|
VNPNXR <3 YEARS PHYS/QHP SKILL OTHER VEI
|
Facility
|
IP
|
$48.57
|
|
|
Service Code
|
CPT 36406
|
| Hospital Charge Code |
7836406
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$13.26 |
| Max. Negotiated Rate |
$46.14 |
| Rate for Payer: Cash Price |
$29.14
|
| Rate for Payer: Cigna Commercial |
$41.28
|
| Rate for Payer: First Health Commercial |
$43.71
|
| Rate for Payer: First Health Workers Compensation |
$18.75
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$43.71
|
| Rate for Payer: GEHA Commercial |
$34.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$43.71
|
| Rate for Payer: Multiplan All |
$44.20
|
| Rate for Payer: OMNI Networks Commercial |
$34.00
|
| Rate for Payer: One Health Plan PPO/POS |
$43.71
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$46.14
|
| Rate for Payer: Three Rivers Provider Network All |
$36.43
|
| Rate for Payer: United Payors & United Providers UP&UP |
$45.17
|
| Rate for Payer: Zelis Auto |
$19.43
|
| Rate for Payer: Zelis Worker's Compensation |
$13.26
|
|
|
VNPNXR <3 YEARS PHYS/QHP SKILL OTHER VEI
|
Facility
|
OP
|
$48.57
|
|
|
Service Code
|
CPT 36406
|
| Hospital Charge Code |
7836406
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$12.14 |
| Max. Negotiated Rate |
$46.14 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$29.14
|
| Rate for Payer: Cash Price |
$29.14
|
| Rate for Payer: Cigna Commercial |
$41.28
|
| Rate for Payer: First Health Commercial |
$43.71
|
| Rate for Payer: First Health Workers Compensation |
$18.75
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$43.71
|
| Rate for Payer: GEHA Commercial |
$38.86
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$43.71
|
| Rate for Payer: Humana ChoiceCare |
$12.63
|
| Rate for Payer: Multiplan All |
$44.20
|
| Rate for Payer: New Mexico Health Connections Medicare |
$29.14
|
| Rate for Payer: OMNI Networks Commercial |
$34.00
|
| Rate for Payer: One Health Plan PPO/POS |
$43.71
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$46.14
|
| Rate for Payer: Three Rivers Provider Network All |
$36.43
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$42.74
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12.14
|
| Rate for Payer: United Payors & United Providers UP&UP |
$45.17
|
| Rate for Payer: Zelis Auto |
$19.43
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$24.29
|
| Rate for Payer: Zelis Worker's Compensation |
$13.26
|
|
|
VOID PRESSURE STUDIES INTRAABDOMINAL
|
Facility
|
OP
|
$1,094.00
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
6151797
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$161.75 |
| Max. Negotiated Rate |
$1,039.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$204.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$656.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$204.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$161.75
|
| Rate for Payer: Cash Price |
$656.40
|
| Rate for Payer: Cash Price |
$656.40
|
| Rate for Payer: Cigna Commercial |
$929.90
|
| Rate for Payer: First Health Commercial |
$984.60
|
| Rate for Payer: First Health Workers Compensation |
$422.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$984.60
|
| Rate for Payer: GEHA Commercial |
$875.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$984.60
|
| Rate for Payer: Humana ChoiceCare |
$284.44
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$165.05
|
| Rate for Payer: Multiplan All |
$995.54
|
| Rate for Payer: New Mexico Health Connections Medicare |
$656.40
|
| Rate for Payer: OMNI Networks Commercial |
$765.80
|
| Rate for Payer: One Health Plan PPO/POS |
$984.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$190.57
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$165.05
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,039.30
|
| Rate for Payer: Three Rivers Provider Network All |
$820.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$962.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$165.05
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,017.42
|
| Rate for Payer: Zelis Auto |
$437.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$547.00
|
| Rate for Payer: Zelis Worker's Compensation |
$298.66
|
|
|
VOID PRESSURE STUDIES INTRAABDOMINAL
|
Facility
|
IP
|
$1,094.00
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
6151797
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$298.66 |
| Max. Negotiated Rate |
$1,039.30 |
| Rate for Payer: Cash Price |
$656.40
|
| Rate for Payer: Cigna Commercial |
$929.90
|
| Rate for Payer: First Health Commercial |
$984.60
|
| Rate for Payer: First Health Workers Compensation |
$422.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$984.60
|
| Rate for Payer: GEHA Commercial |
