|
COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Facility
|
IP
|
$815.00
|
|
|
Service Code
|
CPT 45393
|
| Hospital Charge Code |
6145393
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$222.50 |
| Max. Negotiated Rate |
$774.25 |
| 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 |
$570.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$733.50
|
| Rate for Payer: Multiplan All |
$741.65
|
| Rate for Payer: OMNI Networks Commercial |
$570.50
|
| Rate for Payer: One Health Plan PPO/POS |
$733.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$774.25
|
| Rate for Payer: Three Rivers Provider Network All |
$611.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$757.95
|
| Rate for Payer: Zelis Auto |
$326.00
|
| Rate for Payer: Zelis Worker's Compensation |
$222.50
|
|
|
COLONOSCOPY, FLEXIBLE; WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE
|
Facility
|
OP
|
$2,239.16
|
|
|
Service Code
|
CPT 45381
|
|
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 REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY FORCEPS
|
Facility
|
OP
|
$2,239.16
|
|
|
Service Code
|
CPT 45384
|
|
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 REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY FORCEPS
|
Facility
|
OP
|
$2,239.16
|
|
|
Service Code
|
CPT 45384
|
|
Hospital Revenue Code
|
360
|
| 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: First Health Workers Compensation |
$1,440.90
|
| 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
|
| Rate for Payer: Zelis Worker's Compensation |
$1,018.82
|
|
|
COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE
|
Facility
|
OP
|
$2,239.16
|
|
|
Service Code
|
CPT 45385
|
|
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 REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE
|
Facility
|
OP
|
$2,239.16
|
|
|
Service Code
|
CPT 45385
|
|
Hospital Revenue Code
|
360
|
| 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: First Health Workers Compensation |
$1,440.90
|
| 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
|
| Rate for Payer: Zelis Worker's Compensation |
$1,018.82
|
|
|
COLONOSCOPY FOR BLEEDING
|
Facility
|
OP
|
$734.00
|
|
|
Service Code
|
CPT 44391
|
| Hospital Charge Code |
6144391
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$200.38 |
| 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 |
$440.40
|
| 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 |
$440.40
|
| Rate for Payer: Cash Price |
$440.40
|
| Rate for Payer: Cigna Commercial |
$623.90
|
| Rate for Payer: First Health Commercial |
$660.60
|
| Rate for Payer: First Health Workers Compensation |
$283.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$660.60
|
| Rate for Payer: GEHA Commercial |
$587.20
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$660.60
|
| 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 |
$667.94
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$513.80
|
| Rate for Payer: One Health Plan PPO/POS |
$660.60
|
| 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 |
$697.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$550.50
|
| 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 |
$682.62
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$293.60
|
| 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 |
$200.38
|
|
|
COLONOSCOPY FOR BLEEDING
|
Facility
|
IP
|
$734.00
|
|
|
Service Code
|
CPT 44391
|
| Hospital Charge Code |
6144391
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$200.38 |
| Max. Negotiated Rate |
$697.30 |
| Rate for Payer: Cash Price |
$440.40
|
| Rate for Payer: Cigna Commercial |
$623.90
|
| Rate for Payer: First Health Commercial |
$660.60
|
| Rate for Payer: First Health Workers Compensation |
$283.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$660.60
|
| Rate for Payer: GEHA Commercial |
$513.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$660.60
|
| Rate for Payer: Multiplan All |
$667.94
|
| Rate for Payer: OMNI Networks Commercial |
$513.80
|
| Rate for Payer: One Health Plan PPO/POS |
$660.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$697.30
|
| Rate for Payer: Three Rivers Provider Network All |
$550.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$682.62
|
| Rate for Payer: Zelis Auto |
$293.60
|
| Rate for Payer: Zelis Worker's Compensation |
$200.38
|
|
|
COLONOSCOPY FOR FOREIGN BODY
|
Facility
|
IP
|
$569.00
|
|
|
Service Code
|
CPT 44390
|
| Hospital Charge Code |
6144390
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$155.34 |
| Max. Negotiated Rate |
$540.55 |
| Rate for Payer: Cash Price |
$341.40
|
| Rate for Payer: Cigna Commercial |
$483.65
|
| Rate for Payer: First Health Commercial |
$512.10
|
| Rate for Payer: First Health Workers Compensation |
