|
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
|
|
|
THORACNTSIS NEEDLE/CATH PLEURA W/O IMAGE
|
Facility
|
IP
|
$1,205.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
20332554
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$328.96 |
| Max. Negotiated Rate |
$1,144.75 |
| Rate for Payer: Cash Price |
$723.00
|
| Rate for Payer: Cigna Commercial |
$1,024.25
|
| Rate for Payer: First Health Commercial |
$1,084.50
|
| Rate for Payer: First Health Workers Compensation |
$465.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,084.50
|
| Rate for Payer: GEHA Commercial |
$843.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,084.50
|
| Rate for Payer: Multiplan All |
$1,096.55
|
| Rate for Payer: OMNI Networks Commercial |
$843.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,084.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,144.75
|
| Rate for Payer: Three Rivers Provider Network All |
$903.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,120.65
|
| Rate for Payer: Zelis Auto |
$482.00
|
| Rate for Payer: Zelis Worker's Compensation |
$328.96
|
|
|
THORACNTSIS NEEDLE/CATH PLEURA W/O IMAGE
|
Facility
|
OP
|
$1,205.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
20332554
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$328.96 |
| 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 |
$723.00
|
| 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 |
$723.00
|
| Rate for Payer: Cash Price |
$723.00
|
| Rate for Payer: Cigna Commercial |
$1,024.25
|
| Rate for Payer: First Health Commercial |
$1,084.50
|
| Rate for Payer: First Health Workers Compensation |
$465.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,084.50
|
| Rate for Payer: GEHA Commercial |
$964.00
|
| Rate for Payer: GEHA Medicare |
$587.06
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,084.50
|
| 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 |
$1,096.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$998.00
|
| Rate for Payer: OMNI Networks Commercial |
$843.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,084.50
|
| 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 |
$1,144.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,174.12
|
| Rate for Payer: Three Rivers Provider Network All |
$903.75
|
| 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 |
$1,120.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$587.06
|
| Rate for Payer: Zelis Auto |
$482.00
|
| Rate for Payer: Zelis Medicare |
$499.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$704.47
|
| Rate for Payer: Zelis Worker's Compensation |
$328.96
|
|
|
THORACOSCOPY BILOBECTOMY
|
Facility
|
IP
|
$3,393.00
|
|
|
Service Code
|
CPT 32670
|
| Hospital Charge Code |
6132670
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$926.29 |
| Max. Negotiated Rate |
$3,223.35 |
| Rate for Payer: Cash Price |
$2,035.80
|
| Rate for Payer: Cigna Commercial |
$2,884.05
|
| Rate for Payer: First Health Commercial |
$3,053.70
|
| Rate for Payer: First Health Workers Compensation |
$1,310.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,053.70
|
| Rate for Payer: GEHA Commercial |
$2,375.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,053.70
|
| Rate for Payer: Multiplan All |
$3,087.63
|
| Rate for Payer: OMNI Networks Commercial |
$2,375.10
|
| Rate for Payer: One Health Plan PPO/POS |
$3,053.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,223.35
|
| Rate for Payer: Three Rivers Provider Network All |
$2,544.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,155.49
|
| Rate for Payer: Zelis Auto |
$1,357.20
|
| Rate for Payer: Zelis Worker's Compensation |
$926.29
|
|
|
THORACOSCOPY BILOBECTOMY
|
Facility
|
OP
|
$3,393.00
|
|
|
Service Code
|
CPT 32670
|
| Hospital Charge Code |
6132670
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$848.25 |
| Max. Negotiated Rate |
$3,223.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,035.80
|
| Rate for Payer: Cash Price |
$2,035.80
|
| Rate for Payer: Cigna Commercial |
$2,884.05
|
| Rate for Payer: First Health Commercial |
$3,053.70
|
| Rate for Payer: First Health Workers Compensation |
$1,310.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,053.70
|
| Rate for Payer: GEHA Commercial |
$2,714.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,053.70
|
| Rate for Payer: Humana ChoiceCare |
$882.18
|
| Rate for Payer: Multiplan All |
$3,087.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,035.80
|
| Rate for Payer: OMNI Networks Commercial |
$2,375.10
|
| Rate for Payer: One Health Plan PPO/POS |
$3,053.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,223.35
|
| Rate for Payer: Three Rivers Provider Network All |
