|
TREATMENT OF THIGH FRACTURE
|
Facility
|
IP
|
$2,761.00
|
|
|
Service Code
|
CPT 27506
|
| Hospital Charge Code |
6127506
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$753.75 |
| Max. Negotiated Rate |
$2,622.95 |
| Rate for Payer: Cash Price |
$1,656.60
|
| Rate for Payer: Cigna Commercial |
$2,346.85
|
| Rate for Payer: First Health Commercial |
$2,484.90
|
| Rate for Payer: First Health Workers Compensation |
$1,066.02
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,484.90
|
| Rate for Payer: GEHA Commercial |
$1,932.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,484.90
|
| Rate for Payer: Multiplan All |
$2,512.51
|
| Rate for Payer: OMNI Networks Commercial |
$1,932.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,484.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,622.95
|
| Rate for Payer: Three Rivers Provider Network All |
$2,070.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,567.73
|
| Rate for Payer: Zelis Auto |
$1,104.40
|
| Rate for Payer: Zelis Worker's Compensation |
$753.75
|
|
|
TREATMENT OF THIGH FRACTURE
|
Facility
|
OP
|
$1,306.00
|
|
|
Service Code
|
CPT 27509
|
| Hospital Charge Code |
6127509
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$356.54 |
| Max. Negotiated Rate |
$13,566.52 |
| 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 |
$783.60
|
| 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 |
$6,783.26
|
| Rate for Payer: Cash Price |
$783.60
|
| Rate for Payer: Cash Price |
$783.60
|
| Rate for Payer: Cigna Commercial |
$1,110.10
|
| Rate for Payer: First Health Commercial |
$1,175.40
|
| Rate for Payer: First Health Workers Compensation |
$504.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,175.40
|
| Rate for Payer: GEHA Commercial |
$1,044.80
|
| Rate for Payer: GEHA Medicare |
$6,783.26
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,175.40
|
| Rate for Payer: Humana ChoiceCare |
$7,461.59
|
| Rate for Payer: Humana Medicare Advantage |
$6,783.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,395.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,112.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,783.26
|
| Rate for Payer: Multiplan All |
$1,188.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,531.54
|
| Rate for Payer: OMNI Networks Commercial |
$914.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,175.40
|
| 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 |
$6,783.26
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,240.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,566.52
|
| Rate for Payer: Three Rivers Provider Network All |
$979.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,647.59
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,112.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,783.26
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,214.58
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,783.26
|
| Rate for Payer: Zelis Auto |
$522.40
|
| Rate for Payer: Zelis Medicare |
$5,765.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,139.91
|
| Rate for Payer: Zelis Worker's Compensation |
$356.54
|
|
|
TREATMENT OF THIGH FRACTURE
|
Facility
|
OP
|
$1,648.00
|
|
|
Service Code
|
CPT 27503
|
| Hospital Charge Code |
6127503
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$132.77 |
| Max. Negotiated Rate |
$3,039.30 |
| 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 |
$988.80
|
| 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 |
$1,519.65
|
| Rate for Payer: Cash Price |
$988.80
|
| Rate for Payer: Cash Price |
$988.80
|
| Rate for Payer: Cigna Commercial |
$1,400.80
|
| Rate for Payer: First Health Commercial |
$1,483.20
|
| Rate for Payer: First Health Workers Compensation |
$636.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,483.20
|
| Rate for Payer: GEHA Commercial |
$1,318.40
|
| Rate for Payer: GEHA Medicare |
$1,519.65
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,483.20
|
| 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 |
$135.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,519.65
|
| Rate for Payer: Multiplan All |
$1,499.68
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,583.41
|
| Rate for Payer: OMNI Networks Commercial |
$1,153.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,483.20
|
| 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 |
$1,519.65
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,565.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,039.30
|
| Rate for Payer: Three Rivers Provider Network All |
