|
RPR AA HERNIA 1ST > 10 CM NCRC8/STRANGUL
|
Facility
|
IP
|
$3,026.85
|
|
|
Service Code
|
CPT 49596
|
| Hospital Charge Code |
6149596
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$826.33 |
| Max. Negotiated Rate |
$2,875.51 |
| Rate for Payer: Cash Price |
$1,816.11
|
| Rate for Payer: Cigna Commercial |
$2,572.82
|
| Rate for Payer: First Health Commercial |
$2,724.16
|
| Rate for Payer: First Health Workers Compensation |
$1,168.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,724.16
|
| Rate for Payer: GEHA Commercial |
$2,118.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,724.16
|
| Rate for Payer: Multiplan All |
$2,754.43
|
| Rate for Payer: OMNI Networks Commercial |
$2,118.80
|
| Rate for Payer: One Health Plan PPO/POS |
$2,724.16
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,875.51
|
| Rate for Payer: Three Rivers Provider Network All |
$2,270.14
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,814.97
|
| Rate for Payer: Zelis Auto |
$1,210.74
|
| Rate for Payer: Zelis Worker's Compensation |
$826.33
|
|
|
RPR AA HERNIA 1ST > 10 CM REDUCIBLE
|
Facility
|
IP
|
$2,278.62
|
|
|
Service Code
|
CPT 49595
|
| Hospital Charge Code |
6149595
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$622.06 |
| Max. Negotiated Rate |
$2,164.69 |
| Rate for Payer: Cash Price |
$1,367.17
|
| Rate for Payer: Cigna Commercial |
$1,936.83
|
| Rate for Payer: First Health Commercial |
$2,050.76
|
| Rate for Payer: First Health Workers Compensation |
$879.78
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,050.76
|
| Rate for Payer: GEHA Commercial |
$1,595.03
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,050.76
|
| Rate for Payer: Multiplan All |
$2,073.54
|
| Rate for Payer: OMNI Networks Commercial |
$1,595.03
|
| Rate for Payer: One Health Plan PPO/POS |
$2,050.76
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,164.69
|
| Rate for Payer: Three Rivers Provider Network All |
$1,708.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,119.12
|
| Rate for Payer: Zelis Auto |
$911.45
|
| Rate for Payer: Zelis Worker's Compensation |
$622.06
|
|
|
RPR AA HERNIA 1ST > 10 CM REDUCIBLE
|
Facility
|
OP
|
$2,278.62
|
|
|
Service Code
|
CPT 49595
|
| Hospital Charge Code |
6149595
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$622.06 |
| Max. Negotiated Rate |
$11,849.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,312.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,367.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,312.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,208.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,924.89
|
| Rate for Payer: Cash Price |
$1,367.17
|
| Rate for Payer: Cash Price |
$1,367.17
|
| Rate for Payer: Cigna Commercial |
$1,936.83
|
| Rate for Payer: First Health Commercial |
$2,050.76
|
| Rate for Payer: First Health Workers Compensation |
$879.78
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,050.76
|
| Rate for Payer: GEHA Commercial |
$1,822.90
|
| Rate for Payer: GEHA Medicare |
$5,924.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,050.76
|
| Rate for Payer: Humana ChoiceCare |
$6,517.38
|
| Rate for Payer: Humana Medicare Advantage |
$5,924.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$9,953.82
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,294.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,924.89
|
| Rate for Payer: Multiplan All |
$2,073.54
|
| Rate for Payer: New Mexico Health Connections Medicare |
$10,072.31
|
| Rate for Payer: OMNI Networks Commercial |
$1,595.03
|
| Rate for Payer: One Health Plan PPO/POS |
$2,050.76
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,958.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,294.59
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,924.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,164.69
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,849.78
|
| Rate for Payer: Three Rivers Provider Network All |
$1,708.96
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,806.39
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,294.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,924.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,119.12
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,924.89
|
| Rate for Payer: Zelis Auto |
$911.45
|
| Rate for Payer: Zelis Medicare |
$5,036.16
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,109.87
|
| Rate for Payer: Zelis Worker's Compensation |
$622.06
|
|
|
RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGUL
|
Facility
|
OP
|
$2,208.48
|
|
|
Service Code
|
CPT 49594
|
| Hospital Charge Code |
6149594
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$602.92 |
| Max. Negotiated Rate |
