|
TREAT TAIL BONE FRACTURE
|
Facility
|
IP
|
$564.00
|
|
|
Service Code
|
CPT 27200
|
| Hospital Charge Code |
6127200
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$153.97 |
| Max. Negotiated Rate |
$535.80 |
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Cigna Commercial |
$479.40
|
| Rate for Payer: First Health Commercial |
$507.60
|
| Rate for Payer: First Health Workers Compensation |
$217.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$507.60
|
| Rate for Payer: GEHA Commercial |
$394.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$507.60
|
| Rate for Payer: Multiplan All |
$513.24
|
| Rate for Payer: OMNI Networks Commercial |
$394.80
|
| Rate for Payer: One Health Plan PPO/POS |
$507.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$535.80
|
| Rate for Payer: Three Rivers Provider Network All |
$423.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$524.52
|
| Rate for Payer: Zelis Auto |
$225.60
|
| Rate for Payer: Zelis Worker's Compensation |
$153.97
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
OP
|
$984.00
|
|
|
Service Code
|
CPT 27246
|
| Hospital Charge Code |
6127246
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$197.57 |
| Max. Negotiated Rate |
$934.80 |
| 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 |
$590.40
|
| 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 |
$232.44
|
| Rate for Payer: Cash Price |
$590.40
|
| Rate for Payer: Cash Price |
$590.40
|
| Rate for Payer: Cigna Commercial |
$836.40
|
| Rate for Payer: First Health Commercial |
$885.60
|
| Rate for Payer: First Health Workers Compensation |
$379.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$885.60
|
| Rate for Payer: GEHA Commercial |
$787.20
|
| Rate for Payer: GEHA Medicare |
$232.44
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$885.60
|
| 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 |
$391.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$232.44
|
| Rate for Payer: Multiplan All |
$895.44
|
| Rate for Payer: New Mexico Health Connections Medicare |
$395.15
|
| Rate for Payer: OMNI Networks Commercial |
$688.80
|
| Rate for Payer: One Health Plan PPO/POS |
$885.60
|
| 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 |
$232.44
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$934.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$464.88
|
| Rate for Payer: Three Rivers Provider Network All |
$738.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$227.79
|
| Rate for Payer: United Healthcare Managed Medicaid |
$391.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$232.44
|
| Rate for Payer: United Payors & United Providers UP&UP |
$915.12
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$232.44
|
| Rate for Payer: Zelis Auto |
$393.60
|
| Rate for Payer: Zelis Medicare |
$197.57
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$278.93
|
| Rate for Payer: Zelis Worker's Compensation |
$268.63
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
OP
|
$2,470.00
|
|
|
Service Code
|
CPT 27236
|
| Hospital Charge Code |
6127236
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$617.50 |
| Max. Negotiated Rate |
$2,346.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,482.00
|
| Rate for Payer: Cash Price |
$1,482.00
|
| Rate for Payer: Cigna Commercial |
$2,099.50
|
| Rate for Payer: First Health Commercial |
$2,223.00
|
| Rate for Payer: First Health Workers Compensation |
$953.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,223.00
|
| Rate for Payer: GEHA Commercial |
$1,976.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,223.00
|
| Rate for Payer: Humana ChoiceCare |
$642.20
|
| Rate for Payer: Multiplan All |
$2,247.70
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,482.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,729.00
|
| Rate for Payer: One Health Plan PPO/POS |
$2,223.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,346.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,852.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,173.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$617.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,297.10
|
| Rate for Payer: Zelis Auto |
$988.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,235.00
|
| Rate for Payer: Zelis Worker's Compensation |
$674.31
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
OP
|
$1,555.00
|
|
|
Service Code
|
CPT 27232
|
| Hospital Charge Code |
6127232
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$388.75 |
| Max. Negotiated Rate |
$1,477.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$933.00
|
| Rate for Payer: Cash Price |
$933.00
|
| Rate for Payer: Cigna Commercial |
$1,321.75
|
| Rate for Payer: First Health Commercial |
$1,399.50
|
| Rate for Payer: First Health Workers Compensation |
$600.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,399.50
|
| Rate for Payer: GEHA Commercial |
$1,244.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,399.50
|
| Rate for Payer: Humana ChoiceCare |
$404.30
|
| Rate for Payer: Multiplan All |
$1,415.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$933.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,088.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,399.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,477.25
