|
COLPOPEXY EXTRAPERITONEAL
|
Facility
|
OP
|
$2,052.03
|
|
|
Service Code
|
CPT 57282
|
| Hospital Charge Code |
6157282
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$560.20 |
| Max. Negotiated Rate |
$14,043.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,548.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,231.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,548.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,603.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,021.67
|
| Rate for Payer: Cash Price |
$1,231.22
|
| Rate for Payer: Cash Price |
$1,231.22
|
| Rate for Payer: Cigna Commercial |
$1,744.23
|
| Rate for Payer: First Health Commercial |
$1,846.83
|
| Rate for Payer: First Health Workers Compensation |
$792.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,846.83
|
| Rate for Payer: GEHA Commercial |
$1,641.62
|
| Rate for Payer: GEHA Medicare |
$7,021.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,846.83
|
| Rate for Payer: Humana ChoiceCare |
$7,723.84
|
| Rate for Payer: Humana Medicare Advantage |
$7,021.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,796.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,676.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,021.67
|
| Rate for Payer: Multiplan All |
$1,867.35
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,936.84
|
| Rate for Payer: OMNI Networks Commercial |
$1,436.42
|
| Rate for Payer: One Health Plan PPO/POS |
$1,846.83
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,245.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,676.98
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,021.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,949.43
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,043.34
|
| Rate for Payer: Three Rivers Provider Network All |
$1,539.02
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,881.24
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,676.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,021.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,908.39
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$7,021.67
|
| Rate for Payer: Zelis Auto |
$820.81
|
| Rate for Payer: Zelis Medicare |
$5,968.42
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,426.00
|
| Rate for Payer: Zelis Worker's Compensation |
$560.20
|
|
|
COLPOPEXY EXTRAPERITONEAL
|
Facility
|
IP
|
$2,052.03
|
|
|
Service Code
|
CPT 57282
|
| Hospital Charge Code |
6157282
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$560.20 |
| Max. Negotiated Rate |
$1,949.43 |
| Rate for Payer: Cash Price |
$1,231.22
|
| Rate for Payer: Cigna Commercial |
$1,744.23
|
| Rate for Payer: First Health Commercial |
$1,846.83
|
| Rate for Payer: First Health Workers Compensation |
$792.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,846.83
|
| Rate for Payer: GEHA Commercial |
$1,436.42
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,846.83
|
| Rate for Payer: Multiplan All |
$1,867.35
|
| Rate for Payer: OMNI Networks Commercial |
$1,436.42
|
| Rate for Payer: One Health Plan PPO/POS |
$1,846.83
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,949.43
|
| Rate for Payer: Three Rivers Provider Network All |
$1,539.02
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,908.39
|
| Rate for Payer: Zelis Auto |
$820.81
|
| Rate for Payer: Zelis Worker's Compensation |
$560.20
|
|
|
COLPOPEXY INTRAPERITONEAL
|
Facility
|
OP
|
$1,399.00
|
|
|
Service Code
|
CPT 57283
|
| Hospital Charge Code |
6157283
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$381.93 |
| Max. Negotiated Rate |
$14,043.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,548.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$839.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,548.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,603.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,021.67
|
| Rate for Payer: Cash Price |
$839.40
|
| Rate for Payer: Cash Price |
$839.40
|
| Rate for Payer: Cigna Commercial |
$1,189.15
|
| Rate for Payer: First Health Commercial |
$1,259.10
|
| Rate for Payer: First Health Workers Compensation |
$540.15
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,259.10
|
| Rate for Payer: GEHA Commercial |
$1,119.20
|
| Rate for Payer: GEHA Medicare |
$7,021.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,259.10
|
| Rate for Payer: Humana ChoiceCare |
$7,723.84
|
| Rate for Payer: Humana Medicare Advantage |
$7,021.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,796.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,676.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,021.67
|
| Rate for Payer: Multiplan All |
$1,273.09
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,936.84
|
| Rate for Payer: OMNI Networks Commercial |
$979.30
|
| Rate for Payer: One Health Plan PPO/POS |
$1,259.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,245.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,676.98