$11,079.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,818.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,325.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,818.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,193.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,539.96
|
| Rate for Payer: Cash Price |
$1,325.09
|
| Rate for Payer: Cash Price |
$1,325.09
|
| Rate for Payer: Cigna Commercial |
$1,877.21
|
| Rate for Payer: First Health Commercial |
$1,987.63
|
| Rate for Payer: First Health Workers Compensation |
$852.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,987.63
|
| Rate for Payer: GEHA Commercial |
$1,766.78
|
| Rate for Payer: GEHA Medicare |
$5,539.96
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,987.63
|
| Rate for Payer: Humana ChoiceCare |
$6,093.96
|
| Rate for Payer: Humana Medicare Advantage |
$5,539.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$9,307.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,319.73
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,539.96
|
| Rate for Payer: Multiplan All |
$2,009.72
|
| Rate for Payer: New Mexico Health Connections Medicare |
$9,417.93
|
| Rate for Payer: OMNI Networks Commercial |
$1,545.94
|
| Rate for Payer: One Health Plan PPO/POS |
$1,987.63
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$7,297.01
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,319.73
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,539.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,098.06
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,079.92
|
| Rate for Payer: Three Rivers Provider Network All |
$1,656.36
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,429.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,319.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,539.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,053.89
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,539.96
|
| Rate for Payer: Zelis Auto |
$883.39
|
| Rate for Payer: Zelis Medicare |
$4,708.97
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,647.95
|
| Rate for Payer: Zelis Worker's Compensation |
$602.92
|
|
|
RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGUL
|
Facility
|
IP
|
$2,208.48
|
|
|
Service Code
|
CPT 49594
|
| Hospital Charge Code |
6149594
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$602.92 |
| Max. Negotiated Rate |
$2,098.06 |
| Rate for Payer: Cash Price |
$1,325.09
|
| Rate for Payer: Cigna Commercial |
$1,877.21
|
| Rate for Payer: First Health Commercial |
$1,987.63
|
| Rate for Payer: First Health Workers Compensation |
$852.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,987.63
|
| Rate for Payer: GEHA Commercial |
$1,545.94
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,987.63
|
| Rate for Payer: Multiplan All |
$2,009.72
|
| Rate for Payer: OMNI Networks Commercial |
$1,545.94
|
| Rate for Payer: One Health Plan PPO/POS |
$1,987.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,098.06
|
| Rate for Payer: Three Rivers Provider Network All |
$1,656.36
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,053.89
|
| Rate for Payer: Zelis Auto |
$883.39
|
| Rate for Payer: Zelis Worker's Compensation |
$602.92
|
|
|
RPR AA HERNIA 1ST 3-10 CM RDUCIBLE
|
Facility
|
IP
|
$1,693.14
|
|
|
Service Code
|
CPT 49593
|
| Hospital Charge Code |
6149593
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$462.23 |
| Max. Negotiated Rate |
$1,608.48 |
| Rate for Payer: Cash Price |
$1,015.88
|
| Rate for Payer: Cigna Commercial |
$1,439.17
|
| Rate for Payer: First Health Commercial |
$1,523.83
|
| Rate for Payer: First Health Workers Compensation |
$653.72
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,523.83
|
| Rate for Payer: GEHA Commercial |
$1,185.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,523.83
|
| Rate for Payer: Multiplan All |
$1,540.76
|
| Rate for Payer: OMNI Networks Commercial |
$1,185.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,523.83
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,608.48
|
| Rate for Payer: Three Rivers Provider Network All |
$1,269.86
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,574.62
|
| Rate for Payer: Zelis Auto |
$677.26
|
| Rate for Payer: Zelis Worker's Compensation |
$462.23
|
|
|
RPR AA HERNIA 1ST 3-10 CM RDUCIBLE
|
Facility
|
OP
|
$1,693.14
|
|
|
Service Code
|
CPT 49593
|
| Hospital Charge Code |
6149593
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$462.23 |
| Max. Negotiated Rate |
$11,849.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,312.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,015.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,312.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,208.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,924.89
|
| Rate for Payer: Cash Price |
