|
sickle cell solubility test REF005223
|
Facility
|
IP
|
$107.00
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
22003423
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.36 |
| Max. Negotiated Rate |
$101.65 |
| Rate for Payer: Cash Price |
$64.20
|
| Rate for Payer: Cash Price |
$64.20
|
| Rate for Payer: Cigna Commercial |
$90.95
|
| Rate for Payer: First Health Commercial |
$96.30
|
| Rate for Payer: First Health Workers Compensation |
$8.99
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$96.30
|
| Rate for Payer: GEHA Commercial |
$74.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$96.30
|
| Rate for Payer: Multiplan All |
$97.37
|
| Rate for Payer: OMNI Networks Commercial |
$74.90
|
| Rate for Payer: One Health Plan PPO/POS |
$96.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$101.65
|
| Rate for Payer: Three Rivers Provider Network All |
$80.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$99.51
|
| Rate for Payer: Zelis Auto |
$42.80
|
| Rate for Payer: Zelis Worker's Compensation |
$6.36
|
|
|
sickle cell solubility test REF005223
|
Facility
|
OP
|
$107.00
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
22003423
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$101.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$64.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5.51
|
| Rate for Payer: Cash Price |
$64.20
|
| Rate for Payer: Cash Price |
$64.20
|
| Rate for Payer: Cigna Commercial |
$90.95
|
| Rate for Payer: First Health Commercial |
$96.30
|
| Rate for Payer: First Health Workers Compensation |
$8.99
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$96.30
|
| Rate for Payer: GEHA Commercial |
$85.60
|
| Rate for Payer: GEHA Medicare |
$5.51
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$96.30
|
| Rate for Payer: Humana ChoiceCare |
$6.06
|
| Rate for Payer: Humana Medicare Advantage |
$5.51
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$9.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5.51
|
| Rate for Payer: Multiplan All |
$97.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$9.37
|
| Rate for Payer: OMNI Networks Commercial |
$74.90
|
| Rate for Payer: One Health Plan PPO/POS |
$96.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$9.25
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8.01
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5.51
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$101.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11.02
|
| Rate for Payer: Three Rivers Provider Network All |
$80.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5.40
|
| Rate for Payer: United Healthcare Commercial |
$90.95
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.51
|
| Rate for Payer: United Payors & United Providers UP&UP |
$99.51
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5.51
|
| Rate for Payer: Zelis Auto |
$42.80
|
| Rate for Payer: Zelis Medicare |
$4.68
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6.61
|
| Rate for Payer: Zelis Worker's Compensation |
$6.36
|
|
|
SIGMOIDOSCOPY AND BIOPSY
|
Facility
|
IP
|
$225.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
6145331
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$61.42 |
| Max. Negotiated Rate |
$213.75 |
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cigna Commercial |
$191.25
|
| Rate for Payer: First Health Commercial |
$202.50
|
| Rate for Payer: First Health Workers Compensation |
$86.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$202.50
|
| Rate for Payer: GEHA Commercial |
$157.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$202.50
|
| Rate for Payer: Multiplan All |
$204.75
|
| Rate for Payer: OMNI Networks Commercial |
$157.50
|
| Rate for Payer: One Health Plan PPO/POS |
$202.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$213.75
|
| Rate for Payer: Three Rivers Provider Network All |
$168.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$209.25
|
| Rate for Payer: Zelis Auto |
$90.00
|
| Rate for Payer: Zelis Worker's Compensation |
$61.42
|
|
|
SIGMOIDOSCOPY AND BIOPSY
|
Facility
|
OP
|
$225.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
6145331
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$61.42 |
| Max. Negotiated Rate |
$1,731.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$583.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$135.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$583.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$462.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$865.71
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cash Price |
$135.00
|
| Rate for Payer: Cigna Commercial |
$191.25
|
| Rate for Payer: First Health Commercial |
$202.50
|
| Rate for Payer: First Health Workers Compensation |
$86.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$202.50
|
| Rate for Payer: GEHA Commercial |
$180.00
|
| Rate for Payer: GEHA Medicare |
$865.71
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$202.50
|
| Rate for Payer: Humana ChoiceCare |
$952.28
|
| Rate for Payer: Humana Medicare Advantage |
$865.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,454.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$471.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$865.71
|
| Rate for Payer: Multiplan All |
$204.75
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,471.71
|
| Rate for Payer: OMNI Networks Commercial |
$157.50
|
| Rate for Payer: One Health Plan PPO/POS |
$202.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$544.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$471.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$865.71
