|
SHVING SKIN LES 1 S/N/H/F/G DIAM >2.0 CM
|
Facility
|
OP
|
$234.00
|
|
|
Service Code
|
CPT 11308
|
| Hospital Charge Code |
6111308
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$63.88 |
| Max. Negotiated Rate |
$758.74 |
| 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 |
$140.40
|
| 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 |
$379.37
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Cigna Commercial |
$198.90
|
| Rate for Payer: First Health Commercial |
$210.60
|
| Rate for Payer: First Health Workers Compensation |
$90.35
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$210.60
|
| Rate for Payer: GEHA Commercial |
$187.20
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$210.60
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$212.94
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$163.80
|
| Rate for Payer: One Health Plan PPO/POS |
$210.60
|
| 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 |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$222.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$175.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$217.62
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$93.60
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$63.88
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM >2.0 CM
|
Facility
|
OP
|
$395.25
|
|
|
Service Code
|
CPT 11308
|
| Hospital Charge Code |
7211308
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$758.74 |
| 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 |
$237.15
|
| 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 |
$379.37
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cigna Commercial |
$335.96
|
| Rate for Payer: First Health Commercial |
$355.73
|
| Rate for Payer: First Health Workers Compensation |
$152.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$355.73
|
| Rate for Payer: GEHA Commercial |
$316.20
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$355.73
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$359.68
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$276.68
|
| Rate for Payer: One Health Plan PPO/POS |
$355.73
|
| 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 |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$375.49
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$296.44
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$367.58
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$158.10
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$107.90
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM >2.0 CM
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 11308
|
| Hospital Charge Code |
9400008
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$758.74 |
| 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 |
$274.20
|
| 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 |
$379.37
|
| Rate for Payer: Cash Price |
$274.20
|
| Rate for Payer: Cash Price |
$274.20
|
| Rate for Payer: Cigna Commercial |
$388.45
|
| Rate for Payer: First Health Commercial |
$411.30
|
| Rate for Payer: First Health Workers Compensation |
$176.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$411.30
|
| Rate for Payer: GEHA Commercial |
$365.60
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$411.30
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$415.87
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$319.90
|
| Rate for Payer: One Health Plan PPO/POS |
$411.30
|
| 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 |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$434.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$342.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$425.01
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$182.80
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$124.76
|
|
|
SHVING SKIN LES 1 S/N/H/F/G DIAM >2.0 CM
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 11308
|
| Hospital Charge Code |
20300138
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$758.74 |
| 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 |
$274.20
|
| 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 |
$379.37
|
| Rate for Payer: Cash Price |
$274.20
|
| Rate for Payer: Cash Price |
$274.20
|
| Rate for Payer: Cigna Commercial |
$388.45
|
| Rate for Payer: First Health Commercial |
$411.30
|
| Rate for Payer: First Health Workers Compensation |
$176.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$411.30
|
| Rate for Payer: GEHA Commercial |
$365.60
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$411.30
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$415.87
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$319.90
|
| Rate for Payer: One Health Plan PPO/POS |
$411.30
|
| 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 |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$434.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$342.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$425.01
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$182.80
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$124.76
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIA 0.5CM/<
|
Facility
|
IP
|
$148.00
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
6111310
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$40.40 |
| Max. Negotiated Rate |
$140.60 |
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cigna Commercial |
$125.80
|
| Rate for Payer: First Health Commercial |
$133.20
|
| Rate for Payer: First Health Workers Compensation |
$57.14
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$133.20
|
| Rate for Payer: GEHA Commercial |
$103.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$133.20
|
| Rate for Payer: Multiplan All |
$134.68
|
