|
SIGMOIDOSCOPY W/STENT
|
Facility
|
OP
|
$505.00
|
|
|
Service Code
|
CPT 45347
|
| Hospital Charge Code |
8545345
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$137.87 |
| 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 |
$303.00
|
| 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 |
$5,652.43
|
| Rate for Payer: Cash Price |
$303.00
|
| Rate for Payer: Cash Price |
$303.00
|
| Rate for Payer: Cigna Commercial |
$429.25
|
| Rate for Payer: First Health Commercial |
$454.50
|
| Rate for Payer: First Health Workers Compensation |
$194.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$454.50
|
| Rate for Payer: GEHA Commercial |
$404.00
|
| Rate for Payer: GEHA Medicare |
$5,652.43
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$454.50
|
| 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 |
$459.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$9,609.13
|
| Rate for Payer: OMNI Networks Commercial |
$353.50
|
| Rate for Payer: One Health Plan PPO/POS |
$454.50
|
| 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 |
$479.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,304.86
|
| Rate for Payer: Three Rivers Provider Network All |
$378.75
|
| 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 |
$469.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,652.43
|
| Rate for Payer: Zelis Auto |
$202.00
|
| 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 |
$137.87
|
|
|
SIGMOIDOSCOPY W/STENT
|
Facility
|
IP
|
$6,287.00
|
|
|
Service Code
|
CPT 45347
|
| Hospital Charge Code |
21645347
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$1,716.35 |
| Max. Negotiated Rate |
$5,972.65 |
| 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 |
$4,400.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$5,658.30
|
| Rate for Payer: Multiplan All |
$5,721.17
|
| Rate for Payer: OMNI Networks Commercial |
$4,400.90
|
| Rate for Payer: One Health Plan PPO/POS |
$5,658.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,972.65
|
| Rate for Payer: Three Rivers Provider Network All |
$4,715.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5,846.91
|
| Rate for Payer: Zelis Auto |
$2,514.80
|
| Rate for Payer: Zelis Worker's Compensation |
$1,716.35
|
|
|
SIGMOIDOSCOPY W/STENT
|
Facility
|
IP
|
$505.00
|
|
|
Service Code
|
CPT 45347
|
| Hospital Charge Code |
8545345
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$137.87 |
| Max. Negotiated Rate |
$479.75 |
| Rate for Payer: Cash Price |
$303.00
|
| Rate for Payer: Cigna Commercial |
$429.25
|
| Rate for Payer: First Health Commercial |
$454.50
|
| Rate for Payer: First Health Workers Compensation |
$194.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$454.50
|
| Rate for Payer: GEHA Commercial |
$353.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$454.50
|
| Rate for Payer: Multiplan All |
$459.55
|
| Rate for Payer: OMNI Networks Commercial |
$353.50
|
| Rate for Payer: One Health Plan PPO/POS |
$454.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$479.75
|
| Rate for Payer: Three Rivers Provider Network All |
$378.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$469.65
|
| Rate for Payer: Zelis Auto |
$202.00
|
| Rate for Payer: Zelis Worker's Compensation |
$137.87
|
|
|
SIGMOIDOSCOPY W/SUBMUC INJ
|
Facility
|
OP
|
$209.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
6145335
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$57.06 |
| 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 |
$125.40
|
| 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 |
$125.40
|
| Rate for Payer: Cash Price |
$125.40
|
| Rate for Payer: Cigna Commercial |
$177.65
|
| Rate for Payer: First Health Commercial |
$188.10
|
| Rate for Payer: First Health Workers Compensation |
$80.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$188.10
|
| Rate for Payer: GEHA Commercial |
$167.20
|
| Rate for Payer: GEHA Medicare |
$865.71
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$188.10
|
| 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 |
$190.19
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,471.71
|
| Rate for Payer: OMNI Networks Commercial |
$146.30
|
| Rate for Payer: One Health Plan PPO/POS |
$188.10
|
| 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 |
$865.71
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$198.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,731.42
|
| Rate for Payer: Three Rivers Provider Network All |
$156.75
|
| 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 |
$194.37
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$865.71
|
| Rate for Payer: Zelis Auto |
$83.60
|
| 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 |
$57.06
|
|
|
SIGMOIDOSCOPY W/SUBMUC INJ
|
Facility
|
IP
|
