|
uric acid body fluid REF019505
|
Facility
|
OP
|
$80.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
22990909
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.32 |
| Max. Negotiated Rate |
$76.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$48.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5.08
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cigna Commercial |
$68.00
|
| Rate for Payer: First Health Commercial |
$72.00
|
| Rate for Payer: First Health Workers Compensation |
$8.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$72.00
|
| Rate for Payer: GEHA Commercial |
$64.00
|
| Rate for Payer: GEHA Medicare |
$5.08
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$72.00
|
| Rate for Payer: Humana ChoiceCare |
$5.59
|
| Rate for Payer: Humana Medicare Advantage |
$5.08
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$8.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5.08
|
| Rate for Payer: Multiplan All |
$72.80
|
| Rate for Payer: New Mexico Health Connections Medicare |
$8.64
|
| Rate for Payer: OMNI Networks Commercial |
$56.00
|
| Rate for Payer: One Health Plan PPO/POS |
$72.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$8.54
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7.40
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5.08
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$76.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10.16
|
| Rate for Payer: Three Rivers Provider Network All |
$60.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4.98
|
| Rate for Payer: United Healthcare Commercial |
$68.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.08
|
| Rate for Payer: United Payors & United Providers UP&UP |
$74.40
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5.08
|
| Rate for Payer: Zelis Auto |
$32.00
|
| Rate for Payer: Zelis Medicare |
$4.32
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6.10
|
| Rate for Payer: Zelis Worker's Compensation |
$6.05
|
|
|
URIC ACID UA POP
|
Facility
|
OP
|
$80.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
2299387
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.32 |
| Max. Negotiated Rate |
$76.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$48.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5.08
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cigna Commercial |
$68.00
|
| Rate for Payer: First Health Commercial |
$72.00
|
| Rate for Payer: First Health Workers Compensation |
$8.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$72.00
|
| Rate for Payer: GEHA Commercial |
$64.00
|
| Rate for Payer: GEHA Medicare |
$5.08
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$72.00
|
| Rate for Payer: Humana ChoiceCare |
$5.59
|
| Rate for Payer: Humana Medicare Advantage |
$5.08
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$8.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5.08
|
| Rate for Payer: Multiplan All |
$72.80
|
| Rate for Payer: New Mexico Health Connections Medicare |
$8.64
|
| Rate for Payer: OMNI Networks Commercial |
$56.00
|
| Rate for Payer: One Health Plan PPO/POS |
$72.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$8.54
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7.40
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5.08
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$76.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10.16
|
| Rate for Payer: Three Rivers Provider Network All |
$60.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4.98
|
| Rate for Payer: United Healthcare Commercial |
$68.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.08
|
| Rate for Payer: United Payors & United Providers UP&UP |
$74.40
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5.08
|
| Rate for Payer: Zelis Auto |
$32.00
|
| Rate for Payer: Zelis Medicare |
$4.32
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6.10
|
| Rate for Payer: Zelis Worker's Compensation |
$6.05
|
|
|
URIC ACID UA POP
|
Facility
|
IP
|
$80.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
2299387
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.05 |
| Max. Negotiated Rate |
$76.00 |
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cigna Commercial |
$68.00
|
| Rate for Payer: First Health Commercial |
$72.00
|
| Rate for Payer: First Health Workers Compensation |
$8.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$72.00
|
| Rate for Payer: GEHA Commercial |
$56.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$72.00
|
| Rate for Payer: Multiplan All |
$72.80
|
| Rate for Payer: OMNI Networks Commercial |
$56.00
|
| Rate for Payer: One Health Plan PPO/POS |
$72.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$76.00
|
| Rate for Payer: Three Rivers Provider Network All |
$60.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$74.40
|
| Rate for Payer: Zelis Auto |
$32.00
|
| Rate for Payer: Zelis Worker's Compensation |
$6.05
|
|
|
URIC ACID (Vitros)
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
2232229
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.57 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cigna Commercial |
$86.70
|
| Rate for Payer: First Health Commercial |
$91.80
|
| Rate for Payer: First Health Workers Compensation |
