|
RPR F/E/E/N/L/M >30.0 CM
|
Facility
|
OP
|
$548.00
|
|
|
Service Code
|
CPT 12018
|
| Hospital Charge Code |
6112018
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$108.47 |
| Max. Negotiated Rate |
$520.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$136.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$328.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$136.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$108.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$328.80
|
| Rate for Payer: Cash Price |
$328.80
|
| Rate for Payer: Cigna Commercial |
$465.80
|
| Rate for Payer: First Health Commercial |
$493.20
|
| Rate for Payer: First Health Workers Compensation |
$211.58
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$493.20
|
| Rate for Payer: GEHA Commercial |
$438.40
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$493.20
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$110.68
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$498.68
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$383.60
|
| Rate for Payer: One Health Plan PPO/POS |
$493.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$127.79
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$110.68
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$520.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$411.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$110.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$509.64
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$219.20
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$149.60
|
|
|
RPR F/E/E/N/L/M 7.6-12.5 CM
|
Facility
|
IP
|
$295.00
|
|
|
Service Code
|
CPT 12015
|
| Hospital Charge Code |
6112015
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$80.53 |
| Max. Negotiated Rate |
$280.25 |
| Rate for Payer: Cash Price |
$177.00
|
| Rate for Payer: Cigna Commercial |
$250.75
|
| Rate for Payer: First Health Commercial |
$265.50
|
| Rate for Payer: First Health Workers Compensation |
$113.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$265.50
|
| Rate for Payer: GEHA Commercial |
$206.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$265.50
|
| Rate for Payer: Multiplan All |
$268.45
|
| Rate for Payer: OMNI Networks Commercial |
$206.50
|
| Rate for Payer: One Health Plan PPO/POS |
$265.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$280.25
|
| Rate for Payer: Three Rivers Provider Network All |
$221.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$274.35
|
| Rate for Payer: Zelis Auto |
$118.00
|
| Rate for Payer: Zelis Worker's Compensation |
$80.53
|
|
|
RPR F/E/E/N/L/M 7.6-12.5 CM
|
Facility
|
OP
|
$295.00
|
|
|
Service Code
|
CPT 12015
|
| Hospital Charge Code |
6112015
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$80.53 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$136.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$177.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$136.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$108.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$177.00
|
| Rate for Payer: Cash Price |
$177.00
|
| Rate for Payer: Cigna Commercial |
$250.75
|
| Rate for Payer: First Health Commercial |
$265.50
|
| Rate for Payer: First Health Workers Compensation |
$113.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$265.50
|
| Rate for Payer: GEHA Commercial |
$236.00
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$265.50
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$110.68
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$268.45
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$206.50
|
| Rate for Payer: One Health Plan PPO/POS |
$265.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$127.79
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$110.68
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$280.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$221.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$110.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$274.35
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$118.00
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$80.53
|
|
|
RPR FEM HERNIA, INIT BLOCKED
|
Facility
|
IP
|
$1,321.00
|
|
|
Service Code
|
CPT 49553
|
| Hospital Charge Code |
6149553
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$360.63 |
| Max. Negotiated Rate |
$1,254.95 |
| Rate for Payer: Cash Price |
$792.60
|
| Rate for Payer: Cigna Commercial |
$1,122.85
|
| Rate for Payer: First Health Commercial |
$1,188.90
|
| Rate for Payer: First Health Workers Compensation |
$510.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,188.90
|
| Rate for Payer: GEHA Commercial |
$924.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,188.90
|
| Rate for Payer: Multiplan All |
$1,202.11
|
| Rate for Payer: OMNI Networks Commercial |
$924.70
|
| Rate for Payer: One Health Plan PPO/POS |
$1,188.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,254.95
|
| Rate for Payer: Three Rivers Provider Network All |
