|
COLLJ&INTERPJ PHY/QHP PHYSIO COMP 30 MIN
|
Facility
|
OP
|
$183.00
|
|
|
Service Code
|
CPT 99091
|
| Hospital Charge Code |
21900175
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$173.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$109.80
|
| Rate for Payer: Cash Price |
$109.80
|
| Rate for Payer: Cigna Commercial |
$155.55
|
| Rate for Payer: First Health Commercial |
$164.70
|
| Rate for Payer: First Health Workers Compensation |
$70.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$164.70
|
| Rate for Payer: GEHA Commercial |
$146.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$164.70
|
| Rate for Payer: Humana ChoiceCare |
$47.58
|
| Rate for Payer: Multiplan All |
$166.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$109.80
|
| Rate for Payer: OMNI Networks Commercial |
$128.10
|
| Rate for Payer: One Health Plan PPO/POS |
$164.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$173.85
|
| Rate for Payer: Three Rivers Provider Network All |
$137.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$161.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$45.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$170.19
|
| Rate for Payer: Zelis Auto |
$73.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$91.50
|
| Rate for Payer: Zelis Worker's Compensation |
$49.96
|
|
|
COLLJ&INTERPJ PHY/QHP PHYSIO COMP 30 MIN
|
Facility
|
OP
|
$183.00
|
|
|
Service Code
|
CPT 99091
|
| Hospital Charge Code |
25500048
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$173.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$109.80
|
| Rate for Payer: Cash Price |
$109.80
|
| Rate for Payer: Cigna Commercial |
$155.55
|
| Rate for Payer: First Health Commercial |
$164.70
|
| Rate for Payer: First Health Workers Compensation |
$70.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$164.70
|
| Rate for Payer: GEHA Commercial |
$146.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$164.70
|
| Rate for Payer: Humana ChoiceCare |
$47.58
|
| Rate for Payer: Multiplan All |
$166.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$109.80
|
| Rate for Payer: OMNI Networks Commercial |
$128.10
|
| Rate for Payer: One Health Plan PPO/POS |
$164.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$173.85
|
| Rate for Payer: Three Rivers Provider Network All |
$137.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$161.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$45.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$170.19
|
| Rate for Payer: Zelis Auto |
$73.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$91.50
|
| Rate for Payer: Zelis Worker's Compensation |
$49.96
|
|
|
COLLJ&INTERPJ PHY/QHP PHYSIO COMP 30 MIN
|
Facility
|
IP
|
$183.00
|
|
|
Service Code
|
CPT 99091
|
| Hospital Charge Code |
21099091
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$49.96 |
| Max. Negotiated Rate |
$173.85 |
| Rate for Payer: Cash Price |
$109.80
|
| Rate for Payer: Cigna Commercial |
$155.55
|
| Rate for Payer: First Health Commercial |
$164.70
|
| Rate for Payer: First Health Workers Compensation |
$70.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$164.70
|
| Rate for Payer: GEHA Commercial |
$128.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$164.70
|
| Rate for Payer: Multiplan All |
$166.53
|
| Rate for Payer: OMNI Networks Commercial |
$128.10
|
| Rate for Payer: One Health Plan PPO/POS |
$164.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$173.85
|
| Rate for Payer: Three Rivers Provider Network All |
$137.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$170.19
|
| Rate for Payer: Zelis Auto |
$73.20
|
| Rate for Payer: Zelis Worker's Compensation |
$49.96
|
|
|
COLLJ&INTERPJ PHY/QHP PHYSIO COMP 30 MIN
|
Facility
|
IP
|
$183.00
|
|
|
Service Code
|
CPT 99091
|
| Hospital Charge Code |
21900175
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$49.96 |
| Max. Negotiated Rate |
$173.85 |
| Rate for Payer: Cash Price |
$109.80
|
| Rate for Payer: Cigna Commercial |
$155.55
|
| Rate for Payer: First Health Commercial |
$164.70
|
| Rate for Payer: First Health Workers Compensation |
$70.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$164.70
|
| Rate for Payer: GEHA Commercial |
$128.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$164.70
|
| Rate for Payer: Multiplan All |
$166.53
|
| Rate for Payer: OMNI Networks Commercial |
$128.10
|
| Rate for Payer: One Health Plan PPO/POS |
$164.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$173.85
|
| Rate for Payer: Three Rivers Provider Network All |
$137.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$170.19
|
| Rate for Payer: Zelis Auto |
$73.20
|
| Rate for Payer: Zelis Worker's Compensation |
$49.96
|
|
|
COLLJ&INTERPJ PHY/QHP PHYSIO COMP 30 MIN
|
Facility
|
OP
|
$183.00
|
|
|
Service Code
|
CPT 99091
|
| Hospital Charge Code |
21799091
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$173.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$109.80
|
| Rate for Payer: Cash Price |
$109.80
|
| Rate for Payer: Cigna Commercial |
$155.55
|
| Rate for Payer: First Health Commercial |
$164.70
|
| Rate for Payer: First Health Workers Compensation |
$70.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$164.70
|
| Rate for Payer: GEHA Commercial |