$219.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$512.10
|
| Rate for Payer: GEHA Commercial |
$398.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$512.10
|
| Rate for Payer: Multiplan All |
$517.79
|
| Rate for Payer: OMNI Networks Commercial |
$398.30
|
| Rate for Payer: One Health Plan PPO/POS |
$512.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$540.55
|
| Rate for Payer: Three Rivers Provider Network All |
$426.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$529.17
|
| Rate for Payer: Zelis Auto |
$227.60
|
| Rate for Payer: Zelis Worker's Compensation |
$155.34
|
|
|
COLONOSCOPY FOR FOREIGN BODY
|
Facility
|
OP
|
$569.00
|
|
|
Service Code
|
CPT 44390
|
| Hospital Charge Code |
6144390
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$155.34 |
| 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 |
$341.40
|
| 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 |
$341.40
|
| Rate for Payer: Cash Price |
$341.40
|
| Rate for Payer: Cigna Commercial |
$483.65
|
| Rate for Payer: First Health Commercial |
$512.10
|
| Rate for Payer: First Health Workers Compensation |
$219.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$512.10
|
| Rate for Payer: GEHA Commercial |
$455.20
|
| Rate for Payer: GEHA Medicare |
$865.71
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$512.10
|
| 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 |
$517.79
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,471.71
|
| Rate for Payer: OMNI Networks Commercial |
$398.30
|
| Rate for Payer: One Health Plan PPO/POS |
$512.10
|
| 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 |
$540.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,731.42
|
| Rate for Payer: Three Rivers Provider Network All |
$426.75
|
| 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 |
$529.17
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$865.71
|
| Rate for Payer: Zelis Auto |
$227.60
|
| 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 |
$155.34
|
|
|
COLONOSCOPY & POLYPECTOMY
|
Facility
|
IP
|
$539.00
|
|
|
Service Code
|
CPT 44392
|
| Hospital Charge Code |
6144392
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$147.15 |
| Max. Negotiated Rate |
$512.05 |
| Rate for Payer: Cash Price |
$323.40
|
| Rate for Payer: Cigna Commercial |
$458.15
|
| Rate for Payer: First Health Commercial |
$485.10
|
| Rate for Payer: First Health Workers Compensation |
$208.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$485.10
|
| Rate for Payer: GEHA Commercial |
$377.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$485.10
|
| Rate for Payer: Multiplan All |
$490.49
|
| Rate for Payer: OMNI Networks Commercial |
$377.30
|
| Rate for Payer: One Health Plan PPO/POS |
$485.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$512.05
|
| Rate for Payer: Three Rivers Provider Network All |
$404.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$501.27
|
| Rate for Payer: Zelis Auto |
$215.60
|
| Rate for Payer: Zelis Worker's Compensation |
$147.15
|
|
|
COLONOSCOPY & POLYPECTOMY
|
Facility
|
OP
|
$539.00
|
|
|
Service Code
|
CPT 44392
|
| Hospital Charge Code |
6144392
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$147.15 |
| 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 |
$323.40
|
| 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 |
$323.40
|
| Rate for Payer: Cash Price |
$323.40
|
| Rate for Payer: Cigna Commercial |
$458.15
|
| Rate for Payer: First Health Commercial |
$485.10
|
| Rate for Payer: First Health Workers Compensation |
$208.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$485.10
|
| Rate for Payer: GEHA Commercial |
$431.20
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$485.10
|
| 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 |
$744.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,119.58
|
| Rate for Payer: Multiplan All |
$490.49
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$377.30
|
| Rate for Payer: One Health Plan PPO/POS |
$485.10
|
| 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 |
$512.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$404.25
|
| 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 |
$501.27
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$215.60
|
| 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 |
$147.15
|
|
|
COLONOSCOPY SUBMUCOUS INJ
|
Facility
|
IP
|
$543.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
6145381
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$148.24 |
| Max. Negotiated Rate |
$515.85 |
| Rate for Payer: Cash Price |
$325.80
|
| Rate for Payer: Cigna Commercial |
$461.55
|
| Rate for Payer: First Health Commercial |
$488.70
|
| Rate for Payer: First Health Workers Compensation |
