|
SHVG SKIN LESION 1 T/A/L DIAM 0.6-1.0 CM
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
8300008
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$210.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cigna Commercial |
$297.50
|
| Rate for Payer: First Health Commercial |
$315.00
|
| Rate for Payer: First Health Workers Compensation |
$135.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$315.00
|
| Rate for Payer: GEHA Commercial |
$280.00
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$315.00
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$318.50
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$245.00
|
| Rate for Payer: One Health Plan PPO/POS |
$315.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$332.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$262.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$325.50
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$140.00
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$95.55
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM 0.6-1.0 CM
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
6111301
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$210.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cigna Commercial |
$297.50
|
| Rate for Payer: First Health Commercial |
$315.00
|
| Rate for Payer: First Health Workers Compensation |
$135.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$315.00
|
| Rate for Payer: GEHA Commercial |
$280.00
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$315.00
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$318.50
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$245.00
|
| Rate for Payer: One Health Plan PPO/POS |
$315.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$332.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$262.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$325.50
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$140.00
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$95.55
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM 0.6-1.0 CM
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
6111301
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$95.55 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cigna Commercial |
$297.50
|
| Rate for Payer: First Health Commercial |
$315.00
|
| Rate for Payer: First Health Workers Compensation |
$135.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$315.00
|
| Rate for Payer: GEHA Commercial |
$245.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$315.00
|
| Rate for Payer: Multiplan All |
$318.50
|
| Rate for Payer: OMNI Networks Commercial |
$245.00
|
| Rate for Payer: One Health Plan PPO/POS |
$315.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$332.50
|
| Rate for Payer: Three Rivers Provider Network All |
$262.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$325.50
|
| Rate for Payer: Zelis Auto |
$140.00
|
| Rate for Payer: Zelis Worker's Compensation |
$95.55
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM 0.6-1.0 CM
|
Facility
|
OP
|
$326.91
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
7211301
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$196.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$196.15
|
| Rate for Payer: Cash Price |
$196.15
|
| Rate for Payer: Cigna Commercial |
$277.87
|
| Rate for Payer: First Health Commercial |
$294.22
|
| Rate for Payer: First Health Workers Compensation |
$126.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$294.22
|
| Rate for Payer: GEHA Commercial |
$261.53
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$294.22
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$297.49
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$228.84
|
| Rate for Payer: One Health Plan PPO/POS |
$294.22
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$310.56
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$245.18
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$304.03
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$130.76
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$89.25
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM 0.6-1.0 CM
|
Facility
|
IP
|
$326.91
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
7211301
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$89.25 |
| Max. Negotiated Rate |
$310.56 |
| Rate for Payer: Cash Price |
$196.15
|
| Rate for Payer: Cigna Commercial |
$277.87
|
| Rate for Payer: First Health Commercial |
$294.22
|
| Rate for Payer: First Health Workers Compensation |
$126.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$294.22
|
| Rate for Payer: GEHA Commercial |
$228.84
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$294.22
|
| Rate for Payer: Multiplan All |
$297.49
|
| Rate for Payer: OMNI Networks Commercial |
$228.84
|
| Rate for Payer: One Health Plan PPO/POS |
$294.22
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$310.56
|
| Rate for Payer: Three Rivers Provider Network All |
$245.18
|
| Rate for Payer: United Payors & United Providers UP&UP |
$304.03
|
| Rate for Payer: Zelis Auto |
$130.76
|
| Rate for Payer: Zelis Worker's Compensation |
$89.25
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM 0.6-1.0 CM
|
Facility
|
IP
|
$326.91
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
8511301
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$89.25 |
| Max. Negotiated Rate |
$310.56 |
| Rate for Payer: Cash Price |
$196.15
|
| Rate for Payer: Cigna Commercial |
$277.87
|
| Rate for Payer: First Health Commercial |
$294.22
|
| Rate for Payer: First Health Workers Compensation |
$126.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$294.22
|
| Rate for Payer: GEHA Commercial |
$228.84
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$294.22
|
| Rate for Payer: Multiplan All |