$1,015.88
|
| Rate for Payer: Cash Price |
$1,015.88
|
| Rate for Payer: Cigna Commercial |
$1,439.17
|
| Rate for Payer: First Health Commercial |
$1,523.83
|
| Rate for Payer: First Health Workers Compensation |
$653.72
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,523.83
|
| Rate for Payer: GEHA Commercial |
$1,354.51
|
| Rate for Payer: GEHA Medicare |
$5,924.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,523.83
|
| Rate for Payer: Humana ChoiceCare |
$6,517.38
|
| Rate for Payer: Humana Medicare Advantage |
$5,924.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$9,953.82
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,294.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,924.89
|
| Rate for Payer: Multiplan All |
$1,540.76
|
| Rate for Payer: New Mexico Health Connections Medicare |
$10,072.31
|
| Rate for Payer: OMNI Networks Commercial |
$1,185.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,523.83
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,958.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,294.59
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,924.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,608.48
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,849.78
|
| Rate for Payer: Three Rivers Provider Network All |
$1,269.86
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,806.39
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,294.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,924.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,574.62
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,924.89
|
| Rate for Payer: Zelis Auto |
$677.26
|
| Rate for Payer: Zelis Medicare |
$5,036.16
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,109.87
|
| Rate for Payer: Zelis Worker's Compensation |
$462.23
|
|
|
RPR AA HERNIA 1ST < 3 CM NCRCB/STRANGULA
|
Facility
|
OP
|
$1,406.79
|
|
|
Service Code
|
CPT 49592
|
| Hospital Charge Code |
6149592
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$384.05 |
| Max. Negotiated Rate |
$11,079.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,818.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$844.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,818.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,193.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,539.96
|
| Rate for Payer: Cash Price |
$844.07
|
| Rate for Payer: Cash Price |
$844.07
|
| Rate for Payer: Cigna Commercial |
$1,195.77
|
| Rate for Payer: First Health Commercial |
$1,266.11
|
| Rate for Payer: First Health Workers Compensation |
$543.16
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,266.11
|
| Rate for Payer: GEHA Commercial |
$1,125.43
|
| Rate for Payer: GEHA Medicare |
$5,539.96
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,266.11
|
| Rate for Payer: Humana ChoiceCare |
$6,093.96
|
| Rate for Payer: Humana Medicare Advantage |
$5,539.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$9,307.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,319.73
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,539.96
|
| Rate for Payer: Multiplan All |
$1,280.18
|
| Rate for Payer: New Mexico Health Connections Medicare |
$9,417.93
|
| Rate for Payer: OMNI Networks Commercial |
$984.75
|
| Rate for Payer: One Health Plan PPO/POS |
$1,266.11
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$7,297.01
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,319.73
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,539.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,336.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,079.92
|
| Rate for Payer: Three Rivers Provider Network All |
$1,055.09
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,429.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,319.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,539.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,308.31
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,539.96
|
| Rate for Payer: Zelis Auto |
$562.72
|
| Rate for Payer: Zelis Medicare |
$4,708.97
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,647.95
|
| Rate for Payer: Zelis Worker's Compensation |
$384.05
|
|
|
RPR AA HERNIA 1ST < 3 CM NCRCB/STRANGULA
|
Facility
|
IP
|
$1,406.79
|
|
|
Service Code
|
CPT 49592
|
| Hospital Charge Code |
6149592
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$384.05 |
| Max. Negotiated Rate |
$1,336.45 |
| Rate for Payer: Cash Price |
$844.07
|
| Rate for Payer: Cigna Commercial |
$1,195.77
|
| Rate for Payer: First Health Commercial |
$1,266.11
|
| Rate for Payer: First Health Workers Compensation |
$543.16
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,266.11
|
| Rate for Payer: GEHA Commercial |
$984.75
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,266.11