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$213.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,731.42
|
| Rate for Payer: Three Rivers Provider Network All |
$168.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$848.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$471.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$865.71
|
| Rate for Payer: United Payors & United Providers UP&UP |
$209.25
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$865.71
|
| Rate for Payer: Zelis Auto |
$90.00
|
| Rate for Payer: Zelis Medicare |
$735.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,038.85
|
| Rate for Payer: Zelis Worker's Compensation |
$61.42
|
|
|
SIGMOIDOSCOPY & DECOMPRESS
|
Facility
|
IP
|
$382.00
|
|
|
Service Code
|
CPT 45337
|
| Hospital Charge Code |
6145337
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$104.29 |
| Max. Negotiated Rate |
$362.90 |
| Rate for Payer: Cash Price |
$229.20
|
| Rate for Payer: Cigna Commercial |
$324.70
|
| Rate for Payer: First Health Commercial |
$343.80
|
| Rate for Payer: First Health Workers Compensation |
$147.49
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$343.80
|
| Rate for Payer: GEHA Commercial |
$267.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$343.80
|
| Rate for Payer: Multiplan All |
$347.62
|
| Rate for Payer: OMNI Networks Commercial |
$267.40
|
| Rate for Payer: One Health Plan PPO/POS |
$343.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$362.90
|
| Rate for Payer: Three Rivers Provider Network All |
$286.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$355.26
|
| Rate for Payer: Zelis Auto |
$152.80
|
| Rate for Payer: Zelis Worker's Compensation |
$104.29
|
|
|
SIGMOIDOSCOPY & DECOMPRESS
|
Facility
|
OP
|
$382.00
|
|
|
Service Code
|
CPT 45337
|
| Hospital Charge Code |
6145337
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$104.29 |
| Max. Negotiated Rate |
$1,731.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$583.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$229.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$583.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$462.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$865.71
|
| Rate for Payer: Cash Price |
$229.20
|
| Rate for Payer: Cash Price |
$229.20
|
| Rate for Payer: Cigna Commercial |
$324.70
|
| Rate for Payer: First Health Commercial |
$343.80
|
| Rate for Payer: First Health Workers Compensation |
$147.49
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$343.80
|
| Rate for Payer: GEHA Commercial |
$305.60
|
| Rate for Payer: GEHA Medicare |
$865.71
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$343.80
|
| Rate for Payer: Humana ChoiceCare |
$952.28
|
| Rate for Payer: Humana Medicare Advantage |
$865.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,454.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$471.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$865.71
|
| Rate for Payer: Multiplan All |
$347.62
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,471.71
|
| Rate for Payer: OMNI Networks Commercial |
$267.40
|
| Rate for Payer: One Health Plan PPO/POS |
$343.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$544.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$471.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$865.71
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$362.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,731.42
|
| Rate for Payer: Three Rivers Provider Network All |
$286.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$848.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$471.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$865.71
|
| Rate for Payer: United Payors & United Providers UP&UP |
$355.26
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$865.71
|
| Rate for Payer: Zelis Auto |
$152.80
|
| Rate for Payer: Zelis Medicare |
$735.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,038.85
|
| Rate for Payer: Zelis Worker's Compensation |
$104.29
|
|
|
SIGMOIDOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$1,731.42
|
|
|
Service Code
|
CPT 45330
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$462.55 |
| Max. Negotiated Rate |
$1,731.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$583.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$583.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$462.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$865.71
|
| Rate for Payer: GEHA Medicare |
$865.71
|
| Rate for Payer: Humana ChoiceCare |
$952.28
|
| Rate for Payer: Humana Medicare Advantage |
$865.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,454.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$471.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$865.71
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,471.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$544.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$471.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$865.71
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,731.42
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$848.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$471.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$865.71
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$865.71
|
| Rate for Payer: Zelis Medicare |
$735.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,038.85
|
|
|
SIGMOIDOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE
|
Facility
|
OP
|
$1,731.42
|
|
|
Service Code
|
CPT 45331
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$462.55 |
| Max. Negotiated Rate |