$7.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$91.80
|
| Rate for Payer: GEHA Commercial |
$71.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$91.80
|
| Rate for Payer: Multiplan All |
$92.82
|
| Rate for Payer: OMNI Networks Commercial |
$71.40
|
| Rate for Payer: One Health Plan PPO/POS |
$91.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$96.90
|
| Rate for Payer: Three Rivers Provider Network All |
$76.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$94.86
|
| Rate for Payer: Zelis Auto |
$40.80
|
| Rate for Payer: Zelis Worker's Compensation |
$5.57
|
|
|
URIC ACID (Vitros)
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
2232229
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.84 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6.44
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$4.52
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cigna Commercial |
$86.70
|
| Rate for Payer: First Health Commercial |
$91.80
|
| Rate for Payer: First Health Workers Compensation |
$7.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$91.80
|
| Rate for Payer: GEHA Commercial |
$81.60
|
| Rate for Payer: GEHA Medicare |
$4.52
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$91.80
|
| Rate for Payer: Humana ChoiceCare |
$4.97
|
| Rate for Payer: Humana Medicare Advantage |
$4.52
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$7.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$4.52
|
| Rate for Payer: Multiplan All |
$92.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$7.68
|
| Rate for Payer: OMNI Networks Commercial |
$71.40
|
| Rate for Payer: One Health Plan PPO/POS |
$91.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$7.59
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$4.52
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$96.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$9.04
|
| Rate for Payer: Three Rivers Provider Network All |
$76.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4.43
|
| Rate for Payer: United Healthcare Commercial |
$86.70
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.52
|
| Rate for Payer: United Payors & United Providers UP&UP |
$94.86
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$4.52
|
| Rate for Payer: Zelis Auto |
$40.80
|
| Rate for Payer: Zelis Medicare |
$3.84
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5.42
|
| Rate for Payer: Zelis Worker's Compensation |
$5.57
|
|
|
URINALYSIS BY DIPSTICK
|
Facility
|
IP
|
$20.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
25500036
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$19.00 |
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cigna Commercial |
$17.00
|
| Rate for Payer: First Health Commercial |
$18.00
|
| Rate for Payer: First Health Workers Compensation |
$4.42
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$18.00
|
| Rate for Payer: GEHA Commercial |
$14.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$18.00
|
| Rate for Payer: Multiplan All |
$18.20
|
| Rate for Payer: OMNI Networks Commercial |
$14.00
|
| Rate for Payer: One Health Plan PPO/POS |
$18.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$19.00
|
| Rate for Payer: Three Rivers Provider Network All |
$15.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$18.60
|
| Rate for Payer: Zelis Auto |
$8.00
|
| Rate for Payer: Zelis Worker's Compensation |
$3.12
|
|
|
URINALYSIS BY DIPSTICK
|
Facility
|
IP
|
$20.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
21600036
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$19.00 |
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cigna Commercial |
$17.00
|
| Rate for Payer: First Health Commercial |
$18.00
|
| Rate for Payer: First Health Workers Compensation |
$4.42
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$18.00
|
| Rate for Payer: GEHA Commercial |
$14.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$18.00
|
| Rate for Payer: Multiplan All |
$18.20
|
| Rate for Payer: OMNI Networks Commercial |
$14.00
|
| Rate for Payer: One Health Plan PPO/POS |
$18.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$19.00
|
| Rate for Payer: Three Rivers Provider Network All |
$15.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$18.60
|
| Rate for Payer: Zelis Auto |
$8.00
|
| Rate for Payer: Zelis Worker's Compensation |
$3.12
|
|
|
URINALYSIS BY DIPSTICK
|
Facility
|
IP
|
$20.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
21581002
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$19.00 |
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cigna Commercial |
$17.00
|
| Rate for Payer: First Health Commercial |
$18.00
|
| Rate for Payer: First Health Workers Compensation |
$4.42
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$18.00
|
| Rate for Payer: GEHA Commercial |
$14.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$18.00
|
| Rate for Payer: Multiplan All |
$18.20
|
| Rate for Payer: OMNI Networks Commercial |
$14.00
|
| Rate for Payer: One Health Plan PPO/POS |
$18.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$19.00
|
| Rate for Payer: Three Rivers Provider Network All |
$15.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$18.60
|
| Rate for Payer: Zelis Auto |
$8.00
|
| Rate for Payer: Zelis Worker's Compensation |