$209.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
6145335
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$57.06 |
| Max. Negotiated Rate |
$198.55 |
| Rate for Payer: Cash Price |
$125.40
|
| Rate for Payer: Cigna Commercial |
$177.65
|
| Rate for Payer: First Health Commercial |
$188.10
|
| Rate for Payer: First Health Workers Compensation |
$80.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$188.10
|
| Rate for Payer: GEHA Commercial |
$146.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$188.10
|
| Rate for Payer: Multiplan All |
$190.19
|
| Rate for Payer: OMNI Networks Commercial |
$146.30
|
| Rate for Payer: One Health Plan PPO/POS |
$188.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$198.55
|
| Rate for Payer: Three Rivers Provider Network All |
$156.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$194.37
|
| Rate for Payer: Zelis Auto |
$83.60
|
| Rate for Payer: Zelis Worker's Compensation |
$57.06
|
|
|
SIGMOIDOSCOPY W/TUMR REMOVE
|
Facility
|
OP
|
$396.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
6145338
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$108.11 |
| 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 |
$237.60
|
| 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 |
$237.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cigna Commercial |
$336.60
|
| Rate for Payer: First Health Commercial |
$356.40
|
| Rate for Payer: First Health Workers Compensation |
$152.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$356.40
|
| Rate for Payer: GEHA Commercial |
$316.80
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$356.40
|
| 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 |
$360.36
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$277.20
|
| Rate for Payer: One Health Plan PPO/POS |
$356.40
|
| 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 |
$376.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$297.00
|
| 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 |
$368.28
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$158.40
|
| 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 |
$108.11
|
|
|
SIGMOIDOSCOPY W/TUMR REMOVE
|
Facility
|
IP
|
$396.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
6145338
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$108.11 |
| Max. Negotiated Rate |
$376.20 |
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cigna Commercial |
$336.60
|
| Rate for Payer: First Health Commercial |
$356.40
|
| Rate for Payer: First Health Workers Compensation |
$152.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$356.40
|
| Rate for Payer: GEHA Commercial |
$277.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$356.40
|
| Rate for Payer: Multiplan All |
$360.36
|
| Rate for Payer: OMNI Networks Commercial |
$277.20
|
| Rate for Payer: One Health Plan PPO/POS |
$356.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$376.20
|
| Rate for Payer: Three Rivers Provider Network All |
$297.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$368.28
|
| Rate for Payer: Zelis Auto |
$158.40
|
| Rate for Payer: Zelis Worker's Compensation |
$108.11
|
|
|
SIGMOIDOSCOPY W/ULTRASOUND
|
Facility
|
IP
|
$407.00
|
|
|
Service Code
|
CPT 45341
|
| Hospital Charge Code |
6145341
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$111.11 |
| Max. Negotiated Rate |
$386.65 |
| Rate for Payer: Cash Price |
$244.20
|
| Rate for Payer: Cigna Commercial |
$345.95
|
| Rate for Payer: First Health Commercial |
$366.30
|
| Rate for Payer: First Health Workers Compensation |
$157.14
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$366.30
|
| Rate for Payer: GEHA Commercial |
$284.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$366.30
|
| Rate for Payer: Multiplan All |
$370.37
|
| Rate for Payer: OMNI Networks Commercial |
$284.90
|
| Rate for Payer: One Health Plan PPO/POS |
$366.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$386.65
|
| Rate for Payer: Three Rivers Provider Network All |
$305.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$378.51
|
| Rate for Payer: Zelis Auto |
$162.80
|
| Rate for Payer: Zelis Worker's Compensation |
$111.11
|
|
|
SIGMOIDOSCOPY W/ULTRASOUND
|
Facility
|
OP
|
$407.00
|
|
|
Service Code
|
CPT 45341
|
| Hospital Charge Code |
6145341
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$111.11 |
| 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 |
$244.20
|
| 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 |
$244.20
|
| Rate for Payer: Cash Price |
$244.20
|
| Rate for Payer: Cigna Commercial |
$345.95
|
| Rate for Payer: First Health Commercial |
$366.30
|
| Rate for Payer: First Health Workers Compensation |
$157.14
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$366.30
|
