|
TRIAMCINOLONE OINT 0.1% - 15GM
|
Facility
|
IP
|
$39.00
|
|
|
Service Code
|
NDC 45802005535
|
| Hospital Charge Code |
3300919
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$10.65 |
| Max. Negotiated Rate |
$37.05 |
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna Commercial |
$33.15
|
| Rate for Payer: First Health Commercial |
$35.10
|
| Rate for Payer: First Health Workers Compensation |
$15.06
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$35.10
|
| Rate for Payer: GEHA Commercial |
$27.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$35.10
|
| Rate for Payer: Multiplan All |
$35.49
|
| Rate for Payer: OMNI Networks Commercial |
$27.30
|
| Rate for Payer: One Health Plan PPO/POS |
$35.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$37.05
|
| Rate for Payer: Three Rivers Provider Network All |
$29.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$36.27
|
| Rate for Payer: Zelis Auto |
$15.60
|
| Rate for Payer: Zelis Worker's Compensation |
$10.65
|
|
|
TRIAMTERENE/HCTZ 37.5 MG/25 MG TAB
|
Facility
|
IP
|
$3.00
|
|
|
Service Code
|
NDC 60505265601
|
| Hospital Charge Code |
3302962
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$2.85 |
| Rate for Payer: Cash Price |
$1.80
|
| Rate for Payer: Cigna Commercial |
$2.55
|
| Rate for Payer: First Health Commercial |
$2.70
|
| Rate for Payer: First Health Workers Compensation |
$1.16
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2.70
|
| Rate for Payer: GEHA Commercial |
$2.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2.70
|
| Rate for Payer: Multiplan All |
$2.73
|
| Rate for Payer: OMNI Networks Commercial |
$2.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2.85
|
| Rate for Payer: Three Rivers Provider Network All |
$2.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2.79
|
| Rate for Payer: Zelis Auto |
$1.20
|
| Rate for Payer: Zelis Worker's Compensation |
$0.82
|
|
|
TRIAMTERENE/HCTZ 37.5 MG/25 MG TAB
|
Facility
|
OP
|
$3.00
|
|
|
Service Code
|
NDC 60505265601
|
| Hospital Charge Code |
3302962
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$2.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1.80
|
| Rate for Payer: Cash Price |
$1.80
|
| Rate for Payer: Cigna Commercial |
$2.55
|
| Rate for Payer: First Health Commercial |
$2.70
|
| Rate for Payer: First Health Workers Compensation |
$1.16
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2.70
|
| Rate for Payer: GEHA Commercial |
$2.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2.70
|
| Rate for Payer: Humana ChoiceCare |
$0.78
|
| Rate for Payer: Multiplan All |
$2.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1.80
|
| Rate for Payer: OMNI Networks Commercial |
$2.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2.85
|
| Rate for Payer: Three Rivers Provider Network All |
$2.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2.64
|
| Rate for Payer: United Healthcare Managed Medicaid |
$0.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2.79
|
| Rate for Payer: Zelis Auto |
$1.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1.50
|
| Rate for Payer: Zelis Worker's Compensation |
$0.82
|
|
|
TRIAMTERENE & HCTZ CAP 37.5-25MG
|
Facility
|
OP
|
$7.00
|
|
|
Service Code
|
NDC 00781207401
|
| Hospital Charge Code |
3300924
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.75 |
| Max. Negotiated Rate |
$6.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4.20
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cigna Commercial |
$5.95
|
| Rate for Payer: First Health Commercial |
$6.30
|
| Rate for Payer: First Health Workers Compensation |
$2.70
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6.30
|
| Rate for Payer: GEHA Commercial |
$5.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6.30
|
| Rate for Payer: Humana ChoiceCare |
$1.82
|
| Rate for Payer: Multiplan All |
$6.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4.20
|
| Rate for Payer: OMNI Networks Commercial |
$4.90
|
| Rate for Payer: One Health Plan PPO/POS |
$6.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$6.65
|
| Rate for Payer: Three Rivers Provider Network All |
$5.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$6.51
|
| Rate for Payer: Zelis Auto |
$2.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3.50
|
| Rate for Payer: Zelis Worker's Compensation |
$1.91
|
|
|
TRIAMTERENE & HCTZ CAP 37.5-25MG
|
Facility
|
IP
|
$7.00
|
|
|
Service Code
|
NDC 00781207401
|
| Hospital Charge Code |
3300924
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.91 |
| Max. Negotiated Rate |
$6.65 |
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cigna Commercial |
$5.95
|
| Rate for Payer: First Health Commercial |
$6.30
|
| Rate for Payer: First Health Workers Compensation |
$2.70
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6.30