$3.12
|
|
|
URINALYSIS BY DIPSTICK
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
21600036
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$2.96 |
| Max. Negotiated Rate |
$19.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4.97
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3.48
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cigna Commercial |
$17.00
|
| Rate for Payer: First Health Commercial |
$18.00
|
| Rate for Payer: First Health Workers Compensation |
$4.42
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$18.00
|
| Rate for Payer: GEHA Commercial |
$16.00
|
| Rate for Payer: GEHA Medicare |
$3.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$18.00
|
| Rate for Payer: Humana ChoiceCare |
$3.83
|
| Rate for Payer: Humana Medicare Advantage |
$3.48
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3.48
|
| Rate for Payer: Multiplan All |
$18.20
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5.92
|
| Rate for Payer: OMNI Networks Commercial |
$14.00
|
| Rate for Payer: One Health Plan PPO/POS |
$18.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$5.85
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3.48
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$19.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6.96
|
| Rate for Payer: Three Rivers Provider Network All |
$15.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3.41
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.48
|
| Rate for Payer: United Payors & United Providers UP&UP |
$18.60
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3.48
|
| Rate for Payer: Zelis Auto |
$8.00
|
| Rate for Payer: Zelis Medicare |
$2.96
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4.18
|
| Rate for Payer: Zelis Worker's Compensation |
$3.12
|
|
|
URINALYSIS BY DIPSTICK
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
21581002
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2.96 |
| Max. Negotiated Rate |
$19.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4.97
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3.48
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cigna Commercial |
$17.00
|
| Rate for Payer: First Health Commercial |
$18.00
|
| Rate for Payer: First Health Workers Compensation |
$4.42
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$18.00
|
| Rate for Payer: GEHA Commercial |
$16.00
|
| Rate for Payer: GEHA Medicare |
$3.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$18.00
|
| Rate for Payer: Humana ChoiceCare |
$3.83
|
| Rate for Payer: Humana Medicare Advantage |
$3.48
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3.48
|
| Rate for Payer: Multiplan All |
$18.20
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5.92
|
| Rate for Payer: OMNI Networks Commercial |
$14.00
|
| Rate for Payer: One Health Plan PPO/POS |
$18.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$5.85
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3.48
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$19.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6.96
|
| Rate for Payer: Three Rivers Provider Network All |
$15.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3.41
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.48
|
| Rate for Payer: United Payors & United Providers UP&UP |
$18.60
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3.48
|
| Rate for Payer: Zelis Auto |
$8.00
|
| Rate for Payer: Zelis Medicare |
$2.96
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4.18
|
| Rate for Payer: Zelis Worker's Compensation |
$3.12
|
|
|
URINALYSIS BY DIPSTICK
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
25500036
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2.96 |
| Max. Negotiated Rate |
$19.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$12.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$6.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4.97
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3.48
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cigna Commercial |
$17.00
|
| Rate for Payer: First Health Commercial |
$18.00
|
| Rate for Payer: First Health Workers Compensation |
$4.42
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$18.00
|
| Rate for Payer: GEHA Commercial |
$16.00
|
| Rate for Payer: GEHA Medicare |
$3.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$18.00
|
| Rate for Payer: Humana ChoiceCare |
$3.83
|
| Rate for Payer: Humana Medicare Advantage |
$3.48
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$5.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3.48
|
| Rate for Payer: Multiplan All |
$18.20
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5.92
|
| Rate for Payer: OMNI Networks Commercial |
$14.00
|
| Rate for Payer: One Health Plan PPO/POS |
$18.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$5.85
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3.48
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$19.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6.96
|
| Rate for Payer: Three Rivers Provider Network All |
$15.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3.41
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.48
|
| Rate for Payer: United Payors & United Providers UP&UP |
$18.60
