|
STRAPPING ANKLE &/FOOT
|
Facility
|
IP
|
$87.00
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
8229540
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$23.75 |
| Max. Negotiated Rate |
$82.65 |
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Cigna Commercial |
$73.95
|
| Rate for Payer: First Health Commercial |
$78.30
|
| Rate for Payer: First Health Workers Compensation |
$33.59
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$78.30
|
| Rate for Payer: GEHA Commercial |
$60.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$78.30
|
| Rate for Payer: Multiplan All |
$79.17
|
| Rate for Payer: OMNI Networks Commercial |
$60.90
|
| Rate for Payer: One Health Plan PPO/POS |
$78.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$82.65
|
| Rate for Payer: Three Rivers Provider Network All |
$65.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$80.91
|
| Rate for Payer: Zelis Auto |
$34.80
|
| Rate for Payer: Zelis Worker's Compensation |
$23.75
|
|
|
STRAPPING OF ELBOW OR WRIST
|
Facility
|
OP
|
$88.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
8229260
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$24.02 |
| Max. Negotiated Rate |
$115.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$52.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$62.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$57.56
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cigna Commercial |
$74.80
|
| Rate for Payer: First Health Commercial |
$79.20
|
| Rate for Payer: First Health Workers Compensation |
$33.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$79.20
|
| Rate for Payer: GEHA Commercial |
$70.40
|
| Rate for Payer: GEHA Medicare |
$57.56
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$79.20
|
| Rate for Payer: Humana ChoiceCare |
$63.32
|
| Rate for Payer: Humana Medicare Advantage |
$57.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$96.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$63.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$57.56
|
| Rate for Payer: Multiplan All |
$80.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$97.85
|
| Rate for Payer: OMNI Networks Commercial |
$61.60
|
| Rate for Payer: One Health Plan PPO/POS |
$79.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$73.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$63.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$57.56
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$83.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$115.12
|
| Rate for Payer: Three Rivers Provider Network All |
$66.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$56.41
|
| Rate for Payer: United Healthcare Managed Medicaid |
$63.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$57.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$81.84
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$57.56
|
| Rate for Payer: Zelis Auto |
$35.20
|
| Rate for Payer: Zelis Medicare |
$48.93
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$69.07
|
| Rate for Payer: Zelis Worker's Compensation |
$24.02
|
|
|
STRAPPING OF ELBOW OR WRIST
|
Facility
|
IP
|
$88.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
8229260
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$24.02 |
| Max. Negotiated Rate |
$83.60 |
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cigna Commercial |
$74.80
|
| Rate for Payer: First Health Commercial |
$79.20
|
| Rate for Payer: First Health Workers Compensation |
$33.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$79.20
|
| Rate for Payer: GEHA Commercial |
$61.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$79.20
|
| Rate for Payer: Multiplan All |
$80.08
|
| Rate for Payer: OMNI Networks Commercial |
$61.60
|
| Rate for Payer: One Health Plan PPO/POS |
$79.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$83.60
|
| Rate for Payer: Three Rivers Provider Network All |
$66.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$81.84
|
| Rate for Payer: Zelis Auto |
$35.20
|
| Rate for Payer: Zelis Worker's Compensation |
$24.02
|
|
|
STRAPPING OF HIP
|
Facility
|
OP
|
$93.00
|
|
|
Service Code
|
CPT 29520
|
| Hospital Charge Code |
8229520
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$25.39 |
| Max. Negotiated Rate |
$249.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$55.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$62.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$124.90
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cigna Commercial |
$79.05
|
| Rate for Payer: First Health Commercial |
$83.70
|
| Rate for Payer: First Health Workers Compensation |
$35.91
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$83.70
|
| Rate for Payer: GEHA Commercial |
$74.40
|
| Rate for Payer: GEHA Medicare |
$124.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$83.70
|
| Rate for Payer: Humana ChoiceCare |
$137.39
|
| Rate for Payer: Humana Medicare Advantage |
$124.90
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$209.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$63.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$124.90
|
| Rate for Payer: Multiplan All |