$765.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$984.60
|
| Rate for Payer: Multiplan All |
$995.54
|
| Rate for Payer: OMNI Networks Commercial |
$765.80
|
| Rate for Payer: One Health Plan PPO/POS |
$984.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,039.30
|
| Rate for Payer: Three Rivers Provider Network All |
$820.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,017.42
|
| Rate for Payer: Zelis Auto |
$437.60
|
| Rate for Payer: Zelis Worker's Compensation |
$298.66
|
|
|
VOID PRESSURE STUDIES INTRAABDOMINAL
|
Facility
|
OP
|
$326.00
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
23500050
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$84.76 |
| Max. Negotiated Rate |
$309.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$204.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$195.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$204.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$161.75
|
| Rate for Payer: Cash Price |
$195.60
|
| Rate for Payer: Cash Price |
$195.60
|
| Rate for Payer: Cigna Commercial |
$277.10
|
| Rate for Payer: First Health Commercial |
$293.40
|
| Rate for Payer: First Health Workers Compensation |
$125.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$293.40
|
| Rate for Payer: GEHA Commercial |
$260.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$293.40
|
| Rate for Payer: Humana ChoiceCare |
$84.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$165.05
|
| Rate for Payer: Multiplan All |
$296.66
|
| Rate for Payer: New Mexico Health Connections Medicare |
$195.60
|
| Rate for Payer: OMNI Networks Commercial |
$228.20
|
| Rate for Payer: One Health Plan PPO/POS |
$293.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$190.57
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$165.05
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$309.70
|
| Rate for Payer: Three Rivers Provider Network All |
$244.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$286.88
|
| Rate for Payer: United Healthcare Managed Medicaid |
$165.05
|
| Rate for Payer: United Payors & United Providers UP&UP |
$303.18
|
| Rate for Payer: Zelis Auto |
$130.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$163.00
|
| Rate for Payer: Zelis Worker's Compensation |
$89.00
|
|
|
VOID PRESSURE STUDIES INTRAABDOMINAL
|
Facility
|
IP
|
$326.00
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
23500050
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$89.00 |
| Max. Negotiated Rate |
$309.70 |
| Rate for Payer: Cash Price |
$195.60
|
| Rate for Payer: Cigna Commercial |
$277.10
|
| Rate for Payer: First Health Commercial |
$293.40
|
| Rate for Payer: First Health Workers Compensation |
$125.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$293.40
|
| Rate for Payer: GEHA Commercial |
$228.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$293.40
|
| Rate for Payer: Multiplan All |
$296.66
|
| Rate for Payer: OMNI Networks Commercial |
$228.20
|
| Rate for Payer: One Health Plan PPO/POS |
$293.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$309.70
|
| Rate for Payer: Three Rivers Provider Network All |
$244.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$303.18
|
| Rate for Payer: Zelis Auto |
$130.40
|
| Rate for Payer: Zelis Worker's Compensation |
$89.00
|
|
|
VOID PRESSURE STUDIES INTRAABDOMINAL
|
Facility
|
OP
|
$523.59
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
23551797
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$136.13 |
| Max. Negotiated Rate |
$497.41 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$204.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$314.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$204.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$161.75
|
| Rate for Payer: Cash Price |
$314.15
|
| Rate for Payer: Cash Price |
$314.15
|
| Rate for Payer: Cigna Commercial |
$445.05
|
| Rate for Payer: First Health Commercial |
$471.23
|
| Rate for Payer: First Health Workers Compensation |
$202.16
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$471.23
|
| Rate for Payer: GEHA Commercial |
$418.87
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$471.23
|
| Rate for Payer: Humana ChoiceCare |
$136.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$165.05
|
| Rate for Payer: Multiplan All |
$476.47
|
| Rate for Payer: New Mexico Health Connections Medicare |
$314.15
|
| Rate for Payer: OMNI Networks Commercial |
$366.51
|
| Rate for Payer: One Health Plan PPO/POS |
$471.23
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$190.57
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$165.05
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$497.41
|
| Rate for Payer: Three Rivers Provider Network All |
$392.69