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,021.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,329.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,043.34
|
| Rate for Payer: Three Rivers Provider Network All |
$1,049.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,881.24
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,676.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,021.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,301.07
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$7,021.67
|
| Rate for Payer: Zelis Auto |
$559.60
|
| Rate for Payer: Zelis Medicare |
$5,968.42
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,426.00
|
| Rate for Payer: Zelis Worker's Compensation |
$381.93
|
|
|
COLPOPEXY INTRAPERITONEAL
|
Facility
|
IP
|
$1,399.00
|
|
|
Service Code
|
CPT 57283
|
| Hospital Charge Code |
6157283
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$381.93 |
| Max. Negotiated Rate |
$1,329.05 |
| Rate for Payer: Cash Price |
$839.40
|
| Rate for Payer: Cigna Commercial |
$1,189.15
|
| Rate for Payer: First Health Commercial |
$1,259.10
|
| Rate for Payer: First Health Workers Compensation |
$540.15
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,259.10
|
| Rate for Payer: GEHA Commercial |
$979.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,259.10
|
| Rate for Payer: Multiplan All |
$1,273.09
|
| Rate for Payer: OMNI Networks Commercial |
$979.30
|
| Rate for Payer: One Health Plan PPO/POS |
$1,259.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,329.05
|
| Rate for Payer: Three Rivers Provider Network All |
$1,049.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,301.07
|
| Rate for Payer: Zelis Auto |
$559.60
|
| Rate for Payer: Zelis Worker's Compensation |
$381.93
|
|
|
COLPOPEXY VAGINAL EXTRAPERITONEAL APPRO
|
Facility
|
IP
|
$1,012.00
|
|
|
Service Code
|
CPT 57282
|
| Hospital Charge Code |
23500073
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$276.28 |
| Max. Negotiated Rate |
$961.40 |
| Rate for Payer: Cash Price |
$607.20
|
| Rate for Payer: Cigna Commercial |
$860.20
|
| Rate for Payer: First Health Commercial |
$910.80
|
| Rate for Payer: First Health Workers Compensation |
$390.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$910.80
|
| Rate for Payer: GEHA Commercial |
$708.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$910.80
|
| Rate for Payer: Multiplan All |
$920.92
|
| Rate for Payer: OMNI Networks Commercial |
$708.40
|
| Rate for Payer: One Health Plan PPO/POS |
$910.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$961.40
|
| Rate for Payer: Three Rivers Provider Network All |
$759.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$941.16
|
| Rate for Payer: Zelis Auto |
$404.80
|
| Rate for Payer: Zelis Worker's Compensation |
$276.28
|
|
|
COLPOPEXY VAGINAL EXTRAPERITONEAL APPRO
|
Facility
|
OP
|
$1,012.00
|
|
|
Service Code
|
CPT 57282
|
| Hospital Charge Code |
23500073
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$276.28 |
| Max. Negotiated Rate |
$14,043.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,548.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$607.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,548.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,603.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,021.67
|
| Rate for Payer: Cash Price |
$607.20
|
| Rate for Payer: Cash Price |
$607.20
|
| Rate for Payer: Cigna Commercial |
$860.20
|
| Rate for Payer: First Health Commercial |
$910.80
|
| Rate for Payer: First Health Workers Compensation |
$390.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$910.80
|
| Rate for Payer: GEHA Commercial |
$809.60
|
| Rate for Payer: GEHA Medicare |
$7,021.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$910.80
|
| Rate for Payer: Humana ChoiceCare |
$7,723.84
|
| Rate for Payer: Humana Medicare Advantage |
$7,021.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,796.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,676.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,021.67
|
| Rate for Payer: Multiplan All |
$920.92
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,936.84
|
| Rate for Payer: OMNI Networks Commercial |
$708.40
|
| Rate for Payer: One Health Plan PPO/POS |
$910.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,245.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,676.98
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,021.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$961.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,043.34
|
| Rate for Payer: Three Rivers Provider Network All |
$759.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,881.24
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,676.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,021.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$941.16
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$7,021.67
|