$84.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$212.33
|
| Rate for Payer: OMNI Networks Commercial |
$65.10
|
| Rate for Payer: One Health Plan PPO/POS |
$83.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$73.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$63.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$124.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$88.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$249.80
|
| Rate for Payer: Three Rivers Provider Network All |
$69.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$122.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$63.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$124.90
|
| Rate for Payer: United Payors & United Providers UP&UP |
$86.49
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$124.90
|
| Rate for Payer: Zelis Auto |
$37.20
|
| Rate for Payer: Zelis Medicare |
$106.17
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$149.88
|
| Rate for Payer: Zelis Worker's Compensation |
$25.39
|
|
|
STRAPPING OF HIP
|
Facility
|
IP
|
$93.00
|
|
|
Service Code
|
CPT 29520
|
| Hospital Charge Code |
8229520
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$25.39 |
| Max. Negotiated Rate |
$88.35 |
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cigna Commercial |
$79.05
|
| Rate for Payer: First Health Commercial |
$83.70
|
| Rate for Payer: First Health Workers Compensation |
$35.91
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$83.70
|
| Rate for Payer: GEHA Commercial |
$65.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$83.70
|
| Rate for Payer: Multiplan All |
$84.63
|
| Rate for Payer: OMNI Networks Commercial |
$65.10
|
| Rate for Payer: One Health Plan PPO/POS |
$83.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$88.35
|
| Rate for Payer: Three Rivers Provider Network All |
$69.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$86.49
|
| Rate for Payer: Zelis Auto |
$37.20
|
| Rate for Payer: Zelis Worker's Compensation |
$25.39
|
|
|
STRAPPING OF KNEE
|
Facility
|
OP
|
$228.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
8129530
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$62.21 |
| Max. Negotiated Rate |
$249.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$136.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$62.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$124.90
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cigna Commercial |
$193.80
|
| Rate for Payer: First Health Commercial |
$205.20
|
| Rate for Payer: First Health Workers Compensation |
$88.03
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$205.20
|
| Rate for Payer: GEHA Commercial |
$182.40
|
| Rate for Payer: GEHA Medicare |
$124.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$205.20
|
| Rate for Payer: Humana ChoiceCare |
$137.39
|
| Rate for Payer: Humana Medicare Advantage |
$124.90
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$209.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$63.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$124.90
|
| Rate for Payer: Multiplan All |
$207.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$212.33
|
| Rate for Payer: OMNI Networks Commercial |
$159.60
|
| Rate for Payer: One Health Plan PPO/POS |
$205.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$73.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$63.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$124.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$216.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$249.80
|
| Rate for Payer: Three Rivers Provider Network All |
$171.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$122.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$63.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$124.90
|
| Rate for Payer: United Payors & United Providers UP&UP |
$212.04
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$124.90
|
| Rate for Payer: Zelis Auto |
$91.20
|
| Rate for Payer: Zelis Medicare |
$106.17
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$149.88
|
| Rate for Payer: Zelis Worker's Compensation |
$62.24
|
|
|
STRAPPING OF KNEE
|
Facility
|
IP
|
$228.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
8129530
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$62.24 |
| Max. Negotiated Rate |
$216.60 |
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cigna Commercial |
$193.80
|
| Rate for Payer: First Health Commercial |
$205.20
|
| Rate for Payer: First Health Workers Compensation |
$88.03
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$205.20
|
| Rate for Payer: GEHA Commercial |
$159.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$205.20
|
| Rate for Payer: Multiplan All |
$207.48
|
| Rate for Payer: OMNI Networks Commercial |
$159.60
|
| Rate for Payer: One Health Plan PPO/POS |
$205.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$216.60
|
| Rate for Payer: Three Rivers Provider Network All |
$171.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$212.04
|
| Rate for Payer: Zelis Auto |
$91.20
|
| Rate for Payer: Zelis Worker's Compensation |
$62.24
|
|
|
STRAPPING OF KNEE
