|
TREAT KNEE DISLOCATION
|
Facility
|
IP
|
$1,276.00
|
|
|
Service Code
|
CPT 27552
|
| Hospital Charge Code |
6127552
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$348.35 |
| Max. Negotiated Rate |
$1,212.20 |
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cigna Commercial |
$1,084.60
|
| Rate for Payer: First Health Commercial |
$1,148.40
|
| Rate for Payer: First Health Workers Compensation |
$492.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,148.40
|
| Rate for Payer: GEHA Commercial |
$893.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,148.40
|
| Rate for Payer: Multiplan All |
$1,161.16
|
| Rate for Payer: OMNI Networks Commercial |
$893.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,148.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,212.20
|
| Rate for Payer: Three Rivers Provider Network All |
$957.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,186.68
|
| Rate for Payer: Zelis Auto |
$510.40
|
| Rate for Payer: Zelis Worker's Compensation |
$348.35
|
|
|
TREAT KNEE DISLOCATION
|
Facility
|
IP
|
$949.00
|
|
|
Service Code
|
CPT 27550
|
| Hospital Charge Code |
6127550
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$259.08 |
| Max. Negotiated Rate |
$901.55 |
| Rate for Payer: Cash Price |
$569.40
|
| Rate for Payer: Cigna Commercial |
$806.65
|
| Rate for Payer: First Health Commercial |
$854.10
|
| Rate for Payer: First Health Workers Compensation |
$366.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$854.10
|
| Rate for Payer: GEHA Commercial |
$664.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$854.10
|
| Rate for Payer: Multiplan All |
$863.59
|
| Rate for Payer: OMNI Networks Commercial |
$664.30
|
| Rate for Payer: One Health Plan PPO/POS |
$854.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$901.55
|
| Rate for Payer: Three Rivers Provider Network All |
$711.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$882.57
|
| Rate for Payer: Zelis Auto |
$379.60
|
| Rate for Payer: Zelis Worker's Compensation |
$259.08
|
|
|
TREAT KNEE DISLOCATION
|
Facility
|
OP
|
$2,172.00
|
|
|
Service Code
|
CPT 27557
|
| Hospital Charge Code |
6127557
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$543.00 |
| Max. Negotiated Rate |
$2,063.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,303.20
|
| Rate for Payer: Cash Price |
$1,303.20
|
| Rate for Payer: Cigna Commercial |
$1,846.20
|
| Rate for Payer: First Health Commercial |
$1,954.80
|
| Rate for Payer: First Health Workers Compensation |
$838.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,954.80
|
| Rate for Payer: GEHA Commercial |
$1,737.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,954.80
|
| Rate for Payer: Humana ChoiceCare |
$564.72
|
| Rate for Payer: Multiplan All |
$1,976.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,303.20
|
| Rate for Payer: OMNI Networks Commercial |
$1,520.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,954.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,063.40
|
| Rate for Payer: Three Rivers Provider Network All |
$1,629.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,911.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$543.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,019.96
|
| Rate for Payer: Zelis Auto |
$868.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,086.00
|
| Rate for Payer: Zelis Worker's Compensation |
$592.96
|
|
|
TREAT KNEE DISLOCATION
|
Facility
|
OP
|
$1,276.00
|
|
|
Service Code
|
CPT 27552
|
| Hospital Charge Code |
6127552
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$348.35 |
| Max. Negotiated Rate |
$3,039.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,546.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$765.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,546.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,224.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,519.65
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cash Price |
$765.60
|
| Rate for Payer: Cigna Commercial |
$1,084.60
|
| Rate for Payer: First Health Commercial |
$1,148.40
|
| Rate for Payer: First Health Workers Compensation |
$492.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,148.40
|
| Rate for Payer: GEHA Commercial |
$1,020.80
|
| Rate for Payer: GEHA Medicare |
$1,519.65
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,148.40
|
| Rate for Payer: Humana ChoiceCare |
$1,671.62
|
| Rate for Payer: Humana Medicare Advantage |
$1,519.65
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,553.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,249.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,519.65
|
| Rate for Payer: Multiplan All |
$1,161.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,583.41
|
| Rate for Payer: OMNI Networks Commercial |
$893.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,148.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,443.11