|
| Rate for Payer: Three Rivers Provider Network All |
$1,166.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,368.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$388.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,446.15
|
| Rate for Payer: Zelis Auto |
$622.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$777.50
|
| Rate for Payer: Zelis Worker's Compensation |
$424.51
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
IP
|
$1,970.00
|
|
|
Service Code
|
CPT 27240
|
| Hospital Charge Code |
6127240
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$537.81 |
| Max. Negotiated Rate |
$1,871.50 |
| Rate for Payer: Cash Price |
$1,182.00
|
| Rate for Payer: Cigna Commercial |
$1,674.50
|
| Rate for Payer: First Health Commercial |
$1,773.00
|
| Rate for Payer: First Health Workers Compensation |
$760.62
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,773.00
|
| Rate for Payer: GEHA Commercial |
$1,379.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,773.00
|
| Rate for Payer: Multiplan All |
$1,792.70
|
| Rate for Payer: OMNI Networks Commercial |
$1,379.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,773.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,871.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,477.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,832.10
|
| Rate for Payer: Zelis Auto |
$788.00
|
| Rate for Payer: Zelis Worker's Compensation |
$537.81
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
IP
|
$984.00
|
|
|
Service Code
|
CPT 27246
|
| Hospital Charge Code |
6127246
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$268.63 |
| Max. Negotiated Rate |
$934.80 |
| Rate for Payer: Cash Price |
$590.40
|
| Rate for Payer: Cigna Commercial |
$836.40
|
| Rate for Payer: First Health Commercial |
$885.60
|
| Rate for Payer: First Health Workers Compensation |
$379.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$885.60
|
| Rate for Payer: GEHA Commercial |
$688.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$885.60
|
| Rate for Payer: Multiplan All |
$895.44
|
| Rate for Payer: OMNI Networks Commercial |
$688.80
|
| Rate for Payer: One Health Plan PPO/POS |
$885.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$934.80
|
| Rate for Payer: Three Rivers Provider Network All |
$738.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$915.12
|
| Rate for Payer: Zelis Auto |
$393.60
|
| Rate for Payer: Zelis Worker's Compensation |
$268.63
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
IP
|
$2,470.00
|
|
|
Service Code
|
CPT 27236
|
| Hospital Charge Code |
6127236
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$674.31 |
| Max. Negotiated Rate |
$2,346.50 |
| Rate for Payer: Cash Price |
$1,482.00
|
| Rate for Payer: Cigna Commercial |
$2,099.50
|
| Rate for Payer: First Health Commercial |
$2,223.00
|
| Rate for Payer: First Health Workers Compensation |
$953.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,223.00
|
| Rate for Payer: GEHA Commercial |
$1,729.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,223.00
|
| Rate for Payer: Multiplan All |
$2,247.70
|
| Rate for Payer: OMNI Networks Commercial |
$1,729.00
|
| Rate for Payer: One Health Plan PPO/POS |
$2,223.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,346.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,852.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,297.10
|
| Rate for Payer: Zelis Auto |
$988.00
|
| Rate for Payer: Zelis Worker's Compensation |
$674.31
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
OP
|
$1,874.00
|
|
|
Service Code
|
CPT 27235
|
| Hospital Charge Code |
6127235
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$511.60 |
| Max. Negotiated Rate |
$13,844.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,212.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,124.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,212.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,544.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,922.13
|
| Rate for Payer: Cash Price |
$1,124.40
|
| Rate for Payer: Cash Price |
$1,124.40
|
| Rate for Payer: Cigna Commercial |
$1,592.90
|
| Rate for Payer: First Health Commercial |
$1,686.60
|
| Rate for Payer: First Health Workers Compensation |
$723.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,686.60
|
| Rate for Payer: GEHA Commercial |
$1,499.20
|
| Rate for Payer: GEHA Medicare |
$6,922.13
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,686.60
|
| 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 |
$2,596.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,922.13
|
| Rate for Payer: Multiplan All |
$1,705.34
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,767.62
|
| Rate for Payer: OMNI Networks Commercial |
$1,311.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,686.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,998.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,596.69
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,922.13