|
| Rate for Payer: GEHA Commercial |
$4.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6.30
|
| Rate for Payer: Multiplan All |
$6.37
|
| Rate for Payer: OMNI Networks Commercial |
$4.90
|
| Rate for Payer: One Health Plan PPO/POS |
$6.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$6.65
|
| Rate for Payer: Three Rivers Provider Network All |
$5.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$6.51
|
| Rate for Payer: Zelis Auto |
$2.80
|
| Rate for Payer: Zelis Worker's Compensation |
$1.91
|
|
|
trichomonas vaginalis, naa REF188052
|
Facility
|
IP
|
$203.00
|
|
|
Service Code
|
CPT 87661
|
| Hospital Charge Code |
2299565
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.52 |
| Max. Negotiated Rate |
$192.85 |
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cigna Commercial |
$172.55
|
| Rate for Payer: First Health Commercial |
$182.70
|
| Rate for Payer: First Health Workers Compensation |
$45.99
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$182.70
|
| Rate for Payer: GEHA Commercial |
$142.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$182.70
|
| Rate for Payer: Multiplan All |
$184.73
|
| Rate for Payer: OMNI Networks Commercial |
$142.10
|
| Rate for Payer: One Health Plan PPO/POS |
$182.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$192.85
|
| Rate for Payer: Three Rivers Provider Network All |
$152.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$188.79
|
| Rate for Payer: Zelis Auto |
$81.20
|
| Rate for Payer: Zelis Worker's Compensation |
$32.52
|
|
|
trichomonas vaginalis, naa REF188052
|
Facility
|
OP
|
$203.00
|
|
|
Service Code
|
CPT 87661
|
| Hospital Charge Code |
2299565
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.83 |
| Max. Negotiated Rate |
$192.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$63.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$121.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$63.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$50.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cigna Commercial |
$172.55
|
| Rate for Payer: First Health Commercial |
$182.70
|
| Rate for Payer: First Health Workers Compensation |
$45.99
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$182.70
|
| Rate for Payer: GEHA Commercial |
$162.40
|
| Rate for Payer: GEHA Medicare |
$35.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$182.70
|
| Rate for Payer: Humana ChoiceCare |
$38.60
|
| Rate for Payer: Humana Medicare Advantage |
$35.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$58.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$51.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$35.09
|
| Rate for Payer: Multiplan All |
$184.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$59.65
|
| Rate for Payer: OMNI Networks Commercial |
$142.10
|
| Rate for Payer: One Health Plan PPO/POS |
$182.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$58.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$51.06
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$35.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$192.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$70.18
|
| Rate for Payer: Three Rivers Provider Network All |
$152.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$34.39
|
| Rate for Payer: United Healthcare Commercial |
$172.55
|
| Rate for Payer: United Healthcare Managed Medicaid |
$51.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$35.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$188.79
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$35.09
|
| Rate for Payer: Zelis Auto |
$81.20
|
| Rate for Payer: Zelis Medicare |
$29.83
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$42.11
|
| Rate for Payer: Zelis Worker's Compensation |
$32.52
|
|
|
TRIGLYCERIDES (VItros)
|
Facility
|
OP
|
$93.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
2232205
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.88 |
| Max. Negotiated Rate |
$88.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$55.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5.74
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cigna Commercial |
$79.05
|
| Rate for Payer: First Health Commercial |
$83.70
|
| Rate for Payer: First Health Workers Compensation |
$10.02
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$83.70
|
| Rate for Payer: GEHA Commercial |
$74.40
|
| Rate for Payer: GEHA Medicare |
$5.74
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$83.70
|
| Rate for Payer: Humana ChoiceCare |
$6.31
|
| Rate for Payer: Humana Medicare Advantage |
$5.74
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$9.64
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5.74
|
| Rate for Payer: Multiplan All |