$146.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$164.70
|
| Rate for Payer: Humana ChoiceCare |
$47.58
|
| Rate for Payer: Multiplan All |
$166.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$109.80
|
| Rate for Payer: OMNI Networks Commercial |
$128.10
|
| Rate for Payer: One Health Plan PPO/POS |
$164.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$173.85
|
| Rate for Payer: Three Rivers Provider Network All |
$137.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$161.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$45.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$170.19
|
| Rate for Payer: Zelis Auto |
$73.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$91.50
|
| Rate for Payer: Zelis Worker's Compensation |
$49.96
|
|
|
COLLJ&INTERPJ PHYS/QHP PHYSIO COMP 30 MI
|
Facility
|
OP
|
$183.00
|
|
|
Service Code
|
CPT 99091
|
| Hospital Charge Code |
8599091
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$173.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$109.80
|
| Rate for Payer: Cash Price |
$109.80
|
| Rate for Payer: Cigna Commercial |
$155.55
|
| Rate for Payer: First Health Commercial |
$164.70
|
| Rate for Payer: First Health Workers Compensation |
$70.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$164.70
|
| Rate for Payer: GEHA Commercial |
$146.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$164.70
|
| Rate for Payer: Humana ChoiceCare |
$47.58
|
| Rate for Payer: Multiplan All |
$166.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$109.80
|
| Rate for Payer: OMNI Networks Commercial |
$128.10
|
| Rate for Payer: One Health Plan PPO/POS |
$164.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$173.85
|
| Rate for Payer: Three Rivers Provider Network All |
$137.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$161.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$45.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$170.19
|
| Rate for Payer: Zelis Auto |
$73.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$91.50
|
| Rate for Payer: Zelis Worker's Compensation |
$49.96
|
|
|
COLLJ&INTERPJ PHYS/QHP PHYSIO COMP 30 MI
|
Facility
|
IP
|
$183.00
|
|
|
Service Code
|
CPT 99091
|
| Hospital Charge Code |
8599091
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$49.96 |
| Max. Negotiated Rate |
$173.85 |
| Rate for Payer: Cash Price |
$109.80
|
| Rate for Payer: Cigna Commercial |
$155.55
|
| Rate for Payer: First Health Commercial |
$164.70
|
| Rate for Payer: First Health Workers Compensation |
$70.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$164.70
|
| Rate for Payer: GEHA Commercial |
$128.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$164.70
|
| Rate for Payer: Multiplan All |
$166.53
|
| Rate for Payer: OMNI Networks Commercial |
$128.10
|
| Rate for Payer: One Health Plan PPO/POS |
$164.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$173.85
|
| Rate for Payer: Three Rivers Provider Network All |
$137.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$170.19
|
| Rate for Payer: Zelis Auto |
$73.20
|
| Rate for Payer: Zelis Worker's Compensation |
$49.96
|
|
|
COLON CAPSULE PROCEDURE
|
Facility
|
OP
|
$2,681.00
|
|
|
Service Code
|
CPT 91113
|
| Hospital Charge Code |
8091113
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$731.91 |
| Max. Negotiated Rate |
$2,546.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,215.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,608.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,215.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$963.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$865.71
|
| Rate for Payer: Cash Price |
$1,608.60
|
| Rate for Payer: Cash Price |
$1,608.60
|
| Rate for Payer: Cigna Commercial |
$2,278.85
|
| Rate for Payer: First Health Commercial |
$2,412.90
|
| Rate for Payer: First Health Workers Compensation |
$1,035.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,412.90
|
| Rate for Payer: GEHA Commercial |
$2,144.80
|
| Rate for Payer: GEHA Medicare |
$865.71
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,412.90
|
| Rate for Payer: Humana ChoiceCare |
$952.28
|
| Rate for Payer: Humana Medicare Advantage |
$865.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,454.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$982.71
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$865.71
|
| Rate for Payer: Multiplan All |
$2,439.71
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,471.71
|
| Rate for Payer: OMNI Networks Commercial |
$1,876.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,412.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,134.67
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$982.71
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$865.71
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,546.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,731.42
|
| Rate for Payer: Three Rivers Provider Network All |
$2,010.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$848.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$982.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$865.71
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,493.33
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$865.71
|
| Rate for Payer: Zelis Auto |
$1,072.40
|
