|
SHVING SKN LES 1 S/N/H/F/G DIA 0.6-1.0CM
|
Facility
|
IP
|
$328.71
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
8511106
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$89.74 |
| Max. Negotiated Rate |
$312.27 |
| Rate for Payer: Cash Price |
$197.23
|
| Rate for Payer: Cigna Commercial |
$279.40
|
| Rate for Payer: First Health Commercial |
$295.84
|
| Rate for Payer: First Health Workers Compensation |
$126.91
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$295.84
|
| Rate for Payer: GEHA Commercial |
$230.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$295.84
|
| Rate for Payer: Multiplan All |
$299.13
|
| Rate for Payer: OMNI Networks Commercial |
$230.10
|
| Rate for Payer: One Health Plan PPO/POS |
$295.84
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$312.27
|
| Rate for Payer: Three Rivers Provider Network All |
$246.53
|
| Rate for Payer: United Payors & United Providers UP&UP |
$305.70
|
| Rate for Payer: Zelis Auto |
$131.48
|
| Rate for Payer: Zelis Worker's Compensation |
$89.74
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 0.6-1.0CM
|
Facility
|
OP
|
$328.71
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
8511106
|
|
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 |
$197.23
|
| 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 |
$197.23
|
| Rate for Payer: Cash Price |
$197.23
|
| Rate for Payer: Cigna Commercial |
$279.40
|
| Rate for Payer: First Health Commercial |
$295.84
|
| Rate for Payer: First Health Workers Compensation |
$126.91
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$295.84
|
| Rate for Payer: GEHA Commercial |
$262.97
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$295.84
|
| 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 |
$299.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$230.10
|
| Rate for Payer: One Health Plan PPO/POS |
$295.84
|
| 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 |
$312.27
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$246.53
|
| 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 |
$305.70
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$131.48
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$89.74
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 0.6-1.0CM
|
Facility
|
OP
|
$361.00
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
9400006
|
|
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 |
$216.60
|
| 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 |
$188.67
|
| Rate for Payer: Cash Price |
$216.60
|
| 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 |
$288.80
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$324.90
|
| 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 |
$328.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$252.70
|
| Rate for Payer: One Health Plan PPO/POS |
$324.90
|
| 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 |
$342.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$270.75
|
| 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 |
$335.73
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$144.40
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$98.55
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 0.6-1.0CM
|
Facility
|
OP
|
$328.71
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
7211306
|
|
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 |
$197.23
|
| 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 |
$197.23
|
| Rate for Payer: Cash Price |
$197.23
|
| Rate for Payer: Cigna Commercial |
$279.40
|
| Rate for Payer: First Health Commercial |
$295.84
|
| Rate for Payer: First Health Workers Compensation |
$126.91
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$295.84
|
| Rate for Payer: GEHA Commercial |
$262.97
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$295.84
|
| 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 |
$299.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$230.10
|
| Rate for Payer: One Health Plan PPO/POS |
$295.84
|
| 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 |
$312.27
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$246.53
|
| 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 |
$305.70
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$131.48
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$89.74
|
|
|
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 |
7911306
|
|
Hospital Revenue Code
|
519
|
| 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
|
|
|
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
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 0.6-1.0CM
|
Facility
|
OP
|
$361.00
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
7911306
|
|
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 |
$216.60
|
| 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 |
$188.67
|
| Rate for Payer: Cash Price |
$216.60
|
| 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 |
$288.80
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$324.90
|
| 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 |
$328.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$252.70
|
| Rate for Payer: One Health Plan PPO/POS |