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,780.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,844.26
|
| Rate for Payer: Three Rivers Provider Network All |
$1,405.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,783.69
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,596.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,922.13
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,742.82
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,922.13
|
| Rate for Payer: Zelis Auto |
$749.60
|
| 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 |
$511.60
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
IP
|
$2,543.00
|
|
|
Service Code
|
CPT 27244
|
| Hospital Charge Code |
6127244
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$694.24 |
| Max. Negotiated Rate |
$2,415.85 |
| Rate for Payer: Cash Price |
$1,525.80
|
| Rate for Payer: Cigna Commercial |
$2,161.55
|
| Rate for Payer: First Health Commercial |
$2,288.70
|
| Rate for Payer: First Health Workers Compensation |
$981.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,288.70
|
| Rate for Payer: GEHA Commercial |
$1,780.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,288.70
|
| Rate for Payer: Multiplan All |
$2,314.13
|
| Rate for Payer: OMNI Networks Commercial |
$1,780.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2,288.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,415.85
|
| Rate for Payer: Three Rivers Provider Network All |
$1,907.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,364.99
|
| Rate for Payer: Zelis Auto |
$1,017.20
|
| Rate for Payer: Zelis Worker's Compensation |
$694.24
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
IP
|
$956.00
|
|
|
Service Code
|
CPT 27230
|
| Hospital Charge Code |
6127230
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$260.99 |
| Max. Negotiated Rate |
$908.20 |
| Rate for Payer: Cash Price |
$573.60
|
| Rate for Payer: Cigna Commercial |
$812.60
|
| Rate for Payer: First Health Commercial |
$860.40
|
| Rate for Payer: First Health Workers Compensation |
$369.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$860.40
|
| Rate for Payer: GEHA Commercial |
$669.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$860.40
|
| Rate for Payer: Multiplan All |
$869.96
|
| Rate for Payer: OMNI Networks Commercial |
$669.20
|
| Rate for Payer: One Health Plan PPO/POS |
$860.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$908.20
|
| Rate for Payer: Three Rivers Provider Network All |
$717.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$889.08
|
| Rate for Payer: Zelis Auto |
$382.40
|
| Rate for Payer: Zelis Worker's Compensation |
$260.99
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
IP
|
$935.00
|
|
|
Service Code
|
CPT 27238
|
| Hospital Charge Code |
6127238
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$255.25 |
| Max. Negotiated Rate |
$888.25 |
| Rate for Payer: Cash Price |
$561.00
|
| Rate for Payer: Cigna Commercial |
$794.75
|
| Rate for Payer: First Health Commercial |
$841.50
|
| Rate for Payer: First Health Workers Compensation |
$361.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$841.50
|
| Rate for Payer: GEHA Commercial |
$654.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$841.50
|
| Rate for Payer: Multiplan All |
$850.85
|
| Rate for Payer: OMNI Networks Commercial |
$654.50
|
| Rate for Payer: One Health Plan PPO/POS |
$841.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$888.25
|
| Rate for Payer: Three Rivers Provider Network All |
$701.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$869.55
|
| Rate for Payer: Zelis Auto |
$374.00
|
| Rate for Payer: Zelis Worker's Compensation |
$255.25
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
CPT 27248
|
| Hospital Charge Code |
6127248
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$382.50 |
| Max. Negotiated Rate |
$1,453.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$918.00
|
| Rate for Payer: Cash Price |
$918.00
|
| Rate for Payer: Cigna Commercial |
$1,300.50
|
| Rate for Payer: First Health Commercial |
$1,377.00
|
| Rate for Payer: First Health Workers Compensation |
$590.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,377.00
|
| Rate for Payer: GEHA Commercial |
$1,224.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,377.00
|
| Rate for Payer: Humana ChoiceCare |
$397.80
|
| Rate for Payer: Multiplan All |
$1,392.30
|
| Rate for Payer: New Mexico Health Connections Medicare |
$918.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,071.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,377.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,453.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,147.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,346.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$382.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,422.90
|
| Rate for Payer: Zelis Auto |
$612.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$765.00
|
| Rate for Payer: Zelis Worker's Compensation |
$417.69
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
OP
|
$2,543.00
|
|
|
Service Code
|
CPT 27245
|
| Hospital Charge Code |
6127245
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$635.75 |