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,249.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,519.65
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,212.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,039.30
|
| Rate for Payer: Three Rivers Provider Network All |
$957.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,489.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,249.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,519.65
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,186.68
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,519.65
|
| Rate for Payer: Zelis Auto |
$510.40
|
| Rate for Payer: Zelis Medicare |
$1,291.70
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,823.58
|
| Rate for Payer: Zelis Worker's Compensation |
$348.35
|
|
|
TREAT KNEE DISLOCATION
|
Facility
|
IP
|
$1,806.00
|
|
|
Service Code
|
CPT 27556
|
| Hospital Charge Code |
6127556
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$493.04 |
| Max. Negotiated Rate |
$1,715.70 |
| Rate for Payer: Cash Price |
$1,083.60
|
| Rate for Payer: Cigna Commercial |
$1,535.10
|
| Rate for Payer: First Health Commercial |
$1,625.40
|
| Rate for Payer: First Health Workers Compensation |
$697.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,625.40
|
| Rate for Payer: GEHA Commercial |
$1,264.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,625.40
|
| Rate for Payer: Multiplan All |
$1,643.46
|
| Rate for Payer: OMNI Networks Commercial |
$1,264.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,625.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,715.70
|
| Rate for Payer: Three Rivers Provider Network All |
$1,354.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,679.58
|
| Rate for Payer: Zelis Auto |
$722.40
|
| Rate for Payer: Zelis Worker's Compensation |
$493.04
|
|
|
TREAT KNEE DISLOCATION
|
Facility
|
OP
|
$1,806.00
|
|
|
Service Code
|
CPT 27556
|
| Hospital Charge Code |
6127556
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$451.50 |
| Max. Negotiated Rate |
$1,715.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,083.60
|
| Rate for Payer: Cash Price |
$1,083.60
|
| Rate for Payer: Cigna Commercial |
$1,535.10
|
| Rate for Payer: First Health Commercial |
$1,625.40
|
| Rate for Payer: First Health Workers Compensation |
$697.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,625.40
|
| Rate for Payer: GEHA Commercial |
$1,444.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,625.40
|
| Rate for Payer: Humana ChoiceCare |
$469.56
|
| Rate for Payer: Multiplan All |
$1,643.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,083.60
|
| Rate for Payer: OMNI Networks Commercial |
$1,264.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,625.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,715.70
|
| Rate for Payer: Three Rivers Provider Network All |
$1,354.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,589.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$451.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,679.58
|
| Rate for Payer: Zelis Auto |
$722.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$903.00
|
| Rate for Payer: Zelis Worker's Compensation |
$493.04
|
|
|
TREAT KNEE DISLOCATION
|
Facility
|
IP
|
$2,172.00
|
|
|
Service Code
|
CPT 27557
|
| Hospital Charge Code |
6127557
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$592.96 |
| Max. Negotiated Rate |
$2,063.40 |
| Rate for Payer: Cash Price |
$1,303.20
|
| Rate for Payer: Cigna Commercial |
$1,846.20
|
| Rate for Payer: First Health Commercial |
$1,954.80
|
| Rate for Payer: First Health Workers Compensation |
$838.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,954.80
|
| Rate for Payer: GEHA Commercial |
$1,520.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,954.80
|
| Rate for Payer: Multiplan All |
$1,976.52
|
| Rate for Payer: OMNI Networks Commercial |
$1,520.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,954.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,063.40
|
| Rate for Payer: Three Rivers Provider Network All |
$1,629.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,019.96
|
| Rate for Payer: Zelis Auto |
$868.80
|
| Rate for Payer: Zelis Worker's Compensation |
$592.96
|
|
|
TREAT KNEE DISLOCATION
|
Facility
|
OP
|
$949.00
|
|
|
Service Code
|
CPT 27550
|
| Hospital Charge Code |
6127550
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$132.77 |
| Max. Negotiated Rate |
$901.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$167.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$569.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$167.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$132.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$227.78
|
| Rate for Payer: Cash Price |
$569.40
|
| Rate for Payer: Cash Price |
$569.40
|
| Rate for Payer: Cigna Commercial |
$806.65
|
| Rate for Payer: First Health Commercial |
$854.10
|
