|
SCREW LOCKING FASTPITCH 2.7MM
|
Facility
|
OP
|
$2,829.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009263
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$707.25 |
| Max. Negotiated Rate |
$2,687.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,697.40
|
| Rate for Payer: Cash Price |
$1,697.40
|
| Rate for Payer: Cash Price |
$1,697.40
|
| Rate for Payer: Cigna Commercial |
$2,404.65
|
| Rate for Payer: First Health Commercial |
$2,546.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,546.10
|
| Rate for Payer: GEHA Commercial |
$2,263.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,546.10
|
| Rate for Payer: Humana ChoiceCare |
$735.54
|
| Rate for Payer: Multiplan All |
$2,574.39
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,697.40
|
| Rate for Payer: OMNI Networks Commercial |
$1,980.30
|
| Rate for Payer: One Health Plan PPO/POS |
$2,546.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,687.55
|
| Rate for Payer: Three Rivers Provider Network All |
$2,121.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,489.52
|
| Rate for Payer: United Healthcare Managed Medicaid |
$707.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,630.97
|
| Rate for Payer: Zelis Auto |
$1,131.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,414.50
|
|
|
SCREW LOCKING FASTPITCH 2.7MM
|
Facility
|
IP
|
$2,829.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009263
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,131.60 |
| Max. Negotiated Rate |
$2,687.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,263.20
|
| Rate for Payer: Cash Price |
$1,697.40
|
| Rate for Payer: Cash Price |
$1,697.40
|
| Rate for Payer: Cigna Commercial |
$2,404.65
|
| Rate for Payer: First Health Commercial |
$2,546.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,546.10
|
| Rate for Payer: GEHA Commercial |
$1,980.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,546.10
|
| Rate for Payer: Multiplan All |
$2,574.39
|
| Rate for Payer: OMNI Networks Commercial |
$1,980.30
|
| Rate for Payer: One Health Plan PPO/POS |
$2,546.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,687.55
|
| Rate for Payer: Three Rivers Provider Network All |
$2,121.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,630.97
|
| Rate for Payer: Zelis Auto |
$1,131.60
|
|
|
SCREW MICA 3 X 18 FULLY THREADED
|
Facility
|
OP
|
$1,963.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009269
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$490.87 |
| Max. Negotiated Rate |
$1,865.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,178.08
|
| Rate for Payer: Cash Price |
$1,178.08
|
| Rate for Payer: Cash Price |
$1,178.08
|
| Rate for Payer: Cigna Commercial |
$1,668.95
|
| Rate for Payer: First Health Commercial |
$1,767.12
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,767.12
|
| Rate for Payer: GEHA Commercial |
$1,570.78
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,767.12
|
| Rate for Payer: Humana ChoiceCare |
$510.50
|
| Rate for Payer: Multiplan All |
$1,786.76
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,178.08
|
| Rate for Payer: OMNI Networks Commercial |
$1,374.43
|
| Rate for Payer: One Health Plan PPO/POS |
$1,767.12
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,865.30
|
| Rate for Payer: Three Rivers Provider Network All |
$1,472.60
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,727.85
|
| Rate for Payer: United Healthcare Managed Medicaid |
$490.87
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,826.03
|
| Rate for Payer: Zelis Auto |
$785.39
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$981.74
|
|
|
SCREW MICA 3 X 18 FULLY THREADED
|
Facility
|
IP
|
$1,963.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009269
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$785.39 |
| Max. Negotiated Rate |
$1,865.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,570.78
|
| Rate for Payer: Cash Price |
$1,178.08
|
| Rate for Payer: Cash Price |
$1,178.08
|
| Rate for Payer: Cigna Commercial |
$1,668.95
|
| Rate for Payer: First Health Commercial |
$1,767.12
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,767.12
|
| Rate for Payer: GEHA Commercial |
$1,374.43
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,767.12
|
| Rate for Payer: Multiplan All |
$1,786.76
|
| Rate for Payer: OMNI Networks Commercial |
$1,374.43
|
| Rate for Payer: One Health Plan PPO/POS |
$1,767.12
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,865.30
|
| Rate for Payer: Three Rivers Provider Network All |
$1,472.60
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,826.03
|
| Rate for Payer: Zelis Auto |
$785.39
|
|
|
SCREW MICA 4 X 22 FULLY THREADED
|
Facility
|
OP
|
$2,911.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009268
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$727.79 |
| Max. Negotiated Rate |
$2,765.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cigna Commercial |
$2,474.49
|
| Rate for Payer: First Health Commercial |
$2,620.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,620.04
|
| Rate for Payer: GEHA Commercial |
$2,328.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,620.04
|
| Rate for Payer: Humana ChoiceCare |
$756.90
|
| Rate for Payer: Multiplan All |
$2,649.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,746.70
|
| Rate for Payer: OMNI Networks Commercial |
$2,037.81
|
| Rate for Payer: One Health Plan PPO/POS |