| Rate for Payer: GEHA Commercial |
$325.60
|
| Rate for Payer: GEHA Medicare |
$865.71
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$366.30
|
| 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 |
$755.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$865.71
|
| Rate for Payer: Multiplan All |
$370.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,471.71
|
| Rate for Payer: OMNI Networks Commercial |
$284.90
|
| Rate for Payer: One Health Plan PPO/POS |
$366.30
|
| 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 |
$386.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,731.42
|
| Rate for Payer: Three Rivers Provider Network All |
$305.25
|
| 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 |
$378.51
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$865.71
|
| Rate for Payer: Zelis Auto |
$162.80
|
| 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 |
$111.11
|
|
|
SIGMOIDOSCOPY W/US GUIDE BX
|
Facility
|
IP
|
$553.00
|
|
|
Service Code
|
CPT 45342
|
| Hospital Charge Code |
6145342
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$150.97 |
| Max. Negotiated Rate |
$525.35 |
| Rate for Payer: Cash Price |
$331.80
|
| Rate for Payer: Cigna Commercial |
$470.05
|
| Rate for Payer: First Health Commercial |
$497.70
|
| Rate for Payer: First Health Workers Compensation |
$213.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$497.70
|
| Rate for Payer: GEHA Commercial |
$387.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$497.70
|
| Rate for Payer: Multiplan All |
$503.23
|
| Rate for Payer: OMNI Networks Commercial |
$387.10
|
| Rate for Payer: One Health Plan PPO/POS |
$497.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$525.35
|
| Rate for Payer: Three Rivers Provider Network All |
$414.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$514.29
|
| Rate for Payer: Zelis Auto |
$221.20
|
| Rate for Payer: Zelis Worker's Compensation |
$150.97
|
|
|
SIGMOIDOSCOPY W/US GUIDE BX
|
Facility
|
OP
|
$553.00
|
|
|
Service Code
|
CPT 45342
|
| Hospital Charge Code |
6145342
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$150.97 |
| 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 |
$331.80
|
| 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 |
$1,119.58
|
| Rate for Payer: Cash Price |
$331.80
|
| Rate for Payer: Cash Price |
$331.80
|
| Rate for Payer: Cigna Commercial |
$470.05
|
| Rate for Payer: First Health Commercial |
$497.70
|
| Rate for Payer: First Health Workers Compensation |
$213.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$497.70
|
| Rate for Payer: GEHA Commercial |
$442.40
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$497.70
|
| 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 |
$503.23
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$387.10
|
| Rate for Payer: One Health Plan PPO/POS |
$497.70
|
| 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 |
$1,119.58
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$525.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$414.75
|
| 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 |
$514.29
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$221.20
|
| 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 |
$150.97
|
|
|
SIG W/BALLOON DILATION
|
Facility
|
IP
|
$246.00
|
|
|
Service Code
|
CPT 45340
|
| Hospital Charge Code |
6145340
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$67.16 |
| Max. Negotiated Rate |
$233.70 |
| Rate for Payer: Cash Price |
$147.60
|
| Rate for Payer: Cigna Commercial |
$209.10
|
| Rate for Payer: First Health Commercial |
$221.40
|
| Rate for Payer: First Health Workers Compensation |
$94.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$221.40
|
| Rate for Payer: GEHA Commercial |
$172.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$221.40
|
| Rate for Payer: Multiplan All |
$223.86
|
| Rate for Payer: OMNI Networks Commercial |
$172.20
|
| Rate for Payer: One Health Plan PPO/POS |
$221.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$233.70
|
| Rate for Payer: Three Rivers Provider Network All |
$184.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$228.78
|
| Rate for Payer: Zelis Auto |
$98.40
|
| Rate for Payer: Zelis Worker's Compensation |
$67.16
|
|
|
SIG W/BALLOON DILATION
|
Facility
|
OP
|
$246.00
|
|
|
Service Code
|
CPT 45340
|
| Hospital Charge Code |
6145340
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$67.16 |
| 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 |
$147.60
|
| 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 |
$147.60
|
| Rate for Payer: Cash Price |
$147.60
|
| Rate for Payer: Cigna Commercial |
$209.10
|
| Rate for Payer: First Health Commercial |
$221.40
|
| Rate for Payer: First Health Workers Compensation |
