|
THORABD DIAPHR HERN REPAIR
|
Facility
|
IP
|
$3,196.00
|
|
|
Service Code
|
CPT 43336
|
| Hospital Charge Code |
6143336
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$872.51 |
| Max. Negotiated Rate |
$3,036.20 |
| Rate for Payer: Cash Price |
$1,917.60
|
| Rate for Payer: Cigna Commercial |
$2,716.60
|
| Rate for Payer: First Health Commercial |
$2,876.40
|
| Rate for Payer: First Health Workers Compensation |
$1,233.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,876.40
|
| Rate for Payer: GEHA Commercial |
$2,237.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,876.40
|
| Rate for Payer: Multiplan All |
$2,908.36
|
| Rate for Payer: OMNI Networks Commercial |
$2,237.20
|
| Rate for Payer: One Health Plan PPO/POS |
$2,876.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,036.20
|
| Rate for Payer: Three Rivers Provider Network All |
$2,397.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,972.28
|
| Rate for Payer: Zelis Auto |
$1,278.40
|
| Rate for Payer: Zelis Worker's Compensation |
$872.51
|
|
|
THORABD DIAPHR HERN REPAIR
|
Facility
|
OP
|
$3,196.00
|
|
|
Service Code
|
CPT 43336
|
| Hospital Charge Code |
6143336
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$799.00 |
| Max. Negotiated Rate |
$3,036.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,917.60
|
| Rate for Payer: Cash Price |
$1,917.60
|
| Rate for Payer: Cigna Commercial |
$2,716.60
|
| Rate for Payer: First Health Commercial |
$2,876.40
|
| Rate for Payer: First Health Workers Compensation |
$1,233.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,876.40
|
| Rate for Payer: GEHA Commercial |
$2,556.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,876.40
|
| Rate for Payer: Humana ChoiceCare |
$830.96
|
| Rate for Payer: Multiplan All |
$2,908.36
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,917.60
|
| Rate for Payer: OMNI Networks Commercial |
$2,237.20
|
| Rate for Payer: One Health Plan PPO/POS |
$2,876.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,036.20
|
| Rate for Payer: Three Rivers Provider Network All |
$2,397.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,812.48
|
| Rate for Payer: United Healthcare Managed Medicaid |
$799.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,972.28
|
| Rate for Payer: Zelis Auto |
$1,278.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,598.00
|
| Rate for Payer: Zelis Worker's Compensation |
$872.51
|
|
|
THORABD DIAPHR HERN REPAIR
|
Facility
|
IP
|
$3,447.00
|
|
|
Service Code
|
CPT 43337
|
| Hospital Charge Code |
6143337
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$941.03 |
| Max. Negotiated Rate |
$3,274.65 |
| Rate for Payer: Cash Price |
$2,068.20
|
| Rate for Payer: Cigna Commercial |
$2,929.95
|
| Rate for Payer: First Health Commercial |
$3,102.30
|
| Rate for Payer: First Health Workers Compensation |
$1,330.89
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,102.30
|
| Rate for Payer: GEHA Commercial |
$2,412.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,102.30
|
| Rate for Payer: Multiplan All |
$3,136.77
|
| Rate for Payer: OMNI Networks Commercial |
$2,412.90
|
| Rate for Payer: One Health Plan PPO/POS |
$3,102.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,274.65
|
| Rate for Payer: Three Rivers Provider Network All |
$2,585.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,205.71
|
| Rate for Payer: Zelis Auto |
$1,378.80
|
| Rate for Payer: Zelis Worker's Compensation |
$941.03
|
|
|
THORABD DIAPHR HERN REPAIR
|
Facility
|
OP
|
$3,447.00
|
|
|
Service Code
|
CPT 43337
|
| Hospital Charge Code |
6143337
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$861.75 |
| Max. Negotiated Rate |
$3,274.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,068.20
|
| Rate for Payer: Cash Price |
$2,068.20
|
| Rate for Payer: Cigna Commercial |
$2,929.95
|
| Rate for Payer: First Health Commercial |
$3,102.30
|
| Rate for Payer: First Health Workers Compensation |
$1,330.89
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,102.30
|
| Rate for Payer: GEHA Commercial |
$2,757.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,102.30
|
| Rate for Payer: Humana ChoiceCare |
$896.22
|
| Rate for Payer: Multiplan All |
$3,136.77
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,068.20
|
| Rate for Payer: OMNI Networks Commercial |
$2,412.90
|
| Rate for Payer: One Health Plan PPO/POS |
$3,102.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,274.65
|
| Rate for Payer: Three Rivers Provider Network All |
$2,585.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,033.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$861.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,205.71
|
| Rate for Payer: Zelis Auto |
$1,378.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,723.50
|
| Rate for Payer: Zelis Worker's Compensation |
$941.03
|
|
|
THORACENTESIS
|
Facility
|
IP
|
$1,408.00
|
|
| Hospital Charge Code |
2407211
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$384.38 |
| Max. Negotiated Rate |
$1,337.60 |
| Rate for Payer: Cash Price |
$844.80
|
| Rate for Payer: Cigna Commercial |
$1,196.80
|
| Rate for Payer: First Health Commercial |
$1,267.20