| Rate for Payer: First Health Workers Compensation |
$366.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$854.10
|
| Rate for Payer: GEHA Commercial |
$759.20
|
| Rate for Payer: GEHA Medicare |
$227.78
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$854.10
|
| Rate for Payer: Humana ChoiceCare |
$250.56
|
| Rate for Payer: Humana Medicare Advantage |
$227.78
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$382.67
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$135.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$227.78
|
| Rate for Payer: Multiplan All |
$863.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$387.23
|
| Rate for Payer: OMNI Networks Commercial |
$664.30
|
| Rate for Payer: One Health Plan PPO/POS |
$854.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$156.42
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$135.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$227.78
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$901.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$455.56
|
| Rate for Payer: Three Rivers Provider Network All |
$711.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$223.22
|
| Rate for Payer: United Healthcare Managed Medicaid |
$135.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$227.78
|
| Rate for Payer: United Payors & United Providers UP&UP |
$882.57
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$227.78
|
| Rate for Payer: Zelis Auto |
$379.60
|
| Rate for Payer: Zelis Medicare |
$193.61
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$273.34
|
| Rate for Payer: Zelis Worker's Compensation |
$259.08
|
|
|
TREAT KNEE DISLOCATION
|
Facility
|
IP
|
$2,465.00
|
|
|
Service Code
|
CPT 27558
|
| Hospital Charge Code |
6127558
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$672.95 |
| Max. Negotiated Rate |
$2,341.75 |
| Rate for Payer: Cash Price |
$1,479.00
|
| Rate for Payer: Cigna Commercial |
$2,095.25
|
| Rate for Payer: First Health Commercial |
$2,218.50
|
| Rate for Payer: First Health Workers Compensation |
$951.74
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,218.50
|
| Rate for Payer: GEHA Commercial |
$1,725.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,218.50
|
| Rate for Payer: Multiplan All |
$2,243.15
|
| Rate for Payer: OMNI Networks Commercial |
$1,725.50
|
| Rate for Payer: One Health Plan PPO/POS |
$2,218.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,341.75
|
| Rate for Payer: Three Rivers Provider Network All |
$1,848.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,292.45
|
| Rate for Payer: Zelis Auto |
$986.00
|
| Rate for Payer: Zelis Worker's Compensation |
$672.95
|
|
|
TREAT KNEE DISLOCATION
|
Facility
|
OP
|
$2,465.00
|
|
|
Service Code
|
CPT 27558
|
| Hospital Charge Code |
6127558
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$616.25 |
| Max. Negotiated Rate |
$2,341.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,479.00
|
| Rate for Payer: Cash Price |
$1,479.00
|
| Rate for Payer: Cigna Commercial |
$2,095.25
|
| Rate for Payer: First Health Commercial |
$2,218.50
|
| Rate for Payer: First Health Workers Compensation |
$951.74
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,218.50
|
| Rate for Payer: GEHA Commercial |
$1,972.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,218.50
|
| Rate for Payer: Humana ChoiceCare |
$640.90
|
| Rate for Payer: Multiplan All |
$2,243.15
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,479.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,725.50
|
| Rate for Payer: One Health Plan PPO/POS |
$2,218.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,341.75
|
| Rate for Payer: Three Rivers Provider Network All |
$1,848.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,169.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$616.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,292.45
|
| Rate for Payer: Zelis Auto |
$986.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,232.50
|
| Rate for Payer: Zelis Worker's Compensation |
$672.95
|
|
|
TREAT KNEE FRACTURE
|
Facility
|
IP
|
$2,455.00
|
|
|
Service Code
|
CPT 27536
|
| Hospital Charge Code |
6127536
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$670.22 |
| Max. Negotiated Rate |
$2,332.25 |
| Rate for Payer: Cash Price |
$1,473.00
|
| Rate for Payer: Cigna Commercial |
$2,086.75
|
| Rate for Payer: First Health Commercial |
$2,209.50
|
| Rate for Payer: First Health Workers Compensation |
$947.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,209.50
|
| Rate for Payer: GEHA Commercial |
$1,718.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,209.50
|
| Rate for Payer: Multiplan All |
$2,234.05
|
| Rate for Payer: OMNI Networks Commercial |
$1,718.50
|
| Rate for Payer: One Health Plan PPO/POS |
$2,209.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,332.25
|
| Rate for Payer: Three Rivers Provider Network All |
$1,841.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,283.15