$94.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$221.40
|
| Rate for Payer: GEHA Commercial |
$196.80
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$221.40
|
| 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 |
$223.86
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$172.20
|
| Rate for Payer: One Health Plan PPO/POS |
$221.40
|
| 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 |
$233.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$184.50
|
| 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 |
$228.78
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$98.40
|
| 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 |
$67.16
|
|
|
Sildenafil Oral Tablet 20MG
|
Facility
|
IP
|
$6.00
|
|
|
Service Code
|
NDC 00904667104
|
| Hospital Charge Code |
3302549
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.64 |
| Max. Negotiated Rate |
$5.70 |
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cigna Commercial |
$5.10
|
| Rate for Payer: First Health Commercial |
$5.40
|
| Rate for Payer: First Health Workers Compensation |
$2.32
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$5.40
|
| Rate for Payer: GEHA Commercial |
$4.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$5.40
|
| Rate for Payer: Multiplan All |
$5.46
|
| Rate for Payer: OMNI Networks Commercial |
$4.20
|
| Rate for Payer: One Health Plan PPO/POS |
$5.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5.70
|
| Rate for Payer: Three Rivers Provider Network All |
$4.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5.58
|
| Rate for Payer: Zelis Auto |
$2.40
|
| Rate for Payer: Zelis Worker's Compensation |
$1.64
|
|
|
Sildenafil Oral Tablet 20MG
|
Facility
|
OP
|
$6.00
|
|
|
Service Code
|
NDC 00904667104
|
| Hospital Charge Code |
3302549
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$5.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3.60
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cigna Commercial |
$5.10
|
| Rate for Payer: First Health Commercial |
$5.40
|
| Rate for Payer: First Health Workers Compensation |
$2.32
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$5.40
|
| Rate for Payer: GEHA Commercial |
$4.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$5.40
|
| Rate for Payer: Humana ChoiceCare |
$1.56
|
| Rate for Payer: Multiplan All |
$5.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3.60
|
| Rate for Payer: OMNI Networks Commercial |
$4.20
|
| Rate for Payer: One Health Plan PPO/POS |
$5.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5.70
|
| Rate for Payer: Three Rivers Provider Network All |
$4.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5.58
|
| Rate for Payer: Zelis Auto |
$2.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3.00
|
| Rate for Payer: Zelis Worker's Compensation |
$1.64
|
|
|
SILVER NITRATE APPLICATOR
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
NDC 12870000101
|
| Hospital Charge Code |
3300822
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$7.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cigna Commercial |
$6.80
|
| Rate for Payer: First Health Commercial |
$7.20
|
| Rate for Payer: First Health Workers Compensation |
$3.09
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$7.20
|
| Rate for Payer: GEHA Commercial |
$6.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$7.20
|
| Rate for Payer: Humana ChoiceCare |
$2.08
|
| Rate for Payer: Multiplan All |
$7.28
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4.80
|
| Rate for Payer: OMNI Networks Commercial |
$5.60
|
| Rate for Payer: One Health Plan PPO/POS |
$7.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$7.60
|
| Rate for Payer: Three Rivers Provider Network All |
$6.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$7.44
|
| Rate for Payer: Zelis Auto |
$3.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4.00
|
| Rate for Payer: Zelis Worker's Compensation |
$2.18
|
|
|
SILVER NITRATE APPLICATOR
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
NDC 12870000101
|
| Hospital Charge Code |
3300822
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$7.60 |
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cigna Commercial |
$6.80
|
| Rate for Payer: First Health Commercial |
$7.20
|
| Rate for Payer: First Health Workers Compensation |
$3.09
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$7.20
|
| Rate for Payer: GEHA Commercial |
$5.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$7.20
|
| Rate for Payer: Multiplan All |
$7.28
|
| Rate for Payer: OMNI Networks Commercial |
$5.60
|
| Rate for Payer: One Health Plan PPO/POS |
$7.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$7.60
|
| Rate for Payer: Three Rivers Provider Network All |