| Rate for Payer: Zelis Medicare |
$735.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,038.85
|
| Rate for Payer: Zelis Worker's Compensation |
$731.91
|
|
|
COLON CAPSULE PROCEDURE
|
Facility
|
IP
|
$2,681.00
|
|
|
Service Code
|
CPT 91113
|
| Hospital Charge Code |
8091113
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$731.91 |
| Max. Negotiated Rate |
$2,546.95 |
| Rate for Payer: Cash Price |
$1,608.60
|
| Rate for Payer: Cigna Commercial |
$2,278.85
|
| Rate for Payer: First Health Commercial |
$2,412.90
|
| Rate for Payer: First Health Workers Compensation |
$1,035.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,412.90
|
| Rate for Payer: GEHA Commercial |
$1,876.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,412.90
|
| Rate for Payer: Multiplan All |
$2,439.71
|
| Rate for Payer: OMNI Networks Commercial |
$1,876.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,412.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,546.95
|
| Rate for Payer: Three Rivers Provider Network All |
$2,010.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,493.33
|
| Rate for Payer: Zelis Auto |
$1,072.40
|
| Rate for Payer: Zelis Worker's Compensation |
$731.91
|
|
|
COLON CA SCRN NOT HI RSK IND
|
Facility
|
IP
|
$592.00
|
|
|
Service Code
|
CPT G0121
|
| Hospital Charge Code |
6100121
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$161.62 |
| Max. Negotiated Rate |
$562.40 |
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cigna Commercial |
$503.20
|
| Rate for Payer: First Health Commercial |
$532.80
|
| Rate for Payer: First Health Workers Compensation |
$228.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$532.80
|
| Rate for Payer: GEHA Commercial |
$414.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$532.80
|
| Rate for Payer: Multiplan All |
$538.72
|
| Rate for Payer: OMNI Networks Commercial |
$414.40
|
| Rate for Payer: One Health Plan PPO/POS |
$532.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$562.40
|
| Rate for Payer: Three Rivers Provider Network All |
$444.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$550.56
|
| Rate for Payer: Zelis Auto |
$236.80
|
| Rate for Payer: Zelis Worker's Compensation |
$161.62
|
|
|
COLON CA SCRN NOT HI RSK IND
|
Facility
|
OP
|
$592.00
|
|
|
Service Code
|
CPT G0121
|
| Hospital Charge Code |
6100121
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$161.62 |
| Max. Negotiated Rate |
$1,731.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$818.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$355.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$818.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$648.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$865.71
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cigna Commercial |
$503.20
|
| Rate for Payer: First Health Commercial |
$532.80
|
| Rate for Payer: First Health Workers Compensation |
$228.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$532.80
|
| Rate for Payer: GEHA Commercial |
$473.60
|
| Rate for Payer: GEHA Medicare |
$865.71
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$532.80
|
| Rate for Payer: Humana ChoiceCare |
$952.28
|
| Rate for Payer: Humana Medicare Advantage |
$865.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,454.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$661.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$865.71
|
| Rate for Payer: Multiplan All |
$538.72
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,471.71
|
| Rate for Payer: OMNI Networks Commercial |
$414.40
|
| Rate for Payer: One Health Plan PPO/POS |
$532.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$763.56
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$661.30
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$865.71
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$562.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,731.42
|
| Rate for Payer: Three Rivers Provider Network All |
$444.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$848.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$661.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$865.71
|
| Rate for Payer: United Payors & United Providers UP&UP |
$550.56
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$865.71
|
| Rate for Payer: Zelis Auto |
$236.80
|
| Rate for Payer: Zelis Medicare |
$735.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,038.85
|
| Rate for Payer: Zelis Worker's Compensation |
$161.62
|
|
|
COLONOSCOPY
|
Facility
|
OP
|
$513.00
|
|
|
Service Code
|
CPT 44388
|
| Hospital Charge Code |
6144388
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$140.05 |
| Max. Negotiated Rate |
$1,731.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$920.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$307.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$920.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$729.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$865.71
|
| Rate for Payer: Cash Price |
$307.80
|
| Rate for Payer: Cash Price |
$307.80
|
| Rate for Payer: Cigna Commercial |
$436.05
|
| Rate for Payer: First Health Commercial |
$461.70
|
| Rate for Payer: First Health Workers Compensation |
$198.07
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$461.70