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$460.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$165.05
|
| Rate for Payer: United Payors & United Providers UP&UP |
$486.94
|
| Rate for Payer: Zelis Auto |
$209.44
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$261.80
|
| Rate for Payer: Zelis Worker's Compensation |
$142.94
|
|
|
VOID PRESSURE STUDIES INTRAABDOMINAL
|
Facility
|
IP
|
$523.59
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
23551797
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$142.94 |
| Max. Negotiated Rate |
$497.41 |
| Rate for Payer: Cash Price |
$314.15
|
| Rate for Payer: Cigna Commercial |
$445.05
|
| Rate for Payer: First Health Commercial |
$471.23
|
| Rate for Payer: First Health Workers Compensation |
$202.16
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$471.23
|
| Rate for Payer: GEHA Commercial |
$366.51
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$471.23
|
| Rate for Payer: Multiplan All |
$476.47
|
| Rate for Payer: OMNI Networks Commercial |
$366.51
|
| Rate for Payer: One Health Plan PPO/POS |
$471.23
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$497.41
|
| Rate for Payer: Three Rivers Provider Network All |
$392.69
|
| Rate for Payer: United Payors & United Providers UP&UP |
$486.94
|
| Rate for Payer: Zelis Auto |
$209.44
|
| Rate for Payer: Zelis Worker's Compensation |
$142.94
|
|
|
VOID PRESSURE STUDIES INTRAABDOMINAL
|
Facility
|
IP
|
$326.00
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
9200002
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$89.00 |
| Max. Negotiated Rate |
$309.70 |
| Rate for Payer: Cash Price |
$195.60
|
| Rate for Payer: Cigna Commercial |
$277.10
|
| Rate for Payer: First Health Commercial |
$293.40
|
| Rate for Payer: First Health Workers Compensation |
$125.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$293.40
|
| Rate for Payer: GEHA Commercial |
$228.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$293.40
|
| Rate for Payer: Multiplan All |
$296.66
|
| Rate for Payer: OMNI Networks Commercial |
$228.20
|
| Rate for Payer: One Health Plan PPO/POS |
$293.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$309.70
|
| Rate for Payer: Three Rivers Provider Network All |
$244.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$303.18
|
| Rate for Payer: Zelis Auto |
$130.40
|
| Rate for Payer: Zelis Worker's Compensation |
$89.00
|
|
|
VOID PRESSURE STUDIES INTRAABDOMINAL
|
Facility
|
OP
|
$326.00
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
9200002
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$84.76 |
| Max. Negotiated Rate |
$309.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$204.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$195.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$204.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$161.75
|
| Rate for Payer: Cash Price |
$195.60
|
| Rate for Payer: Cash Price |
$195.60
|
| Rate for Payer: Cigna Commercial |
$277.10
|
| Rate for Payer: First Health Commercial |
$293.40
|
| Rate for Payer: First Health Workers Compensation |
$125.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$293.40
|
| Rate for Payer: GEHA Commercial |
$260.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$293.40
|
| Rate for Payer: Humana ChoiceCare |
$84.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$165.05
|
| Rate for Payer: Multiplan All |
$296.66
|
| Rate for Payer: New Mexico Health Connections Medicare |
$195.60
|
| Rate for Payer: OMNI Networks Commercial |
$228.20
|
| Rate for Payer: One Health Plan PPO/POS |
$293.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$190.57
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$165.05
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$309.70
|
| Rate for Payer: Three Rivers Provider Network All |
$244.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$286.88
|
| Rate for Payer: United Healthcare Managed Medicaid |
$165.05
|
| Rate for Payer: United Payors & United Providers UP&UP |
$303.18
|
| Rate for Payer: Zelis Auto |
$130.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$163.00
|
| Rate for Payer: Zelis Worker's Compensation |
$89.00
|
|
|
volatiles, urine REF716001
|
Facility
|
IP
|
$203.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
2200743
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.29 |
| 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 |
$27.28
|
| 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 |
$19.29
|
|
|
volatiles, urine REF716001
|
Facility
|
OP
|
$203.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
2200743
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.29 |
| Max. Negotiated Rate |
$192.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$121.80
