|
TREAT LOWER LEG DISLOCATION
|
Facility
|
OP
|
$894.00
|
|
|
Service Code
|
CPT 27830
|
| Hospital Charge Code |
6127830
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$132.77 |
| Max. Negotiated Rate |
$849.30 |
| 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 |
$536.40
|
| 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 |
$232.44
|
| Rate for Payer: Cash Price |
$536.40
|
| Rate for Payer: Cash Price |
$536.40
|
| Rate for Payer: Cigna Commercial |
$759.90
|
| Rate for Payer: First Health Commercial |
$804.60
|
| Rate for Payer: First Health Workers Compensation |
$345.17
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$804.60
|
| Rate for Payer: GEHA Commercial |
$715.20
|
| Rate for Payer: GEHA Medicare |
$232.44
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$804.60
|
| Rate for Payer: Humana ChoiceCare |
$255.68
|
| Rate for Payer: Humana Medicare Advantage |
$232.44
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$390.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$135.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$232.44
|
| Rate for Payer: Multiplan All |
$813.54
|
| Rate for Payer: New Mexico Health Connections Medicare |
$395.15
|
| Rate for Payer: OMNI Networks Commercial |
$625.80
|
| Rate for Payer: One Health Plan PPO/POS |
$804.60
|
| 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 |
$232.44
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$849.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$464.88
|
| Rate for Payer: Three Rivers Provider Network All |
$670.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$227.79
|
| Rate for Payer: United Healthcare Managed Medicaid |
$135.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$232.44
|
| Rate for Payer: United Payors & United Providers UP&UP |
$831.42
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$232.44
|
| Rate for Payer: Zelis Auto |
$357.60
|
| Rate for Payer: Zelis Medicare |
$197.57
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$278.93
|
| Rate for Payer: Zelis Worker's Compensation |
$244.06
|
|
|
TREAT LOWER LEG DISLOCATION
|
Facility
|
OP
|
$1,551.00
|
|
|
Service Code
|
CPT 27832
|
| Hospital Charge Code |
6127832
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$423.42 |
| Max. Negotiated Rate |
$13,844.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,597.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$930.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,597.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,641.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,922.13
|
| Rate for Payer: Cash Price |
$930.60
|
| Rate for Payer: Cash Price |
$930.60
|
| Rate for Payer: Cigna Commercial |
$1,318.35
|
| Rate for Payer: First Health Commercial |
$1,395.90
|
| Rate for Payer: First Health Workers Compensation |
$598.84
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,395.90
|
| Rate for Payer: GEHA Commercial |
$1,240.80
|
| Rate for Payer: GEHA Medicare |
$6,922.13
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,395.90
|
| Rate for Payer: Humana ChoiceCare |
$7,614.34
|
| Rate for Payer: Humana Medicare Advantage |
$6,922.13
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,629.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,716.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,922.13
|
| Rate for Payer: Multiplan All |
$1,411.41
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,767.62
|
| Rate for Payer: OMNI Networks Commercial |
$1,085.70
|
| Rate for Payer: One Health Plan PPO/POS |
$1,395.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,290.72
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,716.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,922.13
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,473.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,844.26
|
| Rate for Payer: Three Rivers Provider Network All |
$1,163.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,783.69
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,716.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,922.13
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,442.43
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,922.13
|
| Rate for Payer: Zelis Auto |
$620.40
|
| Rate for Payer: Zelis Medicare |
$5,883.81
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,306.56
|
| Rate for Payer: Zelis Worker's Compensation |
$423.42
|
|
|
TREAT LOWER LEG DISLOCATION
|
Facility
|
IP
|
$1,551.00
|
|
|
Service Code
|
CPT 27832
|
| Hospital Charge Code |
6127832
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$423.42 |
| Max. Negotiated Rate |
$1,473.45 |
| Rate for Payer: Cash Price |
$930.60
|
| Rate for Payer: Cigna Commercial |
$1,318.35
|
| Rate for Payer: First Health Commercial |
$1,395.90
|
| Rate for Payer: First Health Workers Compensation |
$598.84
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,395.90
|
| Rate for Payer: GEHA Commercial |
$1,085.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,395.90
|
| Rate for Payer: Multiplan All |
$1,411.41
|
| Rate for Payer: OMNI Networks Commercial |
$1,085.70
|
| Rate for Payer: One Health Plan PPO/POS |
$1,395.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,473.45
