|
REVISION OF HIP BONE
|
Facility
|
OP
|
$3,047.00
|
|
|
Service Code
|
CPT 27147
|
| Hospital Charge Code |
6127147
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$761.75 |
| Max. Negotiated Rate |
$2,894.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,828.20
|
| Rate for Payer: Cash Price |
$1,828.20
|
| Rate for Payer: Cigna Commercial |
$2,589.95
|
| Rate for Payer: First Health Commercial |
$2,742.30
|
| Rate for Payer: First Health Workers Compensation |
$1,176.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,742.30
|
| Rate for Payer: GEHA Commercial |
$2,437.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,742.30
|
| Rate for Payer: Humana ChoiceCare |
$792.22
|
| Rate for Payer: Multiplan All |
$2,772.77
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,828.20
|
| Rate for Payer: OMNI Networks Commercial |
$2,132.90
|
| Rate for Payer: One Health Plan PPO/POS |
$2,742.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,894.65
|
| Rate for Payer: Three Rivers Provider Network All |
$2,285.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,681.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$761.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,833.71
|
| Rate for Payer: Zelis Auto |
$1,218.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,523.50
|
| Rate for Payer: Zelis Worker's Compensation |
$831.83
|
|
|
REVISION OF HIP BONES
|
Facility
|
OP
|
$3,562.00
|
|
|
Service Code
|
CPT 27156
|
| Hospital Charge Code |
6127156
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$890.50 |
| Max. Negotiated Rate |
$3,383.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,137.20
|
| Rate for Payer: Cash Price |
$2,137.20
|
| Rate for Payer: Cigna Commercial |
$3,027.70
|
| Rate for Payer: First Health Commercial |
$3,205.80
|
| Rate for Payer: First Health Workers Compensation |
$1,375.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,205.80
|
| Rate for Payer: GEHA Commercial |
$2,849.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,205.80
|
| Rate for Payer: Humana ChoiceCare |
$926.12
|
| Rate for Payer: Multiplan All |
$3,241.42
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,137.20
|
| Rate for Payer: OMNI Networks Commercial |
$2,493.40
|
| Rate for Payer: One Health Plan PPO/POS |
$3,205.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,383.90
|
| Rate for Payer: Three Rivers Provider Network All |
$2,671.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,134.56
|
| Rate for Payer: United Healthcare Managed Medicaid |
$890.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,312.66
|
| Rate for Payer: Zelis Auto |
$1,424.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,781.00
|
| Rate for Payer: Zelis Worker's Compensation |
$972.43
|
|
|
REVISION OF HIP BONES
|
Facility
|
IP
|
$3,562.00
|
|
|
Service Code
|
CPT 27156
|
| Hospital Charge Code |
6127156
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$972.43 |
| Max. Negotiated Rate |
$3,383.90 |
| Rate for Payer: Cash Price |
$2,137.20
|
| Rate for Payer: Cigna Commercial |
$3,027.70
|
| Rate for Payer: First Health Commercial |
$3,205.80
|
| Rate for Payer: First Health Workers Compensation |
$1,375.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,205.80
|
| Rate for Payer: GEHA Commercial |
$2,493.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,205.80
|
| Rate for Payer: Multiplan All |
$3,241.42
|
| Rate for Payer: OMNI Networks Commercial |
$2,493.40
|
| Rate for Payer: One Health Plan PPO/POS |
$3,205.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,383.90
|
| Rate for Payer: Three Rivers Provider Network All |
$2,671.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,312.66
|
| Rate for Payer: Zelis Auto |
$1,424.80
|
| Rate for Payer: Zelis Worker's Compensation |
$972.43
|
|
|
REVISION OF HIP TENDON
|
Facility
|
IP
|
$1,378.00
|
|
|
Service Code
|
CPT 27097
|
| Hospital Charge Code |
6127097
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$376.19 |
| Max. Negotiated Rate |
$1,309.10 |
| Rate for Payer: Cash Price |
$826.80
|
| Rate for Payer: Cigna Commercial |
$1,171.30
|
| Rate for Payer: First Health Commercial |
$1,240.20
|
| Rate for Payer: First Health Workers Compensation |
$532.05
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,240.20
|
| Rate for Payer: GEHA Commercial |
$964.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,240.20
|
| Rate for Payer: Multiplan All |
$1,253.98
|
| Rate for Payer: OMNI Networks Commercial |
$964.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,240.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,309.10