$297.49
|
| Rate for Payer: OMNI Networks Commercial |
$228.84
|
| Rate for Payer: One Health Plan PPO/POS |
$294.22
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$310.56
|
| Rate for Payer: Three Rivers Provider Network All |
$245.18
|
| Rate for Payer: United Payors & United Providers UP&UP |
$304.03
|
| Rate for Payer: Zelis Auto |
$130.76
|
| Rate for Payer: Zelis Worker's Compensation |
$89.25
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM 0.6-1.0 CM
|
Facility
|
OP
|
$326.91
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
8511301
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$196.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$196.15
|
| Rate for Payer: Cash Price |
$196.15
|
| Rate for Payer: Cigna Commercial |
$277.87
|
| Rate for Payer: First Health Commercial |
$294.22
|
| Rate for Payer: First Health Workers Compensation |
$126.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$294.22
|
| Rate for Payer: GEHA Commercial |
$261.53
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$294.22
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$297.49
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$228.84
|
| Rate for Payer: One Health Plan PPO/POS |
$294.22
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$310.56
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$245.18
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$304.03
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$130.76
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$89.25
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM 0.6-1.0 CM
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
9400002
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$95.55 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cigna Commercial |
$297.50
|
| Rate for Payer: First Health Commercial |
$315.00
|
| Rate for Payer: First Health Workers Compensation |
$135.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$315.00
|
| Rate for Payer: GEHA Commercial |
$245.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$315.00
|
| Rate for Payer: Multiplan All |
$318.50
|
| Rate for Payer: OMNI Networks Commercial |
$245.00
|
| Rate for Payer: One Health Plan PPO/POS |
$315.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$332.50
|
| Rate for Payer: Three Rivers Provider Network All |
$262.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$325.50
|
| Rate for Payer: Zelis Auto |
$140.00
|
| Rate for Payer: Zelis Worker's Compensation |
$95.55
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM 0.6-1.0 CM
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT 11301
|
| Hospital Charge Code |
9400002
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$210.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cigna Commercial |
$297.50
|
| Rate for Payer: First Health Commercial |
$315.00
|
| Rate for Payer: First Health Workers Compensation |
$135.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$315.00
|
| Rate for Payer: GEHA Commercial |
$280.00
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$315.00
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$318.50
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$245.00
|
| Rate for Payer: One Health Plan PPO/POS |
$315.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$332.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$262.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$325.50
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$140.00
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$95.55
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM >2.0 CM
|
Facility
|
IP
|
$428.64
|
|
|
Service Code
|
CPT 11303
|
| Hospital Charge Code |
6111303
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$117.02 |
| Max. Negotiated Rate |
$407.21 |
| Rate for Payer: Cash Price |
$257.18
|
| Rate for Payer: Cigna Commercial |
$364.34
|
| Rate for Payer: First Health Commercial |
$385.78
|
| Rate for Payer: First Health Workers Compensation |
$165.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$385.78
|
| Rate for Payer: GEHA Commercial |
$300.05
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$385.78
|
| Rate for Payer: Multiplan All |
$390.06
|
| Rate for Payer: OMNI Networks Commercial |
$300.05
|
| Rate for Payer: One Health Plan PPO/POS |
$385.78
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$407.21
|
| Rate for Payer: Three Rivers Provider Network All |
$321.48
|
| Rate for Payer: United Payors & United Providers UP&UP |
$398.64
|
| Rate for Payer: Zelis Auto |
$171.46
|
| Rate for Payer: Zelis Worker's Compensation |
$117.02
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM >2.0 CM
|
Facility
|
IP
|
$461.00
|
|
|
Service Code
|
CPT 11303
|
| Hospital Charge Code |
20300134
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$125.85 |
| Max. Negotiated Rate |
$437.95 |
| Rate for Payer: Cash Price |
$276.60
|
| Rate for Payer: Cigna Commercial |
$391.85
|
| Rate for Payer: First Health Commercial |
$414.90
|
| Rate for Payer: First Health Workers Compensation |
$177.99
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$414.90
|
| Rate for Payer: GEHA Commercial |
$322.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$414.90
|
| Rate for Payer: Multiplan All |
$419.51
|
| Rate for Payer: OMNI Networks Commercial |
$322.70
|
| Rate for Payer: One Health Plan PPO/POS |
$414.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$437.95
|
| Rate for Payer: Three Rivers Provider Network All |
$345.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$428.73
|
| Rate for Payer: Zelis Auto |
$184.40
|
| Rate for Payer: Zelis Worker's Compensation |
$125.85
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM >2.0 CM
|
Facility
|
IP
|
$413.28
|
|
|
Service Code
|
CPT 11303
|
| Hospital Charge Code |