$1,236.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,489.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$135.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,519.65
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,532.64
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,519.65
|
| Rate for Payer: Zelis Auto |
$659.20
|
| 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 |
$449.90
|
|
|
TREATMENT OF THIGH FRACTURE
|
Facility
|
IP
|
$1,574.00
|
|
|
Service Code
|
CPT 27502
|
| Hospital Charge Code |
6127502
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$429.70 |
| Max. Negotiated Rate |
$1,495.30 |
| Rate for Payer: Cash Price |
$944.40
|
| Rate for Payer: Cigna Commercial |
$1,337.90
|
| Rate for Payer: First Health Commercial |
$1,416.60
|
| Rate for Payer: First Health Workers Compensation |
$607.72
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,416.60
|
| Rate for Payer: GEHA Commercial |
$1,101.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,416.60
|
| Rate for Payer: Multiplan All |
$1,432.34
|
| Rate for Payer: OMNI Networks Commercial |
$1,101.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,416.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,495.30
|
| Rate for Payer: Three Rivers Provider Network All |
$1,180.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,463.82
|
| Rate for Payer: Zelis Auto |
$629.60
|
| Rate for Payer: Zelis Worker's Compensation |
$429.70
|
|
|
TREATMENT OF THIGH FRACTURE
|
Facility
|
OP
|
$1,018.00
|
|
|
Service Code
|
CPT 27501
|
| Hospital Charge Code |
6127501
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$132.77 |
| Max. Negotiated Rate |
$967.10 |
| 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 |
$610.80
|
| 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 |
$610.80
|
| Rate for Payer: Cash Price |
$610.80
|
| Rate for Payer: Cigna Commercial |
$865.30
|
| Rate for Payer: First Health Commercial |
$916.20
|
| Rate for Payer: First Health Workers Compensation |
$393.05
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$916.20
|
| Rate for Payer: GEHA Commercial |
$814.40
|
| Rate for Payer: GEHA Medicare |
$227.78
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$916.20
|
| 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 |
$926.38
|
| Rate for Payer: New Mexico Health Connections Medicare |
$387.23
|
| Rate for Payer: OMNI Networks Commercial |
$712.60
|
| Rate for Payer: One Health Plan PPO/POS |
$916.20
|
| 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 |
$967.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$455.56
|
| Rate for Payer: Three Rivers Provider Network All |
$763.50
|
| 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 |
$946.74
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$227.78
|
| Rate for Payer: Zelis Auto |
$407.20
|
| Rate for Payer: Zelis Medicare |
$193.61
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$273.34
|
| Rate for Payer: Zelis Worker's Compensation |
$277.91
|
|
|
TREATMENT OF THIGH FRACTURE
|
Facility
|
IP
|
$978.00
|
|
|
Service Code
|
CPT 27500
|
| Hospital Charge Code |
6127500
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$266.99 |
| Max. Negotiated Rate |
$929.10 |
| Rate for Payer: Cash Price |
$586.80
|
| Rate for Payer: Cigna Commercial |
$831.30
|
| Rate for Payer: First Health Commercial |
$880.20
|
| Rate for Payer: First Health Workers Compensation |
$377.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$880.20
|
| Rate for Payer: GEHA Commercial |
$684.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$880.20
|
| Rate for Payer: Multiplan All |
$889.98
|
| Rate for Payer: OMNI Networks Commercial |
$684.60
|
| Rate for Payer: One Health Plan PPO/POS |
$880.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$929.10
|
| Rate for Payer: Three Rivers Provider Network All |
$733.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$909.54
|
| Rate for Payer: Zelis Auto |
$391.20
|
| Rate for Payer: Zelis Worker's Compensation |
$266.99
|
|
|
TREATMENT OF THIGH FRACTURE
|
Facility
|
OP
|
$2,573.00
|
|
|
Service Code
|
CPT 27513
|
| Hospital Charge Code |
6127513
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$643.25 |
| Max. Negotiated Rate |
$2,444.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,543.80
|
| Rate for Payer: Cash Price |
$1,543.80
|
| Rate for Payer: Cigna Commercial |
$2,187.05
|
| Rate for Payer: First Health Commercial |
$2,315.70
|
| Rate for Payer: First Health Workers Compensation |
$993.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,315.70
|
| Rate for Payer: GEHA Commercial |
$2,058.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,315.70