|
| Rate for Payer: Three Rivers Provider Network All |
$1,033.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,281.54
|
| Rate for Payer: Zelis Auto |
$551.20
|
| Rate for Payer: Zelis Worker's Compensation |
$376.19
|
|
|
REVISION OF HIP TENDON
|
Facility
|
OP
|
$1,378.00
|
|
|
Service Code
|
CPT 27097
|
| Hospital Charge Code |
6127097
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$376.19 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,212.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$826.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,212.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,544.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$826.80
|
| Rate for Payer: Cash Price |
$826.80
|
| Rate for Payer: Cigna Commercial |
$1,171.30
|
| Rate for Payer: First Health Commercial |
$1,240.20
|
| Rate for Payer: First Health Workers Compensation |
$532.05
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,240.20
|
| Rate for Payer: GEHA Commercial |
$1,102.40
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,240.20
|
| Rate for Payer: Humana ChoiceCare |
$3,388.98
|
| Rate for Payer: Humana Medicare Advantage |
$3,080.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,175.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,596.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$1,253.98
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$964.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,240.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,998.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,596.69
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,309.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$1,033.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,596.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,281.54
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$551.20
|
| 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 |
$376.19
|
|
|
REVISION OF HORSESHOE KIDNEY
|
Facility
|
OP
|
$2,386.00
|
|
|
Service Code
|
CPT 50540
|
| Hospital Charge Code |
6150540
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$596.50 |
| Max. Negotiated Rate |
$2,266.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,431.60
|
| Rate for Payer: Cash Price |
$1,431.60
|
| Rate for Payer: Cigna Commercial |
$2,028.10
|
| Rate for Payer: First Health Commercial |
$2,147.40
|
| Rate for Payer: First Health Workers Compensation |
$921.23
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,147.40
|
| Rate for Payer: GEHA Commercial |
$1,908.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,147.40
|
| Rate for Payer: Humana ChoiceCare |
$620.36
|
| Rate for Payer: Multiplan All |
$2,171.26
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,431.60
|
| Rate for Payer: OMNI Networks Commercial |
$1,670.20
|
| Rate for Payer: One Health Plan PPO/POS |
$2,147.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,266.70
|
| Rate for Payer: Three Rivers Provider Network All |
$1,789.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,099.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$596.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,218.98
|
| Rate for Payer: Zelis Auto |
$954.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,193.00
|
| Rate for Payer: Zelis Worker's Compensation |
$651.38
|
|
|
REVISION OF HORSESHOE KIDNEY
|
Facility
|
IP
|
$2,386.00
|
|
|
Service Code
|
CPT 50540
|
| Hospital Charge Code |
6150540
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$651.38 |
| Max. Negotiated Rate |
$2,266.70 |
| Rate for Payer: Cash Price |
$1,431.60
|
| Rate for Payer: Cigna Commercial |
$2,028.10
|
| Rate for Payer: First Health Commercial |
$2,147.40
|
| Rate for Payer: First Health Workers Compensation |
$921.23
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,147.40
|
| Rate for Payer: GEHA Commercial |
$1,670.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,147.40
|
| Rate for Payer: Multiplan All |
$2,171.26
|
| Rate for Payer: OMNI Networks Commercial |
$1,670.20
|
| Rate for Payer: One Health Plan PPO/POS |
$2,147.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,266.70
|
| Rate for Payer: Three Rivers Provider Network All |
$1,789.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,218.98
|
| Rate for Payer: Zelis Auto |
$954.40
|
| Rate for Payer: Zelis Worker's Compensation |
$651.38
|
|
|
REVISION OF HUMERUS
|
Facility
|
OP
|
$2,177.00
|
|
|
Service Code
|
CPT 24410
|
| Hospital Charge Code |
6124410
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$594.32 |
