|
95886 NEEDLE EMG PERFORMED W/NCV
|
Facility
|
OP
|
$401.00
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
21799451
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$96.22 |
| Max. Negotiated Rate |
$380.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$121.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$240.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$121.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$96.22
|
| Rate for Payer: Cash Price |
$240.60
|
| Rate for Payer: Cash Price |
$240.60
|
| Rate for Payer: Cigna Commercial |
$340.85
|
| Rate for Payer: First Health Commercial |
$360.90
|
| Rate for Payer: First Health Workers Compensation |
$154.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$360.90
|
| Rate for Payer: GEHA Commercial |
$320.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$360.90
|
| Rate for Payer: Humana ChoiceCare |
$104.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$98.18
|
| Rate for Payer: Multiplan All |
$364.91
|
| Rate for Payer: New Mexico Health Connections Medicare |
$240.60
|
| Rate for Payer: OMNI Networks Commercial |
$280.70
|
| Rate for Payer: One Health Plan PPO/POS |
$360.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$113.36
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$98.18
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$380.95
|
| Rate for Payer: Three Rivers Provider Network All |
$300.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$352.88
|
| Rate for Payer: United Healthcare Managed Medicaid |
$98.18
|
| Rate for Payer: United Payors & United Providers UP&UP |
$372.93
|
| Rate for Payer: Zelis Auto |
$160.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$200.50
|
| Rate for Payer: Zelis Worker's Compensation |
$109.47
|
|
|
95886 NEEDLE EMG PERFORMED W/NCV
|
Facility
|
IP
|
$401.00
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
21995886
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$109.47 |
| Max. Negotiated Rate |
$380.95 |
| Rate for Payer: Cash Price |
$240.60
|
| Rate for Payer: Cigna Commercial |
$340.85
|
| Rate for Payer: First Health Commercial |
$360.90
|
| Rate for Payer: First Health Workers Compensation |
$154.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$360.90
|
| Rate for Payer: GEHA Commercial |
$280.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$360.90
|
| Rate for Payer: Multiplan All |
$364.91
|
| Rate for Payer: OMNI Networks Commercial |
$280.70
|
| Rate for Payer: One Health Plan PPO/POS |
$360.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$380.95
|
| Rate for Payer: Three Rivers Provider Network All |
$300.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$372.93
|
| Rate for Payer: Zelis Auto |
$160.40
|
| Rate for Payer: Zelis Worker's Compensation |
$109.47
|
|
|
95886 NEEDLE EMG PERFORMED W/NCV
|
Facility
|
IP
|
$401.00
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
21799451
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$109.47 |
| Max. Negotiated Rate |
$380.95 |
| Rate for Payer: Cash Price |
$240.60
|
| Rate for Payer: Cigna Commercial |
$340.85
|
| Rate for Payer: First Health Commercial |
$360.90
|
| Rate for Payer: First Health Workers Compensation |
$154.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$360.90
|
| Rate for Payer: GEHA Commercial |
$280.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$360.90
|
| Rate for Payer: Multiplan All |
$364.91
|
| Rate for Payer: OMNI Networks Commercial |
$280.70
|
| Rate for Payer: One Health Plan PPO/POS |
$360.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$380.95
|
| Rate for Payer: Three Rivers Provider Network All |
$300.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$372.93
|
| Rate for Payer: Zelis Auto |
$160.40
|
| Rate for Payer: Zelis Worker's Compensation |
$109.47
|
|
|
95886 NEEDLE EMG PERFORMED W/NCV
|
Facility
|
IP
|
$401.00
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
21900160
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$109.47 |
| Max. Negotiated Rate |
$380.95 |
| Rate for Payer: Cash Price |
$240.60
|
| Rate for Payer: Cigna Commercial |
$340.85
|
| Rate for Payer: First Health Commercial |
$360.90
|
| Rate for Payer: First Health Workers Compensation |
$154.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$360.90
|
| Rate for Payer: GEHA Commercial |
$280.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$360.90
|
| Rate for Payer: Multiplan All |
$364.91
|
| Rate for Payer: OMNI Networks Commercial |
$280.70
|
| Rate for Payer: One Health Plan PPO/POS |
$360.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$380.95
|
| Rate for Payer: Three Rivers Provider Network All |
$300.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$372.93
|
| Rate for Payer: Zelis Auto |
$160.40
|
| Rate for Payer: Zelis Worker's Compensation |
$109.47