$990.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,228.53
|
| Rate for Payer: Zelis Auto |
$528.40
|
| Rate for Payer: Zelis Worker's Compensation |
$360.63
|
|
|
RPR FEM HERNIA, INIT BLOCKED
|
Facility
|
OP
|
$1,321.00
|
|
|
Service Code
|
CPT 49553
|
| Hospital Charge Code |
6149553
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$360.63 |
| Max. Negotiated Rate |
$6,701.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,232.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$792.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,232.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,560.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,350.98
|
| Rate for Payer: Cash Price |
$792.60
|
| Rate for Payer: Cash Price |
$792.60
|
| Rate for Payer: Cigna Commercial |
$1,122.85
|
| Rate for Payer: First Health Commercial |
$1,188.90
|
| Rate for Payer: First Health Workers Compensation |
$510.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,188.90
|
| Rate for Payer: GEHA Commercial |
$1,056.80
|
| Rate for Payer: GEHA Medicare |
$3,350.98
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,188.90
|
| 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 |
$2,612.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,350.98
|
| Rate for Payer: Multiplan All |
$1,202.11
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,696.67
|
| Rate for Payer: OMNI Networks Commercial |
$924.70
|
| Rate for Payer: One Health Plan PPO/POS |
$1,188.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$3,016.79
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,612.76
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,350.98
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,254.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,701.96
|
| Rate for Payer: Three Rivers Provider Network All |
$990.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,283.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,612.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,350.98
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,228.53
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,350.98
|
| Rate for Payer: Zelis Auto |
$528.40
|
| 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 |
$360.63
|
|
|
RPR ING HERNIA, INIT BLOCKED
|
Facility
|
IP
|
$1,214.00
|
|
|
Service Code
|
CPT 49501
|
| Hospital Charge Code |
6149501
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$331.42 |
| Max. Negotiated Rate |
$1,153.30 |
| Rate for Payer: Cash Price |
$728.40
|
| Rate for Payer: Cigna Commercial |
$1,031.90
|
| Rate for Payer: First Health Commercial |
$1,092.60
|
| Rate for Payer: First Health Workers Compensation |
$468.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,092.60
|
| Rate for Payer: GEHA Commercial |
$849.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,092.60
|
| Rate for Payer: Multiplan All |
$1,104.74
|
| Rate for Payer: OMNI Networks Commercial |
$849.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,092.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,153.30
|
| Rate for Payer: Three Rivers Provider Network All |
$910.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,129.02
|
| Rate for Payer: Zelis Auto |
$485.60
|
| Rate for Payer: Zelis Worker's Compensation |
$331.42
|
|
|
RPR ING HERNIA, INIT BLOCKED
|
Facility
|
OP
|
$1,214.00
|
|
|
Service Code
|
CPT 49501
|
| Hospital Charge Code |
6149501
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$331.42 |
| Max. Negotiated Rate |
$6,701.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,232.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$728.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,232.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,560.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,350.98
|
| Rate for Payer: Cash Price |
$728.40
|
| Rate for Payer: Cash Price |
$728.40
|
| Rate for Payer: Cigna Commercial |
$1,031.90
|
| Rate for Payer: First Health Commercial |
$1,092.60
|
| Rate for Payer: First Health Workers Compensation |
$468.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,092.60
|
| Rate for Payer: GEHA Commercial |
$971.20
|
| Rate for Payer: GEHA Medicare |
$3,350.98
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,092.60
|
| 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 |
$2,612.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,350.98
|
| Rate for Payer: Multiplan All |
$1,104.74
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,696.67
|
| Rate for Payer: OMNI Networks Commercial |
$849.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,092.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$3,016.79
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,612.76
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,350.98
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,153.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,701.96
|
| Rate for Payer: Three Rivers Provider Network All |