|
Facility
|
IP
|
$228.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
8229530
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$62.24 |
| Max. Negotiated Rate |
$216.60 |
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cigna Commercial |
$193.80
|
| Rate for Payer: First Health Commercial |
$205.20
|
| Rate for Payer: First Health Workers Compensation |
$88.03
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$205.20
|
| Rate for Payer: GEHA Commercial |
$159.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$205.20
|
| Rate for Payer: Multiplan All |
$207.48
|
| Rate for Payer: OMNI Networks Commercial |
$159.60
|
| Rate for Payer: One Health Plan PPO/POS |
$205.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$216.60
|
| Rate for Payer: Three Rivers Provider Network All |
$171.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$212.04
|
| Rate for Payer: Zelis Auto |
$91.20
|
| Rate for Payer: Zelis Worker's Compensation |
$62.24
|
|
|
STRAPPING OF KNEE
|
Facility
|
OP
|
$228.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
8229530
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$62.21 |
| Max. Negotiated Rate |
$249.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$136.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$62.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$124.90
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cigna Commercial |
$193.80
|
| Rate for Payer: First Health Commercial |
$205.20
|
| Rate for Payer: First Health Workers Compensation |
$88.03
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$205.20
|
| Rate for Payer: GEHA Commercial |
$182.40
|
| Rate for Payer: GEHA Medicare |
$124.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$205.20
|
| Rate for Payer: Humana ChoiceCare |
$137.39
|
| Rate for Payer: Humana Medicare Advantage |
$124.90
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$209.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$63.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$124.90
|
| Rate for Payer: Multiplan All |
$207.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$212.33
|
| Rate for Payer: OMNI Networks Commercial |
$159.60
|
| Rate for Payer: One Health Plan PPO/POS |
$205.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$73.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$63.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$124.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$216.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$249.80
|
| Rate for Payer: Three Rivers Provider Network All |
$171.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$122.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$63.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$124.90
|
| Rate for Payer: United Payors & United Providers UP&UP |
$212.04
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$124.90
|
| Rate for Payer: Zelis Auto |
$91.20
|
| Rate for Payer: Zelis Medicare |
$106.17
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$149.88
|
| Rate for Payer: Zelis Worker's Compensation |
$62.24
|
|
|
STRAPPING OF TOES
|
Facility
|
OP
|
$61.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
8729550
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$16.65 |
| Max. Negotiated Rate |
$115.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$36.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$62.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$57.56
|
| Rate for Payer: Cash Price |
$36.60
|
| Rate for Payer: Cash Price |
$36.60
|
| Rate for Payer: Cigna Commercial |
$51.85
|
| Rate for Payer: First Health Commercial |
$54.90
|
| Rate for Payer: First Health Workers Compensation |
$23.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$54.90
|
| Rate for Payer: GEHA Commercial |
$48.80
|
| Rate for Payer: GEHA Medicare |
$57.56
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$54.90
|
| Rate for Payer: Humana ChoiceCare |
$63.32
|
| Rate for Payer: Humana Medicare Advantage |
$57.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$96.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$63.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$57.56
|
| Rate for Payer: Multiplan All |
$55.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$97.85
|
| Rate for Payer: OMNI Networks Commercial |
$42.70
|
| Rate for Payer: One Health Plan PPO/POS |
$54.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$73.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$63.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$57.56
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$57.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$115.12
|
| Rate for Payer: Three Rivers Provider Network All |
$45.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$56.41
|
| Rate for Payer: United Healthcare Managed Medicaid |
$63.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$57.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$56.73
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$57.56
|
| Rate for Payer: Zelis Auto |
$24.40
|
| Rate for Payer: Zelis Medicare |
$48.93
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$69.07