$84.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$9.76
|
| Rate for Payer: OMNI Networks Commercial |
$65.10
|
| Rate for Payer: One Health Plan PPO/POS |
$83.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$9.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8.35
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5.74
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$88.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11.48
|
| Rate for Payer: Three Rivers Provider Network All |
$69.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5.63
|
| Rate for Payer: United Healthcare Commercial |
$79.05
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.74
|
| Rate for Payer: United Payors & United Providers UP&UP |
$86.49
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5.74
|
| Rate for Payer: Zelis Auto |
$37.20
|
| Rate for Payer: Zelis Medicare |
$4.88
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6.89
|
| Rate for Payer: Zelis Worker's Compensation |
$7.08
|
|
|
TRIGLYCERIDES (VItros)
|
Facility
|
IP
|
$93.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
2232205
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.08 |
| Max. Negotiated Rate |
$88.35 |
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cash Price |
$55.80
|
| Rate for Payer: Cigna Commercial |
$79.05
|
| Rate for Payer: First Health Commercial |
$83.70
|
| Rate for Payer: First Health Workers Compensation |
$10.02
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$83.70
|
| Rate for Payer: GEHA Commercial |
$65.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$83.70
|
| Rate for Payer: Multiplan All |
$84.63
|
| Rate for Payer: OMNI Networks Commercial |
$65.10
|
| Rate for Payer: One Health Plan PPO/POS |
$83.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$88.35
|
| Rate for Payer: Three Rivers Provider Network All |
$69.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$86.49
|
| Rate for Payer: Zelis Auto |
$37.20
|
| Rate for Payer: Zelis Worker's Compensation |
$7.08
|
|
|
TRIG PNT INJ 1-2 MUS
|
Facility
|
OP
|
$1,133.00
|
|
| Hospital Charge Code |
2407252
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$283.25 |
| Max. Negotiated Rate |
$1,076.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$679.80
|
| Rate for Payer: Cash Price |
$679.80
|
| Rate for Payer: Cigna Commercial |
$963.05
|
| Rate for Payer: First Health Commercial |
$1,019.70
|
| Rate for Payer: First Health Workers Compensation |
$437.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,019.70
|
| Rate for Payer: GEHA Commercial |
$906.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,019.70
|
| Rate for Payer: Humana ChoiceCare |
$294.58
|
| Rate for Payer: Multiplan All |
$1,031.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$679.80
|
| Rate for Payer: OMNI Networks Commercial |
$793.10
|
| Rate for Payer: One Health Plan PPO/POS |
$1,019.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,076.35
|
| Rate for Payer: Three Rivers Provider Network All |
$849.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$997.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$283.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,053.69
|
| Rate for Payer: Zelis Auto |
$453.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$566.50
|
| Rate for Payer: Zelis Worker's Compensation |
$309.31
|
|
|
TRIG PNT INJ 1-2 MUS
|
Facility
|
IP
|
$1,133.00
|
|
| Hospital Charge Code |
2407252
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$309.31 |
| Max. Negotiated Rate |
$1,076.35 |
| Rate for Payer: Cash Price |
$679.80
|
| Rate for Payer: Cigna Commercial |
$963.05
|
| Rate for Payer: First Health Commercial |
$1,019.70
|
| Rate for Payer: First Health Workers Compensation |
$437.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,019.70
|
| Rate for Payer: GEHA Commercial |
$793.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,019.70
|
| Rate for Payer: Multiplan All |
$1,031.03
|
| Rate for Payer: OMNI Networks Commercial |
$793.10
|
| Rate for Payer: One Health Plan PPO/POS |
$1,019.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,076.35
|
| Rate for Payer: Three Rivers Provider Network All |
$849.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,053.69
|
| Rate for Payer: Zelis Auto |
$453.20
|
| Rate for Payer: Zelis Worker's Compensation |
$309.31
|
|
|
TRIG PNT INJ >3 MUSC
|
Facility
|
OP
|
$1,330.00
|
|
| Hospital Charge Code |
2407253
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$332.50 |
| Max. Negotiated Rate |
$1,263.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$798.00
|
| Rate for Payer: Cash Price |
$798.00
|
| Rate for Payer: Cigna Commercial |
$1,130.50
|
| Rate for Payer: First Health Commercial |
$1,197.00
|
| Rate for Payer: First Health Workers Compensation |