| Max. Negotiated Rate |
$2,415.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,525.80
|
| Rate for Payer: Cash Price |
$1,525.80
|
| Rate for Payer: Cigna Commercial |
$2,161.55
|
| Rate for Payer: First Health Commercial |
$2,288.70
|
| Rate for Payer: First Health Workers Compensation |
$981.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,288.70
|
| Rate for Payer: GEHA Commercial |
$2,034.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,288.70
|
| Rate for Payer: Humana ChoiceCare |
$661.18
|
| Rate for Payer: Multiplan All |
$2,314.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,525.80
|
| Rate for Payer: OMNI Networks Commercial |
$1,780.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2,288.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,415.85
|
| Rate for Payer: Three Rivers Provider Network All |
$1,907.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,237.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$635.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,364.99
|
| Rate for Payer: Zelis Auto |
$1,017.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,271.50
|
| Rate for Payer: Zelis Worker's Compensation |
$694.24
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
CPT 27248
|
| Hospital Charge Code |
6127248
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$417.69 |
| Max. Negotiated Rate |
$1,453.50 |
| Rate for Payer: Cash Price |
$918.00
|
| Rate for Payer: Cigna Commercial |
$1,300.50
|
| Rate for Payer: First Health Commercial |
$1,377.00
|
| Rate for Payer: First Health Workers Compensation |
$590.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,377.00
|
| Rate for Payer: GEHA Commercial |
$1,071.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,377.00
|
| Rate for Payer: Multiplan All |
$1,392.30
|
| Rate for Payer: OMNI Networks Commercial |
$1,071.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,377.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,453.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,147.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,422.90
|
| Rate for Payer: Zelis Auto |
$612.00
|
| Rate for Payer: Zelis Worker's Compensation |
$417.69
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
IP
|
$2,543.00
|
|
|
Service Code
|
CPT 27245
|
| Hospital Charge Code |
6127245
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$694.24 |
| Max. Negotiated Rate |
$2,415.85 |
| Rate for Payer: Cash Price |
$1,525.80
|
| Rate for Payer: Cigna Commercial |
$2,161.55
|
| Rate for Payer: First Health Commercial |
$2,288.70
|
| Rate for Payer: First Health Workers Compensation |
$981.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,288.70
|
| Rate for Payer: GEHA Commercial |
$1,780.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,288.70
|
| Rate for Payer: Multiplan All |
$2,314.13
|
| Rate for Payer: OMNI Networks Commercial |
$1,780.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2,288.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,415.85
|
| Rate for Payer: Three Rivers Provider Network All |
$1,907.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,364.99
|
| Rate for Payer: Zelis Auto |
$1,017.20
|
| Rate for Payer: Zelis Worker's Compensation |
$694.24
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
OP
|
$1,970.00
|
|
|
Service Code
|
CPT 27240
|
| Hospital Charge Code |
6127240
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$492.50 |
| Max. Negotiated Rate |
$1,871.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,182.00
|
| Rate for Payer: Cash Price |
$1,182.00
|
| Rate for Payer: Cigna Commercial |
$1,674.50
|
| Rate for Payer: First Health Commercial |
$1,773.00
|
| Rate for Payer: First Health Workers Compensation |
$760.62
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,773.00
|
| Rate for Payer: GEHA Commercial |
$1,576.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,773.00
|
| Rate for Payer: Humana ChoiceCare |
$512.20
|
| Rate for Payer: Multiplan All |
$1,792.70
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,182.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,379.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,773.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,871.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,477.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,733.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$492.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,832.10
|
| Rate for Payer: Zelis Auto |
$788.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$985.00
|
| Rate for Payer: Zelis Worker's Compensation |
$537.81
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
OP
|
$935.00
|
|
|
Service Code
|
CPT 27238
|
| Hospital Charge Code |
6127238
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$255.25 |
| 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 |
$561.00
|
| 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 |
$561.00
|
| Rate for Payer: Cash Price |
$561.00
|
| Rate for Payer: Cigna Commercial |
$794.75
|
| Rate for Payer: First Health Commercial |
$841.50
|
| Rate for Payer: First Health Workers Compensation |
$361.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$841.50