|
| Rate for Payer: GEHA Commercial |
$410.40
|
| Rate for Payer: GEHA Medicare |
$865.71
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$461.70
|
| Rate for Payer: Humana ChoiceCare |
$952.28
|
| Rate for Payer: Humana Medicare Advantage |
$865.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,454.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$744.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$865.71
|
| Rate for Payer: Multiplan All |
$466.83
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,471.71
|
| Rate for Payer: OMNI Networks Commercial |
$359.10
|
| Rate for Payer: One Health Plan PPO/POS |
$461.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$859.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$744.16
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$865.71
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$487.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,731.42
|
| Rate for Payer: Three Rivers Provider Network All |
$384.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$848.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$744.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$865.71
|
| Rate for Payer: United Payors & United Providers UP&UP |
$477.09
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$865.71
|
| Rate for Payer: Zelis Auto |
$205.20
|
| Rate for Payer: Zelis Medicare |
$735.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,038.85
|
| Rate for Payer: Zelis Worker's Compensation |
$140.05
|
|
|
COLONOSCOPY
|
Facility
|
IP
|
$513.00
|
|
|
Service Code
|
CPT 44388
|
| Hospital Charge Code |
6144388
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$140.05 |
| Max. Negotiated Rate |
$487.35 |
| Rate for Payer: Cash Price |
$307.80
|
| Rate for Payer: Cigna Commercial |
$436.05
|
| Rate for Payer: First Health Commercial |
$461.70
|
| Rate for Payer: First Health Workers Compensation |
$198.07
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$461.70
|
| Rate for Payer: GEHA Commercial |
$359.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$461.70
|
| Rate for Payer: Multiplan All |
$466.83
|
| Rate for Payer: OMNI Networks Commercial |
$359.10
|
| Rate for Payer: One Health Plan PPO/POS |
$461.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$487.35
|
| Rate for Payer: Three Rivers Provider Network All |
$384.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$477.09
|
| Rate for Payer: Zelis Auto |
$205.20
|
| Rate for Payer: Zelis Worker's Compensation |
$140.05
|
|
|
COLONOSCOPY AND BIOPSY
|
Facility
|
IP
|
$640.00
|
|
|
Service Code
|
CPT 45380
|
| Hospital Charge Code |
6145380
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$174.72 |
| Max. Negotiated Rate |
$608.00 |
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Cigna Commercial |
$544.00
|
| Rate for Payer: First Health Commercial |
$576.00
|
| Rate for Payer: First Health Workers Compensation |
$247.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$576.00
|
| Rate for Payer: GEHA Commercial |
$448.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$576.00
|
| Rate for Payer: Multiplan All |
$582.40
|
| Rate for Payer: OMNI Networks Commercial |
$448.00
|
| Rate for Payer: One Health Plan PPO/POS |
$576.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$608.00
|
| Rate for Payer: Three Rivers Provider Network All |
$480.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$595.20
|
| Rate for Payer: Zelis Auto |
$256.00
|
| Rate for Payer: Zelis Worker's Compensation |
$174.72
|
|
|
COLONOSCOPY AND BIOPSY
|
Facility
|
OP
|
$640.00
|
|
|
Service Code
|
CPT 45380
|
| Hospital Charge Code |
6145380
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$174.72 |
| Max. Negotiated Rate |
$2,239.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$920.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$384.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$920.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$729.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,119.58
|
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Cigna Commercial |
$544.00
|
| Rate for Payer: First Health Commercial |
$576.00
|
| Rate for Payer: First Health Workers Compensation |
$247.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$576.00
|
| Rate for Payer: GEHA Commercial |
$512.00
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$576.00
|
| Rate for Payer: Humana ChoiceCare |
$1,231.54
|
| Rate for Payer: Humana Medicare Advantage |
$1,119.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,880.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$744.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,119.58
|
| Rate for Payer: Multiplan All |
$582.40
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$448.00
|
| Rate for Payer: One Health Plan PPO/POS |
$576.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$859.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$744.16
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,119.58
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$608.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$480.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,097.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$744.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,119.58