$209.65
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$488.70
|
| Rate for Payer: GEHA Commercial |
$380.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$488.70
|
| Rate for Payer: Multiplan All |
$494.13
|
| Rate for Payer: OMNI Networks Commercial |
$380.10
|
| Rate for Payer: One Health Plan PPO/POS |
$488.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$515.85
|
| Rate for Payer: Three Rivers Provider Network All |
$407.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$504.99
|
| Rate for Payer: Zelis Auto |
$217.20
|
| Rate for Payer: Zelis Worker's Compensation |
$148.24
|
|
|
COLONOSCOPY SUBMUCOUS INJ
|
Facility
|
OP
|
$543.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
6145381
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$148.24 |
| 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 |
$325.80
|
| 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 |
$325.80
|
| Rate for Payer: Cash Price |
$325.80
|
| Rate for Payer: Cigna Commercial |
$461.55
|
| Rate for Payer: First Health Commercial |
$488.70
|
| Rate for Payer: First Health Workers Compensation |
$209.65
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$488.70
|
| Rate for Payer: GEHA Commercial |
$434.40
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$488.70
|
| 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 |
$494.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$380.10
|
| Rate for Payer: One Health Plan PPO/POS |
$488.70
|
| 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 |
$1,119.58
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$515.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$407.25
|
| 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 |
$504.99
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$217.20
|
| 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 |
$148.24
|
|
|
COLONOSCOPY THROUGH STOMA; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$1,731.42
|
|
|
Service Code
|
CPT 44388
|
|
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 W/EMR
|
Facility
|
IP
|
$893.00
|
|
|
Service Code
|
CPT 45390
|
| Hospital Charge Code |
6145390
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$243.79 |
| Max. Negotiated Rate |
$848.35 |
| Rate for Payer: Cash Price |
$535.80
|
| Rate for Payer: Cigna Commercial |
$759.05
|
| Rate for Payer: First Health Commercial |
$803.70
|
| Rate for Payer: First Health Workers Compensation |
$344.79
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$803.70
|
| Rate for Payer: GEHA Commercial |
$625.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$803.70
|
| Rate for Payer: Multiplan All |
$812.63
|
| Rate for Payer: OMNI Networks Commercial |
$625.10
|
| Rate for Payer: One Health Plan PPO/POS |
$803.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$848.35
|
| Rate for Payer: Three Rivers Provider Network All |
$669.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$830.49
|
| Rate for Payer: Zelis Auto |
$357.20
|
| Rate for Payer: Zelis Worker's Compensation |
$243.79
|
|
|
COLONOSCOPY W/EMR
|
Facility
|
OP
|
$893.00
|
|
|
Service Code
|
CPT 45390
|
| Hospital Charge Code |
6145390
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$243.79 |
| Max. Negotiated Rate |
$5,208.02 |
| 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 |
$535.80
|
| 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 |
$2,604.01
|
| Rate for Payer: Cash Price |
$535.80
|
| Rate for Payer: Cash Price |
$535.80
|
| Rate for Payer: Cigna Commercial |
$759.05
|
| Rate for Payer: First Health Commercial |
$803.70
|
| Rate for Payer: First Health Workers Compensation |
$344.79
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$803.70
|
| Rate for Payer: GEHA Commercial |
$714.40
|
| Rate for Payer: GEHA Medicare |
$2,604.01
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$803.70
|
| Rate for Payer: Humana ChoiceCare |
$2,864.41
|
| Rate for Payer: Humana Medicare Advantage |
$2,604.01
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,374.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$957.33
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,604.01
|
| Rate for Payer: Multiplan All |
$812.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,426.82
|
| Rate for Payer: OMNI Networks Commercial |
$625.10
|
| Rate for Payer: One Health Plan PPO/POS |
$803.70
|
| 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 |
$2,604.01
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$848.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,208.02
|
| Rate for Payer: Three Rivers Provider Network All |
$669.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,551.93
|
| Rate for Payer: United Healthcare Managed Medicaid |