| Rate for Payer: OMNI Networks Commercial |
$103.60
|
| Rate for Payer: One Health Plan PPO/POS |
$133.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$140.60
|
| Rate for Payer: Three Rivers Provider Network All |
$111.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$137.64
|
| Rate for Payer: Zelis Auto |
$59.20
|
| Rate for Payer: Zelis Worker's Compensation |
$40.40
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIA 0.5CM/<
|
Facility
|
IP
|
$309.66
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
7211310
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$84.54 |
| Max. Negotiated Rate |
$294.18 |
| Rate for Payer: Cash Price |
$185.80
|
| Rate for Payer: Cigna Commercial |
$263.21
|
| Rate for Payer: First Health Commercial |
$278.69
|
| Rate for Payer: First Health Workers Compensation |
$119.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$278.69
|
| Rate for Payer: GEHA Commercial |
$216.76
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$278.69
|
| Rate for Payer: Multiplan All |
$281.79
|
| Rate for Payer: OMNI Networks Commercial |
$216.76
|
| Rate for Payer: One Health Plan PPO/POS |
$278.69
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$294.18
|
| Rate for Payer: Three Rivers Provider Network All |
$232.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$287.98
|
| Rate for Payer: Zelis Auto |
$123.86
|
| Rate for Payer: Zelis Worker's Compensation |
$84.54
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIA 0.5CM/<
|
Facility
|
IP
|
$337.00
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
20300139
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$92.00 |
| Max. Negotiated Rate |
$320.15 |
| Rate for Payer: Cash Price |
$202.20
|
| Rate for Payer: Cigna Commercial |
$286.45
|
| Rate for Payer: First Health Commercial |
$303.30
|
| Rate for Payer: First Health Workers Compensation |
$130.12
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$303.30
|
| Rate for Payer: GEHA Commercial |
$235.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$303.30
|
| Rate for Payer: Multiplan All |
$306.67
|
| Rate for Payer: OMNI Networks Commercial |
$235.90
|
| Rate for Payer: One Health Plan PPO/POS |
$303.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$320.15
|
| Rate for Payer: Three Rivers Provider Network All |
$252.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$313.41
|
| Rate for Payer: Zelis Auto |
$134.80
|
| Rate for Payer: Zelis Worker's Compensation |
$92.00
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIA 0.5CM/<
|
Facility
|
OP
|
$309.66
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
7211310
|
|
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 |
$185.80
|
| 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 |
$185.80
|
| Rate for Payer: Cash Price |
$185.80
|
| Rate for Payer: Cigna Commercial |
$263.21
|
| Rate for Payer: First Health Commercial |
$278.69
|
| Rate for Payer: First Health Workers Compensation |
$119.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$278.69
|
| Rate for Payer: GEHA Commercial |
$247.73
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$278.69
|
| 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 |
$281.79
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$216.76
|
| Rate for Payer: One Health Plan PPO/POS |
$278.69
|
| 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 |
$294.18
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$232.25
|
| 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 |
$287.98
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$123.86
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$84.54
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIA 0.5CM/<
|
Facility
|
IP
|
$337.00
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
9400009
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$92.00 |
| Max. Negotiated Rate |
$320.15 |
| Rate for Payer: Cash Price |
$202.20
|
| Rate for Payer: Cigna Commercial |
$286.45
|
| Rate for Payer: First Health Commercial |
$303.30
|
| Rate for Payer: First Health Workers Compensation |
$130.12
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$303.30
|
| Rate for Payer: GEHA Commercial |
$235.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$303.30
|
| Rate for Payer: Multiplan All |
$306.67
|
| Rate for Payer: OMNI Networks Commercial |
$235.90
|
| Rate for Payer: One Health Plan PPO/POS |
$303.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$320.15
|
| Rate for Payer: Three Rivers Provider Network All |
$252.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$313.41
|
| Rate for Payer: Zelis Auto |
$134.80
|
| Rate for Payer: Zelis Worker's Compensation |
$92.00
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIA 0.5CM/<
|
Facility
|
IP
|
$309.66
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
8511109
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$84.54 |
| Max. Negotiated Rate |
$294.18 |
| Rate for Payer: Cash Price |
$185.80
|
| Rate for Payer: Cigna Commercial |
$263.21
|
| Rate for Payer: First Health Commercial |
$278.69
|
| Rate for Payer: First Health Workers Compensation |
$119.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$278.69
|
| Rate for Payer: GEHA Commercial |
$216.76
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$278.69
|
| Rate for Payer: Multiplan All |
$281.79
|
| Rate for Payer: OMNI Networks Commercial |
$216.76
|
| Rate for Payer: One Health Plan PPO/POS |
$278.69
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$294.18
|
| Rate for Payer: Three Rivers Provider Network All |
$232.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$287.98
|
| Rate for Payer: Zelis Auto |
$123.86
|
| Rate for Payer: Zelis Worker's Compensation |
$84.54
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIA 0.5CM/<