$324.90
|
| 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 |
$342.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$270.75
|
| 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 |
$335.73
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$144.40
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$98.55
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 0.6-1.0CM
|
Facility
|
OP
|
$361.00
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
20300136
|
|
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 |
$216.60
|
| 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 |
$188.67
|
| Rate for Payer: Cash Price |
$216.60
|
| 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 |
$288.80
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$324.90
|
| 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 |
$328.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$252.70
|
| Rate for Payer: One Health Plan PPO/POS |
$324.90
|
| 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 |
$342.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$270.75
|
| 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 |
$335.73
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$144.40
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$98.55
|
|
|
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 |
8300010
|
|
Hospital Revenue Code
|
519
|
| 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
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 0.6-1.0CM
|
Facility
|
IP
|
$162.00
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
6111306
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$44.23 |
| Max. Negotiated Rate |
$153.90 |
| Rate for Payer: Cash Price |
$97.20
|
| Rate for Payer: Cigna Commercial |
$137.70
|
| Rate for Payer: First Health Commercial |
$145.80
|
| Rate for Payer: First Health Workers Compensation |
$62.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$145.80
|
| Rate for Payer: GEHA Commercial |
$113.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$145.80
|
| Rate for Payer: Multiplan All |
$147.42
|
| Rate for Payer: OMNI Networks Commercial |
$113.40
|
| Rate for Payer: One Health Plan PPO/POS |
$145.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$153.90
|
| Rate for Payer: Three Rivers Provider Network All |
$121.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$150.66
|
| Rate for Payer: Zelis Auto |
$64.80
|
| Rate for Payer: Zelis Worker's Compensation |
$44.23
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 0.6-1.0CM
|
Facility
|
OP
|
$361.00
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
8300010
|
|
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 |
$216.60
|
| 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 |
$188.67
|
| Rate for Payer: Cash Price |
$216.60
|
| 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 |
$288.80
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$324.90
|
| 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 |
$328.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$252.70
|
| Rate for Payer: One Health Plan PPO/POS |
$324.90
|
| 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 |
$342.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$270.75
|
| 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 |
$335.73
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$144.40
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$98.55
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 0.6-1.0CM
|
Facility
|
OP
|
$162.00
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
6111306
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$44.23 |
| 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 |
$97.20
|
| 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 |
$97.20
|
| Rate for Payer: Cash Price |
$97.20
|
| Rate for Payer: Cigna Commercial |
$137.70
|
| Rate for Payer: First Health Commercial |
$145.80
|
| Rate for Payer: First Health Workers Compensation |
$62.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$145.80
|
| Rate for Payer: GEHA Commercial |
$129.60
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$145.80
|
| 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 |
$147.42
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$113.40
|
| Rate for Payer: One Health Plan PPO/POS |
$145.80
|
| 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 |
$153.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$121.50
|
| 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 |
$150.66
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$64.80
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$44.23
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 0.6-1.0CM
|
Facility
|
IP
|
$328.71
|
|
|
Service Code
|
CPT 11306
|
| Hospital Charge Code |
7211306
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$89.74 |
| Max. Negotiated Rate |
$312.27 |
| Rate for Payer: Cash Price |
$197.23
|
| Rate for Payer: Cigna Commercial |
$279.40
|
| Rate for Payer: First Health Commercial |
$295.84
|
| Rate for Payer: First Health Workers Compensation |
$126.91
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$295.84