|
| Rate for Payer: Humana ChoiceCare |
$668.98
|
| Rate for Payer: Multiplan All |
$2,341.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,543.80
|
| Rate for Payer: OMNI Networks Commercial |
$1,801.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2,315.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,444.35
|
| Rate for Payer: Three Rivers Provider Network All |
$1,929.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,264.24
|
| Rate for Payer: United Healthcare Managed Medicaid |
$643.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,392.89
|
| Rate for Payer: Zelis Auto |
$1,029.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,286.50
|
| Rate for Payer: Zelis Worker's Compensation |
$702.43
|
|
|
TREATMENT OF THIGH FRACTURE
|
Facility
|
OP
|
$1,401.00
|
|
|
Service Code
|
CPT 27510
|
| Hospital Charge Code |
6127510
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$382.47 |
| Max. Negotiated Rate |
$3,039.30 |
| 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 |
$840.60
|
| 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 |
$1,519.65
|
| Rate for Payer: Cash Price |
$840.60
|
| Rate for Payer: Cash Price |
$840.60
|
| Rate for Payer: Cigna Commercial |
$1,190.85
|
| Rate for Payer: First Health Commercial |
$1,260.90
|
| Rate for Payer: First Health Workers Compensation |
$540.93
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,260.90
|
| Rate for Payer: GEHA Commercial |
$1,120.80
|
| Rate for Payer: GEHA Medicare |
$1,519.65
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,260.90
|
| 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 |
$391.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,519.65
|
| Rate for Payer: Multiplan All |
$1,274.91
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,583.41
|
| Rate for Payer: OMNI Networks Commercial |
$980.70
|
| Rate for Payer: One Health Plan PPO/POS |
$1,260.90
|
| 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 |
$1,519.65
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,330.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,039.30
|
| Rate for Payer: Three Rivers Provider Network All |
$1,050.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,489.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$391.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,519.65
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,302.93
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,519.65
|
| Rate for Payer: Zelis Auto |
$560.40
|
| 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 |
$382.47
|
|
|
TREATMENT OF THIGH FRACTURE
|
Facility
|
OP
|
$2,062.00
|
|
|
Service Code
|
CPT 27511
|
| Hospital Charge Code |
6127511
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$515.50 |
| Max. Negotiated Rate |
$1,958.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,237.20
|
| Rate for Payer: Cash Price |
$1,237.20
|
| Rate for Payer: Cigna Commercial |
$1,752.70
|
| Rate for Payer: First Health Commercial |
$1,855.80
|
| Rate for Payer: First Health Workers Compensation |
$796.14
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,855.80
|
| Rate for Payer: GEHA Commercial |
$1,649.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,855.80
|
| Rate for Payer: Humana ChoiceCare |
$536.12
|
| Rate for Payer: Multiplan All |
$1,876.42
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,237.20
|
| Rate for Payer: OMNI Networks Commercial |
$1,443.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,855.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,958.90
|
| Rate for Payer: Three Rivers Provider Network All |
$1,546.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,814.56
|
| Rate for Payer: United Healthcare Managed Medicaid |
$515.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,917.66
|
| Rate for Payer: Zelis Auto |
$824.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,031.00
|
| Rate for Payer: Zelis Worker's Compensation |
$562.93
|
|
|
TREATMENT OF THIGH FRACTURE
|
Facility
|
OP
|
$978.00
|
|
|
Service Code
|
CPT 27500
|
| Hospital Charge Code |
6127500
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$193.61 |
| Max. Negotiated Rate |
$929.10 |
| 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 |
$586.80
|
| 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 |
$227.78
|
| Rate for Payer: Cash Price |
$586.80
|
| Rate for Payer: Cash Price |
$586.80
|
| Rate for Payer: Cigna Commercial |
$831.30
|
| Rate for Payer: First Health Commercial |
$880.20
|
| Rate for Payer: First Health Workers Compensation |
$377.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$880.20