|
| Rate for Payer: Zelis Auto |
$982.00
|
| Rate for Payer: Zelis Worker's Compensation |
$670.22
|
|
|
TREAT KNEE FRACTURE
|
Facility
|
OP
|
$2,455.00
|
|
|
Service Code
|
CPT 27536
|
| Hospital Charge Code |
6127536
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$613.75 |
| Max. Negotiated Rate |
$2,332.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,473.00
|
| Rate for Payer: Cash Price |
$1,473.00
|
| Rate for Payer: Cigna Commercial |
$2,086.75
|
| Rate for Payer: First Health Commercial |
$2,209.50
|
| Rate for Payer: First Health Workers Compensation |
$947.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,209.50
|
| Rate for Payer: GEHA Commercial |
$1,964.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,209.50
|
| Rate for Payer: Humana ChoiceCare |
$638.30
|
| Rate for Payer: Multiplan All |
$2,234.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,473.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,718.50
|
| Rate for Payer: One Health Plan PPO/POS |
$2,209.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,332.25
|
| Rate for Payer: Three Rivers Provider Network All |
$1,841.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,160.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$613.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,283.15
|
| Rate for Payer: Zelis Auto |
$982.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,227.50
|
| Rate for Payer: Zelis Worker's Compensation |
$670.22
|
|
|
TREAT KNEE FRACTURE
|
Facility
|
OP
|
$1,177.00
|
|
|
Service Code
|
CPT 27532
|
| Hospital Charge Code |
6127532
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$321.32 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,860.02
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$706.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,860.02
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,473.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$706.20
|
| Rate for Payer: Cash Price |
$706.20
|
| Rate for Payer: Cigna Commercial |
$1,000.45
|
| Rate for Payer: First Health Commercial |
$1,059.30
|
| Rate for Payer: First Health Workers Compensation |
$454.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,059.30
|
| Rate for Payer: GEHA Commercial |
$941.60
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,059.30
|
| Rate for Payer: Humana ChoiceCare |
$3,388.98
|
| Rate for Payer: Humana Medicare Advantage |
$3,080.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,175.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,503.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$1,071.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$823.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,059.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,736.01
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,503.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,118.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$882.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,503.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,094.61
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$470.80
|
| Rate for Payer: Zelis Medicare |
$2,618.76
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,697.07
|
| Rate for Payer: Zelis Worker's Compensation |
$321.32
|
|
|
TREAT KNEE FRACTURE
|
Facility
|
OP
|
$699.00
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
6127530
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$132.77 |
| Max. Negotiated Rate |
$664.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$167.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$419.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$167.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$132.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$227.78
|
| Rate for Payer: Cash Price |
$419.40
|
| Rate for Payer: Cash Price |
$419.40
|
| Rate for Payer: Cigna Commercial |
$594.15
|
| Rate for Payer: First Health Commercial |
$629.10
|
| Rate for Payer: First Health Workers Compensation |
$269.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$629.10
|
| Rate for Payer: GEHA Commercial |
$559.20
|
| Rate for Payer: GEHA Medicare |
$227.78
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$629.10
|
| Rate for Payer: Humana ChoiceCare |
$250.56
|
| Rate for Payer: Humana Medicare Advantage |
$227.78
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$382.67
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$135.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$227.78
|
| Rate for Payer: Multiplan All |
$636.09
|
| Rate for Payer: New Mexico Health Connections Medicare |
$387.23
|
| Rate for Payer: OMNI Networks Commercial |
$489.30
|
| Rate for Payer: One Health Plan PPO/POS |
$629.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$156.42
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$135.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$227.78