|
| Rate for Payer: Multiplan All |
$1,280.18
|
| Rate for Payer: OMNI Networks Commercial |
$984.75
|
| Rate for Payer: One Health Plan PPO/POS |
$1,266.11
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,336.45
|
| Rate for Payer: Three Rivers Provider Network All |
$1,055.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,308.31
|
| Rate for Payer: Zelis Auto |
$562.72
|
| Rate for Payer: Zelis Worker's Compensation |
$384.05
|
|
|
RPR AA HERNIA 1ST < 3 CM REDUCIBLE
|
Facility
|
IP
|
$1,008.84
|
|
|
Service Code
|
CPT 49591
|
| Hospital Charge Code |
6149591
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$275.41 |
| Max. Negotiated Rate |
$958.40 |
| Rate for Payer: Cash Price |
$605.30
|
| Rate for Payer: Cigna Commercial |
$857.51
|
| Rate for Payer: First Health Commercial |
$907.96
|
| Rate for Payer: First Health Workers Compensation |
$389.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$907.96
|
| Rate for Payer: GEHA Commercial |
$706.19
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$907.96
|
| Rate for Payer: Multiplan All |
$918.04
|
| Rate for Payer: OMNI Networks Commercial |
$706.19
|
| Rate for Payer: One Health Plan PPO/POS |
$907.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$958.40
|
| Rate for Payer: Three Rivers Provider Network All |
$756.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$938.22
|
| Rate for Payer: Zelis Auto |
$403.54
|
| Rate for Payer: Zelis Worker's Compensation |
$275.41
|
|
|
RPR AA HERNIA 1ST < 3 CM REDUCIBLE
|
Facility
|
OP
|
$1,008.84
|
|
|
Service Code
|
CPT 49591
|
| Hospital Charge Code |
6149591
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$275.41 |
| Max. Negotiated Rate |
$6,701.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,312.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$605.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,312.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,208.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,350.98
|
| Rate for Payer: Cash Price |
$605.30
|
| Rate for Payer: Cash Price |
$605.30
|
| Rate for Payer: Cigna Commercial |
$857.51
|
| Rate for Payer: First Health Commercial |
$907.96
|
| Rate for Payer: First Health Workers Compensation |
$389.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$907.96
|
| Rate for Payer: GEHA Commercial |
$807.07
|
| Rate for Payer: GEHA Medicare |
$3,350.98
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$907.96
|
| Rate for Payer: Humana ChoiceCare |
$3,686.08
|
| Rate for Payer: Humana Medicare Advantage |
$3,350.98
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,629.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,294.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,350.98
|
| Rate for Payer: Multiplan All |
$918.04
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,696.67
|
| Rate for Payer: OMNI Networks Commercial |
$706.19
|
| Rate for Payer: One Health Plan PPO/POS |
$907.96
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,958.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,294.59
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,350.98
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$958.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,701.96
|
| Rate for Payer: Three Rivers Provider Network All |
$756.63
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,283.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,294.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,350.98
|
| Rate for Payer: United Payors & United Providers UP&UP |
$938.22
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,350.98
|
| Rate for Payer: Zelis Auto |
$403.54
|
| Rate for Payer: Zelis Medicare |
$2,848.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,021.18
|
| Rate for Payer: Zelis Worker's Compensation |
$275.41
|
|
|
RPR AA HERNIA RECR > 10 CM NCRC8/STRANGU
|
Facility
|
OP
|
$3,669.60
|
|
|
Service Code
|
CPT 49618
|
| Hospital Charge Code |
6149618
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$917.40 |
| Max. Negotiated Rate |
$3,486.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,201.76
|
| Rate for Payer: Cash Price |
$2,201.76
|
| Rate for Payer: Cigna Commercial |
$3,119.16
|
| Rate for Payer: First Health Commercial |
$3,302.64
|
| Rate for Payer: First Health Workers Compensation |
$1,416.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,302.64
|
| Rate for Payer: GEHA Commercial |
$2,935.68
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,302.64
|
| Rate for Payer: Humana ChoiceCare |
$954.10
|
| Rate for Payer: Multiplan All |
$3,339.34
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,201.76
|
| Rate for Payer: OMNI Networks Commercial |
$2,568.72
|
| Rate for Payer: One Health Plan PPO/POS |
$3,302.64