$910.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,283.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,612.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,350.98
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,129.02
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,350.98
|
| Rate for Payer: Zelis Auto |
$485.60
|
| 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 |
$331.42
|
|
|
RPR ING HERNIA, INIT, REDUCE
|
Facility
|
IP
|
$927.00
|
|
|
Service Code
|
CPT 49500
|
| Hospital Charge Code |
6149500
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$253.07 |
| Max. Negotiated Rate |
$880.65 |
| Rate for Payer: Cash Price |
$556.20
|
| Rate for Payer: Cigna Commercial |
$787.95
|
| Rate for Payer: First Health Commercial |
$834.30
|
| Rate for Payer: First Health Workers Compensation |
$357.91
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$834.30
|
| Rate for Payer: GEHA Commercial |
$648.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$834.30
|
| Rate for Payer: Multiplan All |
$843.57
|
| Rate for Payer: OMNI Networks Commercial |
$648.90
|
| Rate for Payer: One Health Plan PPO/POS |
$834.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$880.65
|
| Rate for Payer: Three Rivers Provider Network All |
$695.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$862.11
|
| Rate for Payer: Zelis Auto |
$370.80
|
| Rate for Payer: Zelis Worker's Compensation |
$253.07
|
|
|
RPR ING HERNIA, INIT, REDUCE
|
Facility
|
OP
|
$927.00
|
|
|
Service Code
|
CPT 49500
|
| Hospital Charge Code |
6149500
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$253.07 |
| Max. Negotiated Rate |
$11,849.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,232.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$556.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,232.28
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,560.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,924.89
|
| Rate for Payer: Cash Price |
$556.20
|
| Rate for Payer: Cash Price |
$556.20
|
| Rate for Payer: Cigna Commercial |
$787.95
|
| Rate for Payer: First Health Commercial |
$834.30
|
| Rate for Payer: First Health Workers Compensation |
$357.91
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$834.30
|
| Rate for Payer: GEHA Commercial |
$741.60
|
| Rate for Payer: GEHA Medicare |
$5,924.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$834.30
|
| 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 |
$2,612.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,924.89
|
| Rate for Payer: Multiplan All |
$843.57
|
| Rate for Payer: New Mexico Health Connections Medicare |
$10,072.31
|
| Rate for Payer: OMNI Networks Commercial |
$648.90
|
| Rate for Payer: One Health Plan PPO/POS |
$834.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$3,016.79
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,612.76
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,924.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$880.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,849.78
|
| Rate for Payer: Three Rivers Provider Network All |
$695.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,806.39
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,612.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,924.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$862.11
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,924.89
|
| Rate for Payer: Zelis Auto |
$370.80
|
| 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 |
$253.07
|
|
|
RPR INTERMED N H F G 20.1-30 CM
|
Facility
|
OP
|
$1,486.00
|
|
| Hospital Charge Code |
8112046
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$371.50 |
| Max. Negotiated Rate |
$1,411.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$891.60
|
| Rate for Payer: Cash Price |
$891.60
|
| Rate for Payer: Cigna Commercial |
$1,263.10
|
| Rate for Payer: First Health Commercial |
$1,337.40
|
| Rate for Payer: First Health Workers Compensation |
$573.74
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,337.40
|
| Rate for Payer: GEHA Commercial |
$1,188.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,337.40
|
| Rate for Payer: Humana ChoiceCare |
$386.36
|
| Rate for Payer: Multiplan All |
$1,352.26
|
| Rate for Payer: New Mexico Health Connections Medicare |
$891.60
|
| Rate for Payer: OMNI Networks Commercial |
$1,040.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,337.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,411.70
|
| Rate for Payer: Three Rivers Provider Network All |
$1,114.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,307.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$371.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,381.98
|
| Rate for Payer: Zelis Auto |
$594.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$743.00
|
| Rate for Payer: Zelis Worker's Compensation |
$405.68
|
|
|
RPR INTERMED N H F G 20.1-30 CM
|
Facility
|
IP
|
$1,486.00
|
|
| Hospital Charge Code |
8112046
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$405.68 |
| Max. Negotiated Rate |
$1,411.70 |
| Rate for Payer: Cash Price |