|
| Rate for Payer: First Health Workers Compensation |
$543.63
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,267.20
|
| Rate for Payer: GEHA Commercial |
$985.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,267.20
|
| Rate for Payer: Multiplan All |
$1,281.28
|
| Rate for Payer: OMNI Networks Commercial |
$985.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,267.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,337.60
|
| Rate for Payer: Three Rivers Provider Network All |
$1,056.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,309.44
|
| Rate for Payer: Zelis Auto |
$563.20
|
| Rate for Payer: Zelis Worker's Compensation |
$384.38
|
|
|
THORACENTESIS
|
Facility
|
OP
|
$1,408.00
|
|
| Hospital Charge Code |
2407211
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$352.00 |
| Max. Negotiated Rate |
$1,337.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$844.80
|
| Rate for Payer: Cash Price |
$844.80
|
| Rate for Payer: Cigna Commercial |
$1,196.80
|
| Rate for Payer: First Health Commercial |
$1,267.20
|
| Rate for Payer: First Health Workers Compensation |
$543.63
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,267.20
|
| Rate for Payer: GEHA Commercial |
$1,126.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,267.20
|
| Rate for Payer: Humana ChoiceCare |
$366.08
|
| Rate for Payer: Multiplan All |
$1,281.28
|
| Rate for Payer: New Mexico Health Connections Medicare |
$844.80
|
| Rate for Payer: OMNI Networks Commercial |
$985.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,267.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,337.60
|
| Rate for Payer: Three Rivers Provider Network All |
$1,056.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,239.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$352.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,309.44
|
| Rate for Payer: Zelis Auto |
$563.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$704.00
|
| Rate for Payer: Zelis Worker's Compensation |
$384.38
|
|
|
THORACENTESIS ASPIR
|
Facility
|
OP
|
$1,407.00
|
|
| Hospital Charge Code |
2407209
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$351.75 |
| Max. Negotiated Rate |
$1,336.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$844.20
|
| Rate for Payer: Cash Price |
$844.20
|
| Rate for Payer: Cigna Commercial |
$1,195.95
|
| Rate for Payer: First Health Commercial |
$1,266.30
|
| Rate for Payer: First Health Workers Compensation |
$543.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,266.30
|
| Rate for Payer: GEHA Commercial |
$1,125.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,266.30
|
| Rate for Payer: Humana ChoiceCare |
$365.82
|
| Rate for Payer: Multiplan All |
$1,280.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$844.20
|
| Rate for Payer: OMNI Networks Commercial |
$984.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,266.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,336.65
|
| Rate for Payer: Three Rivers Provider Network All |
$1,055.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,238.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$351.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,308.51
|
| Rate for Payer: Zelis Auto |
$562.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$703.50
|
| Rate for Payer: Zelis Worker's Compensation |
$384.11
|
|
|
THORACENTESIS ASPIR
|
Facility
|
IP
|
$1,407.00
|
|
| Hospital Charge Code |
2407209
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$384.11 |
| Max. Negotiated Rate |
$1,336.65 |
| Rate for Payer: Cash Price |
$844.20
|
| Rate for Payer: Cigna Commercial |
$1,195.95
|
| Rate for Payer: First Health Commercial |
$1,266.30
|
| Rate for Payer: First Health Workers Compensation |
$543.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,266.30
|
| Rate for Payer: GEHA Commercial |
$984.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,266.30
|
| Rate for Payer: Multiplan All |
$1,280.37
|
| Rate for Payer: OMNI Networks Commercial |
$984.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,266.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,336.65
|
| Rate for Payer: Three Rivers Provider Network All |
$1,055.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,308.51
|
| Rate for Payer: Zelis Auto |
$562.80
|
| Rate for Payer: Zelis Worker's Compensation |
$384.11
|
|
|
THORACENTESIS NEEDLE/CATH PLEURA W/IMAGI
|
Facility
|
OP
|
$631.00
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
8150099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$172.26 |
| Max. Negotiated Rate |
$1,174.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$584.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$378.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$584.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$463.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$587.06
|
| Rate for Payer: Cash Price |
$378.60
|
| Rate for Payer: Cash Price |
$378.60
|
| Rate for Payer: Cigna Commercial |
$536.35
|
| Rate for Payer: First Health Commercial |
$567.90
|
| Rate for Payer: First Health Workers Compensation |
$243.63
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$567.90
|