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,486.12
|
| Rate for Payer: Three Rivers Provider Network All |
$2,752.20
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,229.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$917.40
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,412.73
|
| Rate for Payer: Zelis Auto |
$1,467.84
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,834.80
|
| Rate for Payer: Zelis Worker's Compensation |
$1,001.80
|
|
|
RPR AA HERNIA RECR > 10 CM NCRC8/STRANGU
|
Facility
|
IP
|
$3,669.60
|
|
|
Service Code
|
CPT 49618
|
| Hospital Charge Code |
6149618
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,001.80 |
| Max. Negotiated Rate |
$3,486.12 |
| Rate for Payer: Cash Price |
$2,201.76
|
| Rate for Payer: Cigna Commercial |
$3,119.16
|
| Rate for Payer: First Health Commercial |
$3,302.64
|
| Rate for Payer: First Health Workers Compensation |
$1,416.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,302.64
|
| Rate for Payer: GEHA Commercial |
$2,568.72
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,302.64
|
| Rate for Payer: Multiplan All |
$3,339.34
|
| Rate for Payer: OMNI Networks Commercial |
$2,568.72
|
| Rate for Payer: One Health Plan PPO/POS |
$3,302.64
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,486.12
|
| Rate for Payer: Three Rivers Provider Network All |
$2,752.20
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,412.73
|
| Rate for Payer: Zelis Auto |
$1,467.84
|
| Rate for Payer: Zelis Worker's Compensation |
$1,001.80
|
|
|
RPR AA HERNIA RECR > 10 CM REDUCIBLE
|
Facility
|
OP
|
$2,615.91
|
|
|
Service Code
|
CPT 49617
|
| Hospital Charge Code |
6149617
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$653.98 |
| Max. Negotiated Rate |
$2,485.11 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,569.55
|
| Rate for Payer: Cash Price |
$1,569.55
|
| Rate for Payer: Cigna Commercial |
$2,223.52
|
| Rate for Payer: First Health Commercial |
$2,354.32
|
| Rate for Payer: First Health Workers Compensation |
$1,010.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,354.32
|
| Rate for Payer: GEHA Commercial |
$2,092.73
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,354.32
|
| Rate for Payer: Humana ChoiceCare |
$680.14
|
| Rate for Payer: Multiplan All |
$2,380.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,569.55
|
| Rate for Payer: OMNI Networks Commercial |
$1,831.14
|
| Rate for Payer: One Health Plan PPO/POS |
$2,354.32
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,485.11
|
| Rate for Payer: Three Rivers Provider Network All |
$1,961.93
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,302.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$653.98
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,432.80
|
| Rate for Payer: Zelis Auto |
$1,046.36
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,307.95
|
| Rate for Payer: Zelis Worker's Compensation |
$714.14
|
|
|
RPR AA HERNIA RECR > 10 CM REDUCIBLE
|
Facility
|
IP
|
$2,615.91
|
|
|
Service Code
|
CPT 49617
|
| Hospital Charge Code |
6149617
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$714.14 |
| Max. Negotiated Rate |
$2,485.11 |
| Rate for Payer: Cash Price |
$1,569.55
|
| Rate for Payer: Cigna Commercial |
$2,223.52
|
| Rate for Payer: First Health Commercial |
$2,354.32
|
| Rate for Payer: First Health Workers Compensation |
$1,010.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,354.32
|
| Rate for Payer: GEHA Commercial |
$1,831.14
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,354.32
|
| Rate for Payer: Multiplan All |
$2,380.48
|
| Rate for Payer: OMNI Networks Commercial |
$1,831.14
|
| Rate for Payer: One Health Plan PPO/POS |
$2,354.32
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,485.11
|
| Rate for Payer: Three Rivers Provider Network All |
$1,961.93
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,432.80
|
| Rate for Payer: Zelis Auto |
$1,046.36
|
| Rate for Payer: Zelis Worker's Compensation |
$714.14
|
|
|
RPR AA HERNIA RECR 3-10 CM NCRC8/STRANGU
|
Facility
|
OP
|
$2,542.38
|
|
|
Service Code
|
CPT 49616
|
| Hospital Charge Code |
6149616
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$635.60 |
| Max. Negotiated Rate |
$2,415.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,525.43
|
| Rate for Payer: Cash Price |
$1,525.43
|
| Rate for Payer: Cigna Commercial |
$2,161.02
|
| Rate for Payer: First Health Commercial |
$2,288.14
|
| Rate for Payer: First Health Workers Compensation |
$981.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,288.14
|
| Rate for Payer: GEHA Commercial |
$2,033.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,288.14
|
| Rate for Payer: Humana ChoiceCare |
$661.02
|
| Rate for Payer: Multiplan All |
$2,313.57