| Max. Negotiated Rate |
$24,435.12 |
| 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 |
$1,306.20
|
| 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 |
$12,217.56
|
| Rate for Payer: Cash Price |
$1,306.20
|
| Rate for Payer: Cash Price |
$1,306.20
|
| Rate for Payer: Cigna Commercial |
$1,850.45
|
| Rate for Payer: First Health Commercial |
$1,959.30
|
| Rate for Payer: First Health Workers Compensation |
$840.54
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,959.30
|
| Rate for Payer: GEHA Commercial |
$1,741.60
|
| Rate for Payer: GEHA Medicare |
$12,217.56
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,959.30
|
| Rate for Payer: Humana ChoiceCare |
$13,439.32
|
| Rate for Payer: Humana Medicare Advantage |
$12,217.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,525.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,806.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,217.56
|
| Rate for Payer: Multiplan All |
$1,981.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,769.85
|
| Rate for Payer: OMNI Networks Commercial |
$1,523.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,959.30
|
| 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 |
$12,217.56
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,068.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,435.12
|
| Rate for Payer: Three Rivers Provider Network All |
$1,632.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,973.21
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,806.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,217.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,024.61
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$12,217.56
|
| Rate for Payer: Zelis Auto |
$870.80
|
| Rate for Payer: Zelis Medicare |
$10,384.93
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,661.07
|
| Rate for Payer: Zelis Worker's Compensation |
$594.32
|
|
|
REVISION OF HUMERUS
|
Facility
|
IP
|
$1,674.00
|
|
|
Service Code
|
CPT 24400
|
| Hospital Charge Code |
6124400
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$457.00 |
| Max. Negotiated Rate |
$1,590.30 |
| Rate for Payer: Cash Price |
$1,004.40
|
| Rate for Payer: Cigna Commercial |
$1,422.90
|
| Rate for Payer: First Health Commercial |
$1,506.60
|
| Rate for Payer: First Health Workers Compensation |
$646.33
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,506.60
|
| Rate for Payer: GEHA Commercial |
$1,171.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,506.60
|
| Rate for Payer: Multiplan All |
$1,523.34
|
| Rate for Payer: OMNI Networks Commercial |
$1,171.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,506.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,590.30
|
| Rate for Payer: Three Rivers Provider Network All |
$1,255.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,556.82
|
| Rate for Payer: Zelis Auto |
$669.60
|
| Rate for Payer: Zelis Worker's Compensation |
$457.00
|
|
|
REVISION OF HUMERUS
|
Facility
|
IP
|
$2,008.00
|
|
|
Service Code
|
CPT 24420
|
| Hospital Charge Code |
6124420
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$548.18 |
| Max. Negotiated Rate |
$1,907.60 |
| Rate for Payer: Cash Price |
$1,204.80
|
| Rate for Payer: Cigna Commercial |
$1,706.80
|
| Rate for Payer: First Health Commercial |
$1,807.20
|
| Rate for Payer: First Health Workers Compensation |
$775.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,807.20
|
| Rate for Payer: GEHA Commercial |
$1,405.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,807.20
|
| Rate for Payer: Multiplan All |
$1,827.28
|
| Rate for Payer: OMNI Networks Commercial |
$1,405.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,807.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,907.60
|
| Rate for Payer: Three Rivers Provider Network All |
$1,506.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,867.44
|
| Rate for Payer: Zelis Auto |
$803.20
|
| Rate for Payer: Zelis Worker's Compensation |
$548.18
|
|
|
REVISION OF HUMERUS
|
Facility
|
OP
|
$1,674.00
|
|
|
Service Code
|
CPT 24400
|
| Hospital Charge Code |
6124400
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$457.00 |
| 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 |
$1,004.40
|
| 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 |
$1,004.40
|
| Rate for Payer: Cash Price |
$1,004.40
|
| Rate for Payer: Cigna Commercial |
$1,422.90
|
| Rate for Payer: First Health Commercial |
$1,506.60
|
| Rate for Payer: First Health Workers Compensation |
$646.33
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,506.60
|
| Rate for Payer: GEHA Commercial |