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$664.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$455.56
|
| Rate for Payer: Three Rivers Provider Network All |
$524.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$223.22
|
| Rate for Payer: United Healthcare Managed Medicaid |
$135.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$227.78
|
| Rate for Payer: United Payors & United Providers UP&UP |
$650.07
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$227.78
|
| Rate for Payer: Zelis Auto |
$279.60
|
| Rate for Payer: Zelis Medicare |
$193.61
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$273.34
|
| Rate for Payer: Zelis Worker's Compensation |
$190.83
|
|
|
TREAT KNEE FRACTURE
|
Facility
|
IP
|
$699.00
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
6127530
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$190.83 |
| Max. Negotiated Rate |
$664.05 |
| Rate for Payer: Cash Price |
$419.40
|
| Rate for Payer: Cigna Commercial |
$594.15
|
| Rate for Payer: First Health Commercial |
$629.10
|
| Rate for Payer: First Health Workers Compensation |
$269.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$629.10
|
| Rate for Payer: GEHA Commercial |
$489.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$629.10
|
| Rate for Payer: Multiplan All |
$636.09
|
| Rate for Payer: OMNI Networks Commercial |
$489.30
|
| Rate for Payer: One Health Plan PPO/POS |
$629.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$664.05
|
| Rate for Payer: Three Rivers Provider Network All |
$524.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$650.07
|
| Rate for Payer: Zelis Auto |
$279.60
|
| Rate for Payer: Zelis Worker's Compensation |
$190.83
|
|
|
TREAT KNEE FRACTURE
|
Facility
|
IP
|
$1,177.00
|
|
|
Service Code
|
CPT 27532
|
| Hospital Charge Code |
6127532
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$321.32 |
| Max. Negotiated Rate |
$1,118.15 |
| Rate for Payer: Cash Price |
$706.20
|
| Rate for Payer: Cigna Commercial |
$1,000.45
|
| Rate for Payer: First Health Commercial |
$1,059.30
|
| Rate for Payer: First Health Workers Compensation |
$454.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,059.30
|
| Rate for Payer: GEHA Commercial |
$823.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,059.30
|
| Rate for Payer: Multiplan All |
$1,071.07
|
| Rate for Payer: OMNI Networks Commercial |
$823.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,059.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,118.15
|
| Rate for Payer: Three Rivers Provider Network All |
$882.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,094.61
|
| Rate for Payer: Zelis Auto |
$470.80
|
| Rate for Payer: Zelis Worker's Compensation |
$321.32
|
|
|
TREAT KNEE FRACTURE
|
Facility
|
IP
|
$1,854.00
|
|
|
Service Code
|
CPT 27535
|
| Hospital Charge Code |
6127535
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$506.14 |
| Max. Negotiated Rate |
$1,761.30 |
| Rate for Payer: Cash Price |
$1,112.40
|
| Rate for Payer: Cigna Commercial |
$1,575.90
|
| Rate for Payer: First Health Commercial |
$1,668.60
|
| Rate for Payer: First Health Workers Compensation |
$715.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,668.60
|
| Rate for Payer: GEHA Commercial |
$1,297.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,668.60
|
| Rate for Payer: Multiplan All |
$1,687.14
|
| Rate for Payer: OMNI Networks Commercial |
$1,297.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,668.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,761.30
|
| Rate for Payer: Three Rivers Provider Network All |
$1,390.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,724.22
|
| Rate for Payer: Zelis Auto |
$741.60
|
| Rate for Payer: Zelis Worker's Compensation |
$506.14
|
|
|
TREAT KNEE FRACTURE
|
Facility
|
OP
|
$1,854.00
|
|
|
Service Code
|
CPT 27535
|
| Hospital Charge Code |
6127535
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$463.50 |
| Max. Negotiated Rate |
$1,761.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,112.40
|
| Rate for Payer: Cash Price |
$1,112.40
|
| Rate for Payer: Cigna Commercial |
$1,575.90
|
| Rate for Payer: First Health Commercial |
$1,668.60
|
| Rate for Payer: First Health Workers Compensation |
$715.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,668.60
|
| Rate for Payer: GEHA Commercial |
$1,483.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,668.60
|
| Rate for Payer: Humana ChoiceCare |
$482.04
|
| Rate for Payer: Multiplan All |
$1,687.14
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,112.40
|
| Rate for Payer: OMNI Networks Commercial |
$1,297.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,668.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,761.30
|
| Rate for Payer: Three Rivers Provider Network All |
$1,390.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,631.52
|
| Rate for Payer: United Healthcare Managed Medicaid |