$1,731.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$583.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$583.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$462.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$865.71
|
| Rate for Payer: GEHA Medicare |
$865.71
|
| Rate for Payer: Humana ChoiceCare |
$952.28
|
| Rate for Payer: Humana Medicare Advantage |
$865.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,454.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$471.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$865.71
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,471.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$544.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$471.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$865.71
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,731.42
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$848.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$471.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$865.71
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$865.71
|
| Rate for Payer: Zelis Medicare |
$735.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,038.85
|
|
|
SIGMOIDOSCOPY, FLEXIBLE; WITH CONTROL OF BLEEDING, ANY METHOD
|
Facility
|
OP
|
$2,239.16
|
|
|
Service Code
|
CPT 45334
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$740.51 |
| Max. Negotiated Rate |
$2,239.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$934.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$934.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$740.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,119.58
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Humana ChoiceCare |
$1,231.54
|
| Rate for Payer: Humana Medicare Advantage |
$1,119.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,880.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$755.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,119.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$872.44
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$755.59
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,119.58
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,097.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$755.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,119.58
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Medicare |
$951.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,343.50
|
|
|
SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF FOREIGN BODY(S)
|
Facility
|
OP
|
$2,239.16
|
|
|
Service Code
|
CPT 45332
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$462.55 |
| Max. Negotiated Rate |
$2,239.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$583.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$583.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$462.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,119.58
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Humana ChoiceCare |
$1,231.54
|
| Rate for Payer: Humana Medicare Advantage |
$1,119.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,880.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$471.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,119.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$544.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$471.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,119.58
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,097.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$471.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,119.58
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Medicare |
$951.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,343.50
|
|
|
SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA
|
Facility
|
OP
|
$177.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
6145330
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$48.32 |
| Max. Negotiated Rate |
$1,731.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$583.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$106.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$583.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$462.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$865.71
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cigna Commercial |
$150.45
|
| Rate for Payer: First Health Commercial |
$159.30
|
| Rate for Payer: First Health Workers Compensation |
$68.34
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$159.30
|
| Rate for Payer: GEHA Commercial |
$141.60
|
| Rate for Payer: GEHA Medicare |
$865.71
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$159.30
|
| Rate for Payer: Humana ChoiceCare |
$952.28
|
| Rate for Payer: Humana Medicare Advantage |
$865.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,454.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$471.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$865.71
|
| Rate for Payer: Multiplan All |
$161.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,471.71
|
| Rate for Payer: OMNI Networks Commercial |
$123.90
|
| Rate for Payer: One Health Plan PPO/POS |
$159.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$544.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$471.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$865.71
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$168.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,731.42
|
| Rate for Payer: Three Rivers Provider Network All |
$132.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$848.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$471.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$865.71
|
| Rate for Payer: United Payors & United Providers UP&UP |
$164.61
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$865.71
|
| Rate for Payer: Zelis Auto |