$2,544.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,985.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$848.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,155.49
|
| Rate for Payer: Zelis Auto |
$1,357.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,696.50
|
| Rate for Payer: Zelis Worker's Compensation |
$926.29
|
|
|
THORACOSCOPY DIAGNOSTIC
|
Facility
|
OP
|
$817.00
|
|
|
Service Code
|
CPT 32601
|
| Hospital Charge Code |
6132601
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$223.04 |
| Max. Negotiated Rate |
$11,079.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,438.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$490.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,438.55
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,724.02
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,539.96
|
| Rate for Payer: Cash Price |
$490.20
|
| Rate for Payer: Cash Price |
$490.20
|
| Rate for Payer: Cigna Commercial |
$694.45
|
| Rate for Payer: First Health Commercial |
$735.30
|
| Rate for Payer: First Health Workers Compensation |
$315.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$735.30
|
| Rate for Payer: GEHA Commercial |
$653.60
|
| Rate for Payer: GEHA Medicare |
$5,539.96
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$735.30
|
| Rate for Payer: Humana ChoiceCare |
$6,093.96
|
| Rate for Payer: Humana Medicare Advantage |
$5,539.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$9,307.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,779.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,539.96
|
| Rate for Payer: Multiplan All |
$743.47
|
| Rate for Payer: New Mexico Health Connections Medicare |
$9,417.93
|
| Rate for Payer: OMNI Networks Commercial |
$571.90
|
| Rate for Payer: One Health Plan PPO/POS |
$735.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$3,209.32
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,779.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,539.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$776.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,079.92
|
| Rate for Payer: Three Rivers Provider Network All |
$612.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,429.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,779.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,539.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$759.81
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,539.96
|
| Rate for Payer: Zelis Auto |
$326.80
|
| Rate for Payer: Zelis Medicare |
$4,708.97
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,647.95
|
| Rate for Payer: Zelis Worker's Compensation |
$223.04
|
|
|
THORACOSCOPY DIAGNOSTIC
|
Facility
|
IP
|
$817.00
|
|
|
Service Code
|
CPT 32601
|
| Hospital Charge Code |
6132601
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$223.04 |
| Max. Negotiated Rate |
$776.15 |
| Rate for Payer: Cash Price |
$490.20
|
| Rate for Payer: Cigna Commercial |
$694.45
|
| Rate for Payer: First Health Commercial |
$735.30
|
| Rate for Payer: First Health Workers Compensation |
$315.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$735.30
|
| Rate for Payer: GEHA Commercial |
$571.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$735.30
|
| Rate for Payer: Multiplan All |
$743.47
|
| Rate for Payer: OMNI Networks Commercial |
$571.90
|
| Rate for Payer: One Health Plan PPO/POS |
$735.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$776.15
|
| Rate for Payer: Three Rivers Provider Network All |
$612.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$759.81
|
| Rate for Payer: Zelis Auto |
$326.80
|
| Rate for Payer: Zelis Worker's Compensation |
$223.04
|
|
|
THORACOSCOPY FOR LVRS
|
Facility
|
IP
|
$3,228.00
|
|
|
Service Code
|
CPT 32672
|
| Hospital Charge Code |
6132672
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$881.24 |
| Max. Negotiated Rate |
$3,066.60 |
| Rate for Payer: Cash Price |
$1,936.80
|
| Rate for Payer: Cigna Commercial |
$2,743.80
|
| Rate for Payer: First Health Commercial |
$2,905.20
|
| Rate for Payer: First Health Workers Compensation |
$1,246.33
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,905.20
|
| Rate for Payer: GEHA Commercial |
$2,259.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,905.20
|
| Rate for Payer: Multiplan All |
$2,937.48
|
| Rate for Payer: OMNI Networks Commercial |
$2,259.60
|
| Rate for Payer: One Health Plan PPO/POS |
$2,905.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,066.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,421.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,002.04
|
| Rate for Payer: Zelis Auto |
$1,291.20
|
| Rate for Payer: Zelis Worker's Compensation |
$881.24
|
|
|