|
|
|
95886 NEEDLE EMG PERFORMED W/NCV
|
Facility
|
OP
|
$401.00
|
|
|
Service Code
|
CPT 95886
|
| Hospital Charge Code |
21900160
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$96.22 |
| Max. Negotiated Rate |
$380.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$121.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$240.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$121.45
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$96.22
|
| Rate for Payer: Cash Price |
$240.60
|
| Rate for Payer: Cash Price |
$240.60
|
| Rate for Payer: Cigna Commercial |
$340.85
|
| Rate for Payer: First Health Commercial |
$360.90
|
| Rate for Payer: First Health Workers Compensation |
$154.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$360.90
|
| Rate for Payer: GEHA Commercial |
$320.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$360.90
|
| Rate for Payer: Humana ChoiceCare |
$104.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$98.18
|
| Rate for Payer: Multiplan All |
$364.91
|
| Rate for Payer: New Mexico Health Connections Medicare |
$240.60
|
| Rate for Payer: OMNI Networks Commercial |
$280.70
|
| Rate for Payer: One Health Plan PPO/POS |
$360.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$113.36
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$98.18
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$380.95
|
| Rate for Payer: Three Rivers Provider Network All |
$300.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$352.88
|
| Rate for Payer: United Healthcare Managed Medicaid |
$98.18
|
| Rate for Payer: United Payors & United Providers UP&UP |
$372.93
|
| Rate for Payer: Zelis Auto |
$160.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$200.50
|
| Rate for Payer: Zelis Worker's Compensation |
$109.47
|
|
|
95907 NVR CNDJ TST 1-2 STUDIES
|
Facility
|
OP
|
$288.00
|
|
|
Service Code
|
CPT 95907
|
| Hospital Charge Code |
21700018
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$297.14 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$172.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$48.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$148.57
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cigna Commercial |
$244.80
|
| Rate for Payer: First Health Commercial |
$259.20
|
| Rate for Payer: First Health Workers Compensation |
$111.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$259.20
|
| Rate for Payer: GEHA Commercial |
$230.40
|
| Rate for Payer: GEHA Medicare |
$148.57
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$259.20
|
| Rate for Payer: Humana ChoiceCare |
$163.43
|
| Rate for Payer: Humana Medicare Advantage |
$148.57
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$249.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$49.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$148.57
|
| Rate for Payer: Multiplan All |
$262.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$252.57
|
| Rate for Payer: OMNI Networks Commercial |
$201.60
|
| Rate for Payer: One Health Plan PPO/POS |
$259.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$57.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$49.41
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$148.57
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$273.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$297.14
|
| Rate for Payer: Three Rivers Provider Network All |
$216.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$145.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$49.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$148.57
|
| Rate for Payer: United Payors & United Providers UP&UP |
$267.84
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$148.57
|
| Rate for Payer: Zelis Auto |
$115.20
|
| Rate for Payer: Zelis Medicare |
$126.28
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$178.28
|
| Rate for Payer: Zelis Worker's Compensation |
$78.62
|
|
|
95907 NVR CNDJ TST 1-2 STUDIES
|
Facility
|
IP
|
$288.00
|
|
|
Service Code
|
CPT 95907
|
| Hospital Charge Code |
21900127
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$78.62 |
| Max. Negotiated Rate |
$273.60 |
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cigna Commercial |
$244.80
|
| Rate for Payer: First Health Commercial |
$259.20
|
| Rate for Payer: First Health Workers Compensation |
$111.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$259.20
|
| Rate for Payer: GEHA Commercial |
$201.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$259.20
|
| Rate for Payer: Multiplan All |
$262.08
|
| Rate for Payer: OMNI Networks Commercial |
$201.60
|
| Rate for Payer: One Health Plan PPO/POS |
$259.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$273.60
|
| Rate for Payer: Three Rivers Provider Network All |
$216.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$267.84
|