$70.80
|
| Rate for Payer: Zelis Medicare |
$735.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,038.85
|
| Rate for Payer: Zelis Worker's Compensation |
$48.32
|
|
|
SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA
|
Facility
|
IP
|
$504.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
20300071
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$137.59 |
| Max. Negotiated Rate |
$478.80 |
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cigna Commercial |
$428.40
|
| Rate for Payer: First Health Commercial |
$453.60
|
| Rate for Payer: First Health Workers Compensation |
$194.59
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$453.60
|
| Rate for Payer: GEHA Commercial |
$352.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$453.60
|
| Rate for Payer: Multiplan All |
$458.64
|
| Rate for Payer: OMNI Networks Commercial |
$352.80
|
| Rate for Payer: One Health Plan PPO/POS |
$453.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$478.80
|
| Rate for Payer: Three Rivers Provider Network All |
$378.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$468.72
|
| Rate for Payer: Zelis Auto |
$201.60
|
| Rate for Payer: Zelis Worker's Compensation |
$137.59
|
|
|
SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA
|
Facility
|
OP
|
$504.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
20300071
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$137.59 |
| Max. Negotiated Rate |
$1,731.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$583.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$302.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$583.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$462.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$865.71
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cigna Commercial |
$428.40
|
| Rate for Payer: First Health Commercial |
$453.60
|
| Rate for Payer: First Health Workers Compensation |
$194.59
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$453.60
|
| Rate for Payer: GEHA Commercial |
$403.20
|
| Rate for Payer: GEHA Medicare |
$865.71
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$453.60
|
| Rate for Payer: Humana ChoiceCare |
$952.28
|
| Rate for Payer: Humana Medicare Advantage |
$865.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,454.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$471.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$865.71
|
| Rate for Payer: Multiplan All |
$458.64
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,471.71
|
| Rate for Payer: OMNI Networks Commercial |
$352.80
|
| Rate for Payer: One Health Plan PPO/POS |
$453.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$544.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$471.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$865.71
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$478.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,731.42
|
| Rate for Payer: Three Rivers Provider Network All |
$378.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$848.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$471.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$865.71
|
| Rate for Payer: United Payors & United Providers UP&UP |
$468.72
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$865.71
|
| Rate for Payer: Zelis Auto |
$201.60
|
| Rate for Payer: Zelis Medicare |
$735.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,038.85
|
| Rate for Payer: Zelis Worker's Compensation |
$137.59
|
|
|
SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA
|
Facility
|
IP
|
$177.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
6145330
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$48.32 |
| Max. Negotiated Rate |
$168.15 |
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cigna Commercial |
$150.45
|
| Rate for Payer: First Health Commercial |
$159.30
|
| Rate for Payer: First Health Workers Compensation |
$68.34
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$159.30
|
| Rate for Payer: GEHA Commercial |
$123.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$159.30
|
| Rate for Payer: Multiplan All |
$161.07
|
| Rate for Payer: OMNI Networks Commercial |
$123.90
|
| Rate for Payer: One Health Plan PPO/POS |
$159.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$168.15
|
| Rate for Payer: Three Rivers Provider Network All |
$132.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$164.61
|
| Rate for Payer: Zelis Auto |
$70.80
|
| Rate for Payer: Zelis Worker's Compensation |
$48.32
|
|
|
SIGMOIDOSCOPY FOR BLEEDING
|
Facility
|
OP
|
$1,355.82
|
|
|
Service Code
|
CPT 45334
|
| Hospital Charge Code |
6145334
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$370.14 |
| Max. Negotiated Rate |
$2,239.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$934.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$813.49
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$934.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$740.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,119.58
|
| Rate for Payer: Cash Price |
$813.49
|
| Rate for Payer: Cash Price |
$813.49
|
| Rate for Payer: Cigna Commercial |
$1,152.45
|
| Rate for Payer: First Health Commercial |
$1,220.24
|
| Rate for Payer: First Health Workers Compensation |
$523.48
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,220.24
|
| Rate for Payer: GEHA Commercial |
$1,084.66
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,220.24
|
| Rate for Payer: Humana ChoiceCare |
$1,231.54
|
| Rate for Payer: Humana Medicare Advantage |
$1,119.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,880.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$755.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,119.58