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3.48
|
| Rate for Payer: Zelis Auto |
$8.00
|
| Rate for Payer: Zelis Medicare |
$2.96
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4.18
|
| Rate for Payer: Zelis Worker's Compensation |
$3.12
|
|
|
URINALYSIS MACRO / DIPSTICK
|
Facility
|
IP
|
$38.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
2201005
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.68 |
| Max. Negotiated Rate |
$36.10 |
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cigna Commercial |
$32.30
|
| Rate for Payer: First Health Commercial |
$34.20
|
| Rate for Payer: First Health Workers Compensation |
$3.79
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$34.20
|
| Rate for Payer: GEHA Commercial |
$26.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$34.20
|
| Rate for Payer: Multiplan All |
$34.58
|
| Rate for Payer: OMNI Networks Commercial |
$26.60
|
| Rate for Payer: One Health Plan PPO/POS |
$34.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$36.10
|
| Rate for Payer: Three Rivers Provider Network All |
$28.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$35.34
|
| Rate for Payer: Zelis Auto |
$15.20
|
| Rate for Payer: Zelis Worker's Compensation |
$2.68
|
|
|
URINALYSIS MACRO / DIPSTICK
|
Facility
|
OP
|
$38.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
2201005
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.91 |
| Max. Negotiated Rate |
$36.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$22.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3.21
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2.25
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cash Price |
$22.80
|
| Rate for Payer: Cigna Commercial |
$32.30
|
| Rate for Payer: First Health Commercial |
$34.20
|
| Rate for Payer: First Health Workers Compensation |
$3.79
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$34.20
|
| Rate for Payer: GEHA Commercial |
$30.40
|
| Rate for Payer: GEHA Medicare |
$2.25
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$34.20
|
| Rate for Payer: Humana ChoiceCare |
$2.48
|
| Rate for Payer: Humana Medicare Advantage |
$2.25
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$3.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3.27
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2.25
|
| Rate for Payer: Multiplan All |
$34.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3.83
|
| Rate for Payer: OMNI Networks Commercial |
$26.60
|
| Rate for Payer: One Health Plan PPO/POS |
$34.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$3.78
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3.27
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2.25
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$36.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$4.50
|
| Rate for Payer: Three Rivers Provider Network All |
$28.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2.21
|
| Rate for Payer: United Healthcare Commercial |
$32.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$35.34
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2.25
|
| Rate for Payer: Zelis Auto |
$15.20
|
| Rate for Payer: Zelis Medicare |
$1.91
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2.70
|
| Rate for Payer: Zelis Worker's Compensation |
$2.68
|
|
|
URINARY REFLEX STUDY
|
Facility
|
IP
|
$1,104.00
|
|
|
Service Code
|
CPT 51792
|
| Hospital Charge Code |
6151792
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$301.39 |
| Max. Negotiated Rate |
$1,048.80 |
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cigna Commercial |
$938.40
|
| Rate for Payer: First Health Commercial |
$993.60
|
| Rate for Payer: First Health Workers Compensation |
$426.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$993.60
|
| Rate for Payer: GEHA Commercial |
$772.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$993.60
|
| Rate for Payer: Multiplan All |
$1,004.64
|
| Rate for Payer: OMNI Networks Commercial |
$772.80
|
| Rate for Payer: One Health Plan PPO/POS |
$993.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,048.80
|
| Rate for Payer: Three Rivers Provider Network All |
$828.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,026.72
|
| Rate for Payer: Zelis Auto |
$441.60
|
| Rate for Payer: Zelis Worker's Compensation |
$301.39
|
|
|
URINARY REFLEX STUDY
|
Facility
|
OP
|
$1,104.00
|
|
|
Service Code
|
CPT 51792
|
| Hospital Charge Code |
6151792
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$47.94 |
| Max. Negotiated Rate |
$1,048.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$110.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$662.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$110.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$87.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$56.40
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cigna Commercial |
$938.40
|
| Rate for Payer: First Health Commercial |
$993.60
|
| Rate for Payer: First Health Workers Compensation |
$426.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$993.60
|
| Rate for Payer: GEHA Commercial |
$883.20
|
| Rate for Payer: GEHA Medicare |
$56.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$993.60
|
| 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 |