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,525.43
|
| Rate for Payer: OMNI Networks Commercial |
$1,779.67
|
| Rate for Payer: One Health Plan PPO/POS |
$2,288.14
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,415.26
|
| Rate for Payer: Three Rivers Provider Network All |
$1,906.79
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,237.29
|
| Rate for Payer: United Healthcare Managed Medicaid |
$635.60
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,364.41
|
| Rate for Payer: Zelis Auto |
$1,016.95
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,271.19
|
| Rate for Payer: Zelis Worker's Compensation |
$694.07
|
|
|
RPR AA HERNIA RECR 3-10 CM NCRC8/STRANGU
|
Facility
|
IP
|
$1,689.48
|
|
|
Service Code
|
CPT 49614
|
| Hospital Charge Code |
6149614
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$461.23 |
| Max. Negotiated Rate |
$1,605.01 |
| Rate for Payer: Cash Price |
$1,013.69
|
| Rate for Payer: Cigna Commercial |
$1,436.06
|
| Rate for Payer: First Health Commercial |
$1,520.53
|
| Rate for Payer: First Health Workers Compensation |
$652.31
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,520.53
|
| Rate for Payer: GEHA Commercial |
$1,182.64
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,520.53
|
| Rate for Payer: Multiplan All |
$1,537.43
|
| Rate for Payer: OMNI Networks Commercial |
$1,182.64
|
| Rate for Payer: One Health Plan PPO/POS |
$1,520.53
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,605.01
|
| Rate for Payer: Three Rivers Provider Network All |
$1,267.11
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,571.22
|
| Rate for Payer: Zelis Auto |
$675.79
|
| Rate for Payer: Zelis Worker's Compensation |
$461.23
|
|
|
RPR AA HERNIA RECR 3-10 CM NCRC8/STRANGU
|
Facility
|
IP
|
$2,542.38
|
|
|
Service Code
|
CPT 49616
|
| Hospital Charge Code |
6149616
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$694.07 |
| Max. Negotiated Rate |
$2,415.26 |
| Rate for Payer: Cash Price |
$1,525.43
|
| Rate for Payer: Cigna Commercial |
$2,161.02
|
| Rate for Payer: First Health Commercial |
$2,288.14
|
| Rate for Payer: First Health Workers Compensation |
$981.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,288.14
|
| Rate for Payer: GEHA Commercial |
$1,779.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,288.14
|
| Rate for Payer: Multiplan All |
$2,313.57
|
| Rate for Payer: OMNI Networks Commercial |
$1,779.67
|
| Rate for Payer: One Health Plan PPO/POS |
$2,288.14
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,415.26
|
| Rate for Payer: Three Rivers Provider Network All |
$1,906.79
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,364.41
|
| Rate for Payer: Zelis Auto |
$1,016.95
|
| Rate for Payer: Zelis Worker's Compensation |
$694.07
|
|
|
RPR AA HERNIA RECR 3-10 CM NCRC8/STRANGU
|
Facility
|
OP
|
$1,689.48
|
|
|
Service Code
|
CPT 49614
|
| Hospital Charge Code |
6149614
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$461.23 |
| Max. Negotiated Rate |
$11,079.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,818.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,013.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,818.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6,193.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,539.96
|
| Rate for Payer: Cash Price |
$1,013.69
|
| Rate for Payer: Cash Price |
$1,013.69
|
| Rate for Payer: Cigna Commercial |
$1,436.06
|
| Rate for Payer: First Health Commercial |
$1,520.53
|
| Rate for Payer: First Health Workers Compensation |
$652.31
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,520.53
|
| Rate for Payer: GEHA Commercial |
$1,351.58
|
| Rate for Payer: GEHA Medicare |
$5,539.96
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,520.53
|
| Rate for Payer: Humana ChoiceCare |
$6,093.96
|
| Rate for Payer: Humana Medicare Advantage |
$5,539.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$9,307.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6,319.73
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,539.96
|
| Rate for Payer: Multiplan All |
$1,537.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$9,417.93
|
| Rate for Payer: OMNI Networks Commercial |
$1,182.64
|
| Rate for Payer: One Health Plan PPO/POS |
$1,520.53
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$7,297.01
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6,319.73
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,539.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,605.01
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,079.92
|
| Rate for Payer: Three Rivers Provider Network All |
$1,267.11
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,429.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6,319.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,539.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,571.22