|
| Rate for Payer: United Payors & United Providers UP&UP |
$595.20
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$256.00
|
| Rate for Payer: Zelis Medicare |
$951.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,343.50
|
| Rate for Payer: Zelis Worker's Compensation |
$174.72
|
|
|
COLONOSCOPY/CONTROL BLEEDING
|
Facility
|
IP
|
$828.00
|
|
|
Service Code
|
CPT 45382
|
| Hospital Charge Code |
6145382
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$226.04 |
| Max. Negotiated Rate |
$786.60 |
| Rate for Payer: Cash Price |
$496.80
|
| Rate for Payer: Cigna Commercial |
$703.80
|
| Rate for Payer: First Health Commercial |
$745.20
|
| Rate for Payer: First Health Workers Compensation |
$319.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$745.20
|
| Rate for Payer: GEHA Commercial |
$579.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$745.20
|
| Rate for Payer: Multiplan All |
$753.48
|
| Rate for Payer: OMNI Networks Commercial |
$579.60
|
| Rate for Payer: One Health Plan PPO/POS |
$745.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$786.60
|
| Rate for Payer: Three Rivers Provider Network All |
$621.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$770.04
|
| Rate for Payer: Zelis Auto |
$331.20
|
| Rate for Payer: Zelis Worker's Compensation |
$226.04
|
|
|
COLONOSCOPY/CONTROL BLEEDING
|
Facility
|
OP
|
$828.00
|
|
|
Service Code
|
CPT 45382
|
| Hospital Charge Code |
6145382
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$226.04 |
| Max. Negotiated Rate |
$2,239.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$920.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$496.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$920.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$729.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,119.58
|
| Rate for Payer: Cash Price |
$496.80
|
| Rate for Payer: Cash Price |
$496.80
|
| Rate for Payer: Cigna Commercial |
$703.80
|
| Rate for Payer: First Health Commercial |
$745.20
|
| Rate for Payer: First Health Workers Compensation |
$319.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$745.20
|
| Rate for Payer: GEHA Commercial |
$662.40
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$745.20
|
| Rate for Payer: Humana ChoiceCare |
$1,231.54
|
| Rate for Payer: Humana Medicare Advantage |
$1,119.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,880.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$744.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,119.58
|
| Rate for Payer: Multiplan All |
$753.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$579.60
|
| Rate for Payer: One Health Plan PPO/POS |
$745.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$859.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$744.16
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,119.58
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$786.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$621.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,097.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$744.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,119.58
|
| Rate for Payer: United Payors & United Providers UP&UP |
$770.04
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$331.20
|
| Rate for Payer: Zelis Medicare |
$951.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,343.50
|
| Rate for Payer: Zelis Worker's Compensation |
$226.04
|
|
|
COLONOSCOPY DILATE STRICTURE
|
Facility
|
OP
|
$678.00
|
|
|
Service Code
|
CPT 45386
|
| Hospital Charge Code |
6145386
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$185.09 |
| Max. Negotiated Rate |
$2,239.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$920.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$406.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$920.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$729.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,119.58
|
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Cigna Commercial |
$576.30
|
| Rate for Payer: First Health Commercial |
$610.20
|
| Rate for Payer: First Health Workers Compensation |
$261.78
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$610.20
|
| Rate for Payer: GEHA Commercial |
$542.40
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$610.20
|
| Rate for Payer: Humana ChoiceCare |
$1,231.54
|
| Rate for Payer: Humana Medicare Advantage |
$1,119.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,880.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$744.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,119.58
|
| Rate for Payer: Multiplan All |
$616.98
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$474.60
|
| Rate for Payer: One Health Plan PPO/POS |
$610.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$859.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$744.16
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,119.58
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$644.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$508.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,097.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$744.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,119.58
|
| Rate for Payer: United Payors & United Providers UP&UP |