$957.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,604.01
|
| Rate for Payer: United Payors & United Providers UP&UP |
$830.49
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,604.01
|
| Rate for Payer: Zelis Auto |
$357.20
|
| Rate for Payer: Zelis Medicare |
$2,213.41
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,124.81
|
| Rate for Payer: Zelis Worker's Compensation |
$243.79
|
|
|
COLONOSCOPY W/ENDOSCOPE US
|
Facility
|
OP
|
$694.00
|
|
|
Service Code
|
CPT 45391
|
| Hospital Charge Code |
6145391
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$189.46 |
| 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 |
$416.40
|
| 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 |
$416.40
|
| Rate for Payer: Cash Price |
$416.40
|
| Rate for Payer: Cigna Commercial |
$589.90
|
| Rate for Payer: First Health Commercial |
$624.60
|
| Rate for Payer: First Health Workers Compensation |
$267.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$624.60
|
| Rate for Payer: GEHA Commercial |
$555.20
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$624.60
|
| 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 |
$631.54
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$485.80
|
| Rate for Payer: One Health Plan PPO/POS |
$624.60
|
| 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 |
$659.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$520.50
|
| 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 |
$645.42
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$277.60
|
| 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 |
$189.46
|
|
|
COLONOSCOPY W/ENDOSCOPE US
|
Facility
|
IP
|
$694.00
|
|
|
Service Code
|
CPT 45391
|
| Hospital Charge Code |
6145391
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$189.46 |
| Max. Negotiated Rate |
$659.30 |
| Rate for Payer: Cash Price |
$416.40
|
| Rate for Payer: Cigna Commercial |
$589.90
|
| Rate for Payer: First Health Commercial |
$624.60
|
| Rate for Payer: First Health Workers Compensation |
$267.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$624.60
|
| Rate for Payer: GEHA Commercial |
$485.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$624.60
|
| Rate for Payer: Multiplan All |
$631.54
|
| Rate for Payer: OMNI Networks Commercial |
$485.80
|
| Rate for Payer: One Health Plan PPO/POS |
$624.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$659.30
|
| Rate for Payer: Three Rivers Provider Network All |
$520.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$645.42
|
| Rate for Payer: Zelis Auto |
$277.60
|
| Rate for Payer: Zelis Worker's Compensation |
$189.46
|
|
|
COLONOSCOPY W/ENDOSCOPIC FNB
|
Facility
|
IP
|
$818.00
|
|
|
Service Code
|
CPT 45392
|
| Hospital Charge Code |
6145392
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$223.31 |
| Max. Negotiated Rate |
$777.10 |
| Rate for Payer: Cash Price |
$490.80
|
| Rate for Payer: Cigna Commercial |
$695.30
|
| Rate for Payer: First Health Commercial |
$736.20
|
| Rate for Payer: First Health Workers Compensation |
$315.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$736.20
|
| Rate for Payer: GEHA Commercial |
$572.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$736.20
|
| Rate for Payer: Multiplan All |
$744.38
|
| Rate for Payer: OMNI Networks Commercial |
$572.60
|
| Rate for Payer: One Health Plan PPO/POS |
$736.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$777.10
|
| Rate for Payer: Three Rivers Provider Network All |
$613.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$760.74
|
| Rate for Payer: Zelis Auto |
$327.20
|
| Rate for Payer: Zelis Worker's Compensation |
$223.31
|
|
|
COLONOSCOPY W/ENDOSCOPIC FNB
|
Facility
|
OP
|
$818.00
|
|
|
Service Code
|
CPT 45392
|
| Hospital Charge Code |
6145392
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$223.31 |
| 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 Community HMO |
$490.80
|
| 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 |
$490.80
|
| Rate for Payer: Cash Price |
$490.80
|
| Rate for Payer: Cigna Commercial |
$695.30
|
| Rate for Payer: First Health Commercial |
$736.20
|
| Rate for Payer: First Health Workers Compensation |
$315.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$736.20
|
| Rate for Payer: GEHA Commercial |
$654.40
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$736.20
|
| 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 |
$744.38
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$572.60
|
| Rate for Payer: One Health Plan PPO/POS |
$736.20
|
| 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 |
$777.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$613.50
|
| 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 |
$760.74