| Rate for Payer: GEHA Commercial |
$504.80
|
| Rate for Payer: GEHA Medicare |
$587.06
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$567.90
|
| Rate for Payer: Humana ChoiceCare |
$645.77
|
| Rate for Payer: Humana Medicare Advantage |
$587.06
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$986.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$472.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$587.06
|
| Rate for Payer: Multiplan All |
$574.21
|
| Rate for Payer: New Mexico Health Connections Medicare |
$998.00
|
| Rate for Payer: OMNI Networks Commercial |
$441.70
|
| Rate for Payer: One Health Plan PPO/POS |
$567.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$545.72
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$472.63
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$587.06
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$599.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,174.12
|
| Rate for Payer: Three Rivers Provider Network All |
$473.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$575.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$472.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$587.06
|
| Rate for Payer: United Payors & United Providers UP&UP |
$586.83
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$587.06
|
| Rate for Payer: Zelis Auto |
$252.40
|
| Rate for Payer: Zelis Medicare |
$499.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$704.47
|
| Rate for Payer: Zelis Worker's Compensation |
$172.26
|
|
|
THORACENTESIS NEEDLE/CATH PLEURA W/IMAGI
|
Facility
|
IP
|
$631.00
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
8150099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$172.26 |
| Max. Negotiated Rate |
$599.45 |
| Rate for Payer: Cash Price |
$378.60
|
| Rate for Payer: Cigna Commercial |
$536.35
|
| Rate for Payer: First Health Commercial |
$567.90
|
| Rate for Payer: First Health Workers Compensation |
$243.63
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$567.90
|
| Rate for Payer: GEHA Commercial |
$441.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$567.90
|
| Rate for Payer: Multiplan All |
$574.21
|
| Rate for Payer: OMNI Networks Commercial |
$441.70
|
| Rate for Payer: One Health Plan PPO/POS |
$567.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$599.45
|
| Rate for Payer: Three Rivers Provider Network All |
$473.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$586.83
|
| Rate for Payer: Zelis Auto |
$252.40
|
| Rate for Payer: Zelis Worker's Compensation |
$172.26
|
|
|
THORACENTESIS NEEDLE/CATH PLEURA W/IMAGI
|
Facility
|
IP
|
$2,544.00
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
1000033
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$694.51 |
| Max. Negotiated Rate |
$2,416.80 |
| Rate for Payer: Cash Price |
$1,526.40
|
| Rate for Payer: Cigna Commercial |
$2,162.40
|
| Rate for Payer: First Health Commercial |
$2,289.60
|
| Rate for Payer: First Health Workers Compensation |
$982.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,289.60
|
| Rate for Payer: GEHA Commercial |
$1,780.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,289.60
|
| Rate for Payer: Multiplan All |
$2,315.04
|
| Rate for Payer: OMNI Networks Commercial |
$1,780.80
|
| Rate for Payer: One Health Plan PPO/POS |
$2,289.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,416.80
|
| Rate for Payer: Three Rivers Provider Network All |
$1,908.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,365.92
|
| Rate for Payer: Zelis Auto |
$1,017.60
|
| Rate for Payer: Zelis Worker's Compensation |
$694.51
|
|
|
THORACENTESIS NEEDLE/CATH PLEURA W/IMAGI
|
Facility
|
IP
|
$351.00
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
6132555
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$95.82 |
| Max. Negotiated Rate |
$333.45 |
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Cigna Commercial |
$298.35
|
| Rate for Payer: First Health Commercial |
$315.90
|
| Rate for Payer: First Health Workers Compensation |
$135.52
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$315.90
|
| Rate for Payer: GEHA Commercial |
$245.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$315.90
|
| Rate for Payer: Multiplan All |
$319.41
|
| Rate for Payer: OMNI Networks Commercial |
$245.70
|
| Rate for Payer: One Health Plan PPO/POS |
$315.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$333.45
|
| Rate for Payer: Three Rivers Provider Network All |
$263.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$326.43
|
| Rate for Payer: Zelis Auto |
$140.40
|
| Rate for Payer: Zelis Worker's Compensation |
$95.82
|
|
|
THORACENTESIS NEEDLE/CATH PLEURA W/IMAGI
|
Facility
|
OP
|
$351.00
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
6132555
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$95.82 |
| Max. Negotiated Rate |
$1,174.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$584.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$210.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$584.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$463.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$587.06
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Cigna Commercial |