|
| Rate for Payer: GEHA Commercial |
$748.00
|
| Rate for Payer: GEHA Medicare |
$1,550.77
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$841.50
|
| 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 |
$850.85
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,636.31
|
| Rate for Payer: OMNI Networks Commercial |
$654.50
|
| Rate for Payer: One Health Plan PPO/POS |
$841.50
|
| 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 |
$888.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,101.54
|
| Rate for Payer: Three Rivers Provider Network All |
$701.25
|
| 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 |
$869.55
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,550.77
|
| Rate for Payer: Zelis Auto |
$374.00
|
| 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 |
$255.25
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
IP
|
$1,555.00
|
|
|
Service Code
|
CPT 27232
|
| Hospital Charge Code |
6127232
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$424.51 |
| Max. Negotiated Rate |
$1,477.25 |
| Rate for Payer: Cash Price |
$933.00
|
| Rate for Payer: Cigna Commercial |
$1,321.75
|
| Rate for Payer: First Health Commercial |
$1,399.50
|
| Rate for Payer: First Health Workers Compensation |
$600.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,399.50
|
| Rate for Payer: GEHA Commercial |
$1,088.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,399.50
|
| Rate for Payer: Multiplan All |
$1,415.05
|
| Rate for Payer: OMNI Networks Commercial |
$1,088.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,399.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,477.25
|
| Rate for Payer: Three Rivers Provider Network All |
$1,166.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,446.15
|
| Rate for Payer: Zelis Auto |
$622.00
|
| Rate for Payer: Zelis Worker's Compensation |
$424.51
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
OP
|
$2,543.00
|
|
|
Service Code
|
CPT 27244
|
| Hospital Charge Code |
6127244
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$635.75 |
| Max. Negotiated Rate |
$2,415.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,525.80
|
| Rate for Payer: Cash Price |
$1,525.80
|
| Rate for Payer: Cigna Commercial |
$2,161.55
|
| Rate for Payer: First Health Commercial |
$2,288.70
|
| Rate for Payer: First Health Workers Compensation |
$981.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,288.70
|
| Rate for Payer: GEHA Commercial |
$2,034.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,288.70
|
| Rate for Payer: Humana ChoiceCare |
$661.18
|
| Rate for Payer: Multiplan All |
$2,314.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,525.80
|
| Rate for Payer: OMNI Networks Commercial |
$1,780.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2,288.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,415.85
|
| Rate for Payer: Three Rivers Provider Network All |
$1,907.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,237.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$635.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,364.99
|
| Rate for Payer: Zelis Auto |
$1,017.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,271.50
|
| Rate for Payer: Zelis Worker's Compensation |
$694.24
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
IP
|
$1,874.00
|
|
|
Service Code
|
CPT 27235
|
| Hospital Charge Code |
6127235
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$511.60 |
| Max. Negotiated Rate |
$1,780.30 |
| Rate for Payer: Cash Price |
$1,124.40
|
| Rate for Payer: Cigna Commercial |
$1,592.90
|
| Rate for Payer: First Health Commercial |
$1,686.60
|
| Rate for Payer: First Health Workers Compensation |
$723.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,686.60
|
| Rate for Payer: GEHA Commercial |
$1,311.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,686.60
|
| Rate for Payer: Multiplan All |
$1,705.34
|
| Rate for Payer: OMNI Networks Commercial |
$1,311.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,686.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,780.30
|
| Rate for Payer: Three Rivers Provider Network All |
$1,405.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,742.82
|
| Rate for Payer: Zelis Auto |
$749.60
|
| Rate for Payer: Zelis Worker's Compensation |
$511.60
|
|
|
TREAT THIGH FRACTURE
|
Facility
|
OP
|
$956.00
|
|
|
Service Code
|
CPT 27230
|
| Hospital Charge Code |
6127230
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$132.77 |
| Max. Negotiated Rate |
$908.20 |
| 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 |
$573.60
|
| 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 |
$232.44
|
| Rate for Payer: Cash Price |
$573.60
|
| Rate for Payer: Cash Price |
$573.60
|
| Rate for Payer: Cigna Commercial |
$812.60
|
| Rate for Payer: First Health Commercial |
$860.40
|
| Rate for Payer: First Health Workers Compensation |
$369.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$860.40
|
| Rate for Payer: GEHA Commercial |
$764.80
|
| Rate for Payer: GEHA Medicare |
$232.44
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$860.40
|
| 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 |