|
| Rate for Payer: GEHA Commercial |
$230.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$295.84
|
| Rate for Payer: Multiplan All |
$299.13
|
| Rate for Payer: OMNI Networks Commercial |
$230.10
|
| Rate for Payer: One Health Plan PPO/POS |
$295.84
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$312.27
|
| Rate for Payer: Three Rivers Provider Network All |
$246.53
|
| Rate for Payer: United Payors & United Providers UP&UP |
$305.70
|
| Rate for Payer: Zelis Auto |
$131.48
|
| Rate for Payer: Zelis Worker's Compensation |
$89.74
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 1.1-2.0CM
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT 11307
|
| Hospital Charge Code |
6111307
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$57.33 |
| Max. Negotiated Rate |
$199.50 |
| Rate for Payer: Cash Price |
$126.00
|
| Rate for Payer: Cigna Commercial |
$178.50
|
| Rate for Payer: First Health Commercial |
$189.00
|
| Rate for Payer: First Health Workers Compensation |
$81.08
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$189.00
|
| Rate for Payer: GEHA Commercial |
$147.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$189.00
|
| Rate for Payer: Multiplan All |
$191.10
|
| Rate for Payer: OMNI Networks Commercial |
$147.00
|
| Rate for Payer: One Health Plan PPO/POS |
$189.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$199.50
|
| Rate for Payer: Three Rivers Provider Network All |
$157.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$195.30
|
| Rate for Payer: Zelis Auto |
$84.00
|
| Rate for Payer: Zelis Worker's Compensation |
$57.33
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 1.1-2.0CM
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT 11307
|
| Hospital Charge Code |
6111307
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$57.33 |
| 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 |
$126.00
|
| 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 |
$126.00
|
| Rate for Payer: Cash Price |
$126.00
|
| Rate for Payer: Cigna Commercial |
$178.50
|
| Rate for Payer: First Health Commercial |
$189.00
|
| Rate for Payer: First Health Workers Compensation |
$81.08
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$189.00
|
| Rate for Payer: GEHA Commercial |
$168.00
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$189.00
|
| 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 |
$191.10
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$147.00
|
| Rate for Payer: One Health Plan PPO/POS |
$189.00
|
| 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 |
$199.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$157.50
|
| 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 |
$195.30
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$84.00
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$57.33
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 1.1-2.0CM
|
Facility
|
OP
|
$373.29
|
|
|
Service Code
|
CPT 11307
|
| Hospital Charge Code |
7211307
|
|
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 |
$223.97
|
| 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 |
$223.97
|
| Rate for Payer: Cash Price |
$223.97
|
| Rate for Payer: Cigna Commercial |
$317.30
|
| Rate for Payer: First Health Commercial |
$335.96
|
| Rate for Payer: First Health Workers Compensation |
$144.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$335.96
|
| Rate for Payer: GEHA Commercial |
$298.63
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$335.96
|
| 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 |
$339.69
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$261.30
|
| Rate for Payer: One Health Plan PPO/POS |
$335.96
|
| 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 |
$354.63
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$279.97
|
| 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 |
$347.16
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$149.32
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$101.91
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 1.1-2.0CM
|
Facility
|
IP
|
$429.00
|
|
|
Service Code
|
CPT 11307
|
| Hospital Charge Code |
20300137
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$117.12 |
| Max. Negotiated Rate |
$407.55 |
| Rate for Payer: Cash Price |
$257.40
|
| Rate for Payer: Cigna Commercial |
$364.65
|
| Rate for Payer: First Health Commercial |
$386.10
|
| Rate for Payer: First Health Workers Compensation |
$165.64
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$386.10
|
| Rate for Payer: GEHA Commercial |
$300.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$386.10
|
| Rate for Payer: Multiplan All |
$390.39
|
| Rate for Payer: OMNI Networks Commercial |
$300.30
|
| Rate for Payer: One Health Plan PPO/POS |
$386.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$407.55
|
| Rate for Payer: Three Rivers Provider Network All |
$321.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$398.97
|
| Rate for Payer: Zelis Auto |
$171.60
|
| Rate for Payer: Zelis Worker's Compensation |
$117.12
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 1.1-2.0CM
|
Facility
|
OP
|
$429.00