$2,620.04
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,765.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,183.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,561.82
|
| Rate for Payer: United Healthcare Managed Medicaid |
$727.79
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,707.38
|
| Rate for Payer: Zelis Auto |
$1,164.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,455.58
|
|
|
SCREW MICA 4 X 22 FULLY THREADED
|
Facility
|
IP
|
$2,911.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009268
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,164.46 |
| Max. Negotiated Rate |
$2,765.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,328.93
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cigna Commercial |
$2,474.49
|
| Rate for Payer: First Health Commercial |
$2,620.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,620.04
|
| Rate for Payer: GEHA Commercial |
$2,037.81
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,620.04
|
| Rate for Payer: Multiplan All |
$2,649.16
|
| Rate for Payer: OMNI Networks Commercial |
$2,037.81
|
| Rate for Payer: One Health Plan PPO/POS |
$2,620.04
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,765.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,183.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,707.38
|
| Rate for Payer: Zelis Auto |
$1,164.46
|
|
|
SCREW MICA 4 X 30 FULLY THREADED
|
Facility
|
OP
|
$2,911.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009270
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$727.79 |
| Max. Negotiated Rate |
$2,765.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cigna Commercial |
$2,474.49
|
| Rate for Payer: First Health Commercial |
$2,620.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,620.04
|
| Rate for Payer: GEHA Commercial |
$2,328.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,620.04
|
| Rate for Payer: Humana ChoiceCare |
$756.90
|
| Rate for Payer: Multiplan All |
$2,649.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,746.70
|
| Rate for Payer: OMNI Networks Commercial |
$2,037.81
|
| Rate for Payer: One Health Plan PPO/POS |
$2,620.04
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,765.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,183.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,561.82
|
| Rate for Payer: United Healthcare Managed Medicaid |
$727.79
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,707.38
|
| Rate for Payer: Zelis Auto |
$1,164.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,455.58
|
|
|
SCREW MICA 4 X 30 FULLY THREADED
|
Facility
|
IP
|
$2,911.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009270
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,164.46 |
| Max. Negotiated Rate |
$2,765.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,328.93
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cigna Commercial |
$2,474.49
|
| Rate for Payer: First Health Commercial |
$2,620.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,620.04
|
| Rate for Payer: GEHA Commercial |
$2,037.81
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,620.04
|
| Rate for Payer: Multiplan All |
$2,649.16
|
| Rate for Payer: OMNI Networks Commercial |
$2,037.81
|
| Rate for Payer: One Health Plan PPO/POS |
$2,620.04
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,765.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,183.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,707.38
|
| Rate for Payer: Zelis Auto |
$1,164.46
|
|
|
SCREW MICA PROSTEP
|
Facility
|
OP
|
$2,911.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$727.79 |
| Max. Negotiated Rate |
$2,765.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cigna Commercial |
$2,474.49
|
| Rate for Payer: First Health Commercial |
$2,620.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,620.04
|
| Rate for Payer: GEHA Commercial |
$2,328.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,620.04
|
| Rate for Payer: Humana ChoiceCare |
$756.90
|
| Rate for Payer: Multiplan All |
$2,649.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,746.70
|
| Rate for Payer: OMNI Networks Commercial |
$2,037.81
|
| Rate for Payer: One Health Plan PPO/POS |
$2,620.04
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,765.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,183.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,561.82
|
| Rate for Payer: United Healthcare Managed Medicaid |
$727.79
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,707.38
|
| Rate for Payer: Zelis Auto |
$1,164.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,455.58
|
|
|
SCREW MICA PROSTEP
|
Facility
|
IP
|
$2,911.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009265
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,164.46 |
| Max. Negotiated Rate |
$2,765.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,328.93
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cigna Commercial |
$2,474.49
|
| Rate for Payer: First Health Commercial |
$2,620.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,620.04
|
| Rate for Payer: GEHA Commercial |
$2,037.81
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,620.04
|
| Rate for Payer: Multiplan All |
$2,649.16
|
| Rate for Payer: OMNI Networks Commercial |
$2,037.81
|
| Rate for Payer: One Health Plan PPO/POS |
$2,620.04