$869.96
|
| Rate for Payer: New Mexico Health Connections Medicare |
$395.15
|
| Rate for Payer: OMNI Networks Commercial |
$669.20
|
| Rate for Payer: One Health Plan PPO/POS |
$860.40
|
| 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 |
$908.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$464.88
|
| Rate for Payer: Three Rivers Provider Network All |
$717.00
|
| 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 |
$889.08
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$232.44
|
| Rate for Payer: Zelis Auto |
$382.40
|
| Rate for Payer: Zelis Medicare |
$197.57
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$278.93
|
| Rate for Payer: Zelis Worker's Compensation |
$260.99
|
|
|
TREAT THIGH FX GROWTH PLATE
|
Facility
|
IP
|
$1,843.00
|
|
|
Service Code
|
CPT 27519
|
| Hospital Charge Code |
6127519
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$503.14 |
| Max. Negotiated Rate |
$1,750.85 |
| Rate for Payer: Cash Price |
$1,105.80
|
| Rate for Payer: Cigna Commercial |
$1,566.55
|
| Rate for Payer: First Health Commercial |
$1,658.70
|
| Rate for Payer: First Health Workers Compensation |
$711.58
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,658.70
|
| Rate for Payer: GEHA Commercial |
$1,290.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,658.70
|
| Rate for Payer: Multiplan All |
$1,677.13
|
| Rate for Payer: OMNI Networks Commercial |
$1,290.10
|
| Rate for Payer: One Health Plan PPO/POS |
$1,658.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,750.85
|
| Rate for Payer: Three Rivers Provider Network All |
$1,382.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,713.99
|
| Rate for Payer: Zelis Auto |
$737.20
|
| Rate for Payer: Zelis Worker's Compensation |
$503.14
|
|
|
TREAT THIGH FX GROWTH PLATE
|
Facility
|
OP
|
$1,843.00
|
|
|
Service Code
|
CPT 27519
|
| Hospital Charge Code |
6127519
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$460.75 |
| Max. Negotiated Rate |
$1,750.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,105.80
|
| Rate for Payer: Cash Price |
$1,105.80
|
| Rate for Payer: Cigna Commercial |
$1,566.55
|
| Rate for Payer: First Health Commercial |
$1,658.70
|
| Rate for Payer: First Health Workers Compensation |
$711.58
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,658.70
|
| Rate for Payer: GEHA Commercial |
$1,474.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,658.70
|
| Rate for Payer: Humana ChoiceCare |
$479.18
|
| Rate for Payer: Multiplan All |
$1,677.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,105.80
|
| Rate for Payer: OMNI Networks Commercial |
$1,290.10
|
| Rate for Payer: One Health Plan PPO/POS |
$1,658.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,750.85
|
| Rate for Payer: Three Rivers Provider Network All |
$1,382.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,621.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$460.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,713.99
|
| Rate for Payer: Zelis Auto |
$737.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$921.50
|
| Rate for Payer: Zelis Worker's Compensation |
$503.14
|
|
|
TREAT THIGH FX GROWTH PLATE
|
Facility
|
IP
|
$966.00
|
|
|
Service Code
|
CPT 27516
|
| Hospital Charge Code |
6127516
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$263.72 |
| Max. Negotiated Rate |
$917.70 |
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Cigna Commercial |
$821.10
|
| Rate for Payer: First Health Commercial |
$869.40
|
| Rate for Payer: First Health Workers Compensation |
$372.97
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$869.40
|
| Rate for Payer: GEHA Commercial |
$676.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$869.40
|
| Rate for Payer: Multiplan All |
$879.06
|
| Rate for Payer: OMNI Networks Commercial |
$676.20
|
| Rate for Payer: One Health Plan PPO/POS |
$869.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$917.70
|
| Rate for Payer: Three Rivers Provider Network All |
$724.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$898.38
|
| Rate for Payer: Zelis Auto |
$386.40
|
| Rate for Payer: Zelis Worker's Compensation |
$263.72
|
|
|
TREAT THIGH FX GROWTH PLATE
|
Facility
|
IP
|
$1,383.00
|
|
|
Service Code
|
CPT 27517
|
| Hospital Charge Code |
6127517
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$377.56 |
| Max. Negotiated Rate |
$1,313.85 |
| Rate for Payer: Cash Price |
$829.80
|
| Rate for Payer: Cigna Commercial |
$1,175.55
|
| Rate for Payer: First Health Commercial |
$1,244.70
|
| Rate for Payer: First Health Workers Compensation |
$533.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,244.70
|
| Rate for Payer: GEHA Commercial |
$968.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,244.70
|
| Rate for Payer: Multiplan All |
$1,258.53
|
| Rate for Payer: OMNI Networks Commercial |
$968.10
|
| Rate for Payer: One Health Plan PPO/POS |
$1,244.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,313.85
|
| Rate for Payer: Three Rivers Provider Network All |
$1,037.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,286.19
|
| Rate for Payer: Zelis Auto |
$553.20
|
| Rate for Payer: Zelis Worker's Compensation |
$377.56
|
|