|
| 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 |
$27.28
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$182.70
|
| Rate for Payer: GEHA Commercial |
$162.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$182.70
|
| Rate for Payer: Humana ChoiceCare |
$52.78
|
| Rate for Payer: Multiplan All |
$184.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$121.80
|
| 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: TriWest Veterans Administration/VAPC3 |
$178.64
|
| Rate for Payer: United Healthcare Commercial |
$172.55
|
| Rate for Payer: United Healthcare Managed Medicaid |
$50.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$188.79
|
| Rate for Payer: Zelis Auto |
$81.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$101.50
|
| Rate for Payer: Zelis Worker's Compensation |
$19.29
|
|
|
volatiles whole blood REF007062
|
Facility
|
IP
|
$203.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
2200438
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.29 |
| 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 |
$27.28
|
| 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 |
$19.29
|
|
|
volatiles whole blood REF007062
|
Facility
|
OP
|
$203.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
2200438
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.29 |
| Max. Negotiated Rate |
$192.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$121.80
|
| 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 |
$27.28
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$182.70
|
| Rate for Payer: GEHA Commercial |
$162.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$182.70
|
| Rate for Payer: Humana ChoiceCare |
$52.78
|
| Rate for Payer: Multiplan All |
$184.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$121.80
|
| 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: TriWest Veterans Administration/VAPC3 |
$178.64
|
| Rate for Payer: United Healthcare Commercial |
$172.55
|
| Rate for Payer: United Healthcare Managed Medicaid |
$50.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$188.79
|
| Rate for Payer: Zelis Auto |
$81.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$101.50
|
| Rate for Payer: Zelis Worker's Compensation |
$19.29
|
|
|
voltage-gated ca channel ab REF140640
|
Facility
|
OP
|
$162.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
2299510
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$153.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$20.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$97.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$20.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$16.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$97.20
|
| Rate for Payer: Cash Price |
$97.20
|
| Rate for Payer: Cigna Commercial |
$137.70
|
| Rate for Payer: First Health Commercial |
$145.80
|
| Rate for Payer: First Health Workers Compensation |
$20.09
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$145.80
|
| Rate for Payer: GEHA Commercial |
$129.60
|
| Rate for Payer: GEHA Medicare |
$11.53
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$145.80
|
| Rate for Payer: Humana ChoiceCare |
$12.68
|
| Rate for Payer: Humana Medicare Advantage |
$11.53
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$19.37
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$16.78
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$11.53
|
| Rate for Payer: Multiplan All |
$147.42
|
| Rate for Payer: New Mexico Health Connections Medicare |
$19.60
|
| Rate for Payer: OMNI Networks Commercial |
$113.40
|
| Rate for Payer: One Health Plan PPO/POS |
$145.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$19.38
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$16.78
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$11.53
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$153.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$23.06
|
| Rate for Payer: Three Rivers Provider Network All |
$121.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11.30
|
| Rate for Payer: United Healthcare Commercial |
$137.70
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.53
|
| Rate for Payer: United Payors & United Providers UP&UP |
$150.66
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$11.53
|
| Rate for Payer: Zelis Auto |
$64.80
|
| Rate for Payer: Zelis Medicare |
$9.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$13.84
|
| Rate for Payer: Zelis Worker's Compensation |
$14.20
|
|
|
voltage-gated ca channel ab REF140640
|
Facility
|
IP
|
$162.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
2299510
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.20 |
| Max. Negotiated Rate |
$153.90 |