| Rate for Payer: Zelis Auto |
$404.80
|
| Rate for Payer: Zelis Medicare |
$5,968.42
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,426.00
|
| Rate for Payer: Zelis Worker's Compensation |
$276.28
|
|
|
COLPOPEXY, VAGINAL; EXTRA-PERITONEAL APPROACH (SACROSPINOUS, ILIOCOCCYGEUS)
|
Facility
|
OP
|
$14,043.34
|
|
|
Service Code
|
CPT 57282
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,603.59 |
| Max. Negotiated Rate |
$14,043.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,548.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,548.84
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,603.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7,021.67
|
| Rate for Payer: First Health Workers Compensation |
$9,036.89
|
| Rate for Payer: GEHA Medicare |
$7,021.67
|
| Rate for Payer: Humana ChoiceCare |
$7,723.84
|
| Rate for Payer: Humana Medicare Advantage |
$7,021.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,796.41
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,676.98
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7,021.67
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,936.84
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,245.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,676.98
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7,021.67
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$14,043.34
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,881.24
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,676.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,021.67
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$7,021.67
|
| Rate for Payer: Zelis Medicare |
$5,968.42
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,426.00
|
| Rate for Payer: Zelis Worker's Compensation |
$6,389.72
|
|
|
COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CU
|
Facility
|
OP
|
$415.00
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
6157454
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$113.30 |
| Max. Negotiated Rate |
$577.68 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$249.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$273.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$288.84
|
| Rate for Payer: Cash Price |
$249.00
|
| Rate for Payer: Cash Price |
$249.00
|
| Rate for Payer: Cigna Commercial |
$352.75
|
| Rate for Payer: First Health Commercial |
$373.50
|
| Rate for Payer: First Health Workers Compensation |
$160.23
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$373.50
|
| Rate for Payer: GEHA Commercial |
$332.00
|
| Rate for Payer: GEHA Medicare |
$288.84
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$373.50
|
| Rate for Payer: Humana ChoiceCare |
$317.72
|
| Rate for Payer: Humana Medicare Advantage |
$288.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$485.25
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$278.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$288.84
|
| Rate for Payer: Multiplan All |
$377.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$491.03
|
| Rate for Payer: OMNI Networks Commercial |
$290.50
|
| Rate for Payer: One Health Plan PPO/POS |
$373.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$321.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$278.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$288.84
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$394.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$577.68
|
| Rate for Payer: Three Rivers Provider Network All |
$311.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$283.06
|
| Rate for Payer: United Healthcare Managed Medicaid |
$278.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$288.84
|
| Rate for Payer: United Payors & United Providers UP&UP |
$385.95
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$288.84
|
| Rate for Payer: Zelis Auto |
$166.00
|
| Rate for Payer: Zelis Medicare |
$245.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$346.61
|
| Rate for Payer: Zelis Worker's Compensation |
$113.30
|
|
|
COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CU
|
Facility
|
IP
|
$415.00
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
6157454
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$113.30 |
| Max. Negotiated Rate |
$394.25 |
| Rate for Payer: Cash Price |
$249.00
|
| Rate for Payer: Cigna Commercial |
$352.75
|
| Rate for Payer: First Health Commercial |
$373.50
|
| Rate for Payer: First Health Workers Compensation |
$160.23
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$373.50
|
| Rate for Payer: GEHA Commercial |
$290.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$373.50
|
| Rate for Payer: Multiplan All |
$377.65
|
| Rate for Payer: OMNI Networks Commercial |
$290.50
|
| Rate for Payer: One Health Plan PPO/POS |
$373.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$394.25
|
| Rate for Payer: Three Rivers Provider Network All |
$311.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$385.95