| Rate for Payer: Zelis Auto |
$115.20
|
| Rate for Payer: Zelis Worker's Compensation |
$78.62
|
|
|
95907 NVR CNDJ TST 1-2 STUDIES
|
Facility
|
IP
|
$288.00
|
|
|
Service Code
|
CPT 95907
|
| Hospital Charge Code |
21700018
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$78.62 |
| Max. Negotiated Rate |
$273.60 |
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cigna Commercial |
$244.80
|
| Rate for Payer: First Health Commercial |
$259.20
|
| Rate for Payer: First Health Workers Compensation |
$111.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$259.20
|
| Rate for Payer: GEHA Commercial |
$201.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$259.20
|
| Rate for Payer: Multiplan All |
$262.08
|
| Rate for Payer: OMNI Networks Commercial |
$201.60
|
| Rate for Payer: One Health Plan PPO/POS |
$259.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$273.60
|
| Rate for Payer: Three Rivers Provider Network All |
$216.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$267.84
|
| Rate for Payer: Zelis Auto |
$115.20
|
| Rate for Payer: Zelis Worker's Compensation |
$78.62
|
|
|
95907 NVR CNDJ TST 1-2 STUDIES
|
Facility
|
OP
|
$288.00
|
|
|
Service Code
|
CPT 95907
|
| Hospital Charge Code |
21900127
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$297.14 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$172.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$48.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$148.57
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cigna Commercial |
$244.80
|
| Rate for Payer: First Health Commercial |
$259.20
|
| Rate for Payer: First Health Workers Compensation |
$111.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$259.20
|
| Rate for Payer: GEHA Commercial |
$230.40
|
| Rate for Payer: GEHA Medicare |
$148.57
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$259.20
|
| Rate for Payer: Humana ChoiceCare |
$163.43
|
| Rate for Payer: Humana Medicare Advantage |
$148.57
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$249.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$49.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$148.57
|
| Rate for Payer: Multiplan All |
$262.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$252.57
|
| Rate for Payer: OMNI Networks Commercial |
$201.60
|
| Rate for Payer: One Health Plan PPO/POS |
$259.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$57.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$49.41
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$148.57
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$273.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$297.14
|
| Rate for Payer: Three Rivers Provider Network All |
$216.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$145.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$49.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$148.57
|
| Rate for Payer: United Payors & United Providers UP&UP |
$267.84
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$148.57
|
| Rate for Payer: Zelis Auto |
$115.20
|
| Rate for Payer: Zelis Medicare |
$126.28
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$178.28
|
| Rate for Payer: Zelis Worker's Compensation |
$78.62
|
|
|
95908 NRV CNDJ TST 3-4 STUDIES
|
Facility
|
IP
|
$370.00
|
|
|
Service Code
|
CPT 95908
|
| Hospital Charge Code |
21900128
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$101.01 |
| Max. Negotiated Rate |
$351.50 |
| Rate for Payer: Cash Price |
$222.00
|
| Rate for Payer: Cigna Commercial |
$314.50
|
| Rate for Payer: First Health Commercial |
$333.00
|
| Rate for Payer: First Health Workers Compensation |
$142.86
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$333.00
|
| Rate for Payer: GEHA Commercial |
$259.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$333.00
|
| Rate for Payer: Multiplan All |
$336.70
|
| Rate for Payer: OMNI Networks Commercial |
$259.00
|
| Rate for Payer: One Health Plan PPO/POS |
$333.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$351.50
|
| Rate for Payer: Three Rivers Provider Network All |
$277.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$344.10
|
| Rate for Payer: Zelis Auto |
$148.00
|
| Rate for Payer: Zelis Worker's Compensation |
$101.01
|
|
|
95908 NRV CNDJ TST 3-4 STUDIES
|
Facility
|
OP
|
$370.00
|
|
|
Service Code
|
CPT 95908
|
| Hospital Charge Code |
21700019
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$591.38 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$222.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$48.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$295.69
|
| Rate for Payer: Cash Price |
$222.00
|
| Rate for Payer: Cash Price |
$222.00
|
| Rate for Payer: Cigna Commercial |
$314.50
|
| Rate for Payer: First Health Commercial |
$333.00
|