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,765.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,183.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,707.38
|
| Rate for Payer: Zelis Auto |
$1,164.46
|
|
|
SCREW MICA PROSTEP
|
Facility
|
IP
|
$2,911.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,164.46 |
| Max. Negotiated Rate |
$2,765.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,328.93
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cigna Commercial |
$2,474.49
|
| Rate for Payer: First Health Commercial |
$2,620.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,620.04
|
| Rate for Payer: GEHA Commercial |
$2,037.81
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,620.04
|
| Rate for Payer: Multiplan All |
$2,649.16
|
| Rate for Payer: OMNI Networks Commercial |
$2,037.81
|
| Rate for Payer: One Health Plan PPO/POS |
$2,620.04
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,765.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,183.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,707.38
|
| Rate for Payer: Zelis Auto |
$1,164.46
|
|
|
SCREW MICA PROSTEP
|
Facility
|
OP
|
$2,911.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009265
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$727.79 |
| Max. Negotiated Rate |
$2,765.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cigna Commercial |
$2,474.49
|
| Rate for Payer: First Health Commercial |
$2,620.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,620.04
|
| Rate for Payer: GEHA Commercial |
$2,328.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,620.04
|
| Rate for Payer: Humana ChoiceCare |
$756.90
|
| Rate for Payer: Multiplan All |
$2,649.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,746.70
|
| Rate for Payer: OMNI Networks Commercial |
$2,037.81
|
| Rate for Payer: One Health Plan PPO/POS |
$2,620.04
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,765.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,183.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,561.82
|
| Rate for Payer: United Healthcare Managed Medicaid |
$727.79
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,707.38
|
| Rate for Payer: Zelis Auto |
$1,164.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,455.58
|
|
|
SCREW MICA PROSTEP 4X38MM
|
Facility
|
IP
|
$2,911.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009262
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,164.46 |
| Max. Negotiated Rate |
$2,765.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,328.93
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cigna Commercial |
$2,474.49
|
| Rate for Payer: First Health Commercial |
$2,620.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,620.04
|
| Rate for Payer: GEHA Commercial |
$2,037.81
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,620.04
|
| Rate for Payer: Multiplan All |
$2,649.16
|
| Rate for Payer: OMNI Networks Commercial |
$2,037.81
|
| Rate for Payer: One Health Plan PPO/POS |
$2,620.04
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,765.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,183.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,707.38
|
| Rate for Payer: Zelis Auto |
$1,164.46
|
|
|
SCREW MICA PROSTEP 4X38MM
|
Facility
|
OP
|
$2,911.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009262
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$727.79 |
| Max. Negotiated Rate |
$2,765.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cigna Commercial |
$2,474.49
|
| Rate for Payer: First Health Commercial |
$2,620.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,620.04
|
| Rate for Payer: GEHA Commercial |
$2,328.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,620.04
|
| Rate for Payer: Humana ChoiceCare |
$756.90
|
| Rate for Payer: Multiplan All |
$2,649.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,746.70
|
| Rate for Payer: OMNI Networks Commercial |
$2,037.81
|
| Rate for Payer: One Health Plan PPO/POS |
$2,620.04
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,765.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,183.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,561.82
|
| Rate for Payer: United Healthcare Managed Medicaid |
$727.79
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,707.38
|
| Rate for Payer: Zelis Auto |
$1,164.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,455.58
|
|
|
SCREW MICA PROSTEP 4X40MM
|
Facility
|
IP
|
$2,911.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009267
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,164.46 |
| Max. Negotiated Rate |
$2,765.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,328.93
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cigna Commercial |
$2,474.49
|
| Rate for Payer: First Health Commercial |
$2,620.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,620.04
|
| Rate for Payer: GEHA Commercial |
$2,037.81
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,620.04
|
| Rate for Payer: Multiplan All |
$2,649.16
|
| Rate for Payer: OMNI Networks Commercial |
$2,037.81
|
| Rate for Payer: One Health Plan PPO/POS |
$2,620.04
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,765.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,183.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,707.38
|
| Rate for Payer: Zelis Auto |
$1,164.46
|
|
|
SCREW MICA PROSTEP 4X40MM
|
Facility
|
OP
|
$2,911.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009267