$513.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,197.00
|
| Rate for Payer: GEHA Commercial |
$1,064.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,197.00
|
| Rate for Payer: Humana ChoiceCare |
$345.80
|
| Rate for Payer: Multiplan All |
$1,210.30
|
| Rate for Payer: New Mexico Health Connections Medicare |
$798.00
|
| Rate for Payer: OMNI Networks Commercial |
$931.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,197.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,263.50
|
| Rate for Payer: Three Rivers Provider Network All |
$997.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,170.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$332.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,236.90
|
| Rate for Payer: Zelis Auto |
$532.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$665.00
|
| Rate for Payer: Zelis Worker's Compensation |
$363.09
|
|
|
TRIG PNT INJ >3 MUSC
|
Facility
|
IP
|
$1,330.00
|
|
| Hospital Charge Code |
2407253
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$363.09 |
| Max. Negotiated Rate |
$1,263.50 |
| Rate for Payer: Cash Price |
$798.00
|
| Rate for Payer: Cigna Commercial |
$1,130.50
|
| Rate for Payer: First Health Commercial |
$1,197.00
|
| Rate for Payer: First Health Workers Compensation |
$513.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,197.00
|
| Rate for Payer: GEHA Commercial |
$931.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,197.00
|
| Rate for Payer: Multiplan All |
$1,210.30
|
| Rate for Payer: OMNI Networks Commercial |
$931.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,197.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,263.50
|
| Rate for Payer: Three Rivers Provider Network All |
$997.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,236.90
|
| Rate for Payer: Zelis Auto |
$532.00
|
| Rate for Payer: Zelis Worker's Compensation |
$363.09
|
|
|
TRIM DYSTROPHIC NAILS ANY NUMBER
|
Facility
|
IP
|
$71.00
|
|
|
Service Code
|
CPT G0127
|
| Hospital Charge Code |
9600127
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.38 |
| Max. Negotiated Rate |
$67.45 |
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$60.35
|
| Rate for Payer: First Health Commercial |
$63.90
|
| Rate for Payer: First Health Workers Compensation |
$27.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$63.90
|
| Rate for Payer: GEHA Commercial |
$49.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$63.90
|
| Rate for Payer: Multiplan All |
$64.61
|
| Rate for Payer: OMNI Networks Commercial |
$49.70
|
| Rate for Payer: One Health Plan PPO/POS |
$63.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$67.45
|
| Rate for Payer: Three Rivers Provider Network All |
$53.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$66.03
|
| Rate for Payer: Zelis Auto |
$28.40
|
| Rate for Payer: Zelis Worker's Compensation |
$19.38
|
|
|
TRIM DYSTROPHIC NAILS ANY NUMBER
|
Facility
|
OP
|
$71.00
|
|
|
Service Code
|
CPT G0127
|
| Hospital Charge Code |
9600127
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$17.75 |
| Max. Negotiated Rate |
$112.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$42.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$56.40
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$60.35
|
| Rate for Payer: First Health Commercial |
$63.90
|
| Rate for Payer: First Health Workers Compensation |
$27.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$63.90
|
| Rate for Payer: GEHA Commercial |
$56.80
|
| Rate for Payer: GEHA Medicare |
$56.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$63.90
|
| Rate for Payer: Humana ChoiceCare |
$62.04
|
| Rate for Payer: Humana Medicare Advantage |
$56.40
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$94.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$56.40
|
| Rate for Payer: Multiplan All |
$64.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$95.88
|
| Rate for Payer: OMNI Networks Commercial |
$49.70
|
| Rate for Payer: One Health Plan PPO/POS |
$63.90
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$56.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$67.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$112.80
|
| Rate for Payer: Three Rivers Provider Network All |
$53.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$55.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$17.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$56.40
|
| Rate for Payer: United Payors & United Providers UP&UP |
$66.03
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$56.40
|
| Rate for Payer: Zelis Auto |
$28.40
|
| Rate for Payer: Zelis Medicare |
$47.94
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$67.68
|
| Rate for Payer: Zelis Worker's Compensation |
$19.38
|
|
|
TRIM DYSTROPHIC NAILS ANY NUMBER
|
Facility
|
OP
|