|
| Rate for Payer: Zelis Auto |
$166.00
|
| Rate for Payer: Zelis Worker's Compensation |
$113.30
|
|
|
COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CU
|
Facility
|
OP
|
$415.00
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
23500017
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$113.30 |
| Max. Negotiated Rate |
$577.68 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$249.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$273.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$288.84
|
| Rate for Payer: Cash Price |
$249.00
|
| Rate for Payer: Cash Price |
$249.00
|
| Rate for Payer: Cigna Commercial |
$352.75
|
| Rate for Payer: First Health Commercial |
$373.50
|
| Rate for Payer: First Health Workers Compensation |
$160.23
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$373.50
|
| Rate for Payer: GEHA Commercial |
$332.00
|
| Rate for Payer: GEHA Medicare |
$288.84
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$373.50
|
| Rate for Payer: Humana ChoiceCare |
$317.72
|
| Rate for Payer: Humana Medicare Advantage |
$288.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$485.25
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$278.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$288.84
|
| Rate for Payer: Multiplan All |
$377.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$491.03
|
| Rate for Payer: OMNI Networks Commercial |
$290.50
|
| Rate for Payer: One Health Plan PPO/POS |
$373.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$321.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$278.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$288.84
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$394.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$577.68
|
| Rate for Payer: Three Rivers Provider Network All |
$311.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$283.06
|
| Rate for Payer: United Healthcare Managed Medicaid |
$278.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$288.84
|
| Rate for Payer: United Payors & United Providers UP&UP |
$385.95
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$288.84
|
| Rate for Payer: Zelis Auto |
$166.00
|
| Rate for Payer: Zelis Medicare |
$245.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$346.61
|
| Rate for Payer: Zelis Worker's Compensation |
$113.30
|
|
|
COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CU
|
Facility
|
IP
|
$415.00
|
|
|
Service Code
|
CPT 57454
|
| Hospital Charge Code |
23500017
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$113.30 |
| Max. Negotiated Rate |
$394.25 |
| Rate for Payer: Cash Price |
$249.00
|
| Rate for Payer: Cigna Commercial |
$352.75
|
| Rate for Payer: First Health Commercial |
$373.50
|
| Rate for Payer: First Health Workers Compensation |
$160.23
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$373.50
|
| Rate for Payer: GEHA Commercial |
$290.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$373.50
|
| Rate for Payer: Multiplan All |
$377.65
|
| Rate for Payer: OMNI Networks Commercial |
$290.50
|
| Rate for Payer: One Health Plan PPO/POS |
$373.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$394.25
|
| Rate for Payer: Three Rivers Provider Network All |
$311.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$385.95
|
| Rate for Payer: Zelis Auto |
$166.00
|
| Rate for Payer: Zelis Worker's Compensation |
$113.30
|
|
|
COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE
|
Facility
|
OP
|
$317.00
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
6157456
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$86.54 |
| Max. Negotiated Rate |
$577.68 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$190.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$273.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$288.84
|
| Rate for Payer: Cash Price |
$190.20
|
| Rate for Payer: Cash Price |
$190.20
|
| Rate for Payer: Cigna Commercial |
$269.45
|
| Rate for Payer: First Health Commercial |
$285.30
|
| Rate for Payer: First Health Workers Compensation |
$122.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$285.30
|
| Rate for Payer: GEHA Commercial |
$253.60
|
| Rate for Payer: GEHA Medicare |
$288.84
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$285.30
|
| Rate for Payer: Humana ChoiceCare |
$317.72
|
| Rate for Payer: Humana Medicare Advantage |
$288.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$485.25
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$278.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$288.84
|
| Rate for Payer: Multiplan All |
$288.47
|
| Rate for Payer: New Mexico Health Connections Medicare |
$491.03
|
| Rate for Payer: OMNI Networks Commercial |
$221.90
|
| Rate for Payer: One Health Plan PPO/POS |
$285.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$321.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$278.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$288.84