$630.54
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$271.20
|
| Rate for Payer: Zelis Medicare |
$951.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,343.50
|
| Rate for Payer: Zelis Worker's Compensation |
$185.09
|
|
|
COLONOSCOPY DILATE STRICTURE
|
Facility
|
IP
|
$678.00
|
|
|
Service Code
|
CPT 45386
|
| Hospital Charge Code |
6145386
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$185.09 |
| Max. Negotiated Rate |
$644.10 |
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Cigna Commercial |
$576.30
|
| Rate for Payer: First Health Commercial |
$610.20
|
| Rate for Payer: First Health Workers Compensation |
$261.78
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$610.20
|
| Rate for Payer: GEHA Commercial |
$474.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$610.20
|
| Rate for Payer: Multiplan All |
$616.98
|
| Rate for Payer: OMNI Networks Commercial |
$474.60
|
| Rate for Payer: One Health Plan PPO/POS |
$610.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$644.10
|
| Rate for Payer: Three Rivers Provider Network All |
$508.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$630.54
|
| Rate for Payer: Zelis Auto |
$271.20
|
| Rate for Payer: Zelis Worker's Compensation |
$185.09
|
|
|
COLONOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$1,731.42
|
|
|
Service Code
|
CPT 45378
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$729.31 |
| Max. Negotiated Rate |
$1,731.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$920.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$920.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$729.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$865.71
|
| Rate for Payer: GEHA Medicare |
$865.71
|
| Rate for Payer: Humana ChoiceCare |
$952.28
|
| Rate for Payer: Humana Medicare Advantage |
$865.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,454.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$744.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$865.71
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,471.71
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$859.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$744.16
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$865.71
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,731.42
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$848.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$744.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$865.71
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$865.71
|
| Rate for Payer: Zelis Medicare |
$735.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,038.85
|
|
|
COLONOSCOPY FLEXIBLE W/BAND LIGATION(S)
|
Facility
|
OP
|
$1,649.00
|
|
|
Service Code
|
CPT 45398
|
| Hospital Charge Code |
6145398
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$450.18 |
| Max. Negotiated Rate |
$2,239.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,184.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$989.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,184.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$938.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,119.58
|
| Rate for Payer: Cash Price |
$989.40
|
| Rate for Payer: Cash Price |
$989.40
|
| Rate for Payer: Cigna Commercial |
$1,401.65
|
| Rate for Payer: First Health Commercial |
$1,484.10
|
| Rate for Payer: First Health Workers Compensation |
$636.68
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,484.10
|
| Rate for Payer: GEHA Commercial |
$1,319.20
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,484.10
|
| Rate for Payer: Humana ChoiceCare |
$1,231.54
|
| Rate for Payer: Humana Medicare Advantage |
$1,119.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,880.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$957.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,119.58
|
| Rate for Payer: Multiplan All |
$1,500.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$1,154.30
|
| Rate for Payer: One Health Plan PPO/POS |
$1,484.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,105.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$957.33
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,119.58
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,566.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$1,236.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,097.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$957.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,119.58
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,533.57
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$659.60
|
| Rate for Payer: Zelis Medicare |
$951.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,343.50
|
| Rate for Payer: Zelis Worker's Compensation |
$450.18
|
|
|
COLONOSCOPY FLEXIBLE W/BAND LIGATION(S)
|
Facility
|
IP
|
$1,649.00
|
|
|
Service Code
|
CPT 45398
|
| Hospital Charge Code |
6145398
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$450.18 |
| Max. Negotiated Rate |
$1,566.55 |
| Rate for Payer: Cash Price |
$989.40
|
| Rate for Payer: Cigna Commercial |
$1,401.65
|
| Rate for Payer: First Health Commercial |
$1,484.10
|
| Rate for Payer: First Health Workers Compensation |
$636.68
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,484.10