$6.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$7.44
|
| Rate for Payer: Zelis Auto |
$3.20
|
| Rate for Payer: Zelis Worker's Compensation |
$2.18
|
|
|
SILVER SULFADIAZINE CREAM - 400GM
|
Facility
|
OP
|
$270.00
|
|
|
Service Code
|
NDC 67877012440
|
| Hospital Charge Code |
3300823
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$67.50 |
| Max. Negotiated Rate |
$256.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$162.00
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cigna Commercial |
$229.50
|
| Rate for Payer: First Health Commercial |
$243.00
|
| Rate for Payer: First Health Workers Compensation |
$104.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$243.00
|
| Rate for Payer: GEHA Commercial |
$216.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$243.00
|
| Rate for Payer: Humana ChoiceCare |
$70.20
|
| Rate for Payer: Multiplan All |
$245.70
|
| Rate for Payer: New Mexico Health Connections Medicare |
$162.00
|
| Rate for Payer: OMNI Networks Commercial |
$189.00
|
| Rate for Payer: One Health Plan PPO/POS |
$243.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$256.50
|
| Rate for Payer: Three Rivers Provider Network All |
$202.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$237.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$67.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$251.10
|
| Rate for Payer: Zelis Auto |
$108.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$135.00
|
| Rate for Payer: Zelis Worker's Compensation |
$73.71
|
|
|
SILVER SULFADIAZINE CREAM - 400GM
|
Facility
|
IP
|
$270.00
|
|
|
Service Code
|
NDC 67877012440
|
| Hospital Charge Code |
3300823
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$73.71 |
| Max. Negotiated Rate |
$256.50 |
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cigna Commercial |
$229.50
|
| Rate for Payer: First Health Commercial |
$243.00
|
| Rate for Payer: First Health Workers Compensation |
$104.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$243.00
|
| Rate for Payer: GEHA Commercial |
$189.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$243.00
|
| Rate for Payer: Multiplan All |
$245.70
|
| Rate for Payer: OMNI Networks Commercial |
$189.00
|
| Rate for Payer: One Health Plan PPO/POS |
$243.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$256.50
|
| Rate for Payer: Three Rivers Provider Network All |
$202.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$251.10
|
| Rate for Payer: Zelis Auto |
$108.00
|
| Rate for Payer: Zelis Worker's Compensation |
$73.71
|
|
|
SILVER SULFADIAZINE CREAM - 50GM
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
NDC 67877012405
|
| Hospital Charge Code |
3300824
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.02 |
| Max. Negotiated Rate |
$73.15 |
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Cigna Commercial |
$65.45
|
| Rate for Payer: First Health Commercial |
$69.30
|
| Rate for Payer: First Health Workers Compensation |
$29.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$69.30
|
| Rate for Payer: GEHA Commercial |
$53.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$69.30
|
| Rate for Payer: Multiplan All |
$70.07
|
| Rate for Payer: OMNI Networks Commercial |
$53.90
|
| Rate for Payer: One Health Plan PPO/POS |
$69.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$73.15
|
| Rate for Payer: Three Rivers Provider Network All |
$57.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$71.61
|
| Rate for Payer: Zelis Auto |
$30.80
|
| Rate for Payer: Zelis Worker's Compensation |
$21.02
|
|
|
SILVER SULFADIAZINE CREAM - 50GM
|
Facility
|
IP
|
$77.00
|
|
| Hospital Charge Code |
1900018
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.02 |
| Max. Negotiated Rate |
$73.15 |
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Cigna Commercial |
$65.45
|
| Rate for Payer: First Health Commercial |
$69.30
|
| Rate for Payer: First Health Workers Compensation |
$29.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$69.30
|
| Rate for Payer: GEHA Commercial |
$53.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$69.30
|
| Rate for Payer: Multiplan All |
$70.07
|
| Rate for Payer: OMNI Networks Commercial |
$53.90
|
| Rate for Payer: One Health Plan PPO/POS |
$69.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$73.15
|
| Rate for Payer: Three Rivers Provider Network All |
$57.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$71.61
|
| Rate for Payer: Zelis Auto |
$30.80
|
| Rate for Payer: Zelis Worker's Compensation |
$21.02
|
|
|
SILVER SULFADIAZINE CREAM - 50GM
|
Facility
|
OP
|
$77.00
|
|
|
Service Code
|
NDC 00591081046
|
| Hospital Charge Code |
20300018
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$19.25 |
| Max. Negotiated Rate |