|
| Rate for Payer: Zelis Worker's Compensation |
$16.65
|
|
|
STRAPPING OF TOES
|
Facility
|
IP
|
$307.71
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
9629550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$292.32 |
| Rate for Payer: Zelis Auto |
$123.08
|
| Rate for Payer: Zelis Worker's Compensation |
$84.00
|
| Rate for Payer: Cash Price |
$184.63
|
| Rate for Payer: Cigna Commercial |
$261.55
|
| Rate for Payer: First Health Commercial |
$276.94
|
| Rate for Payer: First Health Workers Compensation |
$118.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$276.94
|
| Rate for Payer: GEHA Commercial |
$215.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$276.94
|
| Rate for Payer: Multiplan All |
$280.02
|
| Rate for Payer: OMNI Networks Commercial |
$215.40
|
| Rate for Payer: One Health Plan PPO/POS |
$276.94
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$292.32
|
| Rate for Payer: Three Rivers Provider Network All |
$230.78
|
| Rate for Payer: United Payors & United Providers UP&UP |
$286.17
|
|
|
STRAPPING OF TOES
|
Facility
|
OP
|
$307.71
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
9629550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$48.93 |
| Max. Negotiated Rate |
$292.32 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$184.63
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$62.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$57.56
|
| Rate for Payer: Cash Price |
$184.63
|
| Rate for Payer: Cash Price |
$184.63
|
| Rate for Payer: Cigna Commercial |
$261.55
|
| Rate for Payer: First Health Commercial |
$276.94
|
| Rate for Payer: First Health Workers Compensation |
$118.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$276.94
|
| Rate for Payer: GEHA Commercial |
$246.17
|
| Rate for Payer: GEHA Medicare |
$57.56
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$276.94
|
| Rate for Payer: Humana ChoiceCare |
$63.32
|
| Rate for Payer: Humana Medicare Advantage |
$57.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$96.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$63.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$57.56
|
| Rate for Payer: Multiplan All |
$280.02
|
| Rate for Payer: New Mexico Health Connections Medicare |
$97.85
|
| Rate for Payer: OMNI Networks Commercial |
$215.40
|
| Rate for Payer: One Health Plan PPO/POS |
$276.94
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$73.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$63.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$57.56
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$292.32
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$115.12
|
| Rate for Payer: Three Rivers Provider Network All |
$230.78
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$56.41
|
| Rate for Payer: United Healthcare Managed Medicaid |
$63.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$57.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$286.17
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$57.56
|
| Rate for Payer: Zelis Auto |
$123.08
|
| Rate for Payer: Zelis Medicare |
$48.93
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$69.07
|
| Rate for Payer: Zelis Worker's Compensation |
$84.00
|
|
|
STRAPPING OF TOES
|
Facility
|
OP
|
$396.00
|
|
| Hospital Charge Code |
8129550
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$376.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$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: Great West Healthcare (Cigna) Commercial |
$356.40
|
| Rate for Payer: Humana ChoiceCare |
$102.96
|
| Rate for Payer: Multiplan All |
$360.36
|
| Rate for Payer: New Mexico Health Connections Medicare |
$237.60
|
| 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: TriWest Veterans Administration/VAPC3 |
$348.48
|
| Rate for Payer: United Healthcare Managed Medicaid |
$99.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$368.28
|
| Rate for Payer: Zelis Auto |
$158.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$198.00
|
| Rate for Payer: Zelis Worker's Compensation |
$108.11
|
|
|
STRAPPING OF TOES
|
Facility
|
IP
|
$61.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
8729550
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$16.65 |
| Max. Negotiated Rate |
$57.95 |
| Rate for Payer: Cash Price |
$36.60
|
| Rate for Payer: Cigna Commercial |
$51.85
|
| Rate for Payer: First Health Commercial |
$54.90
|
| Rate for Payer: First Health Workers Compensation |
$23.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$54.90
|
| Rate for Payer: GEHA Commercial |
$42.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$54.90
|
| Rate for Payer: Multiplan All |
$55.51
|
| Rate for Payer: OMNI Networks Commercial |
$42.70
|
| Rate for Payer: One Health Plan PPO/POS |
$54.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$57.95
|
| Rate for Payer: Three Rivers Provider Network All |
$45.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$56.73
|
| Rate for Payer: Zelis Auto |
$24.40
|
| Rate for Payer: Zelis Worker's Compensation |
$16.65
|
|
|
STRAPPING OF TOES
|
Facility
|
IP
|
$396.00
|
|
| Hospital Charge Code |