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$301.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$577.68
|
| Rate for Payer: Three Rivers Provider Network All |
$237.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$283.06
|
| Rate for Payer: United Healthcare Managed Medicaid |
$278.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$288.84
|
| Rate for Payer: United Payors & United Providers UP&UP |
$294.81
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$288.84
|
| Rate for Payer: Zelis Auto |
$126.80
|
| Rate for Payer: Zelis Medicare |
$245.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$346.61
|
| Rate for Payer: Zelis Worker's Compensation |
$86.54
|
|
|
COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE
|
Facility
|
OP
|
$317.00
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
23500040
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$86.54 |
| Max. Negotiated Rate |
$577.68 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$190.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$273.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$288.84
|
| Rate for Payer: Cash Price |
$190.20
|
| Rate for Payer: Cash Price |
$190.20
|
| Rate for Payer: Cigna Commercial |
$269.45
|
| Rate for Payer: First Health Commercial |
$285.30
|
| Rate for Payer: First Health Workers Compensation |
$122.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$285.30
|
| Rate for Payer: GEHA Commercial |
$253.60
|
| Rate for Payer: GEHA Medicare |
$288.84
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$285.30
|
| Rate for Payer: Humana ChoiceCare |
$317.72
|
| Rate for Payer: Humana Medicare Advantage |
$288.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$485.25
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$278.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$288.84
|
| Rate for Payer: Multiplan All |
$288.47
|
| Rate for Payer: New Mexico Health Connections Medicare |
$491.03
|
| Rate for Payer: OMNI Networks Commercial |
$221.90
|
| Rate for Payer: One Health Plan PPO/POS |
$285.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$321.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$278.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$288.84
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$301.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$577.68
|
| Rate for Payer: Three Rivers Provider Network All |
$237.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$283.06
|
| Rate for Payer: United Healthcare Managed Medicaid |
$278.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$288.84
|
| Rate for Payer: United Payors & United Providers UP&UP |
$294.81
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$288.84
|
| Rate for Payer: Zelis Auto |
$126.80
|
| Rate for Payer: Zelis Medicare |
$245.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$346.61
|
| Rate for Payer: Zelis Worker's Compensation |
$86.54
|
|
|
COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE
|
Facility
|
IP
|
$317.00
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
6157456
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$86.54 |
| Max. Negotiated Rate |
$301.15 |
| Rate for Payer: Cash Price |
$190.20
|
| Rate for Payer: Cigna Commercial |
$269.45
|
| Rate for Payer: First Health Commercial |
$285.30
|
| Rate for Payer: First Health Workers Compensation |
$122.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$285.30
|
| Rate for Payer: GEHA Commercial |
$221.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$285.30
|
| Rate for Payer: Multiplan All |
$288.47
|
| Rate for Payer: OMNI Networks Commercial |
$221.90
|
| Rate for Payer: One Health Plan PPO/POS |
$285.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$301.15
|
| Rate for Payer: Three Rivers Provider Network All |
$237.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$294.81
|
| Rate for Payer: Zelis Auto |
$126.80
|
| Rate for Payer: Zelis Worker's Compensation |
$86.54
|
|
|
COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE
|
Facility
|
IP
|
$317.00
|
|
|
Service Code
|
CPT 57456
|
| Hospital Charge Code |
23500040
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$86.54 |
| Max. Negotiated Rate |
$301.15 |
| Rate for Payer: Cash Price |
$190.20
|
| Rate for Payer: Cigna Commercial |
$269.45
|
| Rate for Payer: First Health Commercial |
$285.30
|
| Rate for Payer: First Health Workers Compensation |
$122.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$285.30
|
| Rate for Payer: GEHA Commercial |
$221.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$285.30
|
| Rate for Payer: Multiplan All |
$288.47
|
| Rate for Payer: OMNI Networks Commercial |
$221.90
|
| Rate for Payer: One Health Plan PPO/POS |
$285.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$301.15
|
| Rate for Payer: Three Rivers Provider Network All |
$237.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$294.81
|
| Rate for Payer: Zelis Auto |
$126.80
|