THORACOSCOPY FOR LVRS
|
Facility
|
OP
|
$3,228.00
|
|
|
Service Code
|
CPT 32672
|
| Hospital Charge Code |
6132672
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$807.00 |
| Max. Negotiated Rate |
$3,066.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,936.80
|
| Rate for Payer: Cash Price |
$1,936.80
|
| Rate for Payer: Cigna Commercial |
$2,743.80
|
| Rate for Payer: First Health Commercial |
$2,905.20
|
| Rate for Payer: First Health Workers Compensation |
$1,246.33
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,905.20
|
| Rate for Payer: GEHA Commercial |
$2,582.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,905.20
|
| Rate for Payer: Humana ChoiceCare |
$839.28
|
| Rate for Payer: Multiplan All |
$2,937.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,936.80
|
| Rate for Payer: OMNI Networks Commercial |
$2,259.60
|
| Rate for Payer: One Health Plan PPO/POS |
$2,905.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,066.60
|
| Rate for Payer: Three Rivers Provider Network All |
$2,421.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,840.64
|
| Rate for Payer: United Healthcare Managed Medicaid |
$807.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,002.04
|
| Rate for Payer: Zelis Auto |
$1,291.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,614.00
|
| Rate for Payer: Zelis Worker's Compensation |
$881.24
|
|
|
THORACOSCOPY LYMPH NODE EXC
|
Facility
|
IP
|
$578.00
|
|
|
Service Code
|
CPT 32674
|
| Hospital Charge Code |
6132674
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$157.79 |
| Max. Negotiated Rate |
$549.10 |
| Rate for Payer: Cash Price |
$346.80
|
| Rate for Payer: Cigna Commercial |
$491.30
|
| Rate for Payer: First Health Commercial |
$520.20
|
| Rate for Payer: First Health Workers Compensation |
$223.17
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$520.20
|
| Rate for Payer: GEHA Commercial |
$404.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$520.20
|
| Rate for Payer: Multiplan All |
$525.98
|
| Rate for Payer: OMNI Networks Commercial |
$404.60
|
| Rate for Payer: One Health Plan PPO/POS |
$520.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$549.10
|
| Rate for Payer: Three Rivers Provider Network All |
$433.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$537.54
|
| Rate for Payer: Zelis Auto |
$231.20
|
| Rate for Payer: Zelis Worker's Compensation |
$157.79
|
|
|
THORACOSCOPY LYMPH NODE EXC
|
Facility
|
OP
|
$578.00
|
|
|
Service Code
|
CPT 32674
|
| Hospital Charge Code |
6132674
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$144.50 |
| Max. Negotiated Rate |
$549.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$346.80
|
| Rate for Payer: Cash Price |
$346.80
|
| Rate for Payer: Cigna Commercial |
$491.30
|
| Rate for Payer: First Health Commercial |
$520.20
|
| Rate for Payer: First Health Workers Compensation |
$223.17
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$520.20
|
| Rate for Payer: GEHA Commercial |
$462.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$520.20
|
| Rate for Payer: Humana ChoiceCare |
$150.28
|
| Rate for Payer: Multiplan All |
$525.98
|
| Rate for Payer: New Mexico Health Connections Medicare |
$346.80
|
| Rate for Payer: OMNI Networks Commercial |
$404.60
|
| Rate for Payer: One Health Plan PPO/POS |
$520.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$549.10
|
| Rate for Payer: Three Rivers Provider Network All |
$433.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$508.64
|
| Rate for Payer: United Healthcare Managed Medicaid |
$144.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$537.54
|
| Rate for Payer: Zelis Auto |
$231.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$289.00
|
| Rate for Payer: Zelis Worker's Compensation |
$157.79
|
|
|
THORACOSCOPY PNEUMONECTOMY
|
Facility
|
IP
|
$3,758.00
|
|
|
Service Code
|
CPT 32671
|
| Hospital Charge Code |
6132671
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,025.93 |
| Max. Negotiated Rate |
$3,570.10 |
| Rate for Payer: Cash Price |
$2,254.80
|
| Rate for Payer: Cigna Commercial |
$3,194.30
|
| Rate for Payer: First Health Commercial |
$3,382.20
|
| Rate for Payer: First Health Workers Compensation |
$1,450.96
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,382.20
|
| Rate for Payer: GEHA Commercial |
$2,630.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,382.20
|
| Rate for Payer: Multiplan All |
$3,419.78
|
| Rate for Payer: OMNI Networks Commercial |
$2,630.60
|
| Rate for Payer: One Health Plan PPO/POS |
$3,382.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,570.10
|
| Rate for Payer: Three Rivers Provider Network All |
$2,818.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,494.94