|
| Rate for Payer: Three Rivers Provider Network All |
$1,163.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,442.43
|
| Rate for Payer: Zelis Auto |
$620.40
|
| Rate for Payer: Zelis Worker's Compensation |
$423.42
|
|
|
TREAT LOWER LEG DISLOCATION
|
Facility
|
OP
|
$995.00
|
|
|
Service Code
|
CPT 27831
|
| Hospital Charge Code |
6127831
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$271.63 |
| Max. Negotiated Rate |
$6,287.92 |
| 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 |
$597.00
|
| 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 |
$3,143.96
|
| Rate for Payer: Cash Price |
$597.00
|
| Rate for Payer: Cash Price |
$597.00
|
| Rate for Payer: Cigna Commercial |
$845.75
|
| Rate for Payer: First Health Commercial |
$895.50
|
| Rate for Payer: First Health Workers Compensation |
$384.17
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$895.50
|
| Rate for Payer: GEHA Commercial |
$796.00
|
| Rate for Payer: GEHA Medicare |
$3,143.96
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$895.50
|
| Rate for Payer: Humana ChoiceCare |
$3,458.36
|
| Rate for Payer: Humana Medicare Advantage |
$3,143.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,281.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,503.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,143.96
|
| Rate for Payer: Multiplan All |
$905.45
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,344.73
|
| Rate for Payer: OMNI Networks Commercial |
$696.50
|
| Rate for Payer: One Health Plan PPO/POS |
$895.50
|
| 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 |
$3,143.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$945.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,287.92
|
| Rate for Payer: Three Rivers Provider Network All |
$746.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,081.08
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,503.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,143.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$925.35
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,143.96
|
| Rate for Payer: Zelis Auto |
$398.00
|
| Rate for Payer: Zelis Medicare |
$2,672.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,772.75
|
| Rate for Payer: Zelis Worker's Compensation |
$271.63
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
IP
|
$1,007.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
6127825
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$274.91 |
| Max. Negotiated Rate |
$956.65 |
| Rate for Payer: Cash Price |
$604.20
|
| Rate for Payer: Cigna Commercial |
$855.95
|
| Rate for Payer: First Health Commercial |
$906.30
|
| Rate for Payer: First Health Workers Compensation |
$388.80
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$906.30
|
| Rate for Payer: GEHA Commercial |
$704.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$906.30
|
| Rate for Payer: Multiplan All |
$916.37
|
| Rate for Payer: OMNI Networks Commercial |
$704.90
|
| Rate for Payer: One Health Plan PPO/POS |
$906.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$956.65
|
| Rate for Payer: Three Rivers Provider Network All |
$755.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$936.51
|
| Rate for Payer: Zelis Auto |
$402.80
|
| Rate for Payer: Zelis Worker's Compensation |
$274.91
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
IP
|
$2,216.00
|
|
|
Service Code
|
CPT 27827
|
| Hospital Charge Code |
6127827
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$604.97 |
| Max. Negotiated Rate |
$2,105.20 |
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cigna Commercial |
$1,883.60
|
| Rate for Payer: First Health Commercial |
$1,994.40
|
| Rate for Payer: First Health Workers Compensation |
$855.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,994.40
|
| Rate for Payer: GEHA Commercial |
$1,551.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,994.40
|
| Rate for Payer: Multiplan All |
$2,016.56
|
| Rate for Payer: OMNI Networks Commercial |
$1,551.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,994.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,105.20
|
| Rate for Payer: Three Rivers Provider Network All |
$1,662.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,060.88
|
| Rate for Payer: Zelis Auto |
$886.40
|
| Rate for Payer: Zelis Worker's Compensation |
$604.97
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
IP
|
$2,663.00
|
|
|
Service Code
|
CPT 27828
|
| Hospital Charge Code |
6127828
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$727.00 |
| Max. Negotiated Rate |
$2,529.85 |
| Rate for Payer: Cash Price |
$1,597.80
|
| Rate for Payer: Cigna Commercial |
$2,263.55
|
| Rate for Payer: First Health Commercial |
$2,396.70
|
| Rate for Payer: First Health Workers Compensation |
$1,028.18
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,396.70
|
| Rate for Payer: GEHA Commercial |
$1,864.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,396.70
|
| Rate for Payer: Multiplan All |
$2,423.33
|
| Rate for Payer: OMNI Networks Commercial |
$1,864.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2,396.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,529.85
|