|
| Rate for Payer: GEHA Commercial |
$1,154.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,484.10
|
| Rate for Payer: Multiplan All |
$1,500.59
|
| Rate for Payer: OMNI Networks Commercial |
$1,154.30
|
| Rate for Payer: One Health Plan PPO/POS |
$1,484.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,566.55
|
| Rate for Payer: Three Rivers Provider Network All |
$1,236.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,533.57
|
| Rate for Payer: Zelis Auto |
$659.60
|
| Rate for Payer: Zelis Worker's Compensation |
$450.18
|
|
|
COLONOSCOPY, FLEXIBLE; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) (INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)
|
Facility
|
OP
|
$2,239.16
|
|
|
Service Code
|
CPT 45388
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$938.22 |
| Max. Negotiated Rate |
$2,239.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,184.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,184.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$938.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,119.58
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Humana ChoiceCare |
$1,231.54
|
| Rate for Payer: Humana Medicare Advantage |
$1,119.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,880.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$957.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,119.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,105.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$957.33
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,119.58
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,097.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$957.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,119.58
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Medicare |
$951.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,343.50
|
|
|
COLONOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE
|
Facility
|
OP
|
$2,239.16
|
|
|
Service Code
|
CPT 45380
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$729.31 |
| Max. Negotiated Rate |
$2,239.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$920.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$920.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$729.31
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,119.58
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Humana ChoiceCare |
$1,231.54
|
| Rate for Payer: Humana Medicare Advantage |
$1,119.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,880.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$744.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,119.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$859.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$744.16
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,119.58
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,097.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$744.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,119.58
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Medicare |
$951.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,343.50
|
|
|
COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Facility
|
OP
|
$815.00
|
|
|
Service Code
|
CPT 45393
|
| Hospital Charge Code |
6145393
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$222.50 |
| Max. Negotiated Rate |
$2,239.16 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,184.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$489.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,184.33
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$938.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,119.58
|
| Rate for Payer: Cash Price |
$489.00
|
| Rate for Payer: Cash Price |
$489.00
|
| Rate for Payer: Cigna Commercial |
$692.75
|
| Rate for Payer: First Health Commercial |
$733.50
|
| Rate for Payer: First Health Workers Compensation |
$314.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$733.50
|
| Rate for Payer: GEHA Commercial |
$652.00
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$733.50
|
| Rate for Payer: Humana ChoiceCare |
$1,231.54
|
| Rate for Payer: Humana Medicare Advantage |
$1,119.58
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,880.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$957.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,119.58
|
| Rate for Payer: Multiplan All |
$741.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$570.50
|
| Rate for Payer: One Health Plan PPO/POS |
$733.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,105.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$957.33
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,119.58
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$774.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$611.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,097.19
|
| Rate for Payer: United Healthcare Managed Medicaid |
$957.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,119.58
|
| Rate for Payer: United Payors & United Providers UP&UP |
$757.95
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$326.00
|
| Rate for Payer: Zelis Medicare |
$951.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,343.50
|
| Rate for Payer: Zelis Worker's Compensation |
$222.50
|
|