|
|
|
Service Code
|
CPT 11307
|
| Hospital Charge Code |
20300137
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$407.55 |
| 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 |
$257.40
|
| 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 |
$188.67
|
| Rate for Payer: Cash Price |
$257.40
|
| Rate for Payer: Cash Price |
$257.40
|
| Rate for Payer: Cigna Commercial |
$364.65
|
| Rate for Payer: First Health Commercial |
$386.10
|
| Rate for Payer: First Health Workers Compensation |
$165.64
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$386.10
|
| Rate for Payer: GEHA Commercial |
$343.20
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$386.10
|
| 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 |
$390.39
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$300.30
|
| Rate for Payer: One Health Plan PPO/POS |
$386.10
|
| 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 |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$407.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$321.75
|
| 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 |
$398.97
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$171.60
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$117.12
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 1.1-2.0CM
|
Facility
|
IP
|
$373.29
|
|
|
Service Code
|
CPT 11307
|
| Hospital Charge Code |
7211307
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$101.91 |
| Max. Negotiated Rate |
$354.63 |
| Rate for Payer: Cash Price |
$223.97
|
| Rate for Payer: Cigna Commercial |
$317.30
|
| Rate for Payer: First Health Commercial |
$335.96
|
| Rate for Payer: First Health Workers Compensation |
$144.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$335.96
|
| Rate for Payer: GEHA Commercial |
$261.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$335.96
|
| Rate for Payer: Multiplan All |
$339.69
|
| Rate for Payer: OMNI Networks Commercial |
$261.30
|
| Rate for Payer: One Health Plan PPO/POS |
$335.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$354.63
|
| Rate for Payer: Three Rivers Provider Network All |
$279.97
|
| Rate for Payer: United Payors & United Providers UP&UP |
$347.16
|
| Rate for Payer: Zelis Auto |
$149.32
|
| Rate for Payer: Zelis Worker's Compensation |
$101.91
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 1.1-2.0CM
|
Facility
|
OP
|
$373.29
|
|
|
Service Code
|
CPT 11307
|
| Hospital Charge Code |
8511107
|
|
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 |
$223.97
|
| 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 |
$223.97
|
| Rate for Payer: Cash Price |
$223.97
|
| Rate for Payer: Cigna Commercial |
$317.30
|
| Rate for Payer: First Health Commercial |
$335.96
|
| Rate for Payer: First Health Workers Compensation |
$144.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$335.96
|
| Rate for Payer: GEHA Commercial |
$298.63
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$335.96
|
| 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 |
$339.69
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$261.30
|
| Rate for Payer: One Health Plan PPO/POS |
$335.96
|
| 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 |
$354.63
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$279.97
|
| 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 |
$347.16
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$149.32
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$101.91
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 1.1-2.0CM
|
Facility
|
OP
|
$429.00
|
|
|
Service Code
|
CPT 11307
|
| Hospital Charge Code |
9400007
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$407.55 |
| 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 |
$257.40
|
| 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 |
$188.67
|
| Rate for Payer: Cash Price |
$257.40
|
| Rate for Payer: Cash Price |
$257.40
|
| Rate for Payer: Cigna Commercial |
$364.65
|
| Rate for Payer: First Health Commercial |
$386.10
|
| Rate for Payer: First Health Workers Compensation |
$165.64
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$386.10
|
| Rate for Payer: GEHA Commercial |
$343.20
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$386.10
|
| 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 |
$390.39
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$300.30
|
| Rate for Payer: One Health Plan PPO/POS |
$386.10
|
| 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 |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$407.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$321.75
|
| 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 |
$398.97
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$171.60
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$117.12
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 1.1-2.0CM
|
Facility
|
IP
|
$429.00
|
|
|
Service Code
|
CPT 11307
|
| Hospital Charge Code |
9400007
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$117.12 |
| Max. Negotiated Rate |
$407.55 |
| Rate for Payer: Cash Price |
$257.40
|
| Rate for Payer: Cigna Commercial |
$364.65
|
| Rate for Payer: First Health Commercial |