| Rate for Payer: Three Rivers Provider Network All |
$1,997.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,476.59
|
| Rate for Payer: Zelis Auto |
$1,065.20
|
| Rate for Payer: Zelis Worker's Compensation |
$727.00
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
OP
|
$1,700.00
|
|
|
Service Code
|
CPT 27826
|
| Hospital Charge Code |
6127826
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$464.10 |
| Max. Negotiated Rate |
$13,844.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,597.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,020.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,597.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,641.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,922.13
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cigna Commercial |
$1,445.00
|
| Rate for Payer: First Health Commercial |
$1,530.00
|
| Rate for Payer: First Health Workers Compensation |
$656.37
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,530.00
|
| Rate for Payer: GEHA Commercial |
$1,360.00
|
| Rate for Payer: GEHA Medicare |
$6,922.13
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,530.00
|
| Rate for Payer: Humana ChoiceCare |
$7,614.34
|
| Rate for Payer: Humana Medicare Advantage |
$6,922.13
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,629.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,716.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,922.13
|
| Rate for Payer: Multiplan All |
$1,547.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,767.62
|
| Rate for Payer: OMNI Networks Commercial |
$1,190.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,530.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,290.72
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,716.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,922.13
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,615.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,844.26
|
| Rate for Payer: Three Rivers Provider Network All |
$1,275.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,783.69
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,716.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,922.13
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,581.00
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,922.13
|
| Rate for Payer: Zelis Auto |
$680.00
|
| Rate for Payer: Zelis Medicare |
$5,883.81
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,306.56
|
| Rate for Payer: Zelis Worker's Compensation |
$464.10
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
IP
|
$1,700.00
|
|
|
Service Code
|
CPT 27826
|
| Hospital Charge Code |
6127826
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$464.10 |
| Max. Negotiated Rate |
$1,615.00 |
| Rate for Payer: Cash Price |
$1,020.00
|
| Rate for Payer: Cigna Commercial |
$1,445.00
|
| Rate for Payer: First Health Commercial |
$1,530.00
|
| Rate for Payer: First Health Workers Compensation |
$656.37
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,530.00
|
| Rate for Payer: GEHA Commercial |
$1,190.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,530.00
|
| Rate for Payer: Multiplan All |
$1,547.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,190.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,530.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,615.00
|
| Rate for Payer: Three Rivers Provider Network All |
$1,275.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,581.00
|
| Rate for Payer: Zelis Auto |
$680.00
|
| Rate for Payer: Zelis Worker's Compensation |
$464.10
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
OP
|
$2,663.00
|
|
|
Service Code
|
CPT 27828
|
| Hospital Charge Code |
6127828
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$727.00 |
| Max. Negotiated Rate |
$24,935.38 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,620.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,597.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,620.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,244.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,467.69
|
| Rate for Payer: Cash Price |
$1,597.80
|
| Rate for Payer: Cash Price |
$1,597.80
|
| Rate for Payer: Cigna Commercial |
$2,263.55
|
| Rate for Payer: First Health Commercial |
$2,396.70
|
| Rate for Payer: First Health Workers Compensation |
$1,028.18
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,396.70
|
| Rate for Payer: GEHA Commercial |
$2,130.40
|
| Rate for Payer: GEHA Medicare |
$12,467.69
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,396.70
|
| Rate for Payer: Humana ChoiceCare |
$13,714.46
|
| Rate for Payer: Humana Medicare Advantage |
$12,467.69
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,945.72
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,351.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,467.69
|
| Rate for Payer: Multiplan All |
$2,423.33
|
| Rate for Payer: New Mexico Health Connections Medicare |
$21,195.07
|
| Rate for Payer: OMNI Networks Commercial |
$1,864.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2,396.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$6,178.79
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,351.27