|
| Rate for Payer: Zelis Auto |
$1,503.20
|
| Rate for Payer: Zelis Worker's Compensation |
$1,025.93
|
|
|
THORACOSCOPY PNEUMONECTOMY
|
Facility
|
OP
|
$3,758.00
|
|
|
Service Code
|
CPT 32671
|
| Hospital Charge Code |
6132671
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$939.50 |
| Max. Negotiated Rate |
$3,570.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,254.80
|
| Rate for Payer: Cash Price |
$2,254.80
|
| Rate for Payer: Cigna Commercial |
$3,194.30
|
| Rate for Payer: First Health Commercial |
$3,382.20
|
| Rate for Payer: First Health Workers Compensation |
$1,450.96
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,382.20
|
| Rate for Payer: GEHA Commercial |
$3,006.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,382.20
|
| Rate for Payer: Humana ChoiceCare |
$977.08
|
| Rate for Payer: Multiplan All |
$3,419.78
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,254.80
|
| Rate for Payer: OMNI Networks Commercial |
$2,630.60
|
| Rate for Payer: One Health Plan PPO/POS |
$3,382.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,570.10
|
| Rate for Payer: Three Rivers Provider Network All |
$2,818.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,307.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$939.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,494.94
|
| Rate for Payer: Zelis Auto |
$1,503.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,879.00
|
| Rate for Payer: Zelis Worker's Compensation |
$1,025.93
|
|
|
THORACOSCOPY REMOVE SEGMENT
|
Facility
|
OP
|
$2,851.00
|
|
|
Service Code
|
CPT 32669
|
| Hospital Charge Code |
6132669
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$712.75 |
| Max. Negotiated Rate |
$2,708.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,710.60
|
| Rate for Payer: Cash Price |
$1,710.60
|
| Rate for Payer: Cigna Commercial |
$2,423.35
|
| Rate for Payer: First Health Commercial |
$2,565.90
|
| Rate for Payer: First Health Workers Compensation |
$1,100.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,565.90
|
| Rate for Payer: GEHA Commercial |
$2,280.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,565.90
|
| Rate for Payer: Humana ChoiceCare |
$741.26
|
| Rate for Payer: Multiplan All |
$2,594.41
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,710.60
|
| Rate for Payer: OMNI Networks Commercial |
$1,995.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,565.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,708.45
|
| Rate for Payer: Three Rivers Provider Network All |
$2,138.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,508.88
|
| Rate for Payer: United Healthcare Managed Medicaid |
$712.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,651.43
|
| Rate for Payer: Zelis Auto |
$1,140.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,425.50
|
| Rate for Payer: Zelis Worker's Compensation |
$778.32
|
|
|
THORACOSCOPY REMOVE SEGMENT
|
Facility
|
IP
|
$2,851.00
|
|
|
Service Code
|
CPT 32669
|
| Hospital Charge Code |
6132669
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$778.32 |
| Max. Negotiated Rate |
$2,708.45 |
| Rate for Payer: Cash Price |
$1,710.60
|
| Rate for Payer: Cigna Commercial |
$2,423.35
|
| Rate for Payer: First Health Commercial |
$2,565.90
|
| Rate for Payer: First Health Workers Compensation |
$1,100.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,565.90
|
| Rate for Payer: GEHA Commercial |
$1,995.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,565.90
|
| Rate for Payer: Multiplan All |
$2,594.41
|
| Rate for Payer: OMNI Networks Commercial |
$1,995.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,565.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,708.45
|
| Rate for Payer: Three Rivers Provider Network All |
$2,138.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,651.43
|
| Rate for Payer: Zelis Auto |
$1,140.40
|
| Rate for Payer: Zelis Worker's Compensation |
$778.32
|
|
|
THORACOSCOPY RESECT BULLAE
|
Facility
|
OP
|
$2,017.00
|
|
|
Service Code
|
CPT 32655
|
| Hospital Charge Code |
6132655
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$504.25 |
| Max. Negotiated Rate |
$1,916.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,210.20
|
| Rate for Payer: Cash Price |
$1,210.20
|
| Rate for Payer: Cigna Commercial |
$1,714.45
|
| Rate for Payer: First Health Commercial |
$1,815.30
|
| Rate for Payer: First Health Workers Compensation |
$778.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,815.30
|
| Rate for Payer: GEHA Commercial |
$1,613.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,815.30
|
| Rate for Payer: Humana ChoiceCare |
$524.42
|
| Rate for Payer: Multiplan All |
$1,835.47
