
|
| Rate for Payer: One Health Plan PPO/POS |
$490.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$517.75
|
| Rate for Payer: Three Rivers Provider Network All |
$408.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$506.85
|
| Rate for Payer: Zelis Auto |
$218.00
|
| Rate for Payer: Zelis Worker's Compensation |
$148.78
|
|
|
BIOPSY THIGH SOFT TISSUES
|
Facility
|
OP
|
$815.00
|
|
|
Service Code
|
CPT 27324
|
| Hospital Charge Code |
6127324
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$222.50 |
| 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 |
$489.00
|
| 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 |
$489.00
|
| Rate for Payer: Cash Price |
$489.00
|
| Rate for Payer: Cigna Commercial |
$692.75
|
| Rate for Payer: First Health Commercial |
$733.50
|
| Rate for Payer: First Health Workers Compensation |
$314.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$733.50
|
| Rate for Payer: GEHA Commercial |
$652.00
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$733.50
|
| 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 |
$741.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$570.50
|
| Rate for Payer: One Health Plan PPO/POS |
$733.50
|
| 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 |
$774.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$611.25
|
| 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 |
$757.95
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$326.00
|
| 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 |
$222.50
|
|
|
BIOPSY THIGH SOFT TISSUES
|
Facility
|
OP
|
$545.00
|
|
|
Service Code
|
CPT 27323
|
| Hospital Charge Code |
6127323
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$148.78 |
| Max. Negotiated Rate |
$3,076.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$327.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$657.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,538.48
|
| Rate for Payer: Cash Price |
$327.00
|
| Rate for Payer: Cash Price |
$327.00
|
| Rate for Payer: Cigna Commercial |
$463.25
|
| Rate for Payer: First Health Commercial |
$490.50
|
| Rate for Payer: First Health Workers Compensation |
$210.42
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$490.50
|
| Rate for Payer: GEHA Commercial |
$436.00
|
| Rate for Payer: GEHA Medicare |
$1,538.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$490.50
|
| Rate for Payer: Humana ChoiceCare |
$1,692.33
|
| Rate for Payer: Humana Medicare Advantage |
$1,538.48
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,584.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$670.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,538.48
|
| Rate for Payer: Multiplan All |
$495.95
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,615.42
|
| Rate for Payer: OMNI Networks Commercial |
$381.50
|
| Rate for Payer: One Health Plan PPO/POS |
$490.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$774.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$670.42
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,538.48
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$517.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,076.96
|
| Rate for Payer: Three Rivers Provider Network All |
$408.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,507.71
|
| Rate for Payer: United Healthcare Managed Medicaid |
$670.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,538.48
|
| Rate for Payer: United Payors & United Providers UP&UP |
$506.85
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,538.48
|
| Rate for Payer: Zelis Auto |
$218.00
|
| Rate for Payer: Zelis Medicare |
$1,307.71
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,846.18
|
| Rate for Payer: Zelis Worker's Compensation |
$148.78
|
|
|
BIOPSY THYROID PERCUTANEOUS CORE NEEDLE
|
Facility
|
OP
|
$247.00
|
|
|
Service Code
|
CPT 60100
|
| Hospital Charge Code |
6160100
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$67.43 |
| Max. Negotiated Rate |
$1,336.18 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$465.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$148.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$465.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$368.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$668.09
|
| Rate for Payer: Cash Price |
$148.20
|
| Rate for Payer: Cash Price |
$148.20
|
| Rate for Payer: Cigna Commercial |
$209.95
|
| Rate for Payer: First Health Commercial |
$222.30
|
| Rate for Payer: First Health Workers Compensation |
$95.37
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$222.30
|
| Rate for Payer: GEHA Commercial |
$197.60
|
| Rate for Payer: GEHA Medicare |
$668.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$222.30
|
| Rate for Payer: Humana ChoiceCare |
$734.90
|
| Rate for Payer: Humana Medicare Advantage |