|
| Rate for Payer: GEHA Commercial |
$782.40
|
| Rate for Payer: GEHA Medicare |
$227.78
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$880.20
|
| 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 |
$391.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$227.78
|
| Rate for Payer: Multiplan All |
$889.98
|
| Rate for Payer: New Mexico Health Connections Medicare |
$387.23
|
| Rate for Payer: OMNI Networks Commercial |
$684.60
|
| Rate for Payer: One Health Plan PPO/POS |
$880.20
|
| 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 |
$227.78
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$929.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$455.56
|
| Rate for Payer: Three Rivers Provider Network All |
$733.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$223.22
|
| Rate for Payer: United Healthcare Managed Medicaid |
$391.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$227.78
|
| Rate for Payer: United Payors & United Providers UP&UP |
$909.54
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$227.78
|
| Rate for Payer: Zelis Auto |
$391.20
|
| Rate for Payer: Zelis Medicare |
$193.61
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$273.34
|
| Rate for Payer: Zelis Worker's Compensation |
$266.99
|
|
|
TREATMENT OF THIGH FRACTURE
|
Facility
|
OP
|
$1,003.00
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
6127508
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$132.77 |
| Max. Negotiated Rate |
$952.85 |
| 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 |
$601.80
|
| 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 |
$601.80
|
| Rate for Payer: Cash Price |
$601.80
|
| Rate for Payer: Cigna Commercial |
$852.55
|
| Rate for Payer: First Health Commercial |
$902.70
|
| Rate for Payer: First Health Workers Compensation |
$387.26
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$902.70
|
| Rate for Payer: GEHA Commercial |
$802.40
|
| Rate for Payer: GEHA Medicare |
$227.78
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$902.70
|
| 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 |
$912.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$387.23
|
| Rate for Payer: OMNI Networks Commercial |
$702.10
|
| Rate for Payer: One Health Plan PPO/POS |
$902.70
|
| 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 |
$952.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$455.56
|
| Rate for Payer: Three Rivers Provider Network All |
$752.25
|
| 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 |
$932.79
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$227.78
|
| Rate for Payer: Zelis Auto |
$401.20
|
| Rate for Payer: Zelis Medicare |
$193.61
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$273.34
|
| Rate for Payer: Zelis Worker's Compensation |
$273.82
|
|
|
TREATMENT OF THIGH FRACTURE
|
Facility
|
IP
|
$1,648.00
|
|
|
Service Code
|
CPT 27503
|
| Hospital Charge Code |
6127503
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$449.90 |
| Max. Negotiated Rate |
$1,565.60 |
| Rate for Payer: Cash Price |
$988.80
|
| Rate for Payer: Cigna Commercial |
$1,400.80
|
| Rate for Payer: First Health Commercial |
$1,483.20
|
| Rate for Payer: First Health Workers Compensation |
$636.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,483.20
|
| Rate for Payer: GEHA Commercial |
$1,153.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,483.20
|
| Rate for Payer: Multiplan All |
$1,499.68
|
| Rate for Payer: OMNI Networks Commercial |
$1,153.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,483.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,565.60
|
| Rate for Payer: Three Rivers Provider Network All |
$1,236.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,532.64
|
| Rate for Payer: Zelis Auto |
$659.20
|
| Rate for Payer: Zelis Worker's Compensation |
$449.90
|
|
|
TREATMENT OF THIGH FRACTURE
|
Facility
|
OP
|
$1,574.00
|
|
|
Service Code
|
CPT 27502
|
| Hospital Charge Code |
6127502
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$429.70 |
| Max. Negotiated Rate |
$3,039.30 |
| 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 |
$944.40
|
| 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 |
$1,519.65
|
| Rate for Payer: Cash Price |
$944.40
|
| Rate for Payer: Cash Price |
$944.40
|
| Rate for Payer: Cigna Commercial |
$1,337.90
|
| Rate for Payer: First Health Commercial |
$1,416.60
|
| Rate for Payer: First Health Workers Compensation |
$607.72
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,416.60
|
| Rate for Payer: GEHA Commercial |
$1,259.20
|
| Rate for Payer: GEHA Medicare |