|
| Rate for Payer: Multiplan All |
$1,233.80
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$949.07
|
| Rate for Payer: One Health Plan PPO/POS |
$1,220.24
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$872.44
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$755.59
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,119.58
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,288.03
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$1,016.87
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,097.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$755.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,119.58
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,260.91
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$542.33
|
| Rate for Payer: Zelis Medicare |
$951.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,343.50
|
| Rate for Payer: Zelis Worker's Compensation |
$370.14
|
|
|
SIGMOIDOSCOPY FOR BLEEDING
|
Facility
|
IP
|
$1,355.82
|
|
|
Service Code
|
CPT 45334
|
| Hospital Charge Code |
6145334
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$370.14 |
| Max. Negotiated Rate |
$1,288.03 |
| Rate for Payer: Cash Price |
$813.49
|
| Rate for Payer: Cigna Commercial |
$1,152.45
|
| Rate for Payer: First Health Commercial |
$1,220.24
|
| Rate for Payer: First Health Workers Compensation |
$523.48
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,220.24
|
| Rate for Payer: GEHA Commercial |
$949.07
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,220.24
|
| Rate for Payer: Multiplan All |
$1,233.80
|
| Rate for Payer: OMNI Networks Commercial |
$949.07
|
| Rate for Payer: One Health Plan PPO/POS |
$1,220.24
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,288.03
|
| Rate for Payer: Three Rivers Provider Network All |
$1,016.87
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,260.91
|
| Rate for Payer: Zelis Auto |
$542.33
|
| Rate for Payer: Zelis Worker's Compensation |
$370.14
|
|
|
SIGMOIDOSCOPY & POLYPECTOMY
|
Facility
|
IP
|
$313.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
6145333
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$85.45 |
| Max. Negotiated Rate |
$297.35 |
| Rate for Payer: Cash Price |
$187.80
|
| Rate for Payer: Cigna Commercial |
$266.05
|
| Rate for Payer: First Health Commercial |
$281.70
|
| Rate for Payer: First Health Workers Compensation |
$120.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$281.70
|
| Rate for Payer: GEHA Commercial |
$219.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$281.70
|
| Rate for Payer: Multiplan All |
$284.83
|
| Rate for Payer: OMNI Networks Commercial |
$219.10
|
| Rate for Payer: One Health Plan PPO/POS |
$281.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$297.35
|
| Rate for Payer: Three Rivers Provider Network All |
$234.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$291.09
|
| Rate for Payer: Zelis Auto |
$125.20
|
| Rate for Payer: Zelis Worker's Compensation |
$85.45
|
|
|
SIGMOIDOSCOPY & POLYPECTOMY
|
Facility
|
OP
|
$313.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
6145333
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$85.45 |
| Max. Negotiated Rate |
$1,731.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$934.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$187.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$934.75
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$740.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$865.71
|
| Rate for Payer: Cash Price |
$187.80
|
| Rate for Payer: Cash Price |
$187.80
|
| Rate for Payer: Cigna Commercial |
$266.05
|
| Rate for Payer: First Health Commercial |
$281.70
|
| Rate for Payer: First Health Workers Compensation |
$120.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$281.70
|
| Rate for Payer: GEHA Commercial |
$250.40
|
| Rate for Payer: GEHA Medicare |
$865.71
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$281.70
|
| Rate for Payer: Humana ChoiceCare |
$952.28
|
| Rate for Payer: Humana Medicare Advantage |
$865.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,454.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$755.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$865.71
|
| Rate for Payer: Multiplan All |
$284.83
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,471.71
|
| Rate for Payer: OMNI Networks Commercial |
$219.10
|
| Rate for Payer: One Health Plan PPO/POS |
$281.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$872.44
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$755.59
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$865.71
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$297.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,731.42
|
| Rate for Payer: Three Rivers Provider Network All |
$234.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$848.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$755.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$865.71
|
| Rate for Payer: United Payors & United Providers UP&UP |
$291.09
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$865.71
|
| Rate for Payer: Zelis Auto |
$125.20
|
| Rate for Payer: Zelis Medicare |
$735.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,038.85
|
| Rate for Payer: Zelis Worker's Compensation |
$85.45
|
|
|
SIGMOIDOSCOPY W/ABLATE TUMR
|
Facility
|
OP
|
$4,128.00
|
|
|
Service Code
|
CPT 45346
|
| Hospital Charge Code |
21645346
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$951.64 |
| Max. Negotiated Rate |