$89.56
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$56.40
|
| Rate for Payer: Multiplan All |
$1,004.64
|
| Rate for Payer: New Mexico Health Connections Medicare |
$95.88
|
| Rate for Payer: OMNI Networks Commercial |
$772.80
|
| Rate for Payer: One Health Plan PPO/POS |
$993.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$103.40
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$89.56
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$56.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,048.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$112.80
|
| Rate for Payer: Three Rivers Provider Network All |
$828.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$55.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$89.56
|
| Rate for Payer: United Healthcare Medicare Advantage |
$56.40
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,026.72
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$56.40
|
| Rate for Payer: Zelis Auto |
$441.60
|
| Rate for Payer: Zelis Medicare |
$47.94
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$67.68
|
| Rate for Payer: Zelis Worker's Compensation |
$301.39
|
|
|
urine calcium 24hr w/o crea REF003269
|
Facility
|
IP
|
$90.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
2200306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cigna Commercial |
$76.50
|
| Rate for Payer: First Health Commercial |
$81.00
|
| Rate for Payer: First Health Workers Compensation |
$10.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$81.00
|
| Rate for Payer: GEHA Commercial |
$63.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$81.00
|
| Rate for Payer: Multiplan All |
$81.90
|
| Rate for Payer: OMNI Networks Commercial |
$63.00
|
| Rate for Payer: One Health Plan PPO/POS |
$81.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$85.50
|
| Rate for Payer: Three Rivers Provider Network All |
$67.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$83.70
|
| Rate for Payer: Zelis Auto |
$36.00
|
| Rate for Payer: Zelis Worker's Compensation |
$7.72
|
|
|
urine calcium 24hr w/o crea REF003269
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
2200306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$10.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$54.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$10.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6.03
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cigna Commercial |
$76.50
|
| Rate for Payer: First Health Commercial |
$81.00
|
| Rate for Payer: First Health Workers Compensation |
$10.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$81.00
|
| Rate for Payer: GEHA Commercial |
$72.00
|
| Rate for Payer: GEHA Medicare |
$6.03
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$81.00
|
| Rate for Payer: Humana ChoiceCare |
$6.63
|
| Rate for Payer: Humana Medicare Advantage |
$6.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$10.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6.03
|
| Rate for Payer: Multiplan All |
$81.90
|
| Rate for Payer: New Mexico Health Connections Medicare |
$10.25
|
| Rate for Payer: OMNI Networks Commercial |
$63.00
|
| Rate for Payer: One Health Plan PPO/POS |
$81.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10.14
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8.78
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6.03
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$85.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$12.06
|
| Rate for Payer: Three Rivers Provider Network All |
$67.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5.91
|
| Rate for Payer: United Healthcare Commercial |
$76.50
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.03
|
| Rate for Payer: United Payors & United Providers UP&UP |
$83.70
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6.03
|
| Rate for Payer: Zelis Auto |
$36.00
|
| Rate for Payer: Zelis Medicare |
$5.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7.24
|
| Rate for Payer: Zelis Worker's Compensation |
$7.72
|
|
|
URINE CREAT 24 HOUR (Vitros)
|
Facility
|
OP
|
$205.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
2232289
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$194.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$123.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cigna Commercial |
$174.25
|
| Rate for Payer: First Health Commercial |
$184.50
|
| Rate for Payer: First Health Workers Compensation |
$9.19
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$184.50
|
| Rate for Payer: GEHA Commercial |
$164.00
|
| Rate for Payer: GEHA Medicare |
$5.18
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$184.50
|
| Rate for Payer: Humana ChoiceCare |
$5.70
|
| Rate for Payer: Humana Medicare Advantage |
$5.18
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$8.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5.18
|
| Rate for Payer: Multiplan All |
$186.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$8.81
|
| Rate for Payer: OMNI Networks Commercial |
$143.50
|
| Rate for Payer: One Health Plan PPO/POS |
$184.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$8.71
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5.18