$1,519.65
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,416.60
|
| 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 |
$1,503.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,519.65
|
| Rate for Payer: Multiplan All |
$1,432.34
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,583.41
|
| Rate for Payer: OMNI Networks Commercial |
$1,101.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,416.60
|
| 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 |
$1,519.65
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,495.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,039.30
|
| Rate for Payer: Three Rivers Provider Network All |
$1,180.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,489.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,503.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,519.65
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,463.82
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,519.65
|
| Rate for Payer: Zelis Auto |
$629.60
|
| 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 |
$429.70
|
|
|
TREATMENT OF THIGH FRACTURE
|
Facility
|
IP
|
$1,401.00
|
|
|
Service Code
|
CPT 27510
|
| Hospital Charge Code |
6127510
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$382.47 |
| Max. Negotiated Rate |
$1,330.95 |
| Rate for Payer: Cash Price |
$840.60
|
| Rate for Payer: Cigna Commercial |
$1,190.85
|
| Rate for Payer: First Health Commercial |
$1,260.90
|
| Rate for Payer: First Health Workers Compensation |
$540.93
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,260.90
|
| Rate for Payer: GEHA Commercial |
$980.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,260.90
|
| Rate for Payer: Multiplan All |
$1,274.91
|
| Rate for Payer: OMNI Networks Commercial |
$980.70
|
| Rate for Payer: One Health Plan PPO/POS |
$1,260.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,330.95
|
| Rate for Payer: Three Rivers Provider Network All |
$1,050.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,302.93
|
| Rate for Payer: Zelis Auto |
$560.40
|
| Rate for Payer: Zelis Worker's Compensation |
$382.47
|
|
|
TREATMENT OF THIGH FRACTURE
|
Facility
|
IP
|
$1,018.00
|
|
|
Service Code
|
CPT 27501
|
| Hospital Charge Code |
6127501
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$277.91 |
| Max. Negotiated Rate |
$967.10 |
| Rate for Payer: Cash Price |
$610.80
|
| Rate for Payer: Cigna Commercial |
$865.30
|
| Rate for Payer: First Health Commercial |
$916.20
|
| Rate for Payer: First Health Workers Compensation |
$393.05
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$916.20
|
| Rate for Payer: GEHA Commercial |
$712.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$916.20
|
| Rate for Payer: Multiplan All |
$926.38
|
| Rate for Payer: OMNI Networks Commercial |
$712.60
|
| Rate for Payer: One Health Plan PPO/POS |
$916.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$967.10
|
| Rate for Payer: Three Rivers Provider Network All |
$763.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$946.74
|
| Rate for Payer: Zelis Auto |
$407.20
|
| Rate for Payer: Zelis Worker's Compensation |
$277.91
|
|
|
TREATMENT OF URETHRA LESION
|
Facility
|
OP
|
$556.00
|
|
|
Service Code
|
CPT 53260
|
| Hospital Charge Code |
6153260
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$151.79 |
| Max. Negotiated Rate |
$6,549.86 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,056.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$333.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,056.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,628.99
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,274.93
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cigna Commercial |
$472.60
|
| Rate for Payer: First Health Commercial |
$500.40
|
| Rate for Payer: First Health Workers Compensation |
$214.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$500.40
|
| Rate for Payer: GEHA Commercial |
$444.80
|
| Rate for Payer: GEHA Medicare |
$3,274.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$500.40
|
| Rate for Payer: Humana ChoiceCare |
$3,602.42
|
| Rate for Payer: Humana Medicare Advantage |
$3,274.93
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,501.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,662.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,274.93
|
| Rate for Payer: Multiplan All |
$505.96
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,567.38
|
| Rate for Payer: OMNI Networks Commercial |
$389.20
|
| Rate for Payer: One Health Plan PPO/POS |
$500.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,919.20