7211303
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$112.83 |
| Max. Negotiated Rate |
$392.62 |
| Rate for Payer: Cash Price |
$247.97
|
| Rate for Payer: Cigna Commercial |
$351.29
|
| Rate for Payer: First Health Commercial |
$371.95
|
| Rate for Payer: First Health Workers Compensation |
$159.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$371.95
|
| Rate for Payer: GEHA Commercial |
$289.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$371.95
|
| Rate for Payer: Multiplan All |
$376.08
|
| Rate for Payer: OMNI Networks Commercial |
$289.30
|
| Rate for Payer: One Health Plan PPO/POS |
$371.95
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$392.62
|
| Rate for Payer: Three Rivers Provider Network All |
$309.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$384.35
|
| Rate for Payer: Zelis Auto |
$165.31
|
| Rate for Payer: Zelis Worker's Compensation |
$112.83
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM >2.0 CM
|
Facility
|
OP
|
$428.64
|
|
|
Service Code
|
CPT 11303
|
| Hospital Charge Code |
6111303
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$117.02 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$155.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$257.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$155.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$123.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$257.18
|
| Rate for Payer: Cash Price |
$257.18
|
| Rate for Payer: Cigna Commercial |
$364.34
|
| Rate for Payer: First Health Commercial |
$385.78
|
| Rate for Payer: First Health Workers Compensation |
$165.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$385.78
|
| Rate for Payer: GEHA Commercial |
$342.91
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$385.78
|
| 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 |
$125.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$390.06
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$300.05
|
| Rate for Payer: One Health Plan PPO/POS |
$385.78
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$145.45
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$125.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$407.21
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$321.48
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$125.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$398.64
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$171.46
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$117.02
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM >2.0 CM
|
Facility
|
OP
|
$461.00
|
|
|
Service Code
|
CPT 11303
|
| Hospital Charge Code |
9400004
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$123.45 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$155.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$276.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$155.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$123.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$276.60
|
| Rate for Payer: Cash Price |
$276.60
|
| Rate for Payer: Cigna Commercial |
$391.85
|
| Rate for Payer: First Health Commercial |
$414.90
|
| Rate for Payer: First Health Workers Compensation |
$177.99
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$414.90
|
| Rate for Payer: GEHA Commercial |
$368.80
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$414.90
|
| 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 |
$125.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$419.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$322.70
|
| Rate for Payer: One Health Plan PPO/POS |
$414.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$145.45
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$125.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$437.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$345.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$125.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$428.73
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$184.40
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$125.85
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM >2.0 CM
|
Facility
|
IP
|
$461.00
|
|
|
Service Code
|
CPT 11303
|
| Hospital Charge Code |
9400004
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$125.85 |
| Max. Negotiated Rate |
$437.95 |
| Rate for Payer: Cash Price |
$276.60
|
| Rate for Payer: Cigna Commercial |
$391.85
|
| Rate for Payer: First Health Commercial |
$414.90
|
| Rate for Payer: First Health Workers Compensation |
$177.99
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$414.90
|
| Rate for Payer: GEHA Commercial |
$322.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$414.90
|
| Rate for Payer: Multiplan All |
$419.51
|
| Rate for Payer: OMNI Networks Commercial |
$322.70
|
| Rate for Payer: One Health Plan PPO/POS |
$414.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$437.95
|
| Rate for Payer: Three Rivers Provider Network All |
$345.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$428.73
|
| Rate for Payer: Zelis Auto |
$184.40
|
| Rate for Payer: Zelis Worker's Compensation |
$125.85
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM >2.0 CM
|
Facility
|
IP
|
$413.28
|
|
|
Service Code
|
CPT 11303
|
| Hospital Charge Code |
8511104
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$112.83 |
| Max. Negotiated Rate |
$392.62 |
| Rate for Payer: Cash Price |
$247.97
|
| Rate for Payer: Cigna Commercial |
$351.29
|
| Rate for Payer: First Health Commercial |
$371.95
|
| Rate for Payer: First Health Workers Compensation |
$159.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$371.95
|
| Rate for Payer: GEHA Commercial |
$289.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$371.95
|
| Rate for Payer: Multiplan All |
$376.08
|