$73.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$46.20
|
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Cigna Commercial |
$65.45
|
| Rate for Payer: First Health Commercial |
$69.30
|
| Rate for Payer: First Health Workers Compensation |
$29.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$69.30
|
| Rate for Payer: GEHA Commercial |
$61.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$69.30
|
| Rate for Payer: Humana ChoiceCare |
$20.02
|
| Rate for Payer: Multiplan All |
$70.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$46.20
|
| Rate for Payer: OMNI Networks Commercial |
$53.90
|
| Rate for Payer: One Health Plan PPO/POS |
$69.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$73.15
|
| Rate for Payer: Three Rivers Provider Network All |
$57.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$67.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$19.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$71.61
|
| Rate for Payer: Zelis Auto |
$30.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$38.50
|
| Rate for Payer: Zelis Worker's Compensation |
$21.02
|
|
|
SILVER SULFADIAZINE CREAM - 50GM
|
Facility
|
OP
|
$77.00
|
|
| Hospital Charge Code |
1900018
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.25 |
| Max. Negotiated Rate |
$73.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$46.20
|
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Cigna Commercial |
$65.45
|
| Rate for Payer: First Health Commercial |
$69.30
|
| Rate for Payer: First Health Workers Compensation |
$29.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$69.30
|
| Rate for Payer: GEHA Commercial |
$61.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$69.30
|
| Rate for Payer: Humana ChoiceCare |
$20.02
|
| Rate for Payer: Multiplan All |
$70.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$46.20
|
| Rate for Payer: OMNI Networks Commercial |
$53.90
|
| Rate for Payer: One Health Plan PPO/POS |
$69.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$73.15
|
| Rate for Payer: Three Rivers Provider Network All |
$57.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$67.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$19.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$71.61
|
| Rate for Payer: Zelis Auto |
$30.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$38.50
|
| Rate for Payer: Zelis Worker's Compensation |
$21.02
|
|
|
SILVER SULFADIAZINE CREAM - 50GM
|
Facility
|
OP
|
$77.00
|
|
|
Service Code
|
NDC 67877012405
|
| Hospital Charge Code |
3300824
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$19.25 |
| Max. Negotiated Rate |
$73.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$46.20
|
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Cigna Commercial |
$65.45
|
| Rate for Payer: First Health Commercial |
$69.30
|
| Rate for Payer: First Health Workers Compensation |
$29.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$69.30
|
| Rate for Payer: GEHA Commercial |
$61.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$69.30
|
| Rate for Payer: Humana ChoiceCare |
$20.02
|
| Rate for Payer: Multiplan All |
$70.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$46.20
|
| Rate for Payer: OMNI Networks Commercial |
$53.90
|
| Rate for Payer: One Health Plan PPO/POS |
$69.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$73.15
|
| Rate for Payer: Three Rivers Provider Network All |
$57.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$67.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$19.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$71.61
|
| Rate for Payer: Zelis Auto |
$30.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$38.50
|
| Rate for Payer: Zelis Worker's Compensation |
$21.02
|
|
|
SILVER SULFADIAZINE CREAM - 50GM
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
NDC 00591081046
|
| Hospital Charge Code |
20300018
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.02 |
| Max. Negotiated Rate |
$73.15 |
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Cigna Commercial |
$65.45
|
| Rate for Payer: First Health Commercial |
$69.30
|
| Rate for Payer: First Health Workers Compensation |
$29.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$69.30
|
| Rate for Payer: GEHA Commercial |
$53.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$69.30
|
| Rate for Payer: Multiplan All |
$70.07
|
| Rate for Payer: OMNI Networks Commercial |
$53.90
|
| Rate for Payer: One Health Plan PPO/POS |
$69.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$73.15
|
| Rate for Payer: Three Rivers Provider Network All |
$57.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$71.61
|
| Rate for Payer: Zelis Auto |
$30.80
|
| Rate for Payer: Zelis Worker's Compensation |
$21.02
|
|