$668.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,122.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$375.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$668.09
|
| Rate for Payer: Multiplan All |
$224.77
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,135.75
|
| Rate for Payer: OMNI Networks Commercial |
$172.90
|
| Rate for Payer: One Health Plan PPO/POS |
$222.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$434.01
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$375.89
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$668.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$234.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,336.18
|
| Rate for Payer: Three Rivers Provider Network All |
$185.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$654.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$375.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$668.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$229.71
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$668.09
|
| Rate for Payer: Zelis Auto |
$98.80
|
| Rate for Payer: Zelis Medicare |
$567.88
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$801.71
|
| Rate for Payer: Zelis Worker's Compensation |
$67.43
|
|
|
BIOPSY THYROID PERCUTANEOUS CORE NEEDLE
|
Facility
|
IP
|
$247.00
|
|
|
Service Code
|
CPT 60100
|
| Hospital Charge Code |
6160100
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$67.43 |
| Max. Negotiated Rate |
$234.65 |
| Rate for Payer: Cash Price |
$148.20
|
| Rate for Payer: Cigna Commercial |
$209.95
|
| Rate for Payer: First Health Commercial |
$222.30
|
| Rate for Payer: First Health Workers Compensation |
$95.37
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$222.30
|
| Rate for Payer: GEHA Commercial |
$172.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$222.30
|
| Rate for Payer: Multiplan All |
$224.77
|
| Rate for Payer: OMNI Networks Commercial |
$172.90
|
| Rate for Payer: One Health Plan PPO/POS |
$222.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$234.65
|
| Rate for Payer: Three Rivers Provider Network All |
$185.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$229.71
|
| Rate for Payer: Zelis Auto |
$98.80
|
| Rate for Payer: Zelis Worker's Compensation |
$67.43
|
|
|
BIOPSY TONGUE ANTERIOR TWO-THIRDS
|
Facility
|
OP
|
$335.00
|
|
|
Service Code
|
CPT 41100
|
| Hospital Charge Code |
6141100
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$91.45 |
| Max. Negotiated Rate |
$967.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$770.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$201.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$770.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$610.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$483.55
|
| Rate for Payer: Cash Price |
$201.00
|
| Rate for Payer: Cash Price |
$201.00
|
| Rate for Payer: Cigna Commercial |
$284.75
|
| Rate for Payer: First Health Commercial |
$301.50
|
| Rate for Payer: First Health Workers Compensation |
$129.34
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$301.50
|
| Rate for Payer: GEHA Commercial |
$268.00
|
| Rate for Payer: GEHA Medicare |
$483.55
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$301.50
|
| Rate for Payer: Humana ChoiceCare |
$531.90
|
| Rate for Payer: Humana Medicare Advantage |
$483.55
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$812.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$622.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$483.55
|
| Rate for Payer: Multiplan All |
$304.85
|
| Rate for Payer: New Mexico Health Connections Medicare |
$822.03
|
| Rate for Payer: OMNI Networks Commercial |
$234.50
|
| Rate for Payer: One Health Plan PPO/POS |
$301.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$719.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$622.75
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$483.55
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$318.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$967.10
|
| Rate for Payer: Three Rivers Provider Network All |
$251.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$473.88
|
| Rate for Payer: United Healthcare Managed Medicaid |
$622.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$483.55
|
| Rate for Payer: United Payors & United Providers UP&UP |
$311.55
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$483.55
|
| Rate for Payer: Zelis Auto |
$134.00
|
| Rate for Payer: Zelis Medicare |
$411.02
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$580.26
|
| Rate for Payer: Zelis Worker's Compensation |
$91.45
|
|
|
BIOPSY TONGUE ANTERIOR TWO-THIRDS
|
Facility
|
OP
|
$1,101.00
|
|
|
Service Code
|
CPT 41100
|
| Hospital Charge Code |
6141017
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$300.57 |
| Max. Negotiated Rate |