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,539.96
|
| Rate for Payer: Zelis Auto |
$675.79
|
| Rate for Payer: Zelis Medicare |
$4,708.97
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,647.95
|
| Rate for Payer: Zelis Worker's Compensation |
$461.23
|
|
|
RPR AA HERNIA RECR 3-10 CM REDUCIBLE
|
Facility
|
OP
|
$1,890.78
|
|
|
Service Code
|
CPT 49615
|
| Hospital Charge Code |
6149615
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$516.18 |
| Max. Negotiated Rate |
$11,849.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,312.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,134.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,312.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,208.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,924.89
|
| Rate for Payer: Cash Price |
$1,134.47
|
| Rate for Payer: Cash Price |
$1,134.47
|
| Rate for Payer: Cigna Commercial |
$1,607.16
|
| Rate for Payer: First Health Commercial |
$1,701.70
|
| Rate for Payer: First Health Workers Compensation |
$730.03
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,701.70
|
| Rate for Payer: GEHA Commercial |
$1,512.62
|
| Rate for Payer: GEHA Medicare |
$5,924.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,701.70
|
| Rate for Payer: Humana ChoiceCare |
$6,517.38
|
| Rate for Payer: Humana Medicare Advantage |
$5,924.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$9,953.82
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,294.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,924.89
|
| Rate for Payer: Multiplan All |
$1,720.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$10,072.31
|
| Rate for Payer: OMNI Networks Commercial |
$1,323.55
|
| Rate for Payer: One Health Plan PPO/POS |
$1,701.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,958.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,294.59
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,924.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,796.24
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,849.78
|
| Rate for Payer: Three Rivers Provider Network All |
$1,418.09
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,806.39
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,294.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,924.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,758.43
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,924.89
|
| Rate for Payer: Zelis Auto |
$756.31
|
| Rate for Payer: Zelis Medicare |
$5,036.16
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7,109.87
|
| Rate for Payer: Zelis Worker's Compensation |
$516.18
|
|
|
RPR AA HERNIA RECR 3-10 CM REDUCIBLE
|
Facility
|
IP
|
$1,890.78
|
|
|
Service Code
|
CPT 49615
|
| Hospital Charge Code |
6149615
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$516.18 |
| Max. Negotiated Rate |
$1,796.24 |
| Rate for Payer: Cash Price |
$1,134.47
|
| Rate for Payer: Cigna Commercial |
$1,607.16
|
| Rate for Payer: First Health Commercial |
$1,701.70
|
| Rate for Payer: First Health Workers Compensation |
$730.03
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,701.70
|
| Rate for Payer: GEHA Commercial |
$1,323.55
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,701.70
|
| Rate for Payer: Multiplan All |
$1,720.61
|
| Rate for Payer: OMNI Networks Commercial |
$1,323.55
|
| Rate for Payer: One Health Plan PPO/POS |
$1,701.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,796.24
|
| Rate for Payer: Three Rivers Provider Network All |
$1,418.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,758.43
|
| Rate for Payer: Zelis Auto |
$756.31
|
| Rate for Payer: Zelis Worker's Compensation |
$516.18
|
|
|
RPR AA HERNIA RECR < 3 CM REDUCIBLE
|
Facility
|
IP
|
$1,243.53
|
|
|
Service Code
|
CPT 49613
|
| Hospital Charge Code |
6149613
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$339.48 |
| Max. Negotiated Rate |
$1,181.35 |
| Rate for Payer: Cash Price |
$746.12
|
| Rate for Payer: Cigna Commercial |
$1,057.00
|
| Rate for Payer: First Health Commercial |
$1,119.18
|
| Rate for Payer: First Health Workers Compensation |
$480.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,119.18
|
| Rate for Payer: GEHA Commercial |
$870.47
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,119.18
|
| Rate for Payer: Multiplan All |
$1,131.61
|
| Rate for Payer: OMNI Networks Commercial |
$870.47
|
| Rate for Payer: One Health Plan PPO/POS |
$1,119.18
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,181.35
|
| Rate for Payer: Three Rivers Provider Network All |
$932.65
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,156.48
|
| Rate for Payer: Zelis Auto |
$497.41
|
| Rate for Payer: Zelis Worker's Compensation |