| Rate for Payer: Zelis Worker's Compensation |
$86.54
|
|
|
COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA
|
Facility
|
OP
|
$282.00
|
|
|
Service Code
|
CPT 57452
|
| Hospital Charge Code |
6157452
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$76.99 |
| Max. Negotiated Rate |
$382.04 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$154.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$169.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$154.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$122.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$191.02
|
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Cigna Commercial |
$239.70
|
| Rate for Payer: First Health Commercial |
$253.80
|
| Rate for Payer: First Health Workers Compensation |
$108.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$253.80
|
| Rate for Payer: GEHA Commercial |
$225.60
|
| Rate for Payer: GEHA Medicare |
$191.02
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$253.80
|
| Rate for Payer: Humana ChoiceCare |
$210.12
|
| Rate for Payer: Humana Medicare Advantage |
$191.02
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$320.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$124.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$191.02
|
| Rate for Payer: Multiplan All |
$256.62
|
| Rate for Payer: New Mexico Health Connections Medicare |
$324.73
|
| Rate for Payer: OMNI Networks Commercial |
$197.40
|
| Rate for Payer: One Health Plan PPO/POS |
$253.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$144.17
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$124.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$191.02
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$267.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$382.04
|
| Rate for Payer: Three Rivers Provider Network All |
$211.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$187.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$124.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$191.02
|
| Rate for Payer: United Payors & United Providers UP&UP |
$262.26
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$191.02
|
| Rate for Payer: Zelis Auto |
$112.80
|
| Rate for Payer: Zelis Medicare |
$162.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$229.22
|
| Rate for Payer: Zelis Worker's Compensation |
$76.99
|
|
|
COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA
|
Facility
|
IP
|
$282.00
|
|
|
Service Code
|
CPT 57452
|
| Hospital Charge Code |
6157452
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$76.99 |
| Max. Negotiated Rate |
$267.90 |
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Cigna Commercial |
$239.70
|
| Rate for Payer: First Health Commercial |
$253.80
|
| Rate for Payer: First Health Workers Compensation |
$108.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$253.80
|
| Rate for Payer: GEHA Commercial |
$197.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$253.80
|
| Rate for Payer: Multiplan All |
$256.62
|
| Rate for Payer: OMNI Networks Commercial |
$197.40
|
| Rate for Payer: One Health Plan PPO/POS |
$253.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$267.90
|
| Rate for Payer: Three Rivers Provider Network All |
$211.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$262.26
|
| Rate for Payer: Zelis Auto |
$112.80
|
| Rate for Payer: Zelis Worker's Compensation |
$76.99
|
|
|
COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA
|
Facility
|
OP
|
$282.00
|
|
|
Service Code
|
CPT 57452
|
| Hospital Charge Code |
23500016
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$76.99 |
| Max. Negotiated Rate |
$382.04 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$154.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$169.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$154.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$122.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$191.02
|
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Cigna Commercial |
$239.70
|
| Rate for Payer: First Health Commercial |
$253.80
|
| Rate for Payer: First Health Workers Compensation |
$108.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$253.80
|
| Rate for Payer: GEHA Commercial |
$225.60
|
| Rate for Payer: GEHA Medicare |
$191.02
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$253.80
|
| Rate for Payer: Humana ChoiceCare |
$210.12
|
| Rate for Payer: Humana Medicare Advantage |
$191.02
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$320.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$124.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$191.02
|
| Rate for Payer: Multiplan All |
$256.62
|
| Rate for Payer: New Mexico Health Connections Medicare |
$324.73
|
| Rate for Payer: OMNI Networks Commercial |
$197.40
|
| Rate for Payer: One Health Plan PPO/POS |
$253.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$144.17
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$124.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$191.02