$1,045.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$770.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$660.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$770.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$610.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$483.55
|
| Rate for Payer: Cash Price |
$660.60
|
| Rate for Payer: Cash Price |
$660.60
|
| Rate for Payer: Cigna Commercial |
$935.85
|
| Rate for Payer: First Health Commercial |
$990.90
|
| Rate for Payer: First Health Workers Compensation |
$425.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$990.90
|
| Rate for Payer: GEHA Commercial |
$880.80
|
| Rate for Payer: GEHA Medicare |
$483.55
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$990.90
|
| Rate for Payer: Humana ChoiceCare |
$531.90
|
| Rate for Payer: Humana Medicare Advantage |
$483.55
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$812.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$622.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$483.55
|
| Rate for Payer: Multiplan All |
$1,001.91
|
| Rate for Payer: New Mexico Health Connections Medicare |
$822.03
|
| Rate for Payer: OMNI Networks Commercial |
$770.70
|
| Rate for Payer: One Health Plan PPO/POS |
$990.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$719.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$622.75
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$483.55
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,045.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$967.10
|
| Rate for Payer: Three Rivers Provider Network All |
$825.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$473.88
|
| Rate for Payer: United Healthcare Managed Medicaid |
$622.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$483.55
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,023.93
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$483.55
|
| Rate for Payer: Zelis Auto |
$440.40
|
| Rate for Payer: Zelis Medicare |
$411.02
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$580.26
|
| Rate for Payer: Zelis Worker's Compensation |
$300.57
|
|
|
BIOPSY TONGUE ANTERIOR TWO-THIRDS
|
Facility
|
IP
|
$1,101.00
|
|
|
Service Code
|
CPT 41100
|
| Hospital Charge Code |
6141017
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$300.57 |
| Max. Negotiated Rate |
$1,045.95 |
| Rate for Payer: Cash Price |
$660.60
|
| Rate for Payer: Cigna Commercial |
$935.85
|
| Rate for Payer: First Health Commercial |
$990.90
|
| Rate for Payer: First Health Workers Compensation |
$425.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$990.90
|
| Rate for Payer: GEHA Commercial |
$770.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$990.90
|
| Rate for Payer: Multiplan All |
$1,001.91
|
| Rate for Payer: OMNI Networks Commercial |
$770.70
|
| Rate for Payer: One Health Plan PPO/POS |
$990.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,045.95
|
| Rate for Payer: Three Rivers Provider Network All |
$825.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,023.93
|
| Rate for Payer: Zelis Auto |
$440.40
|
| Rate for Payer: Zelis Worker's Compensation |
$300.57
|
|
|
BIOPSY TONGUE ANTERIOR TWO-THIRDS
|
Facility
|
IP
|
$335.00
|
|
|
Service Code
|
CPT 41100
|
| Hospital Charge Code |
6141100
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$91.45 |
| Max. Negotiated Rate |
$318.25 |
| Rate for Payer: Cash Price |
$201.00
|
| Rate for Payer: Cigna Commercial |
$284.75
|
| Rate for Payer: First Health Commercial |
$301.50
|
| Rate for Payer: First Health Workers Compensation |
$129.34
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$301.50
|
| Rate for Payer: GEHA Commercial |
$234.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$301.50
|
| Rate for Payer: Multiplan All |
$304.85
|
| Rate for Payer: OMNI Networks Commercial |
$234.50
|
| Rate for Payer: One Health Plan PPO/POS |
$301.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$318.25
|
| Rate for Payer: Three Rivers Provider Network All |
$251.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$311.55
|
| Rate for Payer: Zelis Auto |
$134.00
|
| Rate for Payer: Zelis Worker's Compensation |
$91.45
|
|
|
BIOPSY VULVA/PERINEUM 1 LESION SPX
|
Facility
|
IP
|
$267.06
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
8556605
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$72.91 |
| Max. Negotiated Rate |
$253.71 |
| Rate for Payer: Cash Price |
$160.24
|
| Rate for Payer: Cigna Commercial |
$227.00
|
| Rate for Payer: First Health Commercial |
$240.35
|
| Rate for Payer: First Health Workers Compensation |
$103.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$240.35
|
| Rate for Payer: GEHA Commercial |
$186.94
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$240.35
|
| Rate for Payer: Multiplan All |
$243.02
|
| Rate for Payer: OMNI Networks Commercial |
$186.94
|
| Rate for Payer: One Health Plan PPO/POS |
$240.35
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$253.71