| Rate for Payer: First Health Workers Compensation |
$142.86
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$333.00
|
| Rate for Payer: GEHA Commercial |
$296.00
|
| Rate for Payer: GEHA Medicare |
$295.69
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$333.00
|
| Rate for Payer: Humana ChoiceCare |
$325.26
|
| Rate for Payer: Humana Medicare Advantage |
$295.69
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$496.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$49.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$295.69
|
| Rate for Payer: Multiplan All |
$336.70
|
| Rate for Payer: New Mexico Health Connections Medicare |
$502.67
|
| Rate for Payer: OMNI Networks Commercial |
$259.00
|
| Rate for Payer: One Health Plan PPO/POS |
$333.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$57.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$49.41
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$295.69
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$351.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$591.38
|
| Rate for Payer: Three Rivers Provider Network All |
$277.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$289.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$49.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$295.69
|
| Rate for Payer: United Payors & United Providers UP&UP |
$344.10
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$295.69
|
| Rate for Payer: Zelis Auto |
$148.00
|
| Rate for Payer: Zelis Medicare |
$251.34
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$354.83
|
| Rate for Payer: Zelis Worker's Compensation |
$101.01
|
|
|
95908 NRV CNDJ TST 3-4 STUDIES
|
Facility
|
OP
|
$370.00
|
|
|
Service Code
|
CPT 95908
|
| Hospital Charge Code |
21900128
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$591.38 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$222.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$48.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$295.69
|
| Rate for Payer: Cash Price |
$222.00
|
| Rate for Payer: Cash Price |
$222.00
|
| Rate for Payer: Cigna Commercial |
$314.50
|
| Rate for Payer: First Health Commercial |
$333.00
|
| Rate for Payer: First Health Workers Compensation |
$142.86
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$333.00
|
| Rate for Payer: GEHA Commercial |
$296.00
|
| Rate for Payer: GEHA Medicare |
$295.69
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$333.00
|
| Rate for Payer: Humana ChoiceCare |
$325.26
|
| Rate for Payer: Humana Medicare Advantage |
$295.69
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$496.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$49.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$295.69
|
| Rate for Payer: Multiplan All |
$336.70
|
| Rate for Payer: New Mexico Health Connections Medicare |
$502.67
|
| Rate for Payer: OMNI Networks Commercial |
$259.00
|
| Rate for Payer: One Health Plan PPO/POS |
$333.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$57.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$49.41
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$295.69
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$351.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$591.38
|
| Rate for Payer: Three Rivers Provider Network All |
$277.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$289.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$49.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$295.69
|
| Rate for Payer: United Payors & United Providers UP&UP |
$344.10
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$295.69
|
| Rate for Payer: Zelis Auto |
$148.00
|
| Rate for Payer: Zelis Medicare |
$251.34
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$354.83
|
| Rate for Payer: Zelis Worker's Compensation |
$101.01
|
|
|
95908 NRV CNDJ TST 3-4 STUDIES
|
Facility
|
IP
|
$370.00
|
|
|
Service Code
|
CPT 95908
|
| Hospital Charge Code |
21700019
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$101.01 |
| Max. Negotiated Rate |
$351.50 |
| Rate for Payer: Cash Price |
$222.00
|
| Rate for Payer: Cigna Commercial |
$314.50
|
| Rate for Payer: First Health Commercial |
$333.00
|
| Rate for Payer: First Health Workers Compensation |
$142.86
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$333.00
|
| Rate for Payer: GEHA Commercial |
$259.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$333.00
|
| Rate for Payer: Multiplan All |
$336.70
|
| Rate for Payer: OMNI Networks Commercial |
$259.00
|
| Rate for Payer: One Health Plan PPO/POS |
$333.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$351.50
|
| Rate for Payer: Three Rivers Provider Network All |
$277.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$344.10
|
| Rate for Payer: Zelis Auto |
$148.00
|
| Rate for Payer: Zelis Worker's Compensation |
$101.01
|
|