| Rate for Payer: Cash Price |
$97.20
|
| Rate for Payer: Cash Price |
$97.20
|
| Rate for Payer: Cigna Commercial |
$137.70
|
| Rate for Payer: First Health Commercial |
$145.80
|
| Rate for Payer: First Health Workers Compensation |
$20.09
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$145.80
|
| Rate for Payer: GEHA Commercial |
$113.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$145.80
|
| Rate for Payer: Multiplan All |
$147.42
|
| Rate for Payer: OMNI Networks Commercial |
$113.40
|
| Rate for Payer: One Health Plan PPO/POS |
$145.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$153.90
|
| Rate for Payer: Three Rivers Provider Network All |
$121.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$150.66
|
| Rate for Payer: Zelis Auto |
$64.80
|
| Rate for Payer: Zelis Worker's Compensation |
$14.20
|
|
|
VOLUME VENT SUB DAY
|
Facility
|
OP
|
$2,489.39
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
4000622
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$232.67 |
| Max. Negotiated Rate |
$2,364.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$293.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,493.63
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$293.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$232.67
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$627.74
|
| Rate for Payer: Cash Price |
$1,493.63
|
| Rate for Payer: Cash Price |
$1,493.63
|
| Rate for Payer: Cigna Commercial |
$2,115.98
|
| Rate for Payer: First Health Commercial |
$2,240.45
|
| Rate for Payer: First Health Workers Compensation |
$961.15
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,240.45
|
| Rate for Payer: GEHA Commercial |
$1,991.51
|
| Rate for Payer: GEHA Medicare |
$627.74
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,240.45
|
| Rate for Payer: Humana ChoiceCare |
$690.51
|
| Rate for Payer: Humana Medicare Advantage |
$627.74
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,054.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$237.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$627.74
|
| Rate for Payer: Multiplan All |
$2,265.34
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,067.16
|
| Rate for Payer: OMNI Networks Commercial |
$1,742.57
|
| Rate for Payer: One Health Plan PPO/POS |
$2,240.45
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$274.12
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$237.41
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$627.74
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,364.92
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,255.48
|
| Rate for Payer: Three Rivers Provider Network All |
$1,867.04
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$615.19
|
| Rate for Payer: United Healthcare Commercial |
$2,115.98
|
| Rate for Payer: United Healthcare Managed Medicaid |
$237.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$627.74
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,315.13
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$627.74
|
| Rate for Payer: Zelis Auto |
$995.76
|
| Rate for Payer: Zelis Medicare |
$533.58
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$753.29
|
| Rate for Payer: Zelis Worker's Compensation |
$679.60
|
|
|
VOLUME VENT SUB DAY
|
Facility
|
IP
|
$2,489.39
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
4000622
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$679.60 |
| Max. Negotiated Rate |
$2,364.92 |
| Rate for Payer: Cash Price |
$1,493.63
|
| Rate for Payer: Cigna Commercial |
$2,115.98
|
| Rate for Payer: First Health Commercial |
$2,240.45
|
| Rate for Payer: First Health Workers Compensation |
$961.15
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,240.45
|
| Rate for Payer: GEHA Commercial |
$1,742.57
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,240.45
|
| Rate for Payer: Multiplan All |
$2,265.34
|
| Rate for Payer: OMNI Networks Commercial |
$1,742.57
|
| Rate for Payer: One Health Plan PPO/POS |
$2,240.45
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,364.92
|
| Rate for Payer: Three Rivers Provider Network All |
$1,867.04
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,315.13
|
| Rate for Payer: Zelis Auto |
$995.76
|
| Rate for Payer: Zelis Worker's Compensation |
$679.60
|
|
|
von willebrand factor activity REF164509
|
Facility
|
IP
|
$274.00
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
2299407
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$28.64 |
| Max. Negotiated Rate |
$260.30 |
| Rate for Payer: Cash Price |
$164.40
|
| Rate for Payer: Cash Price |
$164.40
|
| Rate for Payer: Cigna Commercial |
$232.90
|
| Rate for Payer: First Health Commercial |
$246.60
|
| Rate for Payer: First Health Workers Compensation |