$891.60
|
| Rate for Payer: Cigna Commercial |
$1,263.10
|
| Rate for Payer: First Health Commercial |
$1,337.40
|
| Rate for Payer: First Health Workers Compensation |
$573.74
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,337.40
|
| Rate for Payer: GEHA Commercial |
$1,040.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,337.40
|
| Rate for Payer: Multiplan All |
$1,352.26
|
| Rate for Payer: OMNI Networks Commercial |
$1,040.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,337.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,411.70
|
| Rate for Payer: Three Rivers Provider Network All |
$1,114.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,381.98
|
| Rate for Payer: Zelis Auto |
$594.40
|
| Rate for Payer: Zelis Worker's Compensation |
$405.68
|
|
|
RPR INTRMEDIATE F/E/E/N/L&MUC 2.6-5.0 CM
|
Facility
|
OP
|
$3,076.92
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
20312052
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$108.47 |
| Max. Negotiated Rate |
$2,923.07 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$136.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,846.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$136.92
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$108.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$1,846.15
|
| Rate for Payer: Cash Price |
$1,846.15
|
| Rate for Payer: Cigna Commercial |
$2,615.38
|
| Rate for Payer: First Health Commercial |
$2,769.23
|
| Rate for Payer: First Health Workers Compensation |
$1,188.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,769.23
|
| Rate for Payer: GEHA Commercial |
$2,461.54
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,769.23
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$110.68
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$2,800.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$2,153.84
|
| Rate for Payer: One Health Plan PPO/POS |
$2,769.23
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$127.79
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$110.68
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,923.07
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$2,307.69
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$110.68
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,861.54
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$1,230.77
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$840.00
|
|
|
RPR INTRMEDIATE F/E/E/N/L&MUC 2.6-5.0 CM
|
Facility
|
IP
|
$3,076.92
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
20312052
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$840.00 |
| Max. Negotiated Rate |
$2,923.07 |
| Rate for Payer: Cash Price |
$1,846.15
|
| Rate for Payer: Cigna Commercial |
$2,615.38
|
| Rate for Payer: First Health Commercial |
$2,769.23
|
| Rate for Payer: First Health Workers Compensation |
$1,188.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,769.23
|
| Rate for Payer: GEHA Commercial |
$2,153.84
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,769.23
|
| Rate for Payer: Multiplan All |
$2,800.00
|
| Rate for Payer: OMNI Networks Commercial |
$2,153.84
|
| Rate for Payer: One Health Plan PPO/POS |
$2,769.23
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,923.07
|
| Rate for Payer: Three Rivers Provider Network All |
$2,307.69
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,861.54
|
| Rate for Payer: Zelis Auto |
$1,230.77
|
| Rate for Payer: Zelis Worker's Compensation |
$840.00
|
|
|
RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS T
|
Facility
|
IP
|
$474.00
|
|
|
Service Code
|
CPT 41250
|
| Hospital Charge Code |
21600174
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$129.40 |
| Max. Negotiated Rate |
$450.30 |
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cigna Commercial |
$402.90
|
| Rate for Payer: First Health Commercial |
$426.60
|
| Rate for Payer: First Health Workers Compensation |
$183.01
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$426.60
|
| Rate for Payer: GEHA Commercial |
$331.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$426.60
|
| Rate for Payer: Multiplan All |
$431.34
|
| Rate for Payer: OMNI Networks Commercial |
$331.80
|
| Rate for Payer: One Health Plan PPO/POS |
$426.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$450.30
|
| Rate for Payer: Three Rivers Provider Network All |
$355.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$440.82
|
| Rate for Payer: Zelis Auto |
$189.60
|
| Rate for Payer: Zelis Worker's Compensation |
$129.40
|
|
|
RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS T
|
Facility
|
OP
|
$474.00
|
|
|
Service Code
|
CPT 41250
|
| Hospital Charge Code |
21600174
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$92.30 |
| Max. Negotiated Rate |
$757.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$116.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$284.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$116.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$92.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$378.90