8129550
|
|
Hospital Revenue Code
|
450
|
| 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
|
|
|
STRAPPING OF TOES
|
Facility
|
IP
|
$61.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
8229550
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$16.65 |
| Max. Negotiated Rate |
$57.95 |
| Rate for Payer: Cash Price |
$36.60
|
| Rate for Payer: Cigna Commercial |
$51.85
|
| Rate for Payer: First Health Commercial |
$54.90
|
| Rate for Payer: First Health Workers Compensation |
$23.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$54.90
|
| Rate for Payer: GEHA Commercial |
$42.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$54.90
|
| Rate for Payer: Multiplan All |
$55.51
|
| Rate for Payer: OMNI Networks Commercial |
$42.70
|
| Rate for Payer: One Health Plan PPO/POS |
$54.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$57.95
|
| Rate for Payer: Three Rivers Provider Network All |
$45.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$56.73
|
| Rate for Payer: Zelis Auto |
$24.40
|
| Rate for Payer: Zelis Worker's Compensation |
$16.65
|
|
|
STRAPPING OF TOES
|
Facility
|
OP
|
$61.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
8229550
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$16.65 |
| Max. Negotiated Rate |
$115.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$36.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$62.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$57.56
|
| Rate for Payer: Cash Price |
$36.60
|
| Rate for Payer: Cash Price |
$36.60
|
| Rate for Payer: Cigna Commercial |
$51.85
|
| Rate for Payer: First Health Commercial |
$54.90
|
| Rate for Payer: First Health Workers Compensation |
$23.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$54.90
|
| Rate for Payer: GEHA Commercial |
$48.80
|
| Rate for Payer: GEHA Medicare |
$57.56
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$54.90
|
| Rate for Payer: Humana ChoiceCare |
$63.32
|
| Rate for Payer: Humana Medicare Advantage |
$57.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$96.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$63.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$57.56
|
| Rate for Payer: Multiplan All |
$55.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$97.85
|
| Rate for Payer: OMNI Networks Commercial |
$42.70
|
| Rate for Payer: One Health Plan PPO/POS |
$54.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$73.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$63.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$57.56
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$57.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$115.12
|
| Rate for Payer: Three Rivers Provider Network All |
$45.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$56.41
|
| Rate for Payer: United Healthcare Managed Medicaid |
$63.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$57.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$56.73
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$57.56
|
| Rate for Payer: Zelis Auto |
$24.40
|
| Rate for Payer: Zelis Medicare |
$48.93
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$69.07
|
| Rate for Payer: Zelis Worker's Compensation |
$16.65
|
|
|
STRAPPING UNNA BOOT
|
Facility
|
IP
|
$187.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
8729580
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$51.05 |
| Max. Negotiated Rate |
$177.65 |
| Rate for Payer: Cash Price |
$112.20
|
| Rate for Payer: Cigna Commercial |
$158.95
|
| Rate for Payer: First Health Commercial |
$168.30
|
| Rate for Payer: First Health Workers Compensation |
$72.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$168.30
|
| Rate for Payer: GEHA Commercial |
$130.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$168.30
|
| Rate for Payer: Multiplan All |
$170.17
|
| Rate for Payer: OMNI Networks Commercial |
$130.90
|
| Rate for Payer: One Health Plan PPO/POS |
$168.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$177.65
|
| Rate for Payer: Three Rivers Provider Network All |
$140.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$173.91
|
| Rate for Payer: Zelis Auto |
$74.80
|
| Rate for Payer: Zelis Worker's Compensation |
$51.05
|
|
|
STRAPPING UNNA BOOT
|
Facility
|
OP
|
$770.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
9629580
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$84.40 |
| Max. Negotiated Rate |
$731.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$106.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$462.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$106.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$84.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$152.90
|
| Rate for Payer: Cash Price |
$462.00
|
| Rate for Payer: Cash Price |
$462.00
|
| Rate for Payer: Cigna Commercial |
$654.50
|
| Rate for Payer: First Health Commercial |
$693.00
|
| Rate for Payer: First Health Workers Compensation |
$297.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$693.00
|
| Rate for Payer: GEHA Commercial |
$616.00
|
| Rate for Payer: GEHA Medicare |
$152.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$693.00