$1,339.20
|
| Rate for Payer: GEHA Medicare |
$6,783.26
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,506.60
|
| 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 |
$1,523.34
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,531.54
|
| Rate for Payer: OMNI Networks Commercial |
$1,171.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,506.60
|
| 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 |
$1,590.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,566.52
|
| Rate for Payer: Three Rivers Provider Network All |
$1,255.50
|
| 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 |
$1,556.82
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,783.26
|
| Rate for Payer: Zelis Auto |
$669.60
|
| 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 |
$457.00
|
|
|
REVISION OF HUMERUS
|
Facility
|
OP
|
$2,008.00
|
|
|
Service Code
|
CPT 24420
|
| Hospital Charge Code |
6124420
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$548.18 |
| 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 |
$1,204.80
|
| 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 |
$1,204.80
|
| Rate for Payer: Cash Price |
$1,204.80
|
| Rate for Payer: Cigna Commercial |
$1,706.80
|
| Rate for Payer: First Health Commercial |
$1,807.20
|
| Rate for Payer: First Health Workers Compensation |
$775.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,807.20
|
| Rate for Payer: GEHA Commercial |
$1,606.40
|
| Rate for Payer: GEHA Medicare |
$6,783.26
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,807.20
|
| 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 |
$1,827.28
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,531.54
|
| Rate for Payer: OMNI Networks Commercial |
$1,405.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,807.20
|
| 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 |
$1,907.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,566.52
|
| Rate for Payer: Three Rivers Provider Network All |
$1,506.00
|
| 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 |
$1,867.44
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,783.26
|
| Rate for Payer: Zelis Auto |
$803.20
|
| 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 |
$548.18
|
|
|
REVISION OF HUMERUS
|
Facility
|
IP
|
$2,177.00
|
|
|
Service Code
|
CPT 24410
|
| Hospital Charge Code |
6124410
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$594.32 |
| Max. Negotiated Rate |
$2,068.15 |
| Rate for Payer: Cash Price |
$1,306.20
|
| Rate for Payer: Cigna Commercial |
$1,850.45
|
| Rate for Payer: First Health Commercial |
$1,959.30
|
| Rate for Payer: First Health Workers Compensation |
$840.54
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,959.30
|
| Rate for Payer: GEHA Commercial |
$1,523.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,959.30
|
| Rate for Payer: Multiplan All |
$1,981.07
|
| Rate for Payer: OMNI Networks Commercial |
$1,523.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,959.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,068.15
|
| Rate for Payer: Three Rivers Provider Network All |
$1,632.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,024.61
|
| Rate for Payer: Zelis Auto |
$870.80
|
| Rate for Payer: Zelis Worker's Compensation |
$594.32
|
|
|
REVISION OF ILEOSTOMY
|
Facility
|
OP
|
$1,228.00
|
|
|
Service Code
|
CPT 44312
|
| Hospital Charge Code |
6144312
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$335.24 |
| Max. Negotiated Rate |
$6,952.48 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,419.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$736.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,419.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,916.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,476.24
|
| Rate for Payer: Cash Price |
$736.80
|
| Rate for Payer: Cash Price |
$736.80
|
| Rate for Payer: Cigna Commercial |
$1,043.80
|
| Rate for Payer: First Health Commercial |
$1,105.20
|
| Rate for Payer: First Health Workers Compensation |
$474.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,105.20
|
| Rate for Payer: GEHA Commercial |
$982.40
|
| Rate for Payer: GEHA Medicare |
$3,476.24
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,105.20
|
| Rate for Payer: Humana ChoiceCare |
$3,823.86
|
| Rate for Payer: Humana Medicare Advantage |
$3,476.24
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,840.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,955.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,476.24
|
| Rate for Payer: Multiplan All |