$386.10
|
| Rate for Payer: First Health Workers Compensation |
$165.64
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$386.10
|
| Rate for Payer: GEHA Commercial |
$300.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$386.10
|
| Rate for Payer: Multiplan All |
$390.39
|
| Rate for Payer: OMNI Networks Commercial |
$300.30
|
| Rate for Payer: One Health Plan PPO/POS |
$386.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$407.55
|
| Rate for Payer: Three Rivers Provider Network All |
$321.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$398.97
|
| Rate for Payer: Zelis Auto |
$171.60
|
| Rate for Payer: Zelis Worker's Compensation |
$117.12
|
|
|
SHVING SKN LES 1 S/N/H/F/G DIA 1.1-2.0CM
|
Facility
|
IP
|
$373.29
|
|
|
Service Code
|
CPT 11307
|
| Hospital Charge Code |
8511107
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$101.91 |
| Max. Negotiated Rate |
$354.63 |
| Rate for Payer: Cash Price |
$223.97
|
| Rate for Payer: Cigna Commercial |
$317.30
|
| Rate for Payer: First Health Commercial |
$335.96
|
| Rate for Payer: First Health Workers Compensation |
$144.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$335.96
|
| Rate for Payer: GEHA Commercial |
$261.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$335.96
|
| Rate for Payer: Multiplan All |
$339.69
|
| Rate for Payer: OMNI Networks Commercial |
$261.30
|
| Rate for Payer: One Health Plan PPO/POS |
$335.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$354.63
|
| Rate for Payer: Three Rivers Provider Network All |
$279.97
|
| Rate for Payer: United Payors & United Providers UP&UP |
$347.16
|
| Rate for Payer: Zelis Auto |
$149.32
|
| Rate for Payer: Zelis Worker's Compensation |
$101.91
|
|
|
SIALOGRAPHY
|
Facility
|
OP
|
$935.00
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
2407254
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$101.51 |
| Max. Negotiated Rate |
$888.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$315.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$561.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$315.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$249.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$229.52
|
| Rate for Payer: Cash Price |
$561.00
|
| Rate for Payer: Cash Price |
$561.00
|
| Rate for Payer: Cigna Commercial |
$794.75
|
| Rate for Payer: First Health Commercial |
$841.50
|
| Rate for Payer: First Health Workers Compensation |
$143.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$841.50
|
| Rate for Payer: GEHA Commercial |
$748.00
|
| Rate for Payer: GEHA Medicare |
$229.52
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$841.50
|
| Rate for Payer: Humana ChoiceCare |
$252.47
|
| Rate for Payer: Humana Medicare Advantage |
$229.52
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$385.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$254.93
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$229.52
|
| Rate for Payer: Multiplan All |
$850.85
|
| Rate for Payer: New Mexico Health Connections Medicare |
$390.18
|
| Rate for Payer: OMNI Networks Commercial |
$654.50
|
| Rate for Payer: One Health Plan PPO/POS |
$841.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$294.35
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$254.93
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$229.52
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$888.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$459.04
|
| Rate for Payer: Three Rivers Provider Network All |
$701.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$224.93
|
| Rate for Payer: United Healthcare Commercial |
$794.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$254.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$229.52
|
| Rate for Payer: United Payors & United Providers UP&UP |
$869.55
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$229.52
|
| Rate for Payer: Zelis Auto |
$374.00
|
| Rate for Payer: Zelis Medicare |
$195.09
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$275.42
|
| Rate for Payer: Zelis Worker's Compensation |
$101.51
|
|
|
SIALOGRAPHY
|
Facility
|
IP
|
$935.00
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
2407254
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$101.51 |
| Max. Negotiated Rate |
$888.25 |
| Rate for Payer: Cash Price |
$561.00
|
| Rate for Payer: Cash Price |
$561.00
|
| Rate for Payer: Cigna Commercial |
$794.75
|
| Rate for Payer: First Health Commercial |
$841.50
|
| Rate for Payer: First Health Workers Compensation |
$143.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$841.50
|
| Rate for Payer: GEHA Commercial |
$654.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$841.50
|
| Rate for Payer: Multiplan All |
$850.85
|
| Rate for Payer: OMNI Networks Commercial |
$654.50
|
| Rate for Payer: One Health Plan PPO/POS |
$841.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$888.25
|
| Rate for Payer: Three Rivers Provider Network All |
$701.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$869.55
|
| Rate for Payer: Zelis Auto |
$374.00
|
| Rate for Payer: Zelis Worker's Compensation |
$101.51
|
|