$463.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,724.22
|
| Rate for Payer: Zelis Auto |
$741.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$927.00
|
| Rate for Payer: Zelis Worker's Compensation |
$506.14
|
|
|
TREAT KNEE FRACTURE
|
Facility
|
OP
|
$1,662.00
|
|
|
Service Code
|
CPT 27540
|
| Hospital Charge Code |
6127540
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$415.50 |
| Max. Negotiated Rate |
$1,578.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$997.20
|
| Rate for Payer: Cash Price |
$997.20
|
| Rate for Payer: Cigna Commercial |
$1,412.70
|
| Rate for Payer: First Health Commercial |
$1,495.80
|
| Rate for Payer: First Health Workers Compensation |
$641.70
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,495.80
|
| Rate for Payer: GEHA Commercial |
$1,329.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,495.80
|
| Rate for Payer: Humana ChoiceCare |
$432.12
|
| Rate for Payer: Multiplan All |
$1,512.42
|
| Rate for Payer: New Mexico Health Connections Medicare |
$997.20
|
| Rate for Payer: OMNI Networks Commercial |
$1,163.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,495.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,578.90
|
| Rate for Payer: Three Rivers Provider Network All |
$1,246.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,462.56
|
| Rate for Payer: United Healthcare Managed Medicaid |
$415.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,545.66
|
| Rate for Payer: Zelis Auto |
$664.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$831.00
|
| Rate for Payer: Zelis Worker's Compensation |
$453.73
|
|
|
TREAT KNEE FRACTURE
|
Facility
|
IP
|
$1,662.00
|
|
|
Service Code
|
CPT 27540
|
| Hospital Charge Code |
6127540
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$453.73 |
| Max. Negotiated Rate |
$1,578.90 |
| Rate for Payer: Cash Price |
$997.20
|
| Rate for Payer: Cigna Commercial |
$1,412.70
|
| Rate for Payer: First Health Commercial |
$1,495.80
|
| Rate for Payer: First Health Workers Compensation |
$641.70
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,495.80
|
| Rate for Payer: GEHA Commercial |
$1,163.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,495.80
|
| Rate for Payer: Multiplan All |
$1,512.42
|
| Rate for Payer: OMNI Networks Commercial |
$1,163.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,495.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,578.90
|
| Rate for Payer: Three Rivers Provider Network All |
$1,246.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,545.66
|
| Rate for Payer: Zelis Auto |
$664.80
|
| Rate for Payer: Zelis Worker's Compensation |
$453.73
|
|
|
TREAT KNEE FRACTURE(S)
|
Facility
|
IP
|
$893.00
|
|
|
Service Code
|
CPT 27538
|
| Hospital Charge Code |
6127538
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$243.79 |
| Max. Negotiated Rate |
$848.35 |
| Rate for Payer: Cash Price |
$535.80
|
| Rate for Payer: Cigna Commercial |
$759.05
|
| Rate for Payer: First Health Commercial |
$803.70
|
| Rate for Payer: First Health Workers Compensation |
$344.79
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$803.70
|
| Rate for Payer: GEHA Commercial |
$625.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$803.70
|
| Rate for Payer: Multiplan All |
$812.63
|
| Rate for Payer: OMNI Networks Commercial |
$625.10
|
| Rate for Payer: One Health Plan PPO/POS |
$803.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$848.35
|
| Rate for Payer: Three Rivers Provider Network All |
$669.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$830.49
|
| Rate for Payer: Zelis Auto |
$357.20
|
| Rate for Payer: Zelis Worker's Compensation |
$243.79
|
|
|
TREAT KNEE FRACTURE(S)
|
Facility
|
OP
|
$893.00
|
|
|
Service Code
|
CPT 27538
|
| Hospital Charge Code |
6127538
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$132.77 |
| Max. Negotiated Rate |
$848.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$167.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$535.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$167.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$132.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$227.78
|
| Rate for Payer: Cash Price |
$535.80
|
| Rate for Payer: Cash Price |
$535.80
|
| Rate for Payer: Cigna Commercial |
$759.05
|
| Rate for Payer: First Health Commercial |
$803.70
|
| Rate for Payer: First Health Workers Compensation |
$344.79
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$803.70
|
| Rate for Payer: GEHA Commercial |
$714.40
|
| Rate for Payer: GEHA Medicare |
$227.78
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$803.70
|
| Rate for Payer: Humana ChoiceCare |
$250.56
|
| Rate for Payer: Humana Medicare Advantage |
$227.78
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$382.67
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$135.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$227.78
|
| Rate for Payer: Multiplan All |