|
| Rate for Payer: Humana ChoiceCare |
$168.19
|
| Rate for Payer: Humana Medicare Advantage |
$152.90
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$256.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$86.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$152.90
|
| Rate for Payer: Multiplan All |
$700.70
|
| Rate for Payer: New Mexico Health Connections Medicare |
$259.93
|
| Rate for Payer: OMNI Networks Commercial |
$539.00
|
| Rate for Payer: One Health Plan PPO/POS |
$693.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$99.44
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$86.12
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$152.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$731.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$305.80
|
| Rate for Payer: Three Rivers Provider Network All |
$577.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$149.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$86.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$152.90
|
| Rate for Payer: United Payors & United Providers UP&UP |
$716.10
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$152.90
|
| Rate for Payer: Zelis Auto |
$308.00
|
| Rate for Payer: Zelis Medicare |
$129.97
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$183.48
|
| Rate for Payer: Zelis Worker's Compensation |
$210.21
|
|
|
STRAPPING UNNA BOOT
|
Facility
|
IP
|
$649.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
1900040
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$177.18 |
| Max. Negotiated Rate |
$616.55 |
| Rate for Payer: Cash Price |
$389.40
|
| Rate for Payer: Cigna Commercial |
$551.65
|
| Rate for Payer: First Health Commercial |
$584.10
|
| Rate for Payer: First Health Workers Compensation |
$250.58
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$584.10
|
| Rate for Payer: GEHA Commercial |
$454.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$584.10
|
| Rate for Payer: Multiplan All |
$590.59
|
| Rate for Payer: OMNI Networks Commercial |
$454.30
|
| Rate for Payer: One Health Plan PPO/POS |
$584.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$616.55
|
| Rate for Payer: Three Rivers Provider Network All |
$486.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$603.57
|
| Rate for Payer: Zelis Auto |
$259.60
|
| Rate for Payer: Zelis Worker's Compensation |
$177.18
|
|
|
STRAPPING UNNA BOOT
|
Facility
|
IP
|
$187.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
8229580
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$51.05 |
| Max. Negotiated Rate |
$177.65 |
| Rate for Payer: Cash Price |
$112.20
|
| Rate for Payer: Cigna Commercial |
$158.95
|
| Rate for Payer: First Health Commercial |
$168.30
|
| Rate for Payer: First Health Workers Compensation |
$72.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$168.30
|
| Rate for Payer: GEHA Commercial |
$130.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$168.30
|
| Rate for Payer: Multiplan All |
$170.17
|
| Rate for Payer: OMNI Networks Commercial |
$130.90
|
| Rate for Payer: One Health Plan PPO/POS |
$168.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$177.65
|
| Rate for Payer: Three Rivers Provider Network All |
$140.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$173.91
|
| Rate for Payer: Zelis Auto |
$74.80
|
| Rate for Payer: Zelis Worker's Compensation |
$51.05
|
|
|
STRAPPING UNNA BOOT
|
Facility
|
OP
|
$187.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
8229580
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$51.05 |
| Max. Negotiated Rate |
$305.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$106.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$112.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$106.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$84.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$152.90
|
| Rate for Payer: Cash Price |
$112.20
|
| Rate for Payer: Cash Price |
$112.20
|
| Rate for Payer: Cigna Commercial |
$158.95
|
| Rate for Payer: First Health Commercial |
$168.30
|
| Rate for Payer: First Health Workers Compensation |
$72.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$168.30
|
| Rate for Payer: GEHA Commercial |
$149.60
|
| Rate for Payer: GEHA Medicare |
$152.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$168.30
|
| Rate for Payer: Humana ChoiceCare |
$168.19
|
| Rate for Payer: Humana Medicare Advantage |
$152.90
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$256.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$86.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$152.90
|
| Rate for Payer: Multiplan All |
$170.17
|
| Rate for Payer: New Mexico Health Connections Medicare |
$259.93
|
| Rate for Payer: OMNI Networks Commercial |
$130.90
|
| Rate for Payer: One Health Plan PPO/POS |
$168.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$99.44
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$86.12
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$152.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$177.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$305.80
|
| Rate for Payer: Three Rivers Provider Network All |