|
95909 NRV CNDJ TST 5-6 STUDIES
|
Facility
|
IP
|
$441.00
|
|
|
Service Code
|
CPT 95909
|
| Hospital Charge Code |
21900129
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$120.39 |
| Max. Negotiated Rate |
$418.95 |
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cigna Commercial |
$374.85
|
| Rate for Payer: First Health Commercial |
$396.90
|
| Rate for Payer: First Health Workers Compensation |
$170.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$396.90
|
| Rate for Payer: GEHA Commercial |
$308.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$396.90
|
| Rate for Payer: Multiplan All |
$401.31
|
| Rate for Payer: OMNI Networks Commercial |
$308.70
|
| Rate for Payer: One Health Plan PPO/POS |
$396.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$418.95
|
| Rate for Payer: Three Rivers Provider Network All |
$330.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$410.13
|
| Rate for Payer: Zelis Auto |
$176.40
|
| Rate for Payer: Zelis Worker's Compensation |
$120.39
|
|
|
95909 NRV CNDJ TST 5-6 STUDIES
|
Facility
|
OP
|
$441.00
|
|
|
Service Code
|
CPT 95909
|
| Hospital Charge Code |
21900129
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$591.38 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$264.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$48.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$295.69
|
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cigna Commercial |
$374.85
|
| Rate for Payer: First Health Commercial |
$396.90
|
| Rate for Payer: First Health Workers Compensation |
$170.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$396.90
|
| Rate for Payer: GEHA Commercial |
$352.80
|
| Rate for Payer: GEHA Medicare |
$295.69
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$396.90
|
| Rate for Payer: Humana ChoiceCare |
$325.26
|
| Rate for Payer: Humana Medicare Advantage |
$295.69
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$496.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$49.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$295.69
|
| Rate for Payer: Multiplan All |
$401.31
|
| Rate for Payer: New Mexico Health Connections Medicare |
$502.67
|
| Rate for Payer: OMNI Networks Commercial |
$308.70
|
| Rate for Payer: One Health Plan PPO/POS |
$396.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$57.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$49.41
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$295.69
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$418.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$591.38
|
| Rate for Payer: Three Rivers Provider Network All |
$330.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$289.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$49.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$295.69
|
| Rate for Payer: United Payors & United Providers UP&UP |
$410.13
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$295.69
|
| Rate for Payer: Zelis Auto |
$176.40
|
| Rate for Payer: Zelis Medicare |
$251.34
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$354.83
|
| Rate for Payer: Zelis Worker's Compensation |
$120.39
|
|
|
95909 NRV CNDJ TST 5-6 STUDIES
|
Facility
|
OP
|
$441.00
|
|
|
Service Code
|
CPT 95909
|
| Hospital Charge Code |
21700020
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$591.38 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$264.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$48.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$295.69
|
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cigna Commercial |
$374.85
|
| Rate for Payer: First Health Commercial |
$396.90
|
| Rate for Payer: First Health Workers Compensation |
$170.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$396.90
|
| Rate for Payer: GEHA Commercial |
$352.80
|
| Rate for Payer: GEHA Medicare |
$295.69
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$396.90
|
| Rate for Payer: Humana ChoiceCare |
$325.26
|
| Rate for Payer: Humana Medicare Advantage |
$295.69
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$496.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$49.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$295.69
|
| Rate for Payer: Multiplan All |
$401.31
|
| Rate for Payer: New Mexico Health Connections Medicare |
$502.67
|
| Rate for Payer: OMNI Networks Commercial |
$308.70
|
| Rate for Payer: One Health Plan PPO/POS |
$396.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$57.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$49.41
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$295.69
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$418.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$591.38
|
| Rate for Payer: Three Rivers Provider Network All |