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,467.69
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,529.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,935.38
|
| Rate for Payer: Three Rivers Provider Network All |
$1,997.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,218.34
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,351.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,467.69
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,476.59
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$12,467.69
|
| Rate for Payer: Zelis Auto |
$1,065.20
|
| Rate for Payer: Zelis Medicare |
$10,597.54
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,961.23
|
| Rate for Payer: Zelis Worker's Compensation |
$727.00
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
OP
|
$2,216.00
|
|
|
Service Code
|
CPT 27827
|
| Hospital Charge Code |
6127827
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$604.97 |
| Max. Negotiated Rate |
$24,935.38 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6,620.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,329.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6,620.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,244.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,467.69
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cash Price |
$1,329.60
|
| Rate for Payer: Cigna Commercial |
$1,883.60
|
| Rate for Payer: First Health Commercial |
$1,994.40
|
| Rate for Payer: First Health Workers Compensation |
$855.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,994.40
|
| Rate for Payer: GEHA Commercial |
$1,772.80
|
| Rate for Payer: GEHA Medicare |
$12,467.69
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,994.40
|
| Rate for Payer: Humana ChoiceCare |
$13,714.46
|
| Rate for Payer: Humana Medicare Advantage |
$12,467.69
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,945.72
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5,351.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,467.69
|
| Rate for Payer: Multiplan All |
$2,016.56
|
| Rate for Payer: New Mexico Health Connections Medicare |
$21,195.07
|
| Rate for Payer: OMNI Networks Commercial |
$1,551.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,994.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$6,178.79
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,351.27
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,467.69
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,105.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,935.38
|
| Rate for Payer: Three Rivers Provider Network All |
$1,662.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$12,218.34
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,351.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,467.69
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,060.88
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$12,467.69
|
| Rate for Payer: Zelis Auto |
$886.40
|
| Rate for Payer: Zelis Medicare |
$10,597.54
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,961.23
|
| Rate for Payer: Zelis Worker's Compensation |
$604.97
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
OP
|
$1,007.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
6127825
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$274.91 |
| Max. Negotiated Rate |
$3,101.54 |
| 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 |
$604.20
|
| 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 |
$1,550.77
|
| Rate for Payer: Cash Price |
$604.20
|
| Rate for Payer: Cash Price |
$604.20
|
| Rate for Payer: Cigna Commercial |
$855.95
|
| Rate for Payer: First Health Commercial |
$906.30
|
| Rate for Payer: First Health Workers Compensation |
$388.80
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$906.30
|
| Rate for Payer: GEHA Commercial |
$805.60
|
| Rate for Payer: GEHA Medicare |
$1,550.77
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$906.30
|
| Rate for Payer: Humana ChoiceCare |
$1,705.85
|
| Rate for Payer: Humana Medicare Advantage |
$1,550.77
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,605.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,503.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,550.77
|
| Rate for Payer: Multiplan All |
$916.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,636.31
|
| Rate for Payer: OMNI Networks Commercial |
$704.90
|
| Rate for Payer: One Health Plan PPO/POS |
$906.30
|
| 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 |
$1,550.77
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$956.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,101.54
|
| Rate for Payer: Three Rivers Provider Network All |
$755.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,519.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,503.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,550.77
|
| Rate for Payer: United Payors & United Providers UP&UP |
$936.51
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,550.77
|
| Rate for Payer: Zelis Auto |
$402.80
|
| Rate for Payer: Zelis Medicare |
$1,318.15
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,860.92
|
| Rate for Payer: Zelis Worker's Compensation |
$274.91
|
|
|
TREAT LOWER LEG JOINT