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$194.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10.36
|
| Rate for Payer: Three Rivers Provider Network All |
$153.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5.08
|
| Rate for Payer: United Healthcare Commercial |
$174.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.18
|
| Rate for Payer: United Payors & United Providers UP&UP |
$190.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5.18
|
| Rate for Payer: Zelis Auto |
$82.00
|
| Rate for Payer: Zelis Medicare |
$4.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6.22
|
| Rate for Payer: Zelis Worker's Compensation |
$6.50
|
|
|
URINE CREAT 24 HOUR (Vitros)
|
Facility
|
IP
|
$205.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
2232289
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$194.75 |
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cigna Commercial |
$174.25
|
| Rate for Payer: First Health Commercial |
$184.50
|
| Rate for Payer: First Health Workers Compensation |
$9.19
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$184.50
|
| Rate for Payer: GEHA Commercial |
$143.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$184.50
|
| Rate for Payer: Multiplan All |
$186.55
|
| Rate for Payer: OMNI Networks Commercial |
$143.50
|
| Rate for Payer: One Health Plan PPO/POS |
$184.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$194.75
|
| Rate for Payer: Three Rivers Provider Network All |
$153.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$190.65
|
| Rate for Payer: Zelis Auto |
$82.00
|
| Rate for Payer: Zelis Worker's Compensation |
$6.50
|
|
|
URINE CREAT CLEARANCE 24 HOUR (Vitros)
|
Facility
|
IP
|
$205.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
2232239
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$194.75 |
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cigna Commercial |
$174.25
|
| Rate for Payer: First Health Commercial |
$184.50
|
| Rate for Payer: First Health Workers Compensation |
$9.19
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$184.50
|
| Rate for Payer: GEHA Commercial |
$143.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$184.50
|
| Rate for Payer: Multiplan All |
$186.55
|
| Rate for Payer: OMNI Networks Commercial |
$143.50
|
| Rate for Payer: One Health Plan PPO/POS |
$184.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$194.75
|
| Rate for Payer: Three Rivers Provider Network All |
$153.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$190.65
|
| Rate for Payer: Zelis Auto |
$82.00
|
| Rate for Payer: Zelis Worker's Compensation |
$6.50
|
|
|
URINE CREAT CLEARANCE 24 HOUR (Vitros)
|
Facility
|
OP
|
$205.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
2232239
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$194.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$123.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cigna Commercial |
$174.25
|
| Rate for Payer: First Health Commercial |
$184.50
|
| Rate for Payer: First Health Workers Compensation |
$9.19
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$184.50
|
| Rate for Payer: GEHA Commercial |
$164.00
|
| Rate for Payer: GEHA Medicare |
$5.18
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$184.50
|
| Rate for Payer: Humana ChoiceCare |
$5.70
|
| Rate for Payer: Humana Medicare Advantage |
$5.18
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$8.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5.18
|
| Rate for Payer: Multiplan All |
$186.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$8.81
|
| Rate for Payer: OMNI Networks Commercial |
$143.50
|
| Rate for Payer: One Health Plan PPO/POS |
$184.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$8.71
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5.18
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$194.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10.36
|
| Rate for Payer: Three Rivers Provider Network All |
$153.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5.08
|
| Rate for Payer: United Healthcare Commercial |
$174.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.18
|
| Rate for Payer: United Payors & United Providers UP&UP |
$190.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5.18
|
| Rate for Payer: Zelis Auto |
$82.00
|
| Rate for Payer: Zelis Medicare |
$4.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6.22
|
| Rate for Payer: Zelis Worker's Compensation |
$6.50
|
|
|
URINE CREATININE RANDOM (Vitros)
|
Facility
|
IP
|
$205.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
2232240
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$194.75 |
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cigna Commercial |
$174.25
|
| Rate for Payer: First Health Commercial |
$184.50
|
| Rate for Payer: First Health Workers Compensation |
$9.19
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$184.50
|
| Rate for Payer: GEHA Commercial |
$143.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$184.50
|
| Rate for Payer: Multiplan All |
$186.55
|
| Rate for Payer: OMNI Networks Commercial |
$143.50
|
| Rate for Payer: One Health Plan PPO/POS |
$184.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$194.75
|
| Rate for Payer: Three Rivers Provider Network All |
$153.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$190.65