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cigna Commercial |
$402.90
|
| Rate for Payer: First Health Commercial |
$426.60
|
| Rate for Payer: First Health Workers Compensation |
$183.01
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$426.60
|
| Rate for Payer: GEHA Commercial |
$379.20
|
| Rate for Payer: GEHA Medicare |
$378.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$426.60
|
| Rate for Payer: Humana ChoiceCare |
$416.79
|
| Rate for Payer: Humana Medicare Advantage |
$378.90
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$636.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$94.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$378.90
|
| Rate for Payer: Multiplan All |
$431.34
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.13
|
| Rate for Payer: OMNI Networks Commercial |
$331.80
|
| Rate for Payer: One Health Plan PPO/POS |
$426.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$108.74
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$94.17
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$378.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$450.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$757.80
|
| Rate for Payer: Three Rivers Provider Network All |
$355.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$94.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$378.90
|
| Rate for Payer: United Payors & United Providers UP&UP |
$440.82
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$378.90
|
| Rate for Payer: Zelis Auto |
$189.60
|
| Rate for Payer: Zelis Medicare |
$322.06
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$454.68
|
| Rate for Payer: Zelis Worker's Compensation |
$129.40
|
|
|
RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS T
|
Facility
|
IP
|
$474.00
|
|
|
Service Code
|
CPT 41250
|
| Hospital Charge Code |
6141250
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$129.40 |
| Max. Negotiated Rate |
$450.30 |
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cigna Commercial |
$402.90
|
| Rate for Payer: First Health Commercial |
$426.60
|
| Rate for Payer: First Health Workers Compensation |
$183.01
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$426.60
|
| Rate for Payer: GEHA Commercial |
$331.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$426.60
|
| Rate for Payer: Multiplan All |
$431.34
|
| Rate for Payer: OMNI Networks Commercial |
$331.80
|
| Rate for Payer: One Health Plan PPO/POS |
$426.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$450.30
|
| Rate for Payer: Three Rivers Provider Network All |
$355.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$440.82
|
| Rate for Payer: Zelis Auto |
$189.60
|
| Rate for Payer: Zelis Worker's Compensation |
$129.40
|
|
|
RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS T
|
Facility
|
OP
|
$474.00
|
|
|
Service Code
|
CPT 41250
|
| Hospital Charge Code |
6141250
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$92.30 |
| Max. Negotiated Rate |
$757.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$116.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$284.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$116.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$92.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$378.90
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cash Price |
$284.40
|
| Rate for Payer: Cigna Commercial |
$402.90
|
| Rate for Payer: First Health Commercial |
$426.60
|
| Rate for Payer: First Health Workers Compensation |
$183.01
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$426.60
|
| Rate for Payer: GEHA Commercial |
$379.20
|
| Rate for Payer: GEHA Medicare |
$378.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$426.60
|
| Rate for Payer: Humana ChoiceCare |
$416.79
|
| Rate for Payer: Humana Medicare Advantage |
$378.90
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$636.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$94.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$378.90
|
| Rate for Payer: Multiplan All |
$431.34
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.13
|
| Rate for Payer: OMNI Networks Commercial |
$331.80
|
| Rate for Payer: One Health Plan PPO/POS |
$426.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$108.74
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$94.17
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$378.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$450.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$757.80
|
| Rate for Payer: Three Rivers Provider Network All |
$355.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$94.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$378.90
|
| Rate for Payer: United Payors & United Providers UP&UP |
$440.82
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$378.90
|
| Rate for Payer: Zelis Auto |
$189.60
|
| Rate for Payer: Zelis Medicare |
$322.06
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$454.68
|
| Rate for Payer: Zelis Worker's Compensation |