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,210.20
|
| Rate for Payer: OMNI Networks Commercial |
$1,411.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,815.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,916.15
|
| Rate for Payer: Three Rivers Provider Network All |
$1,512.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,774.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$504.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,875.81
|
| Rate for Payer: Zelis Auto |
$806.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,008.50
|
| Rate for Payer: Zelis Worker's Compensation |
$550.64
|
|
|
THORACOSCOPY RESECT BULLAE
|
Facility
|
IP
|
$2,017.00
|
|
|
Service Code
|
CPT 32655
|
| Hospital Charge Code |
6132655
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$550.64 |
| Max. Negotiated Rate |
$1,916.15 |
| Rate for Payer: Cash Price |
$1,210.20
|
| Rate for Payer: Cigna Commercial |
$1,714.45
|
| Rate for Payer: First Health Commercial |
$1,815.30
|
| Rate for Payer: First Health Workers Compensation |
$778.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,815.30
|
| Rate for Payer: GEHA Commercial |
$1,411.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,815.30
|
| Rate for Payer: Multiplan All |
$1,835.47
|
| Rate for Payer: OMNI Networks Commercial |
$1,411.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,815.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,916.15
|
| Rate for Payer: Three Rivers Provider Network All |
$1,512.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,875.81
|
| Rate for Payer: Zelis Auto |
$806.80
|
| Rate for Payer: Zelis Worker's Compensation |
$550.64
|
|
|
THORACOSCOPY W/BX INFILTRATE
|
Facility
|
OP
|
$818.00
|
|
|
Service Code
|
CPT 32607
|
| Hospital Charge Code |
6132607
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$223.31 |
| Max. Negotiated Rate |
$19,771.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,482.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$490.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,482.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,759.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,885.87
|
| Rate for Payer: Cash Price |
$490.80
|
| Rate for Payer: Cash Price |
$490.80
|
| Rate for Payer: Cigna Commercial |
$695.30
|
| Rate for Payer: First Health Commercial |
$736.20
|
| Rate for Payer: First Health Workers Compensation |
$315.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$736.20
|
| Rate for Payer: GEHA Commercial |
$654.40
|
| Rate for Payer: GEHA Medicare |
$9,885.87
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$736.20
|
| Rate for Payer: Humana ChoiceCare |
$10,874.46
|
| Rate for Payer: Humana Medicare Advantage |
$9,885.87
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,608.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,815.24
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,885.87
|
| Rate for Payer: Multiplan All |
$744.38
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,805.98
|
| Rate for Payer: OMNI Networks Commercial |
$572.60
|
| Rate for Payer: One Health Plan PPO/POS |
$736.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$3,250.59
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,815.24
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,885.87
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$777.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,771.74
|
| Rate for Payer: Three Rivers Provider Network All |
$613.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,688.15
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,815.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,885.87
|
| Rate for Payer: United Payors & United Providers UP&UP |
$760.74
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$9,885.87
|
| Rate for Payer: Zelis Auto |
$327.20
|
| Rate for Payer: Zelis Medicare |
$8,402.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,863.04
|
| Rate for Payer: Zelis Worker's Compensation |
$223.31
|
|
|
THORACOSCOPY W/BX INFILTRATE
|
Facility
|
IP
|
$818.00
|
|
|
Service Code
|
CPT 32607
|
| Hospital Charge Code |
6132607
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$223.31 |
| Max. Negotiated Rate |
$777.10 |
| Rate for Payer: Cash Price |
$490.80
|
| Rate for Payer: Cigna Commercial |
$695.30
|
| Rate for Payer: First Health Commercial |
$736.20
|
| Rate for Payer: First Health Workers Compensation |
$315.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$736.20
|
| Rate for Payer: GEHA Commercial |
$572.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$736.20
|
| Rate for Payer: Multiplan All |
$744.38
|
| Rate for Payer: OMNI Networks Commercial |
$572.60
|