|
Facility
|
OP
|
$2,014.20
|
|
|
Service Code
|
CPT 27829
|
| Hospital Charge Code |
6127829
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$549.88 |
| Max. Negotiated Rate |
$13,844.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,597.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,208.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,597.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,641.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,922.13
|
| Rate for Payer: Cash Price |
$1,208.52
|
| Rate for Payer: Cash Price |
$1,208.52
|
| Rate for Payer: Cigna Commercial |
$1,712.07
|
| Rate for Payer: First Health Commercial |
$1,812.78
|
| Rate for Payer: First Health Workers Compensation |
$777.68
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,812.78
|
| Rate for Payer: GEHA Commercial |
$1,611.36
|
| Rate for Payer: GEHA Medicare |
$6,922.13
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,812.78
|
| Rate for Payer: Humana ChoiceCare |
$7,614.34
|
| Rate for Payer: Humana Medicare Advantage |
$6,922.13
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,629.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,716.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,922.13
|
| Rate for Payer: Multiplan All |
$1,832.92
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,767.62
|
| Rate for Payer: OMNI Networks Commercial |
$1,409.94
|
| Rate for Payer: One Health Plan PPO/POS |
$1,812.78
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,290.72
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,716.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,922.13
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,913.49
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,844.26
|
| Rate for Payer: Three Rivers Provider Network All |
$1,510.65
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,783.69
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,716.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,922.13
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,873.21
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,922.13
|
| Rate for Payer: Zelis Auto |
$805.68
|
| Rate for Payer: Zelis Medicare |
$5,883.81
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,306.56
|
| Rate for Payer: Zelis Worker's Compensation |
$549.88
|
|
|
TREAT LOWER LEG JOINT
|
Facility
|
IP
|
$2,014.20
|
|
|
Service Code
|
CPT 27829
|
| Hospital Charge Code |
6127829
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$549.88 |
| Max. Negotiated Rate |
$1,913.49 |
| Rate for Payer: Cash Price |
$1,208.52
|
| Rate for Payer: Cigna Commercial |
$1,712.07
|
| Rate for Payer: First Health Commercial |
$1,812.78
|
| Rate for Payer: First Health Workers Compensation |
$777.68
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,812.78
|
| Rate for Payer: GEHA Commercial |
$1,409.94
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,812.78
|
| Rate for Payer: Multiplan All |
$1,832.92
|
| Rate for Payer: OMNI Networks Commercial |
$1,409.94
|
| Rate for Payer: One Health Plan PPO/POS |
$1,812.78
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,913.49
|
| Rate for Payer: Three Rivers Provider Network All |
$1,510.65
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,873.21
|
| Rate for Payer: Zelis Auto |
$805.68
|
| Rate for Payer: Zelis Worker's Compensation |
$549.88
|
|
|
TREATMENT OF ANAL FISSURE
|
Facility
|
IP
|
$406.00
|
|
|
Service Code
|
CPT 46942
|
| Hospital Charge Code |
6146942
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$110.84 |
| Max. Negotiated Rate |
$385.70 |
| Rate for Payer: Cash Price |
$243.60
|
| Rate for Payer: Cigna Commercial |
$345.10
|
| Rate for Payer: First Health Commercial |
$365.40
|
| Rate for Payer: First Health Workers Compensation |
$156.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$365.40
|
| Rate for Payer: GEHA Commercial |
$284.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$365.40
|
| Rate for Payer: Multiplan All |
$369.46
|
| Rate for Payer: OMNI Networks Commercial |
$284.20
|
| Rate for Payer: One Health Plan PPO/POS |
$365.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$385.70
|
| Rate for Payer: Three Rivers Provider Network All |
$304.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$377.58
|
| Rate for Payer: Zelis Auto |
$162.40
|
| Rate for Payer: Zelis Worker's Compensation |
$110.84
|
|
|
TREATMENT OF ANAL FISSURE
|
Facility
|
OP
|
$454.00
|
|
|
Service Code
|
CPT 46940
|
| Hospital Charge Code |
6146940
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$123.94 |
| Max. Negotiated Rate |
$5,314.64 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,423.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$272.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,423.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,919.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,657.32
|
| Rate for Payer: Cash Price |
$272.40
|
| Rate for Payer: Cash Price |
$272.40
|
| Rate for Payer: Cigna Commercial |
$385.90
|
| Rate for Payer: First Health Commercial |
$408.60
|
| Rate for Payer: First Health Workers Compensation |
$175.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$408.60
|