|
| Rate for Payer: Three Rivers Provider Network All |
$200.29
|
| Rate for Payer: United Payors & United Providers UP&UP |
$248.37
|
| Rate for Payer: Zelis Auto |
$106.82
|
| Rate for Payer: Zelis Worker's Compensation |
$72.91
|
|
|
BIOPSY VULVA/PERINEUM 1 LESION SPX
|
Facility
|
OP
|
$186.00
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
6156605
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$50.78 |
| Max. Negotiated Rate |
$1,653.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$111.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$273.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$826.80
|
| Rate for Payer: Cash Price |
$111.60
|
| Rate for Payer: Cash Price |
$111.60
|
| Rate for Payer: Cigna Commercial |
$158.10
|
| Rate for Payer: First Health Commercial |
$167.40
|
| Rate for Payer: First Health Workers Compensation |
$71.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$167.40
|
| Rate for Payer: GEHA Commercial |
$148.80
|
| Rate for Payer: GEHA Medicare |
$826.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$167.40
|
| 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 |
$278.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$826.80
|
| Rate for Payer: Multiplan All |
$169.26
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,405.56
|
| Rate for Payer: OMNI Networks Commercial |
$130.20
|
| Rate for Payer: One Health Plan PPO/POS |
$167.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$321.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$278.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$826.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$176.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,653.60
|
| Rate for Payer: Three Rivers Provider Network All |
$139.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$810.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$278.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$826.80
|
| Rate for Payer: United Payors & United Providers UP&UP |
$172.98
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$826.80
|
| Rate for Payer: Zelis Auto |
$74.40
|
| Rate for Payer: Zelis Medicare |
$702.78
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$992.16
|
| Rate for Payer: Zelis Worker's Compensation |
$50.78
|
|
|
BIOPSY VULVA/PERINEUM 1 LESION SPX
|
Facility
|
IP
|
$267.06
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
7256605
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$72.91 |
| Max. Negotiated Rate |
$253.71 |
| Rate for Payer: Cash Price |
$160.24
|
| Rate for Payer: Cigna Commercial |
$227.00
|
| Rate for Payer: First Health Commercial |
$240.35
|
| Rate for Payer: First Health Workers Compensation |
$103.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$240.35
|
| Rate for Payer: GEHA Commercial |
$186.94
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$240.35
|
| Rate for Payer: Multiplan All |
$243.02
|
| Rate for Payer: OMNI Networks Commercial |
$186.94
|
| Rate for Payer: One Health Plan PPO/POS |
$240.35
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$253.71
|
| Rate for Payer: Three Rivers Provider Network All |
$200.29
|
| Rate for Payer: United Payors & United Providers UP&UP |
$248.37
|
| Rate for Payer: Zelis Auto |
$106.82
|
| Rate for Payer: Zelis Worker's Compensation |
$72.91
|
|
|
BIOPSY VULVA/PERINEUM 1 LESION SPX
|
Facility
|
OP
|
$267.06
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
8556605
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$72.91 |
| Max. Negotiated Rate |
$1,653.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$160.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$273.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$826.80
|
| Rate for Payer: Cash Price |
$160.24
|
| Rate for Payer: Cash Price |
$160.24
|
| Rate for Payer: Cigna Commercial |
$227.00
|
| Rate for Payer: First Health Commercial |
$240.35
|
| Rate for Payer: First Health Workers Compensation |
$103.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$240.35
|
| Rate for Payer: GEHA Commercial |
$213.65
|
| Rate for Payer: GEHA Medicare |
$826.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$240.35
|
| 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 |
$278.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$826.80
|
| Rate for Payer: Multiplan All |
$243.02
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,405.56
|
| Rate for Payer: OMNI Networks Commercial |
$186.94
|
| Rate for Payer: One Health Plan PPO/POS |
$240.35
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$321.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$278.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$826.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$253.71
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,653.60
|
| Rate for Payer: Three Rivers Provider Network All |