| Rate for Payer: OMNI Networks Commercial |
$289.30
|
| Rate for Payer: One Health Plan PPO/POS |
$371.95
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$392.62
|
| Rate for Payer: Three Rivers Provider Network All |
$309.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$384.35
|
| Rate for Payer: Zelis Auto |
$165.31
|
| Rate for Payer: Zelis Worker's Compensation |
$112.83
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM >2.0 CM
|
Facility
|
OP
|
$413.28
|
|
|
Service Code
|
CPT 11303
|
| Hospital Charge Code |
8511104
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$112.83 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$155.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$247.97
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$155.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$123.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$247.97
|
| Rate for Payer: Cash Price |
$247.97
|
| Rate for Payer: Cigna Commercial |
$351.29
|
| Rate for Payer: First Health Commercial |
$371.95
|
| Rate for Payer: First Health Workers Compensation |
$159.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$371.95
|
| Rate for Payer: GEHA Commercial |
$330.62
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$371.95
|
| 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 |
$125.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$376.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$289.30
|
| Rate for Payer: One Health Plan PPO/POS |
$371.95
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$145.45
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$125.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$392.62
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$309.96
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$125.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$384.35
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$165.31
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$112.83
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM >2.0 CM
|
Facility
|
OP
|
$413.28
|
|
|
Service Code
|
CPT 11303
|
| Hospital Charge Code |
7211303
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$112.83 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$155.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$247.97
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$155.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$123.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$247.97
|
| Rate for Payer: Cash Price |
$247.97
|
| Rate for Payer: Cigna Commercial |
$351.29
|
| Rate for Payer: First Health Commercial |
$371.95
|
| Rate for Payer: First Health Workers Compensation |
$159.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$371.95
|
| Rate for Payer: GEHA Commercial |
$330.62
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$371.95
|
| 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 |
$125.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$376.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$289.30
|
| Rate for Payer: One Health Plan PPO/POS |
$371.95
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$145.45
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$125.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$392.62
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$309.96
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$125.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$384.35
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$165.31
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$112.83
|
|
|
SHVG SKIN LESION 1 T/A/L DIAM >2.0 CM
|
Facility
|
OP
|
$461.00
|
|
|
Service Code
|
CPT 11303
|
| Hospital Charge Code |
20300134
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$123.45 |
| Max. Negotiated Rate |
$758.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$155.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$276.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$155.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$123.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$276.60
|
| Rate for Payer: Cash Price |
$276.60
|
| Rate for Payer: Cigna Commercial |
$391.85
|
| Rate for Payer: First Health Commercial |
$414.90
|
| Rate for Payer: First Health Workers Compensation |
$177.99
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$414.90
|
| Rate for Payer: GEHA Commercial |
$368.80
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$414.90
|
| 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 |
$125.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$419.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$322.70
|
| Rate for Payer: One Health Plan PPO/POS |
$414.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$145.45
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$125.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$437.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$345.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$125.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$428.73
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$184.40
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$125.85
|
|
|
SHVG SKN LES 1 F/E/E/N/L/M DIA 0.6-1.0CM
|
Facility
|
OP
|
$205.00
|
|
|
Service Code
|
CPT 11311
|
| Hospital Charge Code |
6111311
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$55.97 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$123.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cigna Commercial |
$174.25
|
| Rate for Payer: First Health Commercial |
$184.50
|
| Rate for Payer: First Health Workers Compensation |
$79.15
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$184.50
|
| Rate for Payer: GEHA Commercial |
$164.00
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$184.50