| Rate for Payer: One Health Plan PPO/POS |
$736.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$777.10
|
| Rate for Payer: Three Rivers Provider Network All |
$613.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$760.74
|
| Rate for Payer: Zelis Auto |
$327.20
|
| Rate for Payer: Zelis Worker's Compensation |
$223.31
|
|
|
THORACOSCOPY W/BX NODULE
|
Facility
|
OP
|
$1,004.00
|
|
|
Service Code
|
CPT 32608
|
| Hospital Charge Code |
6132608
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$274.09 |
| Max. Negotiated Rate |
$19,771.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,482.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$602.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,482.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,759.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,885.87
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cigna Commercial |
$853.40
|
| Rate for Payer: First Health Commercial |
$903.60
|
| Rate for Payer: First Health Workers Compensation |
$387.64
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$903.60
|
| Rate for Payer: GEHA Commercial |
$803.20
|
| Rate for Payer: GEHA Medicare |
$9,885.87
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$903.60
|
| Rate for Payer: Humana ChoiceCare |
$10,874.46
|
| Rate for Payer: Humana Medicare Advantage |
$9,885.87
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,608.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,815.24
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,885.87
|
| Rate for Payer: Multiplan All |
$913.64
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,805.98
|
| Rate for Payer: OMNI Networks Commercial |
$702.80
|
| Rate for Payer: One Health Plan PPO/POS |
$903.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$3,250.59
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,815.24
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,885.87
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$953.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,771.74
|
| Rate for Payer: Three Rivers Provider Network All |
$753.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,688.15
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,815.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,885.87
|
| Rate for Payer: United Payors & United Providers UP&UP |
$933.72
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$9,885.87
|
| Rate for Payer: Zelis Auto |
$401.60
|
| Rate for Payer: Zelis Medicare |
$8,402.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,863.04
|
| Rate for Payer: Zelis Worker's Compensation |
$274.09
|
|
|
THORACOSCOPY W/BX NODULE
|
Facility
|
IP
|
$1,004.00
|
|
|
Service Code
|
CPT 32608
|
| Hospital Charge Code |
6132608
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$274.09 |
| Max. Negotiated Rate |
$953.80 |
| Rate for Payer: Cash Price |
$602.40
|
| Rate for Payer: Cigna Commercial |
$853.40
|
| Rate for Payer: First Health Commercial |
$903.60
|
| Rate for Payer: First Health Workers Compensation |
$387.64
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$903.60
|
| Rate for Payer: GEHA Commercial |
$702.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$903.60
|
| Rate for Payer: Multiplan All |
$913.64
|
| Rate for Payer: OMNI Networks Commercial |
$702.80
|
| Rate for Payer: One Health Plan PPO/POS |
$903.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$953.80
|
| Rate for Payer: Three Rivers Provider Network All |
$753.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$933.72
|
| Rate for Payer: Zelis Auto |
$401.60
|
| Rate for Payer: Zelis Worker's Compensation |
$274.09
|
|
|
THORACOSCOPY W/BX PLEURA
|
Facility
|
IP
|
$685.00
|
|
|
Service Code
|
CPT 32609
|
| Hospital Charge Code |
6132609
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$187.00 |
| Max. Negotiated Rate |
$650.75 |
| Rate for Payer: Cash Price |
$411.00
|
| Rate for Payer: Cigna Commercial |
$582.25
|
| Rate for Payer: First Health Commercial |
$616.50
|
| Rate for Payer: First Health Workers Compensation |
$264.48
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$616.50
|
| Rate for Payer: GEHA Commercial |
$479.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$616.50
|
| Rate for Payer: Multiplan All |
$623.35
|
| Rate for Payer: OMNI Networks Commercial |
$479.50
|
| Rate for Payer: One Health Plan PPO/POS |
$616.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$650.75
|
| Rate for Payer: Three Rivers Provider Network All |
$513.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$637.05
|
| Rate for Payer: Zelis Auto |
$274.00
|
| Rate for Payer: Zelis Worker's Compensation |
$187.00
|
|
|
THORACOSCOPY W/BX PLEURA
|
Facility
|
OP
|
$685.00
|