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$727.79 |
| Max. Negotiated Rate |
$2,765.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cigna Commercial |
$2,474.49
|
| Rate for Payer: First Health Commercial |
$2,620.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,620.04
|
| Rate for Payer: GEHA Commercial |
$2,328.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,620.04
|
| Rate for Payer: Humana ChoiceCare |
$756.90
|
| Rate for Payer: Multiplan All |
$2,649.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,746.70
|
| Rate for Payer: OMNI Networks Commercial |
$2,037.81
|
| Rate for Payer: One Health Plan PPO/POS |
$2,620.04
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,765.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,183.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,561.82
|
| Rate for Payer: United Healthcare Managed Medicaid |
$727.79
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,707.38
|
| Rate for Payer: Zelis Auto |
$1,164.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,455.58
|
|
|
SCREW MICA PROSTEP 4X42MM
|
Facility
|
IP
|
$2,911.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009261
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,164.46 |
| Max. Negotiated Rate |
$2,765.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,328.93
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cigna Commercial |
$2,474.49
|
| Rate for Payer: First Health Commercial |
$2,620.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,620.04
|
| Rate for Payer: GEHA Commercial |
$2,037.81
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,620.04
|
| Rate for Payer: Multiplan All |
$2,649.16
|
| Rate for Payer: OMNI Networks Commercial |
$2,037.81
|
| Rate for Payer: One Health Plan PPO/POS |
$2,620.04
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,765.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,183.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,707.38
|
| Rate for Payer: Zelis Auto |
$1,164.46
|
|
|
SCREW MICA PROSTEP 4X42MM
|
Facility
|
OP
|
$2,911.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009261
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$727.79 |
| Max. Negotiated Rate |
$2,765.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cash Price |
$1,746.70
|
| Rate for Payer: Cigna Commercial |
$2,474.49
|
| Rate for Payer: First Health Commercial |
$2,620.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,620.04
|
| Rate for Payer: GEHA Commercial |
$2,328.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,620.04
|
| Rate for Payer: Humana ChoiceCare |
$756.90
|
| Rate for Payer: Multiplan All |
$2,649.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,746.70
|
| Rate for Payer: OMNI Networks Commercial |
$2,037.81
|
| Rate for Payer: One Health Plan PPO/POS |
$2,620.04
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,765.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,183.37
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,561.82
|
| Rate for Payer: United Healthcare Managed Medicaid |
$727.79
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,707.38
|
| Rate for Payer: Zelis Auto |
$1,164.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,455.58
|
|
|
SCREW NON-LOCKING 2.4 X 10
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006805
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$137.50 |
| Max. Negotiated Rate |
$522.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$330.00
|
| Rate for Payer: Cash Price |
$330.00
|
| Rate for Payer: Cash Price |
$330.00
|
| Rate for Payer: Cigna Commercial |
$467.50
|
| Rate for Payer: First Health Commercial |
$495.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$495.00
|
| Rate for Payer: GEHA Commercial |
$440.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$495.00
|
| Rate for Payer: Humana ChoiceCare |
$143.00
|
| Rate for Payer: Multiplan All |
$500.50
|
| Rate for Payer: New Mexico Health Connections Medicare |
$330.00
|
| Rate for Payer: OMNI Networks Commercial |
$385.00
|
| Rate for Payer: One Health Plan PPO/POS |
$495.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$522.50
|
| Rate for Payer: Three Rivers Provider Network All |
$412.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$484.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$137.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$511.50
|
| Rate for Payer: Zelis Auto |
$220.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$275.00
|
|
|
SCREW NON-LOCKING 2.4 X 10
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006805
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$220.00 |
| Max. Negotiated Rate |
$522.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$440.00
|
| Rate for Payer: Cash Price |
$330.00
|
| Rate for Payer: Cash Price |
$330.00
|
| Rate for Payer: Cigna Commercial |
$467.50
|
| Rate for Payer: First Health Commercial |
$495.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$495.00
|
| Rate for Payer: GEHA Commercial |
$385.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$495.00
|
| Rate for Payer: Multiplan All |
$500.50
|
| Rate for Payer: OMNI Networks Commercial |
$385.00
|
| Rate for Payer: One Health Plan PPO/POS |
$495.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$522.50
|
| Rate for Payer: Three Rivers Provider Network All |
$412.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$511.50
|