$339.48
|
|
|
RPR AA HERNIA RECR < 3 CM REDUCIBLE
|
Facility
|
OP
|
$1,243.53
|
|
|
Service Code
|
CPT 49613
|
| Hospital Charge Code |
6149613
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$339.48 |
| Max. Negotiated Rate |
$6,701.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,312.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$746.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,312.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,208.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,350.98
|
| Rate for Payer: Cash Price |
$746.12
|
| Rate for Payer: Cash Price |
$746.12
|
| Rate for Payer: Cigna Commercial |
$1,057.00
|
| Rate for Payer: First Health Commercial |
$1,119.18
|
| Rate for Payer: First Health Workers Compensation |
$480.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,119.18
|
| Rate for Payer: GEHA Commercial |
$994.82
|
| Rate for Payer: GEHA Medicare |
$3,350.98
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,119.18
|
| Rate for Payer: Humana ChoiceCare |
$3,686.08
|
| Rate for Payer: Humana Medicare Advantage |
$3,350.98
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,629.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$4,294.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,350.98
|
| Rate for Payer: Multiplan All |
$1,131.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,696.67
|
| Rate for Payer: OMNI Networks Commercial |
$870.47
|
| Rate for Payer: One Health Plan PPO/POS |
$1,119.18
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,958.70
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,294.59
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,350.98
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,181.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,701.96
|
| Rate for Payer: Three Rivers Provider Network All |
$932.65
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,283.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,294.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,350.98
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,156.48
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,350.98
|
| Rate for Payer: Zelis Auto |
$497.41
|
| Rate for Payer: Zelis Medicare |
$2,848.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,021.18
|
| Rate for Payer: Zelis Worker's Compensation |
$339.48
|
|
|
RPR BLOOD VESSEL DIRECT LOWER EXTREMITY
|
Facility
|
IP
|
$5,155.00
|
|
| Hospital Charge Code |
8135226
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,407.32 |
| Max. Negotiated Rate |
$4,897.25 |
| Rate for Payer: Cash Price |
$3,093.00
|
| Rate for Payer: Cigna Commercial |
$4,381.75
|
| Rate for Payer: First Health Commercial |
$4,639.50
|
| Rate for Payer: First Health Workers Compensation |
$1,990.35
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,639.50
|
| Rate for Payer: GEHA Commercial |
$3,608.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,639.50
|
| Rate for Payer: Multiplan All |
$4,691.05
|
| Rate for Payer: OMNI Networks Commercial |
$3,608.50
|
| Rate for Payer: One Health Plan PPO/POS |
$4,639.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,897.25
|
| Rate for Payer: Three Rivers Provider Network All |
$3,866.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,794.15
|
| Rate for Payer: Zelis Auto |
$2,062.00
|
| Rate for Payer: Zelis Worker's Compensation |
$1,407.32
|
|
|
RPR BLOOD VESSEL DIRECT LOWER EXTREMITY
|
Facility
|
OP
|
$5,155.00
|
|
| Hospital Charge Code |
8135226
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,288.75 |
| Max. Negotiated Rate |
$4,897.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,093.00
|
| Rate for Payer: Cash Price |
$3,093.00
|
| Rate for Payer: Cigna Commercial |
$4,381.75
|
| Rate for Payer: First Health Commercial |
$4,639.50
|
| Rate for Payer: First Health Workers Compensation |
$1,990.35
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,639.50
|
| Rate for Payer: GEHA Commercial |
$4,124.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,639.50
|
| Rate for Payer: Humana ChoiceCare |
$1,340.30
|
| Rate for Payer: Multiplan All |
$4,691.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,093.00
|
| Rate for Payer: OMNI Networks Commercial |
$3,608.50
|
| Rate for Payer: One Health Plan PPO/POS |
$4,639.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,897.25
|
| Rate for Payer: Three Rivers Provider Network All |
$3,866.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4,536.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,288.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,794.15
|
| Rate for Payer: Zelis Auto |
$2,062.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,577.50
|
| Rate for Payer: Zelis Worker's Compensation |
$1,407.32
|
|