$1,117.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,909.61
|
| Rate for Payer: OMNI Networks Commercial |
$859.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,105.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,258.40
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,955.93
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,476.24
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,166.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,952.48
|
| Rate for Payer: Three Rivers Provider Network All |
$921.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,406.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,955.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,476.24
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,142.04
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,476.24
|
| Rate for Payer: Zelis Auto |
$491.20
|
| Rate for Payer: Zelis Medicare |
$2,954.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,171.49
|
| Rate for Payer: Zelis Worker's Compensation |
$335.24
|
|
|
REVISION OF ILEOSTOMY
|
Facility
|
IP
|
$1,228.00
|
|
|
Service Code
|
CPT 44312
|
| Hospital Charge Code |
6144312
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$335.24 |
| Max. Negotiated Rate |
$1,166.60 |
| Rate for Payer: Cash Price |
$736.80
|
| Rate for Payer: Cigna Commercial |
$1,043.80
|
| Rate for Payer: First Health Commercial |
$1,105.20
|
| Rate for Payer: First Health Workers Compensation |
$474.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,105.20
|
| Rate for Payer: GEHA Commercial |
$859.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,105.20
|
| Rate for Payer: Multiplan All |
$1,117.48
|
| Rate for Payer: OMNI Networks Commercial |
$859.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,105.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,166.60
|
| Rate for Payer: Three Rivers Provider Network All |
$921.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,142.04
|
| Rate for Payer: Zelis Auto |
$491.20
|
| Rate for Payer: Zelis Worker's Compensation |
$335.24
|
|
|
REVISION OF ILEOSTOMY
|
Facility
|
OP
|
$2,100.00
|
|
|
Service Code
|
CPT 44314
|
| Hospital Charge Code |
6144314
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$525.00 |
| Max. Negotiated Rate |
$1,995.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,260.00
|
| Rate for Payer: Cash Price |
$1,260.00
|
| Rate for Payer: Cigna Commercial |
$1,785.00
|
| Rate for Payer: First Health Commercial |
$1,890.00
|
| Rate for Payer: First Health Workers Compensation |
$810.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,890.00
|
| Rate for Payer: GEHA Commercial |
$1,680.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,890.00
|
| Rate for Payer: Humana ChoiceCare |
$546.00
|
| Rate for Payer: Multiplan All |
$1,911.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,260.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,470.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,890.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,995.00
|
| Rate for Payer: Three Rivers Provider Network All |
$1,575.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,848.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$525.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,953.00
|
| Rate for Payer: Zelis Auto |
$840.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,050.00
|
| Rate for Payer: Zelis Worker's Compensation |
$573.30
|
|
|
REVISION OF ILEOSTOMY
|
Facility
|
IP
|
$2,100.00
|
|
|
Service Code
|
CPT 44314
|
| Hospital Charge Code |
6144314
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$573.30 |
| Max. Negotiated Rate |
$1,995.00 |
| Rate for Payer: Cash Price |
$1,260.00
|
| Rate for Payer: Cigna Commercial |
$1,785.00
|
| Rate for Payer: First Health Commercial |
$1,890.00
|
| Rate for Payer: First Health Workers Compensation |
$810.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,890.00
|
| Rate for Payer: GEHA Commercial |
$1,470.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,890.00
|
| Rate for Payer: Multiplan All |
$1,911.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,470.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,890.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,995.00
|
| Rate for Payer: Three Rivers Provider Network All |
$1,575.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,953.00
|
| Rate for Payer: Zelis Auto |
$840.00
|
| Rate for Payer: Zelis Worker's Compensation |
$573.30
|
|
|
REVISION OF KIDNEY/URETER
|
Facility
|
OP
|
$2,888.00
|
|
|
Service Code
|
CPT 50405
|
| Hospital Charge Code |
6150405