$71.00
|
|
|
Service Code
|
CPT G0127
|
| Hospital Charge Code |
8500127
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$17.75 |
| Max. Negotiated Rate |
$112.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$42.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$56.40
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$60.35
|
| Rate for Payer: First Health Commercial |
$63.90
|
| Rate for Payer: First Health Workers Compensation |
$27.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$63.90
|
| Rate for Payer: GEHA Commercial |
$56.80
|
| Rate for Payer: GEHA Medicare |
$56.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$63.90
|
| Rate for Payer: Humana ChoiceCare |
$62.04
|
| Rate for Payer: Humana Medicare Advantage |
$56.40
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$94.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$56.40
|
| Rate for Payer: Multiplan All |
$64.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$95.88
|
| Rate for Payer: OMNI Networks Commercial |
$49.70
|
| Rate for Payer: One Health Plan PPO/POS |
$63.90
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$56.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$67.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$112.80
|
| Rate for Payer: Three Rivers Provider Network All |
$53.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$55.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$17.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$56.40
|
| Rate for Payer: United Payors & United Providers UP&UP |
$66.03
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$56.40
|
| Rate for Payer: Zelis Auto |
$28.40
|
| Rate for Payer: Zelis Medicare |
$47.94
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$67.68
|
| Rate for Payer: Zelis Worker's Compensation |
$19.38
|
|
|
TRIM DYSTROPHIC NAILS ANY NUMBER
|
Facility
|
IP
|
$71.00
|
|
|
Service Code
|
CPT G0127
|
| Hospital Charge Code |
8500127
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$19.38 |
| Max. Negotiated Rate |
$67.45 |
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$60.35
|
| Rate for Payer: First Health Commercial |
$63.90
|
| Rate for Payer: First Health Workers Compensation |
$27.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$63.90
|
| Rate for Payer: GEHA Commercial |
$49.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$63.90
|
| Rate for Payer: Multiplan All |
$64.61
|
| Rate for Payer: OMNI Networks Commercial |
$49.70
|
| Rate for Payer: One Health Plan PPO/POS |
$63.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$67.45
|
| Rate for Payer: Three Rivers Provider Network All |
$53.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$66.03
|
| Rate for Payer: Zelis Auto |
$28.40
|
| Rate for Payer: Zelis Worker's Compensation |
$19.38
|
|
|
TRIM DYSTROPHIC NAILS ANY NUMBER
|
Facility
|
OP
|
$71.00
|
|
|
Service Code
|
CPT G0127
|
| Hospital Charge Code |
8700127
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$17.75 |
| Max. Negotiated Rate |
$112.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$42.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$56.40
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$60.35
|
| Rate for Payer: First Health Commercial |
$63.90
|
| Rate for Payer: First Health Workers Compensation |
$27.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$63.90
|
| Rate for Payer: GEHA Commercial |
$56.80
|
| Rate for Payer: GEHA Medicare |
$56.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$63.90
|
| Rate for Payer: Humana ChoiceCare |
$62.04
|
| Rate for Payer: Humana Medicare Advantage |
$56.40
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$94.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$56.40
|
| Rate for Payer: Multiplan All |
$64.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$95.88
|
| Rate for Payer: OMNI Networks Commercial |
$49.70
|
| Rate for Payer: One Health Plan PPO/POS |
$63.90
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$56.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$67.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$112.80
|
| Rate for Payer: Three Rivers Provider Network All |
$53.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$55.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$17.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$56.40
|
| Rate for Payer: United Payors & United Providers UP&UP |
$66.03
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$56.40
|
| Rate for Payer: Zelis Auto |
$28.40
|
| Rate for Payer: Zelis Medicare |
$47.94
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$67.68
|
| Rate for Payer: Zelis Worker's Compensation |
$19.38
|
|
|
TRIM DYSTROPHIC NAILS ANY NUMBER
|
Facility
|
IP
|
$71.00
|
|
|
Service Code
|
CPT G0127
|
| Hospital Charge Code |