$330.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$289.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$49.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$295.69
|
| Rate for Payer: United Payors & United Providers UP&UP |
$410.13
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$295.69
|
| Rate for Payer: Zelis Auto |
$176.40
|
| Rate for Payer: Zelis Medicare |
$251.34
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$354.83
|
| Rate for Payer: Zelis Worker's Compensation |
$120.39
|
|
|
95909 NRV CNDJ TST 5-6 STUDIES
|
Facility
|
IP
|
$441.00
|
|
|
Service Code
|
CPT 95909
|
| Hospital Charge Code |
21700020
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$120.39 |
| Max. Negotiated Rate |
$418.95 |
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cigna Commercial |
$374.85
|
| Rate for Payer: First Health Commercial |
$396.90
|
| Rate for Payer: First Health Workers Compensation |
$170.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$396.90
|
| Rate for Payer: GEHA Commercial |
$308.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$396.90
|
| Rate for Payer: Multiplan All |
$401.31
|
| Rate for Payer: OMNI Networks Commercial |
$308.70
|
| Rate for Payer: One Health Plan PPO/POS |
$396.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$418.95
|
| Rate for Payer: Three Rivers Provider Network All |
$330.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$410.13
|
| Rate for Payer: Zelis Auto |
$176.40
|
| Rate for Payer: Zelis Worker's Compensation |
$120.39
|
|
|
95910 NRV CNDJ TEST 7-8 STUDIES
|
Facility
|
IP
|
$583.00
|
|
|
Service Code
|
CPT 95910
|
| Hospital Charge Code |
21700021
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$159.16 |
| Max. Negotiated Rate |
$553.85 |
| Rate for Payer: Cash Price |
$349.80
|
| Rate for Payer: Cigna Commercial |
$495.55
|
| Rate for Payer: First Health Commercial |
$524.70
|
| Rate for Payer: First Health Workers Compensation |
$225.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$524.70
|
| Rate for Payer: GEHA Commercial |
$408.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$524.70
|
| Rate for Payer: Multiplan All |
$530.53
|
| Rate for Payer: OMNI Networks Commercial |
$408.10
|
| Rate for Payer: One Health Plan PPO/POS |
$524.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$553.85
|
| Rate for Payer: Three Rivers Provider Network All |
$437.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$542.19
|
| Rate for Payer: Zelis Auto |
$233.20
|
| Rate for Payer: Zelis Worker's Compensation |
$159.16
|
|
|
95910 NRV CNDJ TEST 7-8 STUDIES
|
Facility
|
IP
|
$583.00
|
|
|
Service Code
|
CPT 95910
|
| Hospital Charge Code |
21900130
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$159.16 |
| Max. Negotiated Rate |
$553.85 |
| Rate for Payer: Cash Price |
$349.80
|
| Rate for Payer: Cigna Commercial |
$495.55
|
| Rate for Payer: First Health Commercial |
$524.70
|
| Rate for Payer: First Health Workers Compensation |
$225.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$524.70
|
| Rate for Payer: GEHA Commercial |
$408.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$524.70
|
| Rate for Payer: Multiplan All |
$530.53
|
| Rate for Payer: OMNI Networks Commercial |
$408.10
|
| Rate for Payer: One Health Plan PPO/POS |
$524.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$553.85
|
| Rate for Payer: Three Rivers Provider Network All |
$437.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$542.19
|
| Rate for Payer: Zelis Auto |
$233.20
|
| Rate for Payer: Zelis Worker's Compensation |
$159.16
|
|
|
95910 NRV CNDJ TEST 7-8 STUDIES
|
Facility
|
OP
|
$583.00
|
|
|
Service Code
|
CPT 95910
|
| Hospital Charge Code |
21700021
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$591.38 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$349.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$48.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$295.69
|
| Rate for Payer: Cash Price |
$349.80
|
| Rate for Payer: Cash Price |
$349.80
|
| Rate for Payer: Cigna Commercial |
$495.55
|
| Rate for Payer: First Health Commercial |
$524.70
|
| Rate for Payer: First Health Workers Compensation |
$225.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$524.70
|
| Rate for Payer: GEHA Commercial |
$466.40
|
| Rate for Payer: GEHA Medicare |
$295.69
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$524.70
|
| Rate for Payer: Humana ChoiceCare |
$325.26
|
| Rate for Payer: Humana Medicare Advantage |
$295.69
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$496.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$49.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$295.69
|
| Rate for Payer: Multiplan All |
$530.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$502.67
|
| Rate for Payer: OMNI Networks Commercial |
$408.10
|
| Rate for Payer: One Health Plan PPO/POS |