|
Facility
|
OP
|
$337.00
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
20300139
|
|
Hospital Revenue Code
|
510
|
| 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 |
$202.20
|
| 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 |
$202.20
|
| Rate for Payer: Cash Price |
$202.20
|
| Rate for Payer: Cigna Commercial |
$286.45
|
| Rate for Payer: First Health Commercial |
$303.30
|
| Rate for Payer: First Health Workers Compensation |
$130.12
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$303.30
|
| Rate for Payer: GEHA Commercial |
$269.60
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$303.30
|
| 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 |
$306.67
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$235.90
|
| Rate for Payer: One Health Plan PPO/POS |
$303.30
|
| 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 |
$320.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$252.75
|
| 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 |
$313.41
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$134.80
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$92.00
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIA 0.5CM/<
|
Facility
|
OP
|
$337.00
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
9400009
|
|
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 |
$202.20
|
| 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 |
$202.20
|
| Rate for Payer: Cash Price |
$202.20
|
| Rate for Payer: Cigna Commercial |
$286.45
|
| Rate for Payer: First Health Commercial |
$303.30
|
| Rate for Payer: First Health Workers Compensation |
$130.12
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$303.30
|
| Rate for Payer: GEHA Commercial |
$269.60
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$303.30
|
| 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 |
$306.67
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$235.90
|
| Rate for Payer: One Health Plan PPO/POS |
$303.30
|
| 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 |
$320.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$252.75
|
| 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 |
$313.41
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$134.80
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$92.00
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIA 0.5CM/<
|
Facility
|
OP
|
$148.00
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
6111310
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$40.40 |
| 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 |
$88.80
|
| 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 |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cigna Commercial |
$125.80
|
| Rate for Payer: First Health Commercial |
$133.20
|
| Rate for Payer: First Health Workers Compensation |
$57.14
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$133.20
|
| Rate for Payer: GEHA Commercial |
$118.40
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$133.20
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$134.68
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$103.60
|
| Rate for Payer: One Health Plan PPO/POS |
$133.20
|
| 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 |
$140.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$111.00
|
| 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 |
$137.64
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$59.20
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$40.40
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIA 0.5CM/<
|
Facility
|
OP
|
$309.66
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
8511109
|
|
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 |
$185.80
|
| 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 |
$185.80
|
| Rate for Payer: Cash Price |
$185.80
|
| Rate for Payer: Cigna Commercial |
$263.21
|
| Rate for Payer: First Health Commercial |
$278.69
|
| Rate for Payer: First Health Workers Compensation |
$119.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$278.69
|
| Rate for Payer: GEHA Commercial |
$247.73
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$278.69
|
| 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 |
$281.79
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$216.76
|
| Rate for Payer: One Health Plan PPO/POS |
$278.69
|
| 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 |
$294.18
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$232.25
|
| 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 |
$287.98
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$123.86
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$84.54
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIAM >2.0CM
|
Facility
|
OP
|
$494.52
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
8511112
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$758.74 |
| 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 |
$296.71
|
| 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 |
$379.37
|
| Rate for Payer: Cash Price |
$296.71
|
| Rate for Payer: Cash Price |
$296.71
|
| Rate for Payer: Cigna Commercial |
$420.34
|
| Rate for Payer: First Health Commercial |
$445.07
|
| Rate for Payer: First Health Workers Compensation |
$190.93
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$445.07
|
| Rate for Payer: GEHA Commercial |
$395.62
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$445.07
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$450.01
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$346.16
|
| Rate for Payer: One Health Plan PPO/POS |
$445.07
|
| 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 |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$469.79
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$370.89