8700127
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.38 |
| Max. Negotiated Rate |
$67.45 |
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$60.35
|
| Rate for Payer: First Health Commercial |
$63.90
|
| Rate for Payer: First Health Workers Compensation |
$27.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$63.90
|
| Rate for Payer: GEHA Commercial |
$49.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$63.90
|
| Rate for Payer: Multiplan All |
$64.61
|
| Rate for Payer: OMNI Networks Commercial |
$49.70
|
| Rate for Payer: One Health Plan PPO/POS |
$63.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$67.45
|
| Rate for Payer: Three Rivers Provider Network All |
$53.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$66.03
|
| Rate for Payer: Zelis Auto |
$28.40
|
| Rate for Payer: Zelis Worker's Compensation |
$19.38
|
|
|
trimethylamine n-oxide REF123413
|
Facility
|
IP
|
$263.00
|
|
|
Service Code
|
CPT 84999
|
| Hospital Charge Code |
2200735
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$71.80 |
| Max. Negotiated Rate |
$249.85 |
| Rate for Payer: Cash Price |
$157.80
|
| Rate for Payer: Cigna Commercial |
$223.55
|
| Rate for Payer: First Health Commercial |
$236.70
|
| Rate for Payer: First Health Workers Compensation |
$101.54
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$236.70
|
| Rate for Payer: GEHA Commercial |
$184.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$236.70
|
| Rate for Payer: Multiplan All |
$239.33
|
| Rate for Payer: OMNI Networks Commercial |
$184.10
|
| Rate for Payer: One Health Plan PPO/POS |
$236.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$249.85
|
| Rate for Payer: Three Rivers Provider Network All |
$197.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$244.59
|
| Rate for Payer: Zelis Auto |
$105.20
|
| Rate for Payer: Zelis Worker's Compensation |
$71.80
|
|
|
trimethylamine n-oxide REF123413
|
Facility
|
OP
|
$263.00
|
|
|
Service Code
|
CPT 84999
|
| Hospital Charge Code |
2200735
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$65.75 |
| Max. Negotiated Rate |
$249.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$157.80
|
| Rate for Payer: Cash Price |
$157.80
|
| Rate for Payer: Cigna Commercial |
$223.55
|
| Rate for Payer: First Health Commercial |
$236.70
|
| Rate for Payer: First Health Workers Compensation |
$101.54
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$236.70
|
| Rate for Payer: GEHA Commercial |
$210.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$236.70
|
| Rate for Payer: Humana ChoiceCare |
$68.38
|
| Rate for Payer: Multiplan All |
$239.33
|
| Rate for Payer: New Mexico Health Connections Medicare |
$157.80
|
| Rate for Payer: OMNI Networks Commercial |
$184.10
|
| Rate for Payer: One Health Plan PPO/POS |
$236.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$249.85
|
| Rate for Payer: Three Rivers Provider Network All |
$197.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$231.44
|
| Rate for Payer: United Healthcare Commercial |
$223.55
|
| Rate for Payer: United Healthcare Managed Medicaid |
$65.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$244.59
|
| Rate for Payer: Zelis Auto |
$105.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$131.50
|
| Rate for Payer: Zelis Worker's Compensation |
$71.80
|
|
|
TRIMMING NONDYSTROPHIC NAILS ANY NUMBER
|
Facility
|
OP
|
$24.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
21600088
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$6.55 |
| Max. Negotiated Rate |
$112.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$62.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$56.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna Commercial |
$20.40
|
| Rate for Payer: First Health Commercial |
$21.60
|
| Rate for Payer: First Health Workers Compensation |
$9.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$21.60
|
| Rate for Payer: GEHA Commercial |
$19.20
|
| Rate for Payer: GEHA Medicare |
$56.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$21.60
|
| Rate for Payer: Humana ChoiceCare |
$62.04
|
| Rate for Payer: Humana Medicare Advantage |
$56.40
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$94.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$63.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$56.40
|
| Rate for Payer: Multiplan All |
$21.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$95.88
|
| Rate for Payer: OMNI Networks Commercial |
$16.80
|
| Rate for Payer: One Health Plan PPO/POS |
$21.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$73.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$63.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$56.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$22.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$112.80