$3,921.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,240.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,476.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,240.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$982.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,119.58
|
| Rate for Payer: Cash Price |
$2,476.80
|
| Rate for Payer: Cash Price |
$2,476.80
|
| Rate for Payer: Cigna Commercial |
$3,508.80
|
| Rate for Payer: First Health Commercial |
$3,715.20
|
| Rate for Payer: First Health Workers Compensation |
$1,593.82
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,715.20
|
| Rate for Payer: GEHA Commercial |
$3,302.40
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,715.20
|
| Rate for Payer: Humana ChoiceCare |
$1,231.54
|
| Rate for Payer: Humana Medicare Advantage |
$1,119.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,880.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,002.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,119.58
|
| Rate for Payer: Multiplan All |
$3,756.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$2,889.60
|
| Rate for Payer: One Health Plan PPO/POS |
$3,715.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,157.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,002.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,119.58
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,921.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$3,096.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,097.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,002.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,119.58
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,839.04
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$1,651.20
|
| Rate for Payer: Zelis Medicare |
$951.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,343.50
|
| Rate for Payer: Zelis Worker's Compensation |
$1,126.94
|
|
|
SIGMOIDOSCOPY W/ABLATE TUMR
|
Facility
|
IP
|
$4,128.00
|
|
|
Service Code
|
CPT 45346
|
| Hospital Charge Code |
21645346
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$1,126.94 |
| Max. Negotiated Rate |
$3,921.60 |
| Rate for Payer: Cash Price |
$2,476.80
|
| Rate for Payer: Cigna Commercial |
$3,508.80
|
| Rate for Payer: First Health Commercial |
$3,715.20
|
| Rate for Payer: First Health Workers Compensation |
$1,593.82
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,715.20
|
| Rate for Payer: GEHA Commercial |
$2,889.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,715.20
|
| Rate for Payer: Multiplan All |
$3,756.48
|
| Rate for Payer: OMNI Networks Commercial |
$2,889.60
|
| Rate for Payer: One Health Plan PPO/POS |
$3,715.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,921.60
|
| Rate for Payer: Three Rivers Provider Network All |
$3,096.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,839.04
|
| Rate for Payer: Zelis Auto |
$1,651.20
|
| Rate for Payer: Zelis Worker's Compensation |
$1,126.94
|
|
|
SIGMOIDOSCOPY W/ABLATE TUMR
|
Facility
|
IP
|
$500.00
|
|
|
Service Code
|
CPT 45346
|
| Hospital Charge Code |
8545339
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$136.50 |
| Max. Negotiated Rate |
$475.00 |
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cigna Commercial |
$425.00
|
| Rate for Payer: First Health Commercial |
$450.00
|
| Rate for Payer: First Health Workers Compensation |
$193.05
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$450.00
|
| Rate for Payer: GEHA Commercial |
$350.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$450.00
|
| Rate for Payer: Multiplan All |
$455.00
|
| Rate for Payer: OMNI Networks Commercial |
$350.00
|
| Rate for Payer: One Health Plan PPO/POS |
$450.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$475.00
|
| Rate for Payer: Three Rivers Provider Network All |
$375.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$465.00
|
| Rate for Payer: Zelis Auto |
$200.00
|
| Rate for Payer: Zelis Worker's Compensation |
$136.50
|
|
|
SIGMOIDOSCOPY W/ABLATE TUMR
|
Facility
|
OP
|
$500.00
|
|
|
Service Code
|
CPT 45346
|
| Hospital Charge Code |
8545339
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$136.50 |
| Max. Negotiated Rate |
$2,239.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,240.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$300.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,240.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$982.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,119.58
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cigna Commercial |
$425.00
|
| Rate for Payer: First Health Commercial |
$450.00
|
| Rate for Payer: First Health Workers Compensation |
$193.05
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$450.00
|
| Rate for Payer: GEHA Commercial |
$400.00
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$450.00
|
| Rate for Payer: Humana ChoiceCare |
$1,231.54
|
| Rate for Payer: Humana Medicare Advantage |
$1,119.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,880.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,002.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,119.58
|
| Rate for Payer: Multiplan All |
$455.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$350.00
|
| Rate for Payer: One Health Plan PPO/POS |
$450.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,157.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,002.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,119.58
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$475.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$375.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,097.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,002.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,119.58
|
| Rate for Payer: United Payors & United Providers UP&UP |
$465.00