$524.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$57.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$49.41
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$295.69
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$553.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$591.38
|
| Rate for Payer: Three Rivers Provider Network All |
$437.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$289.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$49.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$295.69
|
| Rate for Payer: United Payors & United Providers UP&UP |
$542.19
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$295.69
|
| Rate for Payer: Zelis Auto |
$233.20
|
| Rate for Payer: Zelis Medicare |
$251.34
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$354.83
|
| Rate for Payer: Zelis Worker's Compensation |
$159.16
|
|
|
95910 NRV CNDJ TEST 7-8 STUDIES
|
Facility
|
OP
|
$583.00
|
|
|
Service Code
|
CPT 95910
|
| Hospital Charge Code |
21900130
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$591.38 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$349.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$48.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$295.69
|
| Rate for Payer: Cash Price |
$349.80
|
| Rate for Payer: Cash Price |
$349.80
|
| Rate for Payer: Cigna Commercial |
$495.55
|
| Rate for Payer: First Health Commercial |
$524.70
|
| Rate for Payer: First Health Workers Compensation |
$225.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$524.70
|
| Rate for Payer: GEHA Commercial |
$466.40
|
| Rate for Payer: GEHA Medicare |
$295.69
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$524.70
|
| Rate for Payer: Humana ChoiceCare |
$325.26
|
| Rate for Payer: Humana Medicare Advantage |
$295.69
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$496.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$49.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$295.69
|
| Rate for Payer: Multiplan All |
$530.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$502.67
|
| Rate for Payer: OMNI Networks Commercial |
$408.10
|
| Rate for Payer: One Health Plan PPO/POS |
$524.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$57.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$49.41
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$295.69
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$553.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$591.38
|
| Rate for Payer: Three Rivers Provider Network All |
$437.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$289.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$49.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$295.69
|
| Rate for Payer: United Payors & United Providers UP&UP |
$542.19
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$295.69
|
| Rate for Payer: Zelis Auto |
$233.20
|
| Rate for Payer: Zelis Medicare |
$251.34
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$354.83
|
| Rate for Payer: Zelis Worker's Compensation |
$159.16
|
|
|
95911 NRV CNDJ TEST 9-10 STUDIE
|
Facility
|
IP
|
$700.00
|
|
|
Service Code
|
CPT 95911
|
| Hospital Charge Code |
21900161
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$191.10 |
| Max. Negotiated Rate |
$665.00 |
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cigna Commercial |
$595.00
|
| Rate for Payer: First Health Commercial |
$630.00
|
| Rate for Payer: First Health Workers Compensation |
$270.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$630.00
|
| Rate for Payer: GEHA Commercial |
$490.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$630.00
|
| Rate for Payer: Multiplan All |
$637.00
|
| Rate for Payer: OMNI Networks Commercial |
$490.00
|
| Rate for Payer: One Health Plan PPO/POS |
$630.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$665.00
|
| Rate for Payer: Three Rivers Provider Network All |
$525.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$651.00
|
| Rate for Payer: Zelis Auto |
$280.00
|
| Rate for Payer: Zelis Worker's Compensation |
$191.10
|
|
|
95911 NRV CNDJ TEST 9-10 STUDIE
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
CPT 95911
|
| Hospital Charge Code |
21795911
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$89.67 |
| Max. Negotiated Rate |
$1,007.66 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$113.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$420.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$113.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$89.67
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$503.83
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cigna Commercial |
$595.00
|
| Rate for Payer: First Health Commercial |
$630.00
|
| Rate for Payer: First Health Workers Compensation |
$270.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$630.00