$40.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$246.60
|
| Rate for Payer: GEHA Commercial |
$191.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$246.60
|
| Rate for Payer: Multiplan All |
$249.34
|
| Rate for Payer: OMNI Networks Commercial |
$191.80
|
| Rate for Payer: One Health Plan PPO/POS |
$246.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$260.30
|
| Rate for Payer: Three Rivers Provider Network All |
$205.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$254.82
|
| Rate for Payer: Zelis Auto |
$109.60
|
| Rate for Payer: Zelis Worker's Compensation |
$28.64
|
|
|
von willebrand factor activity REF164509
|
Facility
|
OP
|
$274.00
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
2299407
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.50 |
| Max. Negotiated Rate |
$260.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$41.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$164.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$41.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$32.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$164.40
|
| Rate for Payer: Cash Price |
$164.40
|
| Rate for Payer: Cigna Commercial |
$232.90
|
| Rate for Payer: First Health Commercial |
$246.60
|
| Rate for Payer: First Health Workers Compensation |
$40.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$246.60
|
| Rate for Payer: GEHA Commercial |
$219.20
|
| Rate for Payer: GEHA Medicare |
$22.94
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$246.60
|
| Rate for Payer: Humana ChoiceCare |
$25.23
|
| Rate for Payer: Humana Medicare Advantage |
$22.94
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$38.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$33.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$22.94
|
| Rate for Payer: Multiplan All |
$249.34
|
| Rate for Payer: New Mexico Health Connections Medicare |
$39.00
|
| Rate for Payer: OMNI Networks Commercial |
$191.80
|
| Rate for Payer: One Health Plan PPO/POS |
$246.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$38.54
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$33.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$22.94
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$260.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$45.88
|
| Rate for Payer: Three Rivers Provider Network All |
$205.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$22.48
|
| Rate for Payer: United Healthcare Commercial |
$232.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$33.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22.94
|
| Rate for Payer: United Payors & United Providers UP&UP |
$254.82
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$22.94
|
| Rate for Payer: Zelis Auto |
$109.60
|
| Rate for Payer: Zelis Medicare |
$19.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$27.53
|
| Rate for Payer: Zelis Worker's Compensation |
$28.64
|
|
|
von willebrand factor antigen REF086280
|
Facility
|
OP
|
$259.00
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
2299408
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.50 |
| Max. Negotiated Rate |
$246.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$41.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$155.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$41.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$32.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$155.40
|
| Rate for Payer: Cash Price |
$155.40
|
| Rate for Payer: Cigna Commercial |
$220.15
|
| Rate for Payer: First Health Commercial |
$233.10
|
| Rate for Payer: First Health Workers Compensation |
$40.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$233.10
|
| Rate for Payer: GEHA Commercial |
$207.20
|
| Rate for Payer: GEHA Medicare |
$22.94
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$233.10
|
| Rate for Payer: Humana ChoiceCare |
$25.23
|
| Rate for Payer: Humana Medicare Advantage |
$22.94
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$38.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$33.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$22.94
|
| Rate for Payer: Multiplan All |
$235.69
|
| Rate for Payer: New Mexico Health Connections Medicare |
$39.00
|
| Rate for Payer: OMNI Networks Commercial |
$181.30
|
| Rate for Payer: One Health Plan PPO/POS |
$233.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$38.54
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$33.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$22.94
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$246.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$45.88
|
| Rate for Payer: Three Rivers Provider Network All |
$194.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$22.48