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$200.00
|
| Rate for Payer: Zelis Medicare |
$951.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,343.50
|
| Rate for Payer: Zelis Worker's Compensation |
$136.50
|
|
|
SIGMOIDOSCOPY W/FB REMOVAL
|
Facility
|
IP
|
$349.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
6145332
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$95.28 |
| Max. Negotiated Rate |
$331.55 |
| Rate for Payer: Cash Price |
$209.40
|
| Rate for Payer: Cigna Commercial |
$296.65
|
| Rate for Payer: First Health Commercial |
$314.10
|
| Rate for Payer: First Health Workers Compensation |
$134.75
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$314.10
|
| Rate for Payer: GEHA Commercial |
$244.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$314.10
|
| Rate for Payer: Multiplan All |
$317.59
|
| Rate for Payer: OMNI Networks Commercial |
$244.30
|
| Rate for Payer: One Health Plan PPO/POS |
$314.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$331.55
|
| Rate for Payer: Three Rivers Provider Network All |
$261.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$324.57
|
| Rate for Payer: Zelis Auto |
$139.60
|
| Rate for Payer: Zelis Worker's Compensation |
$95.28
|
|
|
SIGMOIDOSCOPY W/FB REMOVAL
|
Facility
|
OP
|
$349.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
6145332
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$95.28 |
| Max. Negotiated Rate |
$2,239.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$583.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$209.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$583.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$462.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,119.58
|
| Rate for Payer: Cash Price |
$209.40
|
| Rate for Payer: Cash Price |
$209.40
|
| Rate for Payer: Cigna Commercial |
$296.65
|
| Rate for Payer: First Health Commercial |
$314.10
|
| Rate for Payer: First Health Workers Compensation |
$134.75
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$314.10
|
| Rate for Payer: GEHA Commercial |
$279.20
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$314.10
|
| Rate for Payer: Humana ChoiceCare |
$1,231.54
|
| Rate for Payer: Humana Medicare Advantage |
$1,119.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,880.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$471.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,119.58
|
| Rate for Payer: Multiplan All |
$317.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$244.30
|
| Rate for Payer: One Health Plan PPO/POS |
$314.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$544.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$471.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,119.58
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$331.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$261.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,097.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$471.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,119.58
|
| Rate for Payer: United Payors & United Providers UP&UP |
$324.57
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$139.60
|
| Rate for Payer: Zelis Medicare |
$951.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,343.50
|
| Rate for Payer: Zelis Worker's Compensation |
$95.28
|
|
|
SIGMOIDOSCOPY W/STENT
|
Facility
|
OP
|
$6,287.00
|
|
|
Service Code
|
CPT 45347
|
| Hospital Charge Code |
21645347
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$982.84 |
| Max. Negotiated Rate |
$11,304.86 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,240.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,772.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,240.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$982.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,652.43
|
| Rate for Payer: Cash Price |
$3,772.20
|
| Rate for Payer: Cash Price |
$3,772.20
|
| Rate for Payer: Cigna Commercial |
$5,343.95
|
| Rate for Payer: First Health Commercial |
$5,658.30
|
| Rate for Payer: First Health Workers Compensation |
$2,427.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$5,658.30
|
| Rate for Payer: GEHA Commercial |
$5,029.60
|
| Rate for Payer: GEHA Medicare |
$5,652.43
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$5,658.30
|
| Rate for Payer: Humana ChoiceCare |
$6,217.67
|
| Rate for Payer: Humana Medicare Advantage |
$5,652.43
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$9,496.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,002.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,652.43
|
| Rate for Payer: Multiplan All |
$5,721.17
|
| Rate for Payer: New Mexico Health Connections Medicare |
$9,609.13
|
| Rate for Payer: OMNI Networks Commercial |
$4,400.90
|
| Rate for Payer: One Health Plan PPO/POS |
$5,658.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,157.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,002.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,652.43
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,972.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,304.86
|
| Rate for Payer: Three Rivers Provider Network All |
$4,715.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,539.38
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,002.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,652.43
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5,846.91
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,652.43
|
| Rate for Payer: Zelis Auto |
$2,514.80
|
| Rate for Payer: Zelis Medicare |
$4,804.57
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,782.92
|
| Rate for Payer: Zelis Worker's Compensation |
$1,716.35
|
|