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,662.17
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,274.93
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$528.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,549.86
|
| Rate for Payer: Three Rivers Provider Network All |
$417.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,209.43
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,662.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,274.93
|
| Rate for Payer: United Payors & United Providers UP&UP |
$517.08
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,274.93
|
| Rate for Payer: Zelis Auto |
$222.40
|
| Rate for Payer: Zelis Medicare |
$2,783.69
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,929.92
|
| Rate for Payer: Zelis Worker's Compensation |
$151.79
|
|
|
TREATMENT OF URETHRA LESION
|
Facility
|
IP
|
$556.00
|
|
|
Service Code
|
CPT 53260
|
| Hospital Charge Code |
6153260
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$151.79 |
| Max. Negotiated Rate |
$528.20 |
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cigna Commercial |
$472.60
|
| Rate for Payer: First Health Commercial |
$500.40
|
| Rate for Payer: First Health Workers Compensation |
$214.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$500.40
|
| Rate for Payer: GEHA Commercial |
$389.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$500.40
|
| Rate for Payer: Multiplan All |
$505.96
|
| Rate for Payer: OMNI Networks Commercial |
$389.20
|
| Rate for Payer: One Health Plan PPO/POS |
$500.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$528.20
|
| Rate for Payer: Three Rivers Provider Network All |
$417.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$517.08
|
| Rate for Payer: Zelis Auto |
$222.40
|
| Rate for Payer: Zelis Worker's Compensation |
$151.79
|
|
|
TREATMENT OF URETHRA LESION
|
Facility
|
OP
|
$573.00
|
|
|
Service Code
|
CPT 53265
|
| Hospital Charge Code |
6153265
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$156.43 |
| Max. Negotiated Rate |
$3,890.28 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,056.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$343.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,056.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,628.99
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,945.14
|
| Rate for Payer: Cash Price |
$343.80
|
| Rate for Payer: Cash Price |
$343.80
|
| Rate for Payer: Cigna Commercial |
$487.05
|
| Rate for Payer: First Health Commercial |
$515.70
|
| Rate for Payer: First Health Workers Compensation |
$221.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$515.70
|
| Rate for Payer: GEHA Commercial |
$458.40
|
| Rate for Payer: GEHA Medicare |
$1,945.14
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$515.70
|
| Rate for Payer: Humana ChoiceCare |
$2,139.65
|
| Rate for Payer: Humana Medicare Advantage |
$1,945.14
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$3,267.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,662.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,945.14
|
| Rate for Payer: Multiplan All |
$521.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,306.74
|
| Rate for Payer: OMNI Networks Commercial |
$401.10
|
| Rate for Payer: One Health Plan PPO/POS |
$515.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,919.20
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,662.17
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,945.14
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$544.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,890.28
|
| Rate for Payer: Three Rivers Provider Network All |
$429.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,906.24
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,662.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,945.14
|
| Rate for Payer: United Payors & United Providers UP&UP |
$532.89
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,945.14
|
| Rate for Payer: Zelis Auto |
$229.20
|
| Rate for Payer: Zelis Medicare |
$1,653.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,334.17
|
| Rate for Payer: Zelis Worker's Compensation |
$156.43
|
|
|
TREATMENT OF URETHRA LESION
|
Facility
|
IP
|
$573.00
|
|
|
Service Code
|
CPT 53265
|
| Hospital Charge Code |
6153265
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$156.43 |
| Max. Negotiated Rate |
$544.35 |
| Rate for Payer: Cash Price |
$343.80
|
| Rate for Payer: Cigna Commercial |
$487.05
|
| Rate for Payer: First Health Commercial |
$515.70
|
| Rate for Payer: First Health Workers Compensation |