$298.35
|
| Rate for Payer: First Health Commercial |
$315.90
|
| Rate for Payer: First Health Workers Compensation |
$135.52
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$315.90
|
| Rate for Payer: GEHA Commercial |
$280.80
|
| Rate for Payer: GEHA Medicare |
$587.06
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$315.90
|
| Rate for Payer: Humana ChoiceCare |
$645.77
|
| Rate for Payer: Humana Medicare Advantage |
$587.06
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$986.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$472.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$587.06
|
| Rate for Payer: Multiplan All |
$319.41
|
| Rate for Payer: New Mexico Health Connections Medicare |
$998.00
|
| Rate for Payer: OMNI Networks Commercial |
$245.70
|
| Rate for Payer: One Health Plan PPO/POS |
$315.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$545.72
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$472.63
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$587.06
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$333.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,174.12
|
| Rate for Payer: Three Rivers Provider Network All |
$263.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$575.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$472.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$587.06
|
| Rate for Payer: United Payors & United Providers UP&UP |
$326.43
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$587.06
|
| Rate for Payer: Zelis Auto |
$140.40
|
| Rate for Payer: Zelis Medicare |
$499.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$704.47
|
| Rate for Payer: Zelis Worker's Compensation |
$95.82
|
|
|
THORACENTESIS NEEDLE/CATH PLEURA W/O IMA
|
Facility
|
OP
|
$2,230.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
21632554
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$463.20 |
| Max. Negotiated Rate |
$2,118.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$584.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,338.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$584.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$463.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$587.06
|
| Rate for Payer: Cash Price |
$1,338.00
|
| Rate for Payer: Cash Price |
$1,338.00
|
| Rate for Payer: Cigna Commercial |
$1,895.50
|
| Rate for Payer: First Health Commercial |
$2,007.00
|
| Rate for Payer: First Health Workers Compensation |
$861.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,007.00
|
| Rate for Payer: GEHA Commercial |
$1,784.00
|
| Rate for Payer: GEHA Medicare |
$587.06
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,007.00
|
| Rate for Payer: Humana ChoiceCare |
$645.77
|
| Rate for Payer: Humana Medicare Advantage |
$587.06
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$986.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$472.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$587.06
|
| Rate for Payer: Multiplan All |
$2,029.30
|
| Rate for Payer: New Mexico Health Connections Medicare |
$998.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,561.00
|
| Rate for Payer: One Health Plan PPO/POS |
$2,007.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$545.72
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$472.63
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$587.06
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,118.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,174.12
|
| Rate for Payer: Three Rivers Provider Network All |
$1,672.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$575.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$472.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$587.06
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,073.90
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$587.06
|
| Rate for Payer: Zelis Auto |
$892.00
|
| Rate for Payer: Zelis Medicare |
$499.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$704.47
|
| Rate for Payer: Zelis Worker's Compensation |
$608.79
|
|
|
THORACENTESIS NEEDLE/CATH PLEURA W/O IMA
|
Facility
|
OP
|
$593.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
6132554
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$161.89 |
| Max. Negotiated Rate |
$1,174.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$584.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$355.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$584.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$463.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$587.06
|
| Rate for Payer: Cash Price |
$355.80
|
| Rate for Payer: Cash Price |
$355.80
|
| Rate for Payer: Cigna Commercial |
$504.05
|
| Rate for Payer: First Health Commercial |
$533.70
|
| Rate for Payer: First Health Workers Compensation |
$228.96
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$533.70
|
| Rate for Payer: GEHA Commercial |
$474.40
|
| Rate for Payer: GEHA Medicare |
$587.06
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$533.70
|
| Rate for Payer: Humana ChoiceCare |
$645.77
|
| Rate for Payer: Humana Medicare Advantage |
$587.06