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$722.00 |
| Max. Negotiated Rate |
$2,743.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,732.80
|
| Rate for Payer: Cash Price |
$1,732.80
|
| Rate for Payer: Cigna Commercial |
$2,454.80
|
| Rate for Payer: First Health Commercial |
$2,599.20
|
| Rate for Payer: First Health Workers Compensation |
$1,115.06
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,599.20
|
| Rate for Payer: GEHA Commercial |
$2,310.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,599.20
|
| Rate for Payer: Humana ChoiceCare |
$750.88
|
| Rate for Payer: Multiplan All |
$2,628.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,732.80
|
| Rate for Payer: OMNI Networks Commercial |
$2,021.60
|
| Rate for Payer: One Health Plan PPO/POS |
$2,599.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,743.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,166.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,541.44
|
| Rate for Payer: United Healthcare Managed Medicaid |
$722.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,685.84
|
| Rate for Payer: Zelis Auto |
$1,155.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,444.00
|
| Rate for Payer: Zelis Worker's Compensation |
$788.42
|
|
|
REVISION OF KIDNEY/URETER
|
Facility
|
IP
|
$2,394.00
|
|
|
Service Code
|
CPT 50400
|
| Hospital Charge Code |
6150400
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$653.56 |
| Max. Negotiated Rate |
$2,274.30 |
| Rate for Payer: Cash Price |
$1,436.40
|
| Rate for Payer: Cigna Commercial |
$2,034.90
|
| Rate for Payer: First Health Commercial |
$2,154.60
|
| Rate for Payer: First Health Workers Compensation |
$924.32
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,154.60
|
| Rate for Payer: GEHA Commercial |
$1,675.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,154.60
|
| Rate for Payer: Multiplan All |
$2,178.54
|
| Rate for Payer: OMNI Networks Commercial |
$1,675.80
|
| Rate for Payer: One Health Plan PPO/POS |
$2,154.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,274.30
|
| Rate for Payer: Three Rivers Provider Network All |
$1,795.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,226.42
|
| Rate for Payer: Zelis Auto |
$957.60
|
| Rate for Payer: Zelis Worker's Compensation |
$653.56
|
|
|
REVISION OF KIDNEY/URETER
|
Facility
|
OP
|
$2,394.00
|
|
|
Service Code
|
CPT 50400
|
| Hospital Charge Code |
6150400
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$598.50 |
| Max. Negotiated Rate |
$2,274.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,436.40
|
| Rate for Payer: Cash Price |
$1,436.40
|
| Rate for Payer: Cigna Commercial |
$2,034.90
|
| Rate for Payer: First Health Commercial |
$2,154.60
|
| Rate for Payer: First Health Workers Compensation |
$924.32
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,154.60
|
| Rate for Payer: GEHA Commercial |
$1,915.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,154.60
|
| Rate for Payer: Humana ChoiceCare |
$622.44
|
| Rate for Payer: Multiplan All |
$2,178.54
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,436.40
|
| Rate for Payer: OMNI Networks Commercial |
$1,675.80
|
| Rate for Payer: One Health Plan PPO/POS |
$2,154.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,274.30
|
| Rate for Payer: Three Rivers Provider Network All |
$1,795.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,106.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$598.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,226.42
|
| Rate for Payer: Zelis Auto |
$957.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,197.00
|
| Rate for Payer: Zelis Worker's Compensation |
$653.56
|
|
|
REVISION OF KIDNEY/URETER
|
Facility
|
IP
|
$2,888.00
|
|
|
Service Code
|
CPT 50405
|
| Hospital Charge Code |
6150405
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$788.42 |
| Max. Negotiated Rate |
$2,743.60 |
| Rate for Payer: Cash Price |
$1,732.80
|
| Rate for Payer: Cigna Commercial |
$2,454.80
|
| Rate for Payer: First Health Commercial |
$2,599.20
|
| Rate for Payer: First Health Workers Compensation |
$1,115.06
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,599.20
|
| Rate for Payer: GEHA Commercial |
$2,021.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,599.20
|
| Rate for Payer: Multiplan All |
$2,628.08
|
| Rate for Payer: OMNI Networks Commercial |
$2,021.60
|
| Rate for Payer: One Health Plan PPO/POS |
$2,599.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,743.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,166.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,685.84