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$267.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$382.04
|
| Rate for Payer: Three Rivers Provider Network All |
$211.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$187.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$124.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$191.02
|
| Rate for Payer: United Payors & United Providers UP&UP |
$262.26
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$191.02
|
| Rate for Payer: Zelis Auto |
$112.80
|
| Rate for Payer: Zelis Medicare |
$162.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$229.22
|
| Rate for Payer: Zelis Worker's Compensation |
$76.99
|
|
|
COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA
|
Facility
|
IP
|
$282.00
|
|
|
Service Code
|
CPT 57452
|
| Hospital Charge Code |
23500016
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$76.99 |
| Max. Negotiated Rate |
$267.90 |
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Cigna Commercial |
$239.70
|
| Rate for Payer: First Health Commercial |
$253.80
|
| Rate for Payer: First Health Workers Compensation |
$108.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$253.80
|
| Rate for Payer: GEHA Commercial |
$197.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$253.80
|
| Rate for Payer: Multiplan All |
$256.62
|
| Rate for Payer: OMNI Networks Commercial |
$197.40
|
| Rate for Payer: One Health Plan PPO/POS |
$253.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$267.90
|
| Rate for Payer: Three Rivers Provider Network All |
$211.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$262.26
|
| Rate for Payer: Zelis Auto |
$112.80
|
| Rate for Payer: Zelis Worker's Compensation |
$76.99
|
|
|
COLPOSCOPY CERVIX UPPR/ADJCNT VAG W/C BX
|
Facility
|
IP
|
$470.37
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
6157455
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$128.41 |
| Max. Negotiated Rate |
$446.85 |
| Rate for Payer: Cash Price |
$282.22
|
| Rate for Payer: Cigna Commercial |
$399.81
|
| Rate for Payer: First Health Commercial |
$423.33
|
| Rate for Payer: First Health Workers Compensation |
$181.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$423.33
|
| Rate for Payer: GEHA Commercial |
$329.26
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$423.33
|
| Rate for Payer: Multiplan All |
$428.04
|
| Rate for Payer: OMNI Networks Commercial |
$329.26
|
| Rate for Payer: One Health Plan PPO/POS |
$423.33
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$446.85
|
| Rate for Payer: Three Rivers Provider Network All |
$352.78
|
| Rate for Payer: United Payors & United Providers UP&UP |
$437.44
|
| Rate for Payer: Zelis Auto |
$188.15
|
| Rate for Payer: Zelis Worker's Compensation |
$128.41
|
|
|
COLPOSCOPY CERVIX UPPR/ADJCNT VAG W/C BX
|
Facility
|
OP
|
$470.37
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
23557455
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$128.41 |
| Max. Negotiated Rate |
$577.68 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$282.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$273.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$288.84
|
| Rate for Payer: Cash Price |
$282.22
|
| Rate for Payer: Cash Price |
$282.22
|
| Rate for Payer: Cigna Commercial |
$399.81
|
| Rate for Payer: First Health Commercial |
$423.33
|
| Rate for Payer: First Health Workers Compensation |
$181.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$423.33
|
| Rate for Payer: GEHA Commercial |
$376.30
|
| Rate for Payer: GEHA Medicare |
$288.84
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$423.33
|
| Rate for Payer: Humana ChoiceCare |
$317.72
|
| Rate for Payer: Humana Medicare Advantage |
$288.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$485.25
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$278.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$288.84
|
| Rate for Payer: Multiplan All |
$428.04
|
| Rate for Payer: New Mexico Health Connections Medicare |
$491.03
|
| Rate for Payer: OMNI Networks Commercial |
$329.26
|
| Rate for Payer: One Health Plan PPO/POS |
$423.33
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$321.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$278.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$288.84
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$446.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$577.68
|
| Rate for Payer: Three Rivers Provider Network All |
$352.78
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$283.06
|
| Rate for Payer: United Healthcare Managed Medicaid |
$278.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$288.84
|
| Rate for Payer: United Payors & United Providers UP&UP |
$437.44
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$288.84
|
| Rate for Payer: Zelis Auto |
$188.15
|
| Rate for Payer: Zelis Medicare |
$245.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$346.61