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$986.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$472.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$587.06
|
| Rate for Payer: Multiplan All |
$539.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$998.00
|
| Rate for Payer: OMNI Networks Commercial |
$415.10
|
| Rate for Payer: One Health Plan PPO/POS |
$533.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$545.72
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$472.63
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$587.06
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$563.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,174.12
|
| Rate for Payer: Three Rivers Provider Network All |
$444.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$575.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$472.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$587.06
|
| Rate for Payer: United Payors & United Providers UP&UP |
$551.49
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$587.06
|
| Rate for Payer: Zelis Auto |
$237.20
|
| Rate for Payer: Zelis Medicare |
$499.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$704.47
|
| Rate for Payer: Zelis Worker's Compensation |
$161.89
|
|
|
THORACENTESIS NEEDLE/CATH PLEURA W/O IMA
|
Facility
|
IP
|
$593.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
6132554
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$161.89 |
| Max. Negotiated Rate |
$563.35 |
| Rate for Payer: Cash Price |
$355.80
|
| Rate for Payer: Cigna Commercial |
$504.05
|
| Rate for Payer: First Health Commercial |
$533.70
|
| Rate for Payer: First Health Workers Compensation |
$228.96
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$533.70
|
| Rate for Payer: GEHA Commercial |
$415.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$533.70
|
| Rate for Payer: Multiplan All |
$539.63
|
| Rate for Payer: OMNI Networks Commercial |
$415.10
|
| Rate for Payer: One Health Plan PPO/POS |
$533.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$563.35
|
| Rate for Payer: Three Rivers Provider Network All |
$444.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$551.49
|
| Rate for Payer: Zelis Auto |
$237.20
|
| Rate for Payer: Zelis Worker's Compensation |
$161.89
|
|
|
THORACENTESIS NEEDLE/CATH PLEURA W/O IMA
|
Facility
|
OP
|
$626.97
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
7232554
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$171.16 |
| Max. Negotiated Rate |
$1,174.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$584.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$376.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$584.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$463.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$587.06
|
| Rate for Payer: Cash Price |
$376.18
|
| Rate for Payer: Cash Price |
$376.18
|
| Rate for Payer: Cigna Commercial |
$532.92
|
| Rate for Payer: First Health Commercial |
$564.27
|
| Rate for Payer: First Health Workers Compensation |
$242.07
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$564.27
|
| Rate for Payer: GEHA Commercial |
$501.58
|
| Rate for Payer: GEHA Medicare |
$587.06
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$564.27
|
| Rate for Payer: Humana ChoiceCare |
$645.77
|
| Rate for Payer: Humana Medicare Advantage |
$587.06
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$986.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$472.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$587.06
|
| Rate for Payer: Multiplan All |
$570.54
|
| Rate for Payer: New Mexico Health Connections Medicare |
$998.00
|
| Rate for Payer: OMNI Networks Commercial |
$438.88
|
| Rate for Payer: One Health Plan PPO/POS |
$564.27
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$545.72
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$472.63
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$587.06
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$595.62
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,174.12
|
| Rate for Payer: Three Rivers Provider Network All |
$470.23
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$575.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$472.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$587.06
|
| Rate for Payer: United Payors & United Providers UP&UP |
$583.08
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$587.06
|
| Rate for Payer: Zelis Auto |
$250.79
|
| Rate for Payer: Zelis Medicare |
$499.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$704.47
|
| Rate for Payer: Zelis Worker's Compensation |
$171.16
|
|
|
THORACENTESIS NEEDLE/CATH PLEURA W/O IMA
|
Facility
|
IP
|
$626.97
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
7232554
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$171.16 |
| Max. Negotiated Rate |
$595.62 |
| Rate for Payer: Cash Price |
$376.18
|
| Rate for Payer: Cigna Commercial |
$532.92
|
| Rate for Payer: First Health Commercial |
$564.27
|
| Rate for Payer: First Health Workers Compensation |
$242.07
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$564.27
|
| Rate for Payer: GEHA Commercial |
$438.88