| Rate for Payer: GEHA Commercial |
$363.20
|
| Rate for Payer: GEHA Medicare |
$2,657.32
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$408.60
|
| Rate for Payer: Humana ChoiceCare |
$2,923.05
|
| Rate for Payer: Humana Medicare Advantage |
$2,657.32
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,464.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,959.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,657.32
|
| Rate for Payer: Multiplan All |
$413.14
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,517.44
|
| Rate for Payer: OMNI Networks Commercial |
$317.80
|
| Rate for Payer: One Health Plan PPO/POS |
$408.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,262.04
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,959.08
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,657.32
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$431.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,314.64
|
| Rate for Payer: Three Rivers Provider Network All |
$340.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,604.17
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,959.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,657.32
|
| Rate for Payer: United Payors & United Providers UP&UP |
$422.22
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,657.32
|
| Rate for Payer: Zelis Auto |
$181.60
|
| Rate for Payer: Zelis Medicare |
$2,258.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,188.78
|
| Rate for Payer: Zelis Worker's Compensation |
$123.94
|
|
|
TREATMENT OF ANAL FISSURE
|
Facility
|
OP
|
$406.00
|
|
|
Service Code
|
CPT 46942
|
| Hospital Charge Code |
6146942
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$110.84 |
| Max. Negotiated Rate |
$1,766.86 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$542.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$243.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$542.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$429.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$883.43
|
| Rate for Payer: Cash Price |
$243.60
|
| Rate for Payer: Cash Price |
$243.60
|
| Rate for Payer: Cigna Commercial |
$345.10
|
| Rate for Payer: First Health Commercial |
$365.40
|
| Rate for Payer: First Health Workers Compensation |
$156.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$365.40
|
| Rate for Payer: GEHA Commercial |
$324.80
|
| Rate for Payer: GEHA Medicare |
$883.43
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$365.40
|
| Rate for Payer: Humana ChoiceCare |
$971.77
|
| Rate for Payer: Humana Medicare Advantage |
$883.43
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,484.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$438.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$883.43
|
| Rate for Payer: Multiplan All |
$369.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,501.83
|
| Rate for Payer: OMNI Networks Commercial |
$284.20
|
| Rate for Payer: One Health Plan PPO/POS |
$365.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$506.28
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$438.48
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$883.43
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$385.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,766.86
|
| Rate for Payer: Three Rivers Provider Network All |
$304.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$865.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$438.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$883.43
|
| Rate for Payer: United Payors & United Providers UP&UP |
$377.58
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$883.43
|
| Rate for Payer: Zelis Auto |
$162.40
|
| Rate for Payer: Zelis Medicare |
$750.92
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,060.12
|
| Rate for Payer: Zelis Worker's Compensation |
$110.84
|
|
|
TREATMENT OF ANAL FISSURE
|
Facility
|
IP
|
$454.00
|
|
|
Service Code
|
CPT 46940
|
| Hospital Charge Code |
6146940
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$123.94 |
| Max. Negotiated Rate |
$431.30 |
| Rate for Payer: Cash Price |
$272.40
|
| Rate for Payer: Cigna Commercial |
$385.90
|
| Rate for Payer: First Health Commercial |
$408.60
|
| Rate for Payer: First Health Workers Compensation |
$175.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$408.60
|
| Rate for Payer: GEHA Commercial |
$317.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$408.60
|
| Rate for Payer: Multiplan All |
$413.14
|
| Rate for Payer: OMNI Networks Commercial |
$317.80
|
| Rate for Payer: One Health Plan PPO/POS |
$408.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$431.30
|
| Rate for Payer: Three Rivers Provider Network All |
$340.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$422.22
|
| Rate for Payer: Zelis Auto |
$181.60
|
| Rate for Payer: Zelis Worker's Compensation |
$123.94
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$1,336.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
6127792
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$364.73 |
| Max. Negotiated Rate |
$13,844.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,597.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$801.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,597.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,641.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,922.13