$140.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$149.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$86.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$152.90
|
| Rate for Payer: United Payors & United Providers UP&UP |
$173.91
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$152.90
|
| Rate for Payer: Zelis Auto |
$74.80
|
| Rate for Payer: Zelis Medicare |
$129.97
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$183.48
|
| Rate for Payer: Zelis Worker's Compensation |
$51.05
|
|
|
STRAPPING UNNA BOOT
|
Facility
|
IP
|
$187.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
20300040
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$51.05 |
| Max. Negotiated Rate |
$177.65 |
| Rate for Payer: Cash Price |
$112.20
|
| Rate for Payer: Cigna Commercial |
$158.95
|
| Rate for Payer: First Health Commercial |
$168.30
|
| Rate for Payer: First Health Workers Compensation |
$72.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$168.30
|
| Rate for Payer: GEHA Commercial |
$130.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$168.30
|
| Rate for Payer: Multiplan All |
$170.17
|
| Rate for Payer: OMNI Networks Commercial |
$130.90
|
| Rate for Payer: One Health Plan PPO/POS |
$168.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$177.65
|
| Rate for Payer: Three Rivers Provider Network All |
$140.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$173.91
|
| Rate for Payer: Zelis Auto |
$74.80
|
| Rate for Payer: Zelis Worker's Compensation |
$51.05
|
|
|
STRAPPING UNNA BOOT
|
Facility
|
OP
|
$187.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
21600155
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$51.05 |
| Max. Negotiated Rate |
$305.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$106.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$112.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$106.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$84.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$152.90
|
| Rate for Payer: Cash Price |
$112.20
|
| Rate for Payer: Cash Price |
$112.20
|
| Rate for Payer: Cigna Commercial |
$158.95
|
| Rate for Payer: First Health Commercial |
$168.30
|
| Rate for Payer: First Health Workers Compensation |
$72.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$168.30
|
| Rate for Payer: GEHA Commercial |
$149.60
|
| Rate for Payer: GEHA Medicare |
$152.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$168.30
|
| Rate for Payer: Humana ChoiceCare |
$168.19
|
| Rate for Payer: Humana Medicare Advantage |
$152.90
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$256.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$86.12
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$152.90
|
| Rate for Payer: Multiplan All |
$170.17
|
| Rate for Payer: New Mexico Health Connections Medicare |
$259.93
|
| Rate for Payer: OMNI Networks Commercial |
$130.90
|
| Rate for Payer: One Health Plan PPO/POS |
$168.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$99.44
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$86.12
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$152.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$177.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$305.80
|
| Rate for Payer: Three Rivers Provider Network All |
$140.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$149.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$86.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$152.90
|
| Rate for Payer: United Payors & United Providers UP&UP |
$173.91
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$152.90
|
| Rate for Payer: Zelis Auto |
$74.80
|
| Rate for Payer: Zelis Medicare |
$129.97
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$183.48
|
| Rate for Payer: Zelis Worker's Compensation |
$51.05
|
|
|
STRAPPING UNNA BOOT
|
Facility
|
OP
|
$376.00
|
|
| Hospital Charge Code |
8150060
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$94.00 |
| Max. Negotiated Rate |
$357.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$225.60
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cigna Commercial |
$319.60
|
| Rate for Payer: First Health Commercial |
$338.40
|
| Rate for Payer: First Health Workers Compensation |
$145.17
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$338.40
|
| Rate for Payer: GEHA Commercial |
$300.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$338.40
|
| Rate for Payer: Humana ChoiceCare |
$97.76
|
| Rate for Payer: Multiplan All |
$342.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$225.60
|
| Rate for Payer: OMNI Networks Commercial |
$263.20
|
| Rate for Payer: One Health Plan PPO/POS |
$338.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$357.20
|
| Rate for Payer: Three Rivers Provider Network All |
$282.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$330.88
|
| Rate for Payer: United Healthcare Managed Medicaid |
$94.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$349.68
|
| Rate for Payer: Zelis Auto |
$150.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$188.00
|
| Rate for Payer: Zelis Worker's Compensation |
$102.65
|
|