$221.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$515.70
|
| Rate for Payer: GEHA Commercial |
$401.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$515.70
|
| Rate for Payer: Multiplan All |
$521.43
|
| Rate for Payer: OMNI Networks Commercial |
$401.10
|
| Rate for Payer: One Health Plan PPO/POS |
$515.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$544.35
|
| Rate for Payer: Three Rivers Provider Network All |
$429.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$532.89
|
| Rate for Payer: Zelis Auto |
$229.20
|
| Rate for Payer: Zelis Worker's Compensation |
$156.43
|
|
|
TREATMENT OF URETHRA LESION
|
Facility
|
OP
|
$934.00
|
|
|
Service Code
|
CPT 53220
|
| Hospital Charge Code |
6153220
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$254.98 |
| Max. Negotiated Rate |
$6,549.86 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,172.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$560.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,172.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,513.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,274.93
|
| Rate for Payer: Cash Price |
$560.40
|
| Rate for Payer: Cash Price |
$560.40
|
| Rate for Payer: Cigna Commercial |
$793.90
|
| Rate for Payer: First Health Commercial |
$840.60
|
| Rate for Payer: First Health Workers Compensation |
$360.62
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$840.60
|
| Rate for Payer: GEHA Commercial |
$747.20
|
| Rate for Payer: GEHA Medicare |
$3,274.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$840.60
|
| Rate for Payer: Humana ChoiceCare |
$3,602.42
|
| Rate for Payer: Humana Medicare Advantage |
$3,274.93
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,501.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,564.44
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,274.93
|
| Rate for Payer: Multiplan All |
$849.94
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,567.38
|
| Rate for Payer: OMNI Networks Commercial |
$653.80
|
| Rate for Payer: One Health Plan PPO/POS |
$840.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,961.00
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,564.44
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,274.93
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$887.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,549.86
|
| Rate for Payer: Three Rivers Provider Network All |
$700.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,209.43
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,564.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,274.93
|
| Rate for Payer: United Payors & United Providers UP&UP |
$868.62
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,274.93
|
| Rate for Payer: Zelis Auto |
$373.60
|
| Rate for Payer: Zelis Medicare |
$2,783.69
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,929.92
|
| Rate for Payer: Zelis Worker's Compensation |
$254.98
|
|
|
TREATMENT OF URETHRA LESION
|
Facility
|
IP
|
$934.00
|
|
|
Service Code
|
CPT 53220
|
| Hospital Charge Code |
6153220
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$254.98 |
| Max. Negotiated Rate |
$887.30 |
| Rate for Payer: Cash Price |
$560.40
|
| Rate for Payer: Cigna Commercial |
$793.90
|
| Rate for Payer: First Health Commercial |
$840.60
|
| Rate for Payer: First Health Workers Compensation |
$360.62
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$840.60
|
| Rate for Payer: GEHA Commercial |
$653.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$840.60
|
| Rate for Payer: Multiplan All |
$849.94
|
| Rate for Payer: OMNI Networks Commercial |
$653.80
|
| Rate for Payer: One Health Plan PPO/POS |
$840.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$887.30
|
| Rate for Payer: Three Rivers Provider Network All |
$700.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$868.62
|
| Rate for Payer: Zelis Auto |
$373.60
|
| Rate for Payer: Zelis Worker's Compensation |
$254.98
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
OP
|
$919.00
|
|
|
Service Code
|
CPT 26607
|
| Hospital Charge Code |
6126607
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$250.89 |
| 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 |
$551.40
|
| 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 |
$551.40
|
| Rate for Payer: Cash Price |
$551.40
|
| Rate for Payer: Cigna Commercial |
$781.15
|
| Rate for Payer: First Health Commercial |
$827.10
|
| Rate for Payer: First Health Workers Compensation |
$354.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$827.10
|
| Rate for Payer: GEHA Commercial |