$200.29
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$810.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$278.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$826.80
|
| Rate for Payer: United Payors & United Providers UP&UP |
$248.37
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$826.80
|
| Rate for Payer: Zelis Auto |
$106.82
|
| Rate for Payer: Zelis Medicare |
$702.78
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$992.16
|
| Rate for Payer: Zelis Worker's Compensation |
$72.91
|
|
|
BIOPSY VULVA/PERINEUM 1 LESION SPX
|
Facility
|
IP
|
$260.00
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
23500077
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$70.98 |
| Max. Negotiated Rate |
$247.00 |
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cigna Commercial |
$221.00
|
| Rate for Payer: First Health Commercial |
$234.00
|
| Rate for Payer: First Health Workers Compensation |
$100.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$234.00
|
| Rate for Payer: GEHA Commercial |
$182.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$234.00
|
| Rate for Payer: Multiplan All |
$236.60
|
| Rate for Payer: OMNI Networks Commercial |
$182.00
|
| Rate for Payer: One Health Plan PPO/POS |
$234.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$247.00
|
| Rate for Payer: Three Rivers Provider Network All |
$195.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$241.80
|
| Rate for Payer: Zelis Auto |
$104.00
|
| Rate for Payer: Zelis Worker's Compensation |
$70.98
|
|
|
BIOPSY VULVA/PERINEUM 1 LESION SPX
|
Facility
|
IP
|
$186.00
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
6156605
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$50.78 |
| Max. Negotiated Rate |
$176.70 |
| Rate for Payer: Cash Price |
$111.60
|
| Rate for Payer: Cigna Commercial |
$158.10
|
| Rate for Payer: First Health Commercial |
$167.40
|
| Rate for Payer: First Health Workers Compensation |
$71.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$167.40
|
| Rate for Payer: GEHA Commercial |
$130.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$167.40
|
| Rate for Payer: Multiplan All |
$169.26
|
| Rate for Payer: OMNI Networks Commercial |
$130.20
|
| Rate for Payer: One Health Plan PPO/POS |
$167.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$176.70
|
| Rate for Payer: Three Rivers Provider Network All |
$139.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$172.98
|
| Rate for Payer: Zelis Auto |
$74.40
|
| Rate for Payer: Zelis Worker's Compensation |
$50.78
|
|
|
BIOPSY VULVA/PERINEUM 1 LESION SPX
|
Facility
|
OP
|
$260.00
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
23500077
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$70.98 |
| Max. Negotiated Rate |
$1,653.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$156.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$273.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$826.80
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cigna Commercial |
$221.00
|
| Rate for Payer: First Health Commercial |
$234.00
|
| Rate for Payer: First Health Workers Compensation |
$100.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$234.00
|
| Rate for Payer: GEHA Commercial |
$208.00
|
| Rate for Payer: GEHA Medicare |
$826.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$234.00
|
| 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 |
$278.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$826.80
|
| Rate for Payer: Multiplan All |
$236.60
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,405.56
|
| Rate for Payer: OMNI Networks Commercial |
$182.00
|
| Rate for Payer: One Health Plan PPO/POS |
$234.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$321.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$278.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$826.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$247.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,653.60
|
| Rate for Payer: Three Rivers Provider Network All |
$195.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$810.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$278.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$826.80
|
| Rate for Payer: United Payors & United Providers UP&UP |
$241.80
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$826.80
|
| Rate for Payer: Zelis Auto |
$104.00
|
| Rate for Payer: Zelis Medicare |
$702.78
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$992.16
|
| Rate for Payer: Zelis Worker's Compensation |
$70.98
|
|
|
BIOPSY VULVA/PERINEUM 1 LESION SPX
|
Facility
|
OP
|
$267.06
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
7256605
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$72.91 |
| Max. Negotiated Rate |
$1,653.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$160.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$273.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$826.80