|
| Rate for Payer: Three Rivers Provider Network All |
$18.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$55.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$63.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$56.40
|
| Rate for Payer: United Payors & United Providers UP&UP |
$22.32
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$56.40
|
| Rate for Payer: Zelis Auto |
$9.60
|
| Rate for Payer: Zelis Medicare |
$47.94
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$67.68
|
| Rate for Payer: Zelis Worker's Compensation |
$6.55
|
|
|
TRIMMING NONDYSTROPHIC NAILS ANY NUMBER
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
8711719
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$12.01 |
| Max. Negotiated Rate |
$112.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$26.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$78.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$62.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$56.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cigna Commercial |
$37.40
|
| Rate for Payer: First Health Commercial |
$39.60
|
| Rate for Payer: First Health Workers Compensation |
$16.99
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$39.60
|
| Rate for Payer: GEHA Commercial |
$35.20
|
| Rate for Payer: GEHA Medicare |
$56.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$39.60
|
| Rate for Payer: Humana ChoiceCare |
$62.04
|
| Rate for Payer: Humana Medicare Advantage |
$56.40
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$94.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$63.47
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$56.40
|
| Rate for Payer: Multiplan All |
$40.04
|
| Rate for Payer: New Mexico Health Connections Medicare |
$95.88
|
| Rate for Payer: OMNI Networks Commercial |
$30.80
|
| Rate for Payer: One Health Plan PPO/POS |
$39.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$73.29
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$63.47
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$56.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$41.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$112.80
|
| Rate for Payer: Three Rivers Provider Network All |
$33.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$55.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$63.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$56.40
|
| Rate for Payer: United Payors & United Providers UP&UP |
$40.92
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$56.40
|
| Rate for Payer: Zelis Auto |
$17.60
|
| Rate for Payer: Zelis Medicare |
$47.94
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$67.68
|
| Rate for Payer: Zelis Worker's Compensation |
$12.01
|
|
|
TRIMMING NONDYSTROPHIC NAILS ANY NUMBER
|
Facility
|
IP
|
$24.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
21600088
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$6.55 |
| Max. Negotiated Rate |
$22.80 |
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna Commercial |
$20.40
|
| Rate for Payer: First Health Commercial |
$21.60
|
| Rate for Payer: First Health Workers Compensation |
$9.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$21.60
|
| Rate for Payer: GEHA Commercial |
$16.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$21.60
|
| Rate for Payer: Multiplan All |
$21.84
|
| Rate for Payer: OMNI Networks Commercial |
$16.80
|
| Rate for Payer: One Health Plan PPO/POS |
$21.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$22.80
|
| Rate for Payer: Three Rivers Provider Network All |
$18.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$22.32
|
| Rate for Payer: Zelis Auto |
$9.60
|
| Rate for Payer: Zelis Worker's Compensation |
$6.55
|
|
|
TRIMMING NONDYSTROPHIC NAILS ANY NUMBER
|
Facility
|
IP
|
$221.70
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
1911719
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$60.52 |
| Max. Negotiated Rate |
$210.62 |
| Rate for Payer: Cash Price |
$133.02
|
| Rate for Payer: Cigna Commercial |
$188.44
|
| Rate for Payer: First Health Commercial |
$199.53
|
| Rate for Payer: First Health Workers Compensation |
$85.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$199.53
|
| Rate for Payer: GEHA Commercial |
$155.19
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$199.53
|
| Rate for Payer: Multiplan All |
$201.75
|
| Rate for Payer: OMNI Networks Commercial |
$155.19
|
| Rate for Payer: One Health Plan PPO/POS |
$199.53
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$210.62
|
| Rate for Payer: Three Rivers Provider Network All |
$166.28
|
| Rate for Payer: United Payors & United Providers UP&UP |
$206.18
|
| Rate for Payer: Zelis Auto |
$88.68
|
| Rate for Payer: Zelis Worker's Compensation |
$60.52
|
|