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$186.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$143.50
|
| Rate for Payer: One Health Plan PPO/POS |
$184.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$194.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$153.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$190.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$82.00
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$55.97
|
|
|
SHVG SKN LES 1 F/E/E/N/L/M DIA 0.6-1.0CM
|
Facility
|
OP
|
$405.00
|
|
|
Service Code
|
CPT 11311
|
| Hospital Charge Code |
8300011
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$384.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$243.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Cigna Commercial |
$344.25
|
| Rate for Payer: First Health Commercial |
$364.50
|
| Rate for Payer: First Health Workers Compensation |
$156.37
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$364.50
|
| Rate for Payer: GEHA Commercial |
$324.00
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$364.50
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$368.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$283.50
|
| Rate for Payer: One Health Plan PPO/POS |
$364.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$384.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$303.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$376.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$162.00
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$110.56
|
|
|
SHVG SKN LES 1 F/E/E/N/L/M DIA 0.6-1.0CM
|
Facility
|
OP
|
$371.76
|
|
|
Service Code
|
CPT 11311
|
| Hospital Charge Code |
7211311
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$223.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$223.06
|
| Rate for Payer: Cash Price |
$223.06
|
| Rate for Payer: Cigna Commercial |
$316.00
|
| Rate for Payer: First Health Commercial |
$334.58
|
| Rate for Payer: First Health Workers Compensation |
$143.54
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$334.58
|
| Rate for Payer: GEHA Commercial |
$297.41
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$334.58
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$338.30
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$260.23
|
| Rate for Payer: One Health Plan PPO/POS |
$334.58
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$353.17
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$278.82
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$345.74
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$148.70
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$101.49
|
|
|
SHVG SKN LES 1 F/E/E/N/L/M DIA 0.6-1.0CM
|
Facility
|
IP
|
$371.76
|
|
|
Service Code
|
CPT 11311
|
| Hospital Charge Code |
7211311
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$101.49 |
| Max. Negotiated Rate |
$353.17 |
| Rate for Payer: Cash Price |
$223.06
|
| Rate for Payer: Cigna Commercial |
$316.00
|
| Rate for Payer: First Health Commercial |
$334.58
|
| Rate for Payer: First Health Workers Compensation |
$143.54
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$334.58
|
| Rate for Payer: GEHA Commercial |
$260.23
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$334.58
|
| Rate for Payer: Multiplan All |
$338.30
|
| Rate for Payer: OMNI Networks Commercial |
$260.23
|
| Rate for Payer: One Health Plan PPO/POS |
$334.58
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$353.17
|
| Rate for Payer: Three Rivers Provider Network All |
$278.82
|
| Rate for Payer: United Payors & United Providers UP&UP |
$345.74
|
| Rate for Payer: Zelis Auto |
$148.70
|
| Rate for Payer: Zelis Worker's Compensation |
$101.49
|
|
|
SHVG SKN LES 1 F/E/E/N/L/M DIA 0.6-1.0CM
|
Facility
|
OP
|
$405.00
|
|
|
Service Code
|
CPT 11311
|
| Hospital Charge Code |
7911311
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$384.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$243.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Cigna Commercial |
$344.25
|
| Rate for Payer: First Health Commercial |
$364.50
|
| Rate for Payer: First Health Workers Compensation |
$156.37
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$364.50
|
| Rate for Payer: GEHA Commercial |
$324.00
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$364.50
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$368.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$283.50
|
| Rate for Payer: One Health Plan PPO/POS |
$364.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$384.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$303.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$376.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$162.00
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$110.56
|
|
|
SHVG SKN LES 1 F/E/E/N/L/M DIA 0.6-1.0CM
|
Facility
|
IP
|
$371.76
|
|
|
Service Code
|
CPT 11311
|
| Hospital Charge Code |
8511110
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$101.49 |
| Max. Negotiated Rate |
$353.17 |
| Rate for Payer: Cash Price |
$223.06
|
| Rate for Payer: Cigna Commercial |
$316.00
|
| Rate for Payer: First Health Commercial |
$334.58
|
| Rate for Payer: First Health Workers Compensation |
$143.54
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$334.58
|
| Rate for Payer: GEHA Commercial |
$260.23
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$334.58
|
| Rate for Payer: Multiplan All |
$338.30
|
| Rate for Payer: OMNI Networks Commercial |
$260.23
|
| Rate for Payer: One Health Plan PPO/POS |
$334.58
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$353.17
|
| Rate for Payer: Three Rivers Provider Network All |
$278.82
|
| Rate for Payer: United Payors & United Providers UP&UP |
$345.74
|
| Rate for Payer: Zelis Auto |
$148.70
|
| Rate for Payer: Zelis Worker's Compensation |
$101.49
|
|