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$459.90
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$197.81
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$135.00
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIAM >2.0CM
|
Facility
|
OP
|
$559.00
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
20300142
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$758.74 |
| 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 |
$335.40
|
| 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 |
$379.37
|
| Rate for Payer: Cash Price |
$335.40
|
| Rate for Payer: Cash Price |
$335.40
|
| Rate for Payer: Cigna Commercial |
$475.15
|
| Rate for Payer: First Health Commercial |
$503.10
|
| Rate for Payer: First Health Workers Compensation |
$215.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$503.10
|
| Rate for Payer: GEHA Commercial |
$447.20
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$503.10
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$508.69
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$391.30
|
| Rate for Payer: One Health Plan PPO/POS |
$503.10
|
| 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 |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$531.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$419.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$519.87
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$223.60
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$152.61
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIAM >2.0CM
|
Facility
|
OP
|
$494.52
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
7211313
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$758.74 |
| 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 |
$296.71
|
| 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 |
$379.37
|
| Rate for Payer: Cash Price |
$296.71
|
| Rate for Payer: Cash Price |
$296.71
|
| Rate for Payer: Cigna Commercial |
$420.34
|
| Rate for Payer: First Health Commercial |
$445.07
|
| Rate for Payer: First Health Workers Compensation |
$190.93
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$445.07
|
| Rate for Payer: GEHA Commercial |
$395.62
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$445.07
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$450.01
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$346.16
|
| Rate for Payer: One Health Plan PPO/POS |
$445.07
|
| 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 |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$469.79
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$370.89
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$459.90
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$197.81
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$135.00
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIAM >2.0CM
|
Facility
|
IP
|
$494.52
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
7211313
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$469.79 |
| Rate for Payer: Cash Price |
$296.71
|
| Rate for Payer: Cigna Commercial |
$420.34
|
| Rate for Payer: First Health Commercial |
$445.07
|
| Rate for Payer: First Health Workers Compensation |
$190.93
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$445.07
|
| Rate for Payer: GEHA Commercial |
$346.16
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$445.07
|
| Rate for Payer: Multiplan All |
$450.01
|
| Rate for Payer: OMNI Networks Commercial |
$346.16
|
| Rate for Payer: One Health Plan PPO/POS |
$445.07
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$469.79
|
| Rate for Payer: Three Rivers Provider Network All |
$370.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$459.90
|
| Rate for Payer: Zelis Auto |
$197.81
|
| Rate for Payer: Zelis Worker's Compensation |
$135.00
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIAM >2.0CM
|
Facility
|
IP
|
$559.00
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
20300142
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$531.05 |
| Rate for Payer: Cash Price |
$335.40
|
| Rate for Payer: Cigna Commercial |
$475.15
|
| Rate for Payer: First Health Commercial |
$503.10
|
| Rate for Payer: First Health Workers Compensation |
$215.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$503.10
|
| Rate for Payer: GEHA Commercial |
$391.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$503.10
|
| Rate for Payer: Multiplan All |
$508.69
|
| Rate for Payer: OMNI Networks Commercial |
$391.30
|
| Rate for Payer: One Health Plan PPO/POS |
$503.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$531.05
|
| Rate for Payer: Three Rivers Provider Network All |
$419.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$519.87
|
| Rate for Payer: Zelis Auto |
$223.60
|
| Rate for Payer: Zelis Worker's Compensation |
$152.61
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIAM >2.0CM
|
Facility
|
OP
|
$559.00
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
9400012
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$758.74 |
| 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 |
$335.40
|
| 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 |
$379.37
|
| Rate for Payer: Cash Price |
$335.40
|
| Rate for Payer: Cash Price |
$335.40
|
| Rate for Payer: Cigna Commercial |
$475.15
|
| Rate for Payer: First Health Commercial |
$503.10
|
| Rate for Payer: First Health Workers Compensation |
$215.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$503.10
|
| Rate for Payer: GEHA Commercial |
$447.20
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$503.10
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$508.69
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$391.30
|
| Rate for Payer: One Health Plan PPO/POS |
$503.10
|