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$327.20
|
| 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 |
$223.31
|
|
|
COLONOSCOPY W/FB REMOVAL
|
Facility
|
IP
|
$646.00
|
|
|
Service Code
|
CPT 45379
|
| Hospital Charge Code |
6145379
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$176.36 |
| Max. Negotiated Rate |
$613.70 |
| Rate for Payer: Cash Price |
$387.60
|
| Rate for Payer: Cigna Commercial |
$549.10
|
| Rate for Payer: First Health Commercial |
$581.40
|
| Rate for Payer: First Health Workers Compensation |
$249.42
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$581.40
|
| Rate for Payer: GEHA Commercial |
$452.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$581.40
|
| Rate for Payer: Multiplan All |
$587.86
|
| Rate for Payer: OMNI Networks Commercial |
$452.20
|
| Rate for Payer: One Health Plan PPO/POS |
$581.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$613.70
|
| Rate for Payer: Three Rivers Provider Network All |
$484.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$600.78
|
| Rate for Payer: Zelis Auto |
$258.40
|
| Rate for Payer: Zelis Worker's Compensation |
$176.36
|
|
|
COLONOSCOPY W/FB REMOVAL
|
Facility
|
OP
|
$646.00
|
|
|
Service Code
|
CPT 45379
|
| Hospital Charge Code |
6145379
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$176.36 |
| 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 |
$387.60
|
| 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 |
$387.60
|
| Rate for Payer: Cash Price |
$387.60
|
| Rate for Payer: Cigna Commercial |
$549.10
|
| Rate for Payer: First Health Commercial |
$581.40
|
| Rate for Payer: First Health Workers Compensation |
$249.42
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$581.40
|
| Rate for Payer: GEHA Commercial |
$516.80
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$581.40
|
| 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 |
$587.86
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$452.20
|
| Rate for Payer: One Health Plan PPO/POS |
$581.40
|
| 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 |
$613.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$484.50
|
| 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 |
$600.78
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$258.40
|
| 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 |
$176.36
|
|
|
COLONOSCOPY WITH BIOPSY
|
Facility
|
OP
|
$561.00
|
|
|
Service Code
|
CPT 44389
|
| Hospital Charge Code |
6144389
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$153.15 |
| 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 |
$336.60
|
| 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 |
$336.60
|
| Rate for Payer: Cash Price |
$336.60
|
| Rate for Payer: Cigna Commercial |
$476.85
|
| Rate for Payer: First Health Commercial |
$504.90
|
| Rate for Payer: First Health Workers Compensation |
$216.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$504.90
|
| Rate for Payer: GEHA Commercial |
$448.80
|
| Rate for Payer: GEHA Medicare |
$1,119.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$504.90
|
| 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 |
$510.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,903.29
|
| Rate for Payer: OMNI Networks Commercial |
$392.70
|
| Rate for Payer: One Health Plan PPO/POS |
$504.90
|
| 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 |
$532.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,239.16
|
| Rate for Payer: Three Rivers Provider Network All |
$420.75
|
| 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 |
$521.73
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,119.58
|
| Rate for Payer: Zelis Auto |
$224.40
|
| 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 |
$153.15
|
|
|
COLONOSCOPY WITH BIOPSY
|
Facility
|
IP
|
$561.00
|
|
|
Service Code
|
CPT 44389
|
| Hospital Charge Code |
6144389
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$153.15 |
| Max. Negotiated Rate |
$532.95 |
| Rate for Payer: Cash Price |
$336.60
|
| Rate for Payer: Cigna Commercial |
$476.85
|
| Rate for Payer: First Health Commercial |
$504.90
|
| Rate for Payer: First Health Workers Compensation |
$216.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$504.90
|
| Rate for Payer: GEHA Commercial |
$392.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$504.90
|
| Rate for Payer: Multiplan All |
$510.51
|
| Rate for Payer: OMNI Networks Commercial |
$392.70
|
| Rate for Payer: One Health Plan PPO/POS |
$504.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$532.95
|
| Rate for Payer: Three Rivers Provider Network All |
$420.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$521.73
|
| Rate for Payer: Zelis Auto |
$224.40
|
| Rate for Payer: Zelis Worker's Compensation |
$153.15
|
|