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cigna Commercial |
$1,135.60
|
| Rate for Payer: First Health Commercial |
$1,202.40
|
| Rate for Payer: First Health Workers Compensation |
$515.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,202.40
|
| Rate for Payer: GEHA Commercial |
$1,068.80
|
| Rate for Payer: GEHA Medicare |
$6,922.13
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,202.40
|
| Rate for Payer: Humana ChoiceCare |
$7,614.34
|
| Rate for Payer: Humana Medicare Advantage |
$6,922.13
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,629.18
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,716.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,922.13
|
| Rate for Payer: Multiplan All |
$1,215.76
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,767.62
|
| Rate for Payer: OMNI Networks Commercial |
$935.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,202.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,290.72
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,716.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,922.13
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,269.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,844.26
|
| Rate for Payer: Three Rivers Provider Network All |
$1,002.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,783.69
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,716.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,922.13
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,242.48
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,922.13
|
| Rate for Payer: Zelis Auto |
$534.40
|
| Rate for Payer: Zelis Medicare |
$5,883.81
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,306.56
|
| Rate for Payer: Zelis Worker's Compensation |
$364.73
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$970.00
|
|
|
Service Code
|
CPT 27788
|
| Hospital Charge Code |
6127788
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$264.81 |
| Max. Negotiated Rate |
$921.50 |
| Rate for Payer: Cash Price |
$582.00
|
| Rate for Payer: Cigna Commercial |
$824.50
|
| Rate for Payer: First Health Commercial |
$873.00
|
| Rate for Payer: First Health Workers Compensation |
$374.52
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$873.00
|
| Rate for Payer: GEHA Commercial |
$679.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$873.00
|
| Rate for Payer: Multiplan All |
$882.70
|
| Rate for Payer: OMNI Networks Commercial |
$679.00
|
| Rate for Payer: One Health Plan PPO/POS |
$873.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$921.50
|
| Rate for Payer: Three Rivers Provider Network All |
$727.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$902.10
|
| Rate for Payer: Zelis Auto |
$388.00
|
| Rate for Payer: Zelis Worker's Compensation |
$264.81
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$718.00
|
|
|
Service Code
|
CPT 28435
|
| Hospital Charge Code |
6128435
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$196.01 |
| Max. Negotiated Rate |
$682.10 |
| Rate for Payer: Cash Price |
$430.80
|
| Rate for Payer: Cigna Commercial |
$610.30
|
| Rate for Payer: First Health Commercial |
$646.20
|
| Rate for Payer: First Health Workers Compensation |
$277.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$646.20
|
| Rate for Payer: GEHA Commercial |
$502.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$646.20
|
| Rate for Payer: Multiplan All |
$653.38
|
| Rate for Payer: OMNI Networks Commercial |
$502.60
|
| Rate for Payer: One Health Plan PPO/POS |
$646.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$682.10
|
| Rate for Payer: Three Rivers Provider Network All |
$538.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$667.74
|
| Rate for Payer: Zelis Auto |
$287.20
|
| Rate for Payer: Zelis Worker's Compensation |
$196.01
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$970.00
|
|
|
Service Code
|
CPT 27788
|
| Hospital Charge Code |
6127788
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$132.77 |
| Max. Negotiated Rate |
$921.50 |
| 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 |
$582.00
|
| 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 |
$232.44
|
| Rate for Payer: Cash Price |
$582.00
|
| Rate for Payer: Cash Price |
$582.00
|
| Rate for Payer: Cigna Commercial |
$824.50
|
| Rate for Payer: First Health Commercial |
$873.00
|
| Rate for Payer: First Health Workers Compensation |
$374.52
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$873.00
|
| Rate for Payer: GEHA Commercial |
$776.00
|
| Rate for Payer: GEHA Medicare |
$232.44
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$873.00
|
| Rate for Payer: Humana ChoiceCare |
$255.68
|
| Rate for Payer: Humana Medicare Advantage |
$232.44
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$390.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$135.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$232.44
|
| Rate for Payer: Multiplan All |
$882.70
|
| Rate for Payer: New Mexico Health Connections Medicare |
$395.15
|
| Rate for Payer: OMNI Networks Commercial |
$679.00