| 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 |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$531.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$419.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$519.87
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$223.60
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$152.61
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIAM >2.0CM
|
Facility
|
IP
|
$559.00
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
9400012
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$531.05 |
| Rate for Payer: Cash Price |
$335.40
|
| Rate for Payer: Cigna Commercial |
$475.15
|
| Rate for Payer: First Health Commercial |
$503.10
|
| Rate for Payer: First Health Workers Compensation |
$215.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$503.10
|
| Rate for Payer: GEHA Commercial |
$391.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$503.10
|
| Rate for Payer: Multiplan All |
$508.69
|
| Rate for Payer: OMNI Networks Commercial |
$391.30
|
| Rate for Payer: One Health Plan PPO/POS |
$503.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$531.05
|
| Rate for Payer: Three Rivers Provider Network All |
$419.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$519.87
|
| Rate for Payer: Zelis Auto |
$223.60
|
| Rate for Payer: Zelis Worker's Compensation |
$152.61
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIAM >2.0CM
|
Facility
|
OP
|
$316.00
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
6111313
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$758.74 |
| 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 |
$189.60
|
| 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 |
$379.37
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cigna Commercial |
$268.60
|
| Rate for Payer: First Health Commercial |
$284.40
|
| Rate for Payer: First Health Workers Compensation |
$122.01
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$284.40
|
| Rate for Payer: GEHA Commercial |
$252.80
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$284.40
|
| 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 |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$287.56
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$221.20
|
| Rate for Payer: One Health Plan PPO/POS |
$284.40
|
| 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 |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$300.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$237.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$293.88
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$126.40
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$86.27
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIAM >2.0CM
|
Facility
|
IP
|
$494.52
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
8511112
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$469.79 |
| Rate for Payer: Cash Price |
$296.71
|
| Rate for Payer: Cigna Commercial |
$420.34
|
| Rate for Payer: First Health Commercial |
$445.07
|
| Rate for Payer: First Health Workers Compensation |
$190.93
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$445.07
|
| Rate for Payer: GEHA Commercial |
$346.16
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$445.07
|
| Rate for Payer: Multiplan All |
$450.01
|
| Rate for Payer: OMNI Networks Commercial |
$346.16
|
| Rate for Payer: One Health Plan PPO/POS |
$445.07
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$469.79
|
| Rate for Payer: Three Rivers Provider Network All |
$370.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$459.90
|
| Rate for Payer: Zelis Auto |
$197.81
|
| Rate for Payer: Zelis Worker's Compensation |
$135.00
|
|
|
SHVING SKN LES 1 F/E/E/N/L/M DIAM >2.0CM
|
Facility
|
IP
|
$316.00
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
6111313
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$86.27 |
| Max. Negotiated Rate |
$300.20 |
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cigna Commercial |
$268.60
|
| Rate for Payer: First Health Commercial |
$284.40
|
| Rate for Payer: First Health Workers Compensation |
$122.01
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$284.40
|
| Rate for Payer: GEHA Commercial |
$221.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$284.40
|
| Rate for Payer: Multiplan All |
$287.56
|
| Rate for Payer: OMNI Networks Commercial |
$221.20
|
| Rate for Payer: One Health Plan PPO/POS |
$284.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$300.20
|
| Rate for Payer: Three Rivers Provider Network All |
$237.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$293.88
|
| Rate for Payer: Zelis Auto |
$126.40
|
| Rate for Payer: Zelis Worker's Compensation |
$86.27
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 0.6-1.0CM
|
Facility
|
IP
|
$361.00
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
20300136
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$98.55 |
| Max. Negotiated Rate |
$342.95 |
| Rate for Payer: Cash Price |
$216.60
|
| Rate for Payer: Cigna Commercial |
$306.85
|
| Rate for Payer: First Health Commercial |
$324.90
|
| Rate for Payer: First Health Workers Compensation |
$139.38
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$324.90
|
| Rate for Payer: GEHA Commercial |
$252.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$324.90
|
| Rate for Payer: Multiplan All |
$328.51
|
| Rate for Payer: OMNI Networks Commercial |
$252.70
|
| Rate for Payer: One Health Plan PPO/POS |
$324.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$342.95
|
| Rate for Payer: Three Rivers Provider Network All |
$270.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$335.73
|
| Rate for Payer: Zelis Auto |
$144.40
|
| Rate for Payer: Zelis Worker's Compensation |
$98.55
|
|