$812.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$387.23
|
| Rate for Payer: OMNI Networks Commercial |
$625.10
|
| Rate for Payer: One Health Plan PPO/POS |
$803.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$156.42
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$135.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$227.78
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$848.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$455.56
|
| Rate for Payer: Three Rivers Provider Network All |
$669.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$223.22
|
| Rate for Payer: United Healthcare Managed Medicaid |
$135.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$227.78
|
| Rate for Payer: United Payors & United Providers UP&UP |
$830.49
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$227.78
|
| Rate for Payer: Zelis Auto |
$357.20
|
| Rate for Payer: Zelis Medicare |
$193.61
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$273.34
|
| Rate for Payer: Zelis Worker's Compensation |
$243.79
|
|
|
TREAT KNUCKLE DISLOCATION
|
Facility
|
OP
|
$1,157.00
|
|
|
Service Code
|
CPT 26715
|
| Hospital Charge Code |
6126715
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$315.86 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,613.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$694.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,613.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,070.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$694.20
|
| Rate for Payer: Cash Price |
$694.20
|
| Rate for Payer: Cigna Commercial |
$983.45
|
| Rate for Payer: First Health Commercial |
$1,041.30
|
| Rate for Payer: First Health Workers Compensation |
$446.72
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,041.30
|
| Rate for Payer: GEHA Commercial |
$925.60
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,041.30
|
| Rate for Payer: Humana ChoiceCare |
$3,388.98
|
| Rate for Payer: Humana Medicare Advantage |
$3,080.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,175.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,112.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$1,052.87
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$809.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,041.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,438.91
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,112.27
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,099.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$867.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,112.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,076.01
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$462.80
|
| Rate for Payer: Zelis Medicare |
$2,618.76
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,697.07
|
| Rate for Payer: Zelis Worker's Compensation |
$315.86
|
|
|
TREAT KNUCKLE DISLOCATION
|
Facility
|
IP
|
$959.00
|
|
|
Service Code
|
CPT 26705
|
| Hospital Charge Code |
6126705
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$261.81 |
| Max. Negotiated Rate |
$911.05 |
| Rate for Payer: Cash Price |
$575.40
|
| Rate for Payer: Cigna Commercial |
$815.15
|
| Rate for Payer: First Health Commercial |
$863.10
|
| Rate for Payer: First Health Workers Compensation |
$370.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$863.10
|
| Rate for Payer: GEHA Commercial |
$671.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$863.10
|
| Rate for Payer: Multiplan All |
$872.69
|
| Rate for Payer: OMNI Networks Commercial |
$671.30
|
| Rate for Payer: One Health Plan PPO/POS |
$863.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$911.05
|
| Rate for Payer: Three Rivers Provider Network All |
$719.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$891.87
|
| Rate for Payer: Zelis Auto |
$383.60
|
| Rate for Payer: Zelis Worker's Compensation |
$261.81
|
|
|
TREAT KNUCKLE DISLOCATION
|
Facility
|
IP
|
$1,157.00
|
|
|
Service Code
|
CPT 26715
|
| Hospital Charge Code |
6126715
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$315.86 |
| Max. Negotiated Rate |
$1,099.15 |
| Rate for Payer: Cash Price |
$694.20
|
| Rate for Payer: Cigna Commercial |
$983.45
|
| Rate for Payer: First Health Commercial |
$1,041.30
|
| Rate for Payer: First Health Workers Compensation |
$446.72
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,041.30
|
| Rate for Payer: GEHA Commercial |
$809.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,041.30
|
| Rate for Payer: Multiplan All |
$1,052.87
|
| Rate for Payer: OMNI Networks Commercial |
$809.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,041.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,099.15
|
| Rate for Payer: Three Rivers Provider Network All |
$867.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,076.01
|
| Rate for Payer: Zelis Auto |
$462.80
|
| Rate for Payer: Zelis Worker's Compensation |
$315.86
|
|