|
| Rate for Payer: GEHA Commercial |
$560.00
|
| Rate for Payer: GEHA Medicare |
$503.83
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$630.00
|
| Rate for Payer: Humana ChoiceCare |
$554.21
|
| Rate for Payer: Humana Medicare Advantage |
$503.83
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$846.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$91.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$503.83
|
| Rate for Payer: Multiplan All |
$637.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$856.51
|
| Rate for Payer: OMNI Networks Commercial |
$490.00
|
| Rate for Payer: One Health Plan PPO/POS |
$630.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$105.64
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$91.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$503.83
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$665.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,007.66
|
| Rate for Payer: Three Rivers Provider Network All |
$525.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$493.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$91.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$503.83
|
| Rate for Payer: United Payors & United Providers UP&UP |
$651.00
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$503.83
|
| Rate for Payer: Zelis Auto |
$280.00
|
| Rate for Payer: Zelis Medicare |
$428.26
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$604.60
|
| Rate for Payer: Zelis Worker's Compensation |
$191.10
|
|
|
95911 NRV CNDJ TEST 9-10 STUDIE
|
Facility
|
IP
|
$700.00
|
|
|
Service Code
|
CPT 95911
|
| Hospital Charge Code |
21795911
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$191.10 |
| Max. Negotiated Rate |
$665.00 |
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cigna Commercial |
$595.00
|
| Rate for Payer: First Health Commercial |
$630.00
|
| Rate for Payer: First Health Workers Compensation |
$270.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$630.00
|
| Rate for Payer: GEHA Commercial |
$490.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$630.00
|
| Rate for Payer: Multiplan All |
$637.00
|
| Rate for Payer: OMNI Networks Commercial |
$490.00
|
| Rate for Payer: One Health Plan PPO/POS |
$630.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$665.00
|
| Rate for Payer: Three Rivers Provider Network All |
$525.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$651.00
|
| Rate for Payer: Zelis Auto |
$280.00
|
| Rate for Payer: Zelis Worker's Compensation |
$191.10
|
|
|
95911 NRV CNDJ TEST 9-10 STUDIE
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
CPT 95911
|
| Hospital Charge Code |
21900161
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$89.67 |
| Max. Negotiated Rate |
$1,007.66 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$113.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$420.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$113.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$89.67
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$503.83
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cigna Commercial |
$595.00
|
| Rate for Payer: First Health Commercial |
$630.00
|
| Rate for Payer: First Health Workers Compensation |
$270.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$630.00
|
| Rate for Payer: GEHA Commercial |
$560.00
|
| Rate for Payer: GEHA Medicare |
$503.83
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$630.00
|
| Rate for Payer: Humana ChoiceCare |
$554.21
|
| Rate for Payer: Humana Medicare Advantage |
$503.83
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$846.43
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$91.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$503.83
|
| Rate for Payer: Multiplan All |
$637.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$856.51
|
| Rate for Payer: OMNI Networks Commercial |
$490.00
|
| Rate for Payer: One Health Plan PPO/POS |
$630.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$105.64
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$91.50
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$503.83
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$665.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,007.66
|
| Rate for Payer: Three Rivers Provider Network All |
$525.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$493.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$91.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$503.83
|
| Rate for Payer: United Payors & United Providers UP&UP |
$651.00
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$503.83
|
| Rate for Payer: Zelis Auto |
$280.00
|
| Rate for Payer: Zelis Medicare |
$428.26
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$604.60
|
| Rate for Payer: Zelis Worker's Compensation |
$191.10
|
|