|
| Rate for Payer: Zelis Auto |
$1,155.20
|
| Rate for Payer: Zelis Worker's Compensation |
$788.42
|
|
|
REVISION OF KNEE JOINT
|
Facility
|
IP
|
$1,639.00
|
|
|
Service Code
|
CPT 27440
|
| Hospital Charge Code |
6127440
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$447.45 |
| Max. Negotiated Rate |
$1,557.05 |
| Rate for Payer: Cash Price |
$983.40
|
| Rate for Payer: Cigna Commercial |
$1,393.15
|
| Rate for Payer: First Health Commercial |
$1,475.10
|
| Rate for Payer: First Health Workers Compensation |
$632.82
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,475.10
|
| Rate for Payer: GEHA Commercial |
$1,147.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,475.10
|
| Rate for Payer: Multiplan All |
$1,491.49
|
| Rate for Payer: OMNI Networks Commercial |
$1,147.30
|
| Rate for Payer: One Health Plan PPO/POS |
$1,475.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,557.05
|
| Rate for Payer: Three Rivers Provider Network All |
$1,229.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,524.27
|
| Rate for Payer: Zelis Auto |
$655.60
|
| Rate for Payer: Zelis Worker's Compensation |
$447.45
|
|
|
REVISION OF KNEE JOINT
|
Facility
|
OP
|
$2,578.00
|
|
|
Service Code
|
CPT 27445
|
| Hospital Charge Code |
6127445
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$644.50 |
| Max. Negotiated Rate |
$2,449.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,546.80
|
| Rate for Payer: Cash Price |
$1,546.80
|
| Rate for Payer: Cigna Commercial |
$2,191.30
|
| Rate for Payer: First Health Commercial |
$2,320.20
|
| Rate for Payer: First Health Workers Compensation |
$995.37
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,320.20
|
| Rate for Payer: GEHA Commercial |
$2,062.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,320.20
|
| Rate for Payer: Humana ChoiceCare |
$670.28
|
| Rate for Payer: Multiplan All |
$2,345.98
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,546.80
|
| Rate for Payer: OMNI Networks Commercial |
$1,804.60
|
| Rate for Payer: One Health Plan PPO/POS |
$2,320.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,449.10
|
| Rate for Payer: Three Rivers Provider Network All |
$1,933.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,268.64
|
| Rate for Payer: United Healthcare Managed Medicaid |
$644.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,397.54
|
| Rate for Payer: Zelis Auto |
$1,031.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,289.00
|
| Rate for Payer: Zelis Worker's Compensation |
$703.79
|
|
|
REVISION OF KNEE JOINT
|
Facility
|
IP
|
$1,690.00
|
|
|
Service Code
|
CPT 27441
|
| Hospital Charge Code |
6127441
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$461.37 |
| Max. Negotiated Rate |
$1,605.50 |
| Rate for Payer: Cash Price |
$1,014.00
|
| Rate for Payer: Cigna Commercial |
$1,436.50
|
| Rate for Payer: First Health Commercial |
$1,521.00
|
| Rate for Payer: First Health Workers Compensation |
$652.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,521.00
|
| Rate for Payer: GEHA Commercial |
$1,183.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,521.00
|
| Rate for Payer: Multiplan All |
$1,537.90
|
| Rate for Payer: OMNI Networks Commercial |
$1,183.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,521.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,605.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,267.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,571.70
|
| Rate for Payer: Zelis Auto |
$676.00
|
| Rate for Payer: Zelis Worker's Compensation |
$461.37
|
|
|
REVISION OF KNEE JOINT
|
Facility
|
IP
|
$1,656.00
|
|
|
Service Code
|
CPT 27443
|
| Hospital Charge Code |
6127443
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$452.09 |
| Max. Negotiated Rate |
$1,573.20 |
| Rate for Payer: Cash Price |
$993.60
|
| Rate for Payer: Cigna Commercial |
$1,407.60
|
| Rate for Payer: First Health Commercial |
$1,490.40
|
| Rate for Payer: First Health Workers Compensation |
$639.38
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,490.40
|
| Rate for Payer: GEHA Commercial |
$1,159.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,490.40
|
| Rate for Payer: Multiplan All |
$1,506.96
|
| Rate for Payer: OMNI Networks Commercial |
$1,159.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,490.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,573.20
|
| Rate for Payer: Three Rivers Provider Network All |
$1,242.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,540.08
|
| Rate for Payer: Zelis Auto |
$662.40
|
| Rate for Payer: Zelis Worker's Compensation |
$452.09
|
|