$129.40
|
|
|
RPR NAIL BED
|
Facility
|
IP
|
$1,243.00
|
|
| Hospital Charge Code |
8150044
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$339.34 |
| Max. Negotiated Rate |
$1,180.85 |
| Rate for Payer: Cash Price |
$745.80
|
| Rate for Payer: Cigna Commercial |
$1,056.55
|
| Rate for Payer: First Health Commercial |
$1,118.70
|
| Rate for Payer: First Health Workers Compensation |
$479.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,118.70
|
| Rate for Payer: GEHA Commercial |
$870.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,118.70
|
| Rate for Payer: Multiplan All |
$1,131.13
|
| Rate for Payer: OMNI Networks Commercial |
$870.10
|
| Rate for Payer: One Health Plan PPO/POS |
$1,118.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,180.85
|
| Rate for Payer: Three Rivers Provider Network All |
$932.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,155.99
|
| Rate for Payer: Zelis Auto |
$497.20
|
| Rate for Payer: Zelis Worker's Compensation |
$339.34
|
|
|
RPR NAIL BED
|
Facility
|
OP
|
$1,243.00
|
|
| Hospital Charge Code |
8150044
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$310.75 |
| Max. Negotiated Rate |
$1,180.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$745.80
|
| Rate for Payer: Cash Price |
$745.80
|
| Rate for Payer: Cigna Commercial |
$1,056.55
|
| Rate for Payer: First Health Commercial |
$1,118.70
|
| Rate for Payer: First Health Workers Compensation |
$479.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,118.70
|
| Rate for Payer: GEHA Commercial |
$994.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,118.70
|
| Rate for Payer: Humana ChoiceCare |
$323.18
|
| Rate for Payer: Multiplan All |
$1,131.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$745.80
|
| Rate for Payer: OMNI Networks Commercial |
$870.10
|
| Rate for Payer: One Health Plan PPO/POS |
$1,118.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,180.85
|
| Rate for Payer: Three Rivers Provider Network All |
$932.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,093.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$310.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,155.99
|
| Rate for Payer: Zelis Auto |
$497.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$621.50
|
| Rate for Payer: Zelis Worker's Compensation |
$339.34
|
|
|
RPR PARASTOMAL HERNIA 1ST/RECR REDUCIBLE
|
Facility
|
IP
|
$2,188.77
|
|
|
Service Code
|
CPT 49621
|
| Hospital Charge Code |
6149621
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$597.53 |
| Max. Negotiated Rate |
$2,079.33 |
| Rate for Payer: Cash Price |
$1,313.26
|
| Rate for Payer: Cigna Commercial |
$1,860.45
|
| Rate for Payer: First Health Commercial |
$1,969.89
|
| Rate for Payer: First Health Workers Compensation |
$845.08
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,969.89
|
| Rate for Payer: GEHA Commercial |
$1,532.14
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,969.89
|
| Rate for Payer: Multiplan All |
$1,991.78
|
| Rate for Payer: OMNI Networks Commercial |
$1,532.14
|
| Rate for Payer: One Health Plan PPO/POS |
$1,969.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,079.33
|
| Rate for Payer: Three Rivers Provider Network All |
$1,641.58
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,035.56
|
| Rate for Payer: Zelis Auto |
$875.51
|
| Rate for Payer: Zelis Worker's Compensation |
$597.53
|
|
|
RPR PARASTOMAL HERNIA 1ST/RECR REDUCIBLE
|
Facility
|
OP
|
$2,188.77
|
|
|
Service Code
|
CPT 49621
|
| Hospital Charge Code |
6149621
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$547.19 |
| Max. Negotiated Rate |
$2,079.33 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,313.26
|
| Rate for Payer: Cash Price |
$1,313.26
|
| Rate for Payer: Cigna Commercial |
$1,860.45
|
| Rate for Payer: First Health Commercial |
$1,969.89
|
| Rate for Payer: First Health Workers Compensation |
$845.08
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,969.89
|
| Rate for Payer: GEHA Commercial |
$1,751.02
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,969.89
|
| Rate for Payer: Humana ChoiceCare |
$569.08
|
| Rate for Payer: Multiplan All |
$1,991.78
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,313.26
|
| Rate for Payer: OMNI Networks Commercial |
$1,532.14
|
| Rate for Payer: One Health Plan PPO/POS |
$1,969.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,079.33
|
| Rate for Payer: Three Rivers Provider Network All |
$1,641.58
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,926.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$547.19
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,035.56
|
| Rate for Payer: Zelis Auto |
$875.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,094.38
|
| Rate for Payer: Zelis Worker's Compensation |
$597.53
|
|
|
RPR PARASTOMAL HRNA 1ST/RCR NCRC8/STRANG
|
Facility
|
OP
|
$2,701.95
|
|
|
Service Code
|
CPT 49622
|
| Hospital Charge Code |
6149622
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$675.49 |
| Max. Negotiated Rate |