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$564.27
|
| Rate for Payer: Multiplan All |
$570.54
|
| Rate for Payer: OMNI Networks Commercial |
$438.88
|
| Rate for Payer: One Health Plan PPO/POS |
$564.27
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$595.62
|
| Rate for Payer: Three Rivers Provider Network All |
$470.23
|
| Rate for Payer: United Payors & United Providers UP&UP |
$583.08
|
| Rate for Payer: Zelis Auto |
$250.79
|
| Rate for Payer: Zelis Worker's Compensation |
$171.16
|
|
|
THORACENTESIS NEEDLE/CATH PLEURA W/O IMA
|
Facility
|
OP
|
$626.97
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
8532000
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$171.16 |
| Max. Negotiated Rate |
$1,174.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$584.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$376.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$584.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$463.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$587.06
|
| Rate for Payer: Cash Price |
$376.18
|
| Rate for Payer: Cash Price |
$376.18
|
| Rate for Payer: Cigna Commercial |
$532.92
|
| Rate for Payer: First Health Commercial |
$564.27
|
| Rate for Payer: First Health Workers Compensation |
$242.07
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$564.27
|
| Rate for Payer: GEHA Commercial |
$501.58
|
| Rate for Payer: GEHA Medicare |
$587.06
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$564.27
|
| Rate for Payer: Humana ChoiceCare |
$645.77
|
| Rate for Payer: Humana Medicare Advantage |
$587.06
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$986.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$472.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$587.06
|
| Rate for Payer: Multiplan All |
$570.54
|
| Rate for Payer: New Mexico Health Connections Medicare |
$998.00
|
| Rate for Payer: OMNI Networks Commercial |
$438.88
|
| Rate for Payer: One Health Plan PPO/POS |
$564.27
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$545.72
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$472.63
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$587.06
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$595.62
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,174.12
|
| Rate for Payer: Three Rivers Provider Network All |
$470.23
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$575.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$472.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$587.06
|
| Rate for Payer: United Payors & United Providers UP&UP |
$583.08
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$587.06
|
| Rate for Payer: Zelis Auto |
$250.79
|
| Rate for Payer: Zelis Medicare |
$499.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$704.47
|
| Rate for Payer: Zelis Worker's Compensation |
$171.16
|
|
|
THORACENTESIS NEEDLE/CATH PLEURA W/O IMA
|
Facility
|
IP
|
$626.97
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
8532000
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$171.16 |
| Max. Negotiated Rate |
$595.62 |
| Rate for Payer: Cash Price |
$376.18
|
| Rate for Payer: Cigna Commercial |
$532.92
|
| Rate for Payer: First Health Commercial |
$564.27
|
| Rate for Payer: First Health Workers Compensation |
$242.07
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$564.27
|
| Rate for Payer: GEHA Commercial |
$438.88
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$564.27
|
| Rate for Payer: Multiplan All |
$570.54
|
| Rate for Payer: OMNI Networks Commercial |
$438.88
|
| Rate for Payer: One Health Plan PPO/POS |
$564.27
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$595.62
|
| Rate for Payer: Three Rivers Provider Network All |
$470.23
|
| Rate for Payer: United Payors & United Providers UP&UP |
$583.08
|
| Rate for Payer: Zelis Auto |
$250.79
|
| Rate for Payer: Zelis Worker's Compensation |
$171.16
|
|
|
THORACENTESIS NEEDLE/CATH PLEURA W/O IMA
|
Facility
|
IP
|
$2,051.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
8132554
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$559.92 |
| Max. Negotiated Rate |
$1,948.45 |
| Rate for Payer: Cash Price |
$1,230.60
|
| Rate for Payer: Cigna Commercial |
$1,743.35
|
| Rate for Payer: First Health Commercial |
$1,845.90
|
| Rate for Payer: First Health Workers Compensation |
$791.89
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,845.90
|
| Rate for Payer: GEHA Commercial |
$1,435.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,845.90
|
| Rate for Payer: Multiplan All |
$1,866.41
|
| Rate for Payer: OMNI Networks Commercial |
$1,435.70
|
| Rate for Payer: One Health Plan PPO/POS |
$1,845.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,948.45
|
| Rate for Payer: Three Rivers Provider Network All |
$1,538.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,907.43
|
| Rate for Payer: Zelis Auto |
$820.40
|
| Rate for Payer: Zelis Worker's Compensation |
$559.92
|
|
|
THORACENTESIS NEEDLE/CATH PLEURA W/O IMA
|
Facility
|
OP
|
$2,051.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
8132554
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$463.20 |
| Max. Negotiated Rate |