| Rate for Payer: Zelis Auto |
$220.00
|
|
|
SCREW NON-LOCKING 2.4 X 12
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006807
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$137.50 |
| Max. Negotiated Rate |
$522.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$330.00
|
| Rate for Payer: Cash Price |
$330.00
|
| Rate for Payer: Cash Price |
$330.00
|
| Rate for Payer: Cigna Commercial |
$467.50
|
| Rate for Payer: First Health Commercial |
$495.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$495.00
|
| Rate for Payer: GEHA Commercial |
$440.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$495.00
|
| Rate for Payer: Humana ChoiceCare |
$143.00
|
| Rate for Payer: Multiplan All |
$500.50
|
| Rate for Payer: New Mexico Health Connections Medicare |
$330.00
|
| Rate for Payer: OMNI Networks Commercial |
$385.00
|
| Rate for Payer: One Health Plan PPO/POS |
$495.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$522.50
|
| Rate for Payer: Three Rivers Provider Network All |
$412.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$484.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$137.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$511.50
|
| Rate for Payer: Zelis Auto |
$220.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$275.00
|
|
|
SCREW NON-LOCKING 2.4 X 12
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006807
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$220.00 |
| Max. Negotiated Rate |
$522.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$440.00
|
| Rate for Payer: Cash Price |
$330.00
|
| Rate for Payer: Cash Price |
$330.00
|
| Rate for Payer: Cigna Commercial |
$467.50
|
| Rate for Payer: First Health Commercial |
$495.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$495.00
|
| Rate for Payer: GEHA Commercial |
$385.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$495.00
|
| Rate for Payer: Multiplan All |
$500.50
|
| Rate for Payer: OMNI Networks Commercial |
$385.00
|
| Rate for Payer: One Health Plan PPO/POS |
$495.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$522.50
|
| Rate for Payer: Three Rivers Provider Network All |
$412.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$511.50
|
| Rate for Payer: Zelis Auto |
$220.00
|
|
|
SCREW NON-LOCKING 2.4 X 14
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006806
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$220.00 |
| Max. Negotiated Rate |
$522.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$440.00
|
| Rate for Payer: Cash Price |
$330.00
|
| Rate for Payer: Cash Price |
$330.00
|
| Rate for Payer: Cigna Commercial |
$467.50
|
| Rate for Payer: First Health Commercial |
$495.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$495.00
|
| Rate for Payer: GEHA Commercial |
$385.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$495.00
|
| Rate for Payer: Multiplan All |
$500.50
|
| Rate for Payer: OMNI Networks Commercial |
$385.00
|
| Rate for Payer: One Health Plan PPO/POS |
$495.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$522.50
|
| Rate for Payer: Three Rivers Provider Network All |
$412.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$511.50
|
| Rate for Payer: Zelis Auto |
$220.00
|
|
|
SCREW NON-LOCKING 2.4 X 14
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006806
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$137.50 |
| Max. Negotiated Rate |
$522.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$330.00
|
| Rate for Payer: Cash Price |
$330.00
|
| Rate for Payer: Cash Price |
$330.00
|
| Rate for Payer: Cigna Commercial |
$467.50
|
| Rate for Payer: First Health Commercial |
$495.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$495.00
|
| Rate for Payer: GEHA Commercial |
$440.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$495.00
|
| Rate for Payer: Humana ChoiceCare |
$143.00
|
| Rate for Payer: Multiplan All |
$500.50
|
| Rate for Payer: New Mexico Health Connections Medicare |
$330.00
|
| Rate for Payer: OMNI Networks Commercial |
$385.00
|
| Rate for Payer: One Health Plan PPO/POS |
$495.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$522.50
|
| Rate for Payer: Three Rivers Provider Network All |
$412.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$484.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$137.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$511.50
|
| Rate for Payer: Zelis Auto |
$220.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$275.00
|
|
|
SCREW NON-LOCKING 2.4 X 16
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006809
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$220.00 |
| Max. Negotiated Rate |
$522.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$440.00
|
| Rate for Payer: Cash Price |
$330.00
|
| Rate for Payer: Cash Price |
$330.00
|
| Rate for Payer: Cigna Commercial |
$467.50
|
| Rate for Payer: First Health Commercial |
$495.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$495.00
|
| Rate for Payer: GEHA Commercial |
$385.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$495.00
|
| Rate for Payer: Multiplan All |
$500.50
|
| Rate for Payer: OMNI Networks Commercial |
$385.00
|
| Rate for Payer: One Health Plan PPO/POS |
$495.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$522.50
|
| Rate for Payer: Three Rivers Provider Network All |
$412.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$511.50
|
| Rate for Payer: Zelis Auto |
$220.00
|
|