$735.20
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$827.10
|
| 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 |
$836.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$643.30
|
| Rate for Payer: One Health Plan PPO/POS |
$827.10
|
| 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 |
$873.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$689.25
|
| 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 |
$854.67
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$367.60
|
| 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 |
$250.89
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
IP
|
$919.00
|
|
|
Service Code
|
CPT 26607
|
| Hospital Charge Code |
6126607
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$250.89 |
| Max. Negotiated Rate |
$873.05 |
| Rate for Payer: Cash Price |
$551.40
|
| Rate for Payer: Cigna Commercial |
$781.15
|
| Rate for Payer: First Health Commercial |
$827.10
|
| Rate for Payer: First Health Workers Compensation |
$354.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$827.10
|
| Rate for Payer: GEHA Commercial |
$643.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$827.10
|
| Rate for Payer: Multiplan All |
$836.29
|
| Rate for Payer: OMNI Networks Commercial |
$643.30
|
| Rate for Payer: One Health Plan PPO/POS |
$827.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$873.05
|
| Rate for Payer: Three Rivers Provider Network All |
$689.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$854.67
|
| Rate for Payer: Zelis Auto |
$367.60
|
| Rate for Payer: Zelis Worker's Compensation |
$250.89
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
OP
|
$731.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
6126605
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$132.77 |
| Max. Negotiated Rate |
$694.45 |
| 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 |
$438.60
|
| 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 |
$438.60
|
| Rate for Payer: Cash Price |
$438.60
|
| Rate for Payer: Cigna Commercial |
$621.35
|
| Rate for Payer: First Health Commercial |
$657.90
|
| Rate for Payer: First Health Workers Compensation |
$282.24
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$657.90
|
| Rate for Payer: GEHA Commercial |
$584.80
|
| Rate for Payer: GEHA Medicare |
$227.78
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$657.90
|
| 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 |
$665.21
|
| Rate for Payer: New Mexico Health Connections Medicare |
$387.23
|
| Rate for Payer: OMNI Networks Commercial |
$511.70
|
| Rate for Payer: One Health Plan PPO/POS |
$657.90
|
| 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 |
$694.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$455.56
|
| Rate for Payer: Three Rivers Provider Network All |
$548.25
|
| 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 |
$679.83
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$227.78
|
| Rate for Payer: Zelis Auto |
$292.40
|
| Rate for Payer: Zelis Medicare |
$193.61
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$273.34
|
| Rate for Payer: Zelis Worker's Compensation |
$199.56
|
|
|
TREAT METACARPAL FRACTURE
|
Facility
|
OP
|
$1,708.95
|
|
|
Service Code
|
CPT 26615
|
| Hospital Charge Code |
6126615
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$466.54 |
| Max. Negotiated Rate |
$6,161.78 |
| 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 |
$1,025.37
|
| 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 |
$3,080.89
|
| Rate for Payer: Cash Price |
$1,025.37
|
| Rate for Payer: Cash Price |
$1,025.37
|
| Rate for Payer: Cigna Commercial |
$1,452.61
|
| Rate for Payer: First Health Commercial |
$1,538.06
|
| Rate for Payer: First Health Workers Compensation |
$659.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,538.06
|
| Rate for Payer: GEHA Commercial |
$1,367.16
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,538.06
|
| 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 |
$3,716.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$1,555.14
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$1,196.27
|
| Rate for Payer: One Health Plan PPO/POS |
$1,538.06
|
| 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 |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,623.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$1,281.71
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,716.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,589.32
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$683.58
|
| 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 |
$466.54
|
|