|
| Rate for Payer: Zelis Auto |
$82.00
|
| Rate for Payer: Zelis Worker's Compensation |
$6.50
|
|
|
URINE CREATININE RANDOM (Vitros)
|
Facility
|
OP
|
$205.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
2232240
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$194.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$123.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cash Price |
$123.00
|
| Rate for Payer: Cigna Commercial |
$174.25
|
| Rate for Payer: First Health Commercial |
$184.50
|
| Rate for Payer: First Health Workers Compensation |
$9.19
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$184.50
|
| Rate for Payer: GEHA Commercial |
$164.00
|
| Rate for Payer: GEHA Medicare |
$5.18
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$184.50
|
| Rate for Payer: Humana ChoiceCare |
$5.70
|
| Rate for Payer: Humana Medicare Advantage |
$5.18
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$8.70
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5.18
|
| Rate for Payer: Multiplan All |
$186.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$8.81
|
| Rate for Payer: OMNI Networks Commercial |
$143.50
|
| Rate for Payer: One Health Plan PPO/POS |
$184.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$8.71
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5.18
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$194.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10.36
|
| Rate for Payer: Three Rivers Provider Network All |
$153.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5.08
|
| Rate for Payer: United Healthcare Commercial |
$174.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.18
|
| Rate for Payer: United Payors & United Providers UP&UP |
$190.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5.18
|
| Rate for Payer: Zelis Auto |
$82.00
|
| Rate for Payer: Zelis Medicare |
$4.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6.22
|
| Rate for Payer: Zelis Worker's Compensation |
$6.50
|
|
|
urine cytology REF009068
|
Facility
|
IP
|
$141.00
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
2299068
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$56.40 |
| Max. Negotiated Rate |
$133.95 |
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cigna Commercial |
$119.85
|
| Rate for Payer: First Health Commercial |
$126.90
|
| Rate for Payer: First Health Workers Compensation |
$85.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$126.90
|
| Rate for Payer: GEHA Commercial |
$98.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$126.90
|
| Rate for Payer: Multiplan All |
$128.31
|
| Rate for Payer: OMNI Networks Commercial |
$98.70
|
| Rate for Payer: One Health Plan PPO/POS |
$126.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$133.95
|
| Rate for Payer: Three Rivers Provider Network All |
$105.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$131.13
|
| Rate for Payer: Zelis Auto |
$56.40
|
| Rate for Payer: Zelis Worker's Compensation |
$60.17
|
|
|
urine cytology REF009068
|
Facility
|
OP
|
$141.00
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
2299068
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$19.76 |
| Max. Negotiated Rate |
$133.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$73.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$84.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$73.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$58.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$23.25
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cigna Commercial |
$119.85
|
| Rate for Payer: First Health Commercial |
$126.90
|
| Rate for Payer: First Health Workers Compensation |
$85.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$126.90
|
| Rate for Payer: GEHA Commercial |
$112.80
|
| Rate for Payer: GEHA Medicare |
$23.25
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$126.90
|
| Rate for Payer: Humana ChoiceCare |
$25.57
|
| Rate for Payer: Humana Medicare Advantage |
$23.25
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$39.06
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$59.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$23.25
|
| Rate for Payer: Multiplan All |
$128.31
|
| Rate for Payer: New Mexico Health Connections Medicare |
$39.52
|
| Rate for Payer: OMNI Networks Commercial |
$98.70
|
| Rate for Payer: One Health Plan PPO/POS |
$126.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$68.92
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$59.69
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$23.25
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$133.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$46.50
|
| Rate for Payer: Three Rivers Provider Network All |
$105.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$22.79
|
| Rate for Payer: United Healthcare Commercial |
$119.85
|
| Rate for Payer: United Healthcare Managed Medicaid |
$59.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$131.13
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$23.25
|
| Rate for Payer: Zelis Auto |
$56.40
|
| Rate for Payer: Zelis Medicare |
$19.76
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$27.90
|
| Rate for Payer: Zelis Worker's Compensation |
$60.17
|
|