|
| Rate for Payer: Cash Price |
$160.24
|
| Rate for Payer: Cash Price |
$160.24
|
| Rate for Payer: Cigna Commercial |
$227.00
|
| Rate for Payer: First Health Commercial |
$240.35
|
| Rate for Payer: First Health Workers Compensation |
$103.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$240.35
|
| Rate for Payer: GEHA Commercial |
$213.65
|
| Rate for Payer: GEHA Medicare |
$826.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$240.35
|
| 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 |
$278.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$826.80
|
| Rate for Payer: Multiplan All |
$243.02
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,405.56
|
| Rate for Payer: OMNI Networks Commercial |
$186.94
|
| Rate for Payer: One Health Plan PPO/POS |
$240.35
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$321.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$278.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$826.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$253.71
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,653.60
|
| Rate for Payer: Three Rivers Provider Network All |
$200.29
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$810.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$278.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$826.80
|
| Rate for Payer: United Payors & United Providers UP&UP |
$248.37
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$826.80
|
| Rate for Payer: Zelis Auto |
$106.82
|
| Rate for Payer: Zelis Medicare |
$702.78
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$992.16
|
| Rate for Payer: Zelis Worker's Compensation |
$72.91
|
|
|
BIPAP MASK ALL SIZES
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT 99070
|
| Hospital Charge Code |
4000707
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$85.00
|
| Rate for Payer: First Health Commercial |
$90.00
|
| Rate for Payer: First Health Workers Compensation |
$38.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$90.00
|
| Rate for Payer: GEHA Commercial |
$80.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$90.00
|
| Rate for Payer: Humana ChoiceCare |
$26.00
|
| Rate for Payer: Multiplan All |
$91.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$60.00
|
| Rate for Payer: OMNI Networks Commercial |
$70.00
|
| Rate for Payer: One Health Plan PPO/POS |
$90.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$95.00
|
| Rate for Payer: Three Rivers Provider Network All |
$75.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$88.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$25.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$93.00
|
| Rate for Payer: Zelis Auto |
$40.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$50.00
|
| Rate for Payer: Zelis Worker's Compensation |
$27.30
|
|
|
BIPAP MASK ALL SIZES
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT 99070
|
| Hospital Charge Code |
4000707
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$27.30 |
| Max. Negotiated Rate |
$95.00 |
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cigna Commercial |
$85.00
|
| Rate for Payer: First Health Commercial |
$90.00
|
| Rate for Payer: First Health Workers Compensation |
$38.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$90.00
|
| Rate for Payer: GEHA Commercial |
$70.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$90.00
|
| Rate for Payer: Multiplan All |
$91.00
|
| Rate for Payer: OMNI Networks Commercial |
$70.00
|
| Rate for Payer: One Health Plan PPO/POS |
$90.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$95.00
|
| Rate for Payer: Three Rivers Provider Network All |
$75.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$93.00
|
| Rate for Payer: Zelis Auto |
$40.00
|
| Rate for Payer: Zelis Worker's Compensation |
$27.30
|
|
|
BISACODYL 10MG SUPPOSITORY
|
Facility
|
IP
|
$6.00
|
|
|
Service Code
|
NDC 00574705012
|
| Hospital Charge Code |
3300106
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.64 |
| Max. Negotiated Rate |
$5.70 |
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cigna Commercial |
$5.10
|
| Rate for Payer: First Health Commercial |
$5.40
|
| Rate for Payer: First Health Workers Compensation |
$2.32
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$5.40
|
| Rate for Payer: GEHA Commercial |
$4.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$5.40
|
| Rate for Payer: Multiplan All |
$5.46
|
| Rate for Payer: OMNI Networks Commercial |
$4.20
|
| Rate for Payer: One Health Plan PPO/POS |
$5.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5.70
|
| Rate for Payer: Three Rivers Provider Network All |
$4.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5.58
|
| Rate for Payer: Zelis Auto |
$2.40
|
| Rate for Payer: Zelis Worker's Compensation |
$1.64
|
|