|
|
Service Code
|
CPT 32609
|
| Hospital Charge Code |
6132609
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$187.00 |
| Max. Negotiated Rate |
$11,079.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,482.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$411.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,482.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,759.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,539.96
|
| Rate for Payer: Cash Price |
$411.00
|
| Rate for Payer: Cash Price |
$411.00
|
| Rate for Payer: Cigna Commercial |
$582.25
|
| Rate for Payer: First Health Commercial |
$616.50
|
| Rate for Payer: First Health Workers Compensation |
$264.48
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$616.50
|
| Rate for Payer: GEHA Commercial |
$548.00
|
| Rate for Payer: GEHA Medicare |
$5,539.96
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$616.50
|
| Rate for Payer: Humana ChoiceCare |
$6,093.96
|
| Rate for Payer: Humana Medicare Advantage |
$5,539.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$9,307.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,815.24
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,539.96
|
| Rate for Payer: Multiplan All |
$623.35
|
| Rate for Payer: New Mexico Health Connections Medicare |
$9,417.93
|
| Rate for Payer: OMNI Networks Commercial |
$479.50
|
| Rate for Payer: One Health Plan PPO/POS |
$616.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$3,250.59
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,815.24
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,539.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$650.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,079.92
|
| Rate for Payer: Three Rivers Provider Network All |
$513.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,429.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,815.24
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,539.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$637.05
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,539.96
|
| Rate for Payer: Zelis Auto |
$274.00
|
| Rate for Payer: Zelis Medicare |
$4,708.97
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,647.95
|
| Rate for Payer: Zelis Worker's Compensation |
$187.00
|
|
|
THORACOSCOPY W/LOBECTOMY
|
Facility
|
IP
|
$2,967.00
|
|
|
Service Code
|
CPT 32663
|
| Hospital Charge Code |
6132663
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$809.99 |
| Max. Negotiated Rate |
$2,818.65 |
| Rate for Payer: Cash Price |
$1,780.20
|
| Rate for Payer: Cigna Commercial |
$2,521.95
|
| Rate for Payer: First Health Commercial |
$2,670.30
|
| Rate for Payer: First Health Workers Compensation |
$1,145.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,670.30
|
| Rate for Payer: GEHA Commercial |
$2,076.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,670.30
|
| Rate for Payer: Multiplan All |
$2,699.97
|
| Rate for Payer: OMNI Networks Commercial |
$2,076.90
|
| Rate for Payer: One Health Plan PPO/POS |
$2,670.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,818.65
|
| Rate for Payer: Three Rivers Provider Network All |
$2,225.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,759.31
|
| Rate for Payer: Zelis Auto |
$1,186.80
|
| Rate for Payer: Zelis Worker's Compensation |
$809.99
|
|
|
THORACOSCOPY W/LOBECTOMY
|
Facility
|
OP
|
$2,967.00
|
|
|
Service Code
|
CPT 32663
|
| Hospital Charge Code |
6132663
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$741.75 |
| Max. Negotiated Rate |
$2,818.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,780.20
|
| Rate for Payer: Cash Price |
$1,780.20
|
| Rate for Payer: Cigna Commercial |
$2,521.95
|
| Rate for Payer: First Health Commercial |
$2,670.30
|
| Rate for Payer: First Health Workers Compensation |
$1,145.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,670.30
|
| Rate for Payer: GEHA Commercial |
$2,373.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,670.30
|
| Rate for Payer: Humana ChoiceCare |
$771.42
|
| Rate for Payer: Multiplan All |
$2,699.97
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,780.20
|
| Rate for Payer: OMNI Networks Commercial |
$2,076.90
|
| Rate for Payer: One Health Plan PPO/POS |
$2,670.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,818.65
|
| Rate for Payer: Three Rivers Provider Network All |
$2,225.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,610.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$741.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,759.31
|
| Rate for Payer: Zelis Auto |
$1,186.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,483.50
|
| Rate for Payer: Zelis Worker's Compensation |
$809.99
|
|