$2,566.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,621.17
|
| Rate for Payer: Cash Price |
$1,621.17
|
| Rate for Payer: Cigna Commercial |
$2,296.66
|
| Rate for Payer: First Health Commercial |
$2,431.76
|
| Rate for Payer: First Health Workers Compensation |
$1,043.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,431.76
|
| Rate for Payer: GEHA Commercial |
$2,161.56
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,431.76
|
| Rate for Payer: Humana ChoiceCare |
$702.51
|
| Rate for Payer: Multiplan All |
$2,458.77
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,621.17
|
| Rate for Payer: OMNI Networks Commercial |
$1,891.37
|
| Rate for Payer: One Health Plan PPO/POS |
$2,431.76
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,566.85
|
| Rate for Payer: Three Rivers Provider Network All |
$2,026.46
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,377.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$675.49
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,512.81
|
| Rate for Payer: Zelis Auto |
$1,080.78
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,350.97
|
| Rate for Payer: Zelis Worker's Compensation |
$737.63
|
|
|
RPR PARASTOMAL HRNA 1ST/RCR NCRC8/STRANG
|
Facility
|
IP
|
$2,701.95
|
|
|
Service Code
|
CPT 49622
|
| Hospital Charge Code |
6149622
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$737.63 |
| Max. Negotiated Rate |
$2,566.85 |
| Rate for Payer: Cash Price |
$1,621.17
|
| Rate for Payer: Cigna Commercial |
$2,296.66
|
| Rate for Payer: First Health Commercial |
$2,431.76
|
| Rate for Payer: First Health Workers Compensation |
$1,043.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,431.76
|
| Rate for Payer: GEHA Commercial |
$1,891.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,431.76
|
| Rate for Payer: Multiplan All |
$2,458.77
|
| Rate for Payer: OMNI Networks Commercial |
$1,891.37
|
| Rate for Payer: One Health Plan PPO/POS |
$2,431.76
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,566.85
|
| Rate for Payer: Three Rivers Provider Network All |
$2,026.46
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,512.81
|
| Rate for Payer: Zelis Auto |
$1,080.78
|
| Rate for Payer: Zelis Worker's Compensation |
$737.63
|
|
|
RPR (RAPID PLASMA REAGIN) AGH
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
2206004
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6.08
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cigna Commercial |
$86.70
|
| Rate for Payer: First Health Commercial |
$91.80
|
| Rate for Payer: First Health Workers Compensation |
$7.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$91.80
|
| Rate for Payer: GEHA Commercial |
$81.60
|
| Rate for Payer: GEHA Medicare |
$4.27
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$91.80
|
| Rate for Payer: Humana ChoiceCare |
$4.70
|
| Rate for Payer: Humana Medicare Advantage |
$4.27
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$7.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6.21
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$4.27
|
| Rate for Payer: Multiplan All |
$92.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$7.26
|
| Rate for Payer: OMNI Networks Commercial |
$71.40
|
| Rate for Payer: One Health Plan PPO/POS |
$91.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$7.17
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6.21
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$4.27
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$96.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$8.54
|
| Rate for Payer: Three Rivers Provider Network All |
$76.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4.18
|
| Rate for Payer: United Healthcare Commercial |
$86.70
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.27
|
| Rate for Payer: United Payors & United Providers UP&UP |
$94.86
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$4.27
|
| Rate for Payer: Zelis Auto |
$40.80
|
| Rate for Payer: Zelis Medicare |
$3.63
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5.12
|
| Rate for Payer: Zelis Worker's Compensation |
$5.31
|
|
|
RPR (RAPID PLASMA REAGIN) AGH
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
2206004
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.31 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cigna Commercial |
$86.70
|
| Rate for Payer: First Health Commercial |
$91.80
|
| Rate for Payer: First Health Workers Compensation |
$7.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$91.80
|
| Rate for Payer: GEHA Commercial |
$71.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$91.80
|
| Rate for Payer: Multiplan All |
$92.82
|
| Rate for Payer: OMNI Networks Commercial |
$71.40
|
| Rate for Payer: One Health Plan PPO/POS |
$91.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$96.90
|
| Rate for Payer: Three Rivers Provider Network All |
$76.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$94.86
|
| Rate for Payer: Zelis Auto |
$40.80
|
| Rate for Payer: Zelis Worker's Compensation |
$5.31
|
|