$1,948.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$584.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,230.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$584.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$463.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$587.06
|
| Rate for Payer: Cash Price |
$1,230.60
|
| Rate for Payer: Cash Price |
$1,230.60
|
| Rate for Payer: Cigna Commercial |
$1,743.35
|
| Rate for Payer: First Health Commercial |
$1,845.90
|
| Rate for Payer: First Health Workers Compensation |
$791.89
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,845.90
|
| Rate for Payer: GEHA Commercial |
$1,640.80
|
| Rate for Payer: GEHA Medicare |
$587.06
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,845.90
|
| Rate for Payer: Humana ChoiceCare |
$645.77
|
| Rate for Payer: Humana Medicare Advantage |
$587.06
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$986.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$472.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$587.06
|
| Rate for Payer: Multiplan All |
$1,866.41
|
| Rate for Payer: New Mexico Health Connections Medicare |
$998.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,435.70
|
| Rate for Payer: One Health Plan PPO/POS |
$1,845.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$545.72
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$472.63
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$587.06
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,948.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,174.12
|
| Rate for Payer: Three Rivers Provider Network All |
$1,538.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$575.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$472.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$587.06
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,907.43
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$587.06
|
| Rate for Payer: Zelis Auto |
$820.40
|
| Rate for Payer: Zelis Medicare |
$499.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$704.47
|
| Rate for Payer: Zelis Worker's Compensation |
$559.92
|
|
|
THORACENTESIS NEEDLE/CATH PLEURA W/O IMA
|
Facility
|
IP
|
$2,230.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
21632554
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$608.79 |
| Max. Negotiated Rate |
$2,118.50 |
| Rate for Payer: Cash Price |
$1,338.00
|
| Rate for Payer: Cigna Commercial |
$1,895.50
|
| Rate for Payer: First Health Commercial |
$2,007.00
|
| Rate for Payer: First Health Workers Compensation |
$861.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,007.00
|
| Rate for Payer: GEHA Commercial |
$1,561.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,007.00
|
| Rate for Payer: Multiplan All |
$2,029.30
|
| Rate for Payer: OMNI Networks Commercial |
$1,561.00
|
| Rate for Payer: One Health Plan PPO/POS |
$2,007.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,118.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,672.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,073.90
|
| Rate for Payer: Zelis Auto |
$892.00
|
| Rate for Payer: Zelis Worker's Compensation |
$608.79
|
|
|
THORACENTESIS NEEDLE/CATH PLEURA W/O IMA
|
Facility
|
IP
|
$2,471.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
1000032
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$674.58 |
| Max. Negotiated Rate |
$2,347.45 |
| Rate for Payer: Cash Price |
$1,482.60
|
| Rate for Payer: Cigna Commercial |
$2,100.35
|
| Rate for Payer: First Health Commercial |
$2,223.90
|
| Rate for Payer: First Health Workers Compensation |
$954.05
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,223.90
|
| Rate for Payer: GEHA Commercial |
$1,729.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,223.90
|
| Rate for Payer: Multiplan All |
$2,248.61
|
| Rate for Payer: OMNI Networks Commercial |
$1,729.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,223.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,347.45
|
| Rate for Payer: Three Rivers Provider Network All |
$1,853.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,298.03
|
| Rate for Payer: Zelis Auto |
$988.40
|
| Rate for Payer: Zelis Worker's Compensation |
$674.58
|
|
|
THORACIC STRAPPING
|
Facility
|
IP
|
$371.00
|
|
| Hospital Charge Code |
8129200
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$101.28 |
| Max. Negotiated Rate |
$352.45 |
| Rate for Payer: Cash Price |
$222.60
|
| Rate for Payer: Cigna Commercial |
$315.35
|
| Rate for Payer: First Health Commercial |
$333.90
|
| Rate for Payer: First Health Workers Compensation |
$143.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$333.90
|
| Rate for Payer: GEHA Commercial |
$259.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$333.90
|
| Rate for Payer: Multiplan All |
$337.61
|
| Rate for Payer: OMNI Networks Commercial |
$259.70
|
| Rate for Payer: One Health Plan PPO/POS |
$333.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$352.45
|
| Rate for Payer: Three Rivers Provider Network All |
$278.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$345.03
|
| Rate for Payer: Zelis Auto |
$148.40
|
| Rate for Payer: Zelis Worker's Compensation |
$101.28
|
|