|
| Rate for Payer: One Health Plan PPO/POS |
$873.00
|
| 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 |
$232.44
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$921.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$464.88
|
| Rate for Payer: Three Rivers Provider Network All |
$727.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$227.79
|
| Rate for Payer: United Healthcare Managed Medicaid |
$135.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$232.44
|
| Rate for Payer: United Payors & United Providers UP&UP |
$902.10
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$232.44
|
| Rate for Payer: Zelis Auto |
$388.00
|
| Rate for Payer: Zelis Medicare |
$197.57
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$278.93
|
| Rate for Payer: Zelis Worker's Compensation |
$264.81
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$908.00
|
|
|
Service Code
|
CPT 28436
|
| Hospital Charge Code |
6128436
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$247.88 |
| Max. Negotiated Rate |
$862.60 |
| Rate for Payer: Cash Price |
$544.80
|
| Rate for Payer: Cigna Commercial |
$771.80
|
| Rate for Payer: First Health Commercial |
$817.20
|
| Rate for Payer: First Health Workers Compensation |
$350.58
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$817.20
|
| Rate for Payer: GEHA Commercial |
$635.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$817.20
|
| Rate for Payer: Multiplan All |
$826.28
|
| Rate for Payer: OMNI Networks Commercial |
$635.60
|
| Rate for Payer: One Health Plan PPO/POS |
$817.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$862.60
|
| Rate for Payer: Three Rivers Provider Network All |
$681.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$844.44
|
| Rate for Payer: Zelis Auto |
$363.20
|
| Rate for Payer: Zelis Worker's Compensation |
$247.88
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
OP
|
$879.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
6127818
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$239.97 |
| Max. Negotiated Rate |
$3,101.54 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$484.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$527.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$484.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$384.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,550.77
|
| Rate for Payer: Cash Price |
$527.40
|
| Rate for Payer: Cash Price |
$527.40
|
| Rate for Payer: Cigna Commercial |
$747.15
|
| Rate for Payer: First Health Commercial |
$791.10
|
| Rate for Payer: First Health Workers Compensation |
$339.38
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$791.10
|
| Rate for Payer: GEHA Commercial |
$703.20
|
| Rate for Payer: GEHA Medicare |
$1,550.77
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$791.10
|
| Rate for Payer: Humana ChoiceCare |
$1,705.85
|
| Rate for Payer: Humana Medicare Advantage |
$1,550.77
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,605.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$391.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,550.77
|
| Rate for Payer: Multiplan All |
$799.89
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,636.31
|
| Rate for Payer: OMNI Networks Commercial |
$615.30
|
| Rate for Payer: One Health Plan PPO/POS |
$791.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$452.45
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$391.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,550.77
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$835.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,101.54
|
| Rate for Payer: Three Rivers Provider Network All |
$659.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,519.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$391.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,550.77
|
| Rate for Payer: United Payors & United Providers UP&UP |
$817.47
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,550.77
|
| Rate for Payer: Zelis Auto |
$351.60
|
| Rate for Payer: Zelis Medicare |
$1,318.15
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,860.92
|
| Rate for Payer: Zelis Worker's Compensation |
$239.97
|
|
|
TREATMENT OF ANKLE FRACTURE
|
Facility
|
IP
|
$1,336.00
|
|
|
Service Code
|
CPT 27792
|
| Hospital Charge Code |
6127792
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$364.73 |
| Max. Negotiated Rate |
$1,269.20 |
| Rate for Payer: Cash Price |
$801.60
|
| Rate for Payer: Cigna Commercial |
$1,135.60
|
| Rate for Payer: First Health Commercial |
$1,202.40
|
| Rate for Payer: First Health Workers Compensation |
$515.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,202.40
|
| Rate for Payer: GEHA Commercial |
$935.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,202.40
|
| Rate for Payer: Multiplan All |
$1,215.76
|
| Rate for Payer: OMNI Networks Commercial |
$935.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,202.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,269.20
|
| Rate for Payer: Three Rivers Provider Network All |
$1,002.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,242.48
|
| Rate for Payer: Zelis Auto |
$534.40
|
| Rate for Payer: Zelis Worker's Compensation |
$364.73
|
|