|
| Rate for Payer: United Healthcare Commercial |
$220.15
|
| Rate for Payer: United Healthcare Managed Medicaid |
$33.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22.94
|
| Rate for Payer: United Payors & United Providers UP&UP |
$240.87
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$22.94
|
| Rate for Payer: Zelis Auto |
$103.60
|
| Rate for Payer: Zelis Medicare |
$19.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$27.53
|
| Rate for Payer: Zelis Worker's Compensation |
$28.64
|
|
|
von willebrand factor antigen REF086280
|
Facility
|
IP
|
$259.00
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
2299408
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$28.64 |
| Max. Negotiated Rate |
$246.05 |
| Rate for Payer: Cash Price |
$155.40
|
| Rate for Payer: Cash Price |
$155.40
|
| Rate for Payer: Cigna Commercial |
$220.15
|
| Rate for Payer: First Health Commercial |
$233.10
|
| Rate for Payer: First Health Workers Compensation |
$40.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$233.10
|
| Rate for Payer: GEHA Commercial |
$181.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$233.10
|
| Rate for Payer: Multiplan All |
$235.69
|
| Rate for Payer: OMNI Networks Commercial |
$181.30
|
| Rate for Payer: One Health Plan PPO/POS |
$233.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$246.05
|
| Rate for Payer: Three Rivers Provider Network All |
$194.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$240.87
|
| Rate for Payer: Zelis Auto |
$103.60
|
| Rate for Payer: Zelis Worker's Compensation |
$28.64
|
|
|
VORICONAZOLE 200MG
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
NDC 27241006303
|
| Hospital Charge Code |
3302828
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$30.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cigna Commercial |
$27.20
|
| Rate for Payer: First Health Commercial |
$28.80
|
| Rate for Payer: First Health Workers Compensation |
$12.36
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$28.80
|
| Rate for Payer: GEHA Commercial |
$25.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$28.80
|
| Rate for Payer: Humana ChoiceCare |
$8.32
|
| Rate for Payer: Multiplan All |
$29.12
|
| Rate for Payer: New Mexico Health Connections Medicare |
$19.20
|
| Rate for Payer: OMNI Networks Commercial |
$22.40
|
| Rate for Payer: One Health Plan PPO/POS |
$28.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$30.40
|
| Rate for Payer: Three Rivers Provider Network All |
$24.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$28.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$29.76
|
| Rate for Payer: Zelis Auto |
$12.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$16.00
|
| Rate for Payer: Zelis Worker's Compensation |
$8.74
|
|
|
VORICONAZOLE 200MG
|
Facility
|
IP
|
$32.00
|
|
|
Service Code
|
NDC 27241006303
|
| Hospital Charge Code |
3302828
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$30.40 |
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cigna Commercial |
$27.20
|
| Rate for Payer: First Health Commercial |
$28.80
|
| Rate for Payer: First Health Workers Compensation |
$12.36
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$28.80
|
| Rate for Payer: GEHA Commercial |
$22.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$28.80
|
| Rate for Payer: Multiplan All |
$29.12
|
| Rate for Payer: OMNI Networks Commercial |
$22.40
|
| Rate for Payer: One Health Plan PPO/POS |
$28.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$30.40
|
| Rate for Payer: Three Rivers Provider Network All |
$24.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$29.76
|
| Rate for Payer: Zelis Auto |
$12.80
|
| Rate for Payer: Zelis Worker's Compensation |
$8.74
|
|
|
VORICONAZOLE 200 MG IV VIAL
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT J3465
|
| Hospital Charge Code |
3303111
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$190.00 |
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cigna Commercial |
$170.00
|
| Rate for Payer: First Health Commercial |
$180.00
|
| Rate for Payer: First Health Workers Compensation |
$77.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$180.00
|
| Rate for Payer: GEHA Commercial |
$140.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$180.00
|
| Rate for Payer: Multiplan All |
$182.00
|
| Rate for Payer: OMNI Networks Commercial |
$140.00
|
| Rate for Payer: One Health Plan PPO/POS |
$180.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$190.00
|
| Rate for Payer: Three Rivers Provider Network All |
$150.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$186.00
|
| Rate for Payer: Zelis Auto |
$80.00
|
| Rate for Payer: Zelis Worker's Compensation |
$54.60
|
|