|
| Rate for Payer: Zelis Worker's Compensation |
$128.41
|
|
|
COLPOSCOPY CERVIX UPPR/ADJCNT VAG W/C BX
|
Facility
|
IP
|
$340.00
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
23500039
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$92.82 |
| Max. Negotiated Rate |
$323.00 |
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cigna Commercial |
$289.00
|
| Rate for Payer: First Health Commercial |
$306.00
|
| Rate for Payer: First Health Workers Compensation |
$131.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$306.00
|
| Rate for Payer: GEHA Commercial |
$238.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$306.00
|
| Rate for Payer: Multiplan All |
$309.40
|
| Rate for Payer: OMNI Networks Commercial |
$238.00
|
| Rate for Payer: One Health Plan PPO/POS |
$306.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$323.00
|
| Rate for Payer: Three Rivers Provider Network All |
$255.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$316.20
|
| Rate for Payer: Zelis Auto |
$136.00
|
| Rate for Payer: Zelis Worker's Compensation |
$92.82
|
|
|
COLPOSCOPY CERVIX UPPR/ADJCNT VAG W/C BX
|
Facility
|
OP
|
$340.00
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
23500039
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$92.82 |
| Max. Negotiated Rate |
$577.68 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$273.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$288.84
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cigna Commercial |
$289.00
|
| Rate for Payer: First Health Commercial |
$306.00
|
| Rate for Payer: First Health Workers Compensation |
$131.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$306.00
|
| Rate for Payer: GEHA Commercial |
$272.00
|
| Rate for Payer: GEHA Medicare |
$288.84
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$306.00
|
| Rate for Payer: Humana ChoiceCare |
$317.72
|
| Rate for Payer: Humana Medicare Advantage |
$288.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$485.25
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$278.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$288.84
|
| Rate for Payer: Multiplan All |
$309.40
|
| Rate for Payer: New Mexico Health Connections Medicare |
$491.03
|
| Rate for Payer: OMNI Networks Commercial |
$238.00
|
| Rate for Payer: One Health Plan PPO/POS |
$306.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$321.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$278.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$288.84
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$323.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$577.68
|
| Rate for Payer: Three Rivers Provider Network All |
$255.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$283.06
|
| Rate for Payer: United Healthcare Managed Medicaid |
$278.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$288.84
|
| Rate for Payer: United Payors & United Providers UP&UP |
$316.20
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$288.84
|
| Rate for Payer: Zelis Auto |
$136.00
|
| Rate for Payer: Zelis Medicare |
$245.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$346.61
|
| Rate for Payer: Zelis Worker's Compensation |
$92.82
|
|
|
COLPOSCOPY CERVIX UPPR/ADJCNT VAG W/C BX
|
Facility
|
OP
|
$470.37
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
6157455
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$128.41 |
| Max. Negotiated Rate |
$577.68 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$282.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$344.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$273.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$288.84
|
| Rate for Payer: Cash Price |
$282.22
|
| Rate for Payer: Cash Price |
$282.22
|
| Rate for Payer: Cigna Commercial |
$399.81
|
| Rate for Payer: First Health Commercial |
$423.33
|
| Rate for Payer: First Health Workers Compensation |
$181.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$423.33
|
| Rate for Payer: GEHA Commercial |
$376.30
|
| Rate for Payer: GEHA Medicare |
$288.84
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$423.33
|
| Rate for Payer: Humana ChoiceCare |
$317.72
|
| Rate for Payer: Humana Medicare Advantage |
$288.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$485.25
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$278.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$288.84
|
| Rate for Payer: Multiplan All |
$428.04
|
| Rate for Payer: New Mexico Health Connections Medicare |
$491.03
|
| Rate for Payer: OMNI Networks Commercial |
$329.26
|
| Rate for Payer: One Health Plan PPO/POS |
$423.33
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$321.65
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$278.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$288.84
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$446.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$577.68
|
| Rate for Payer: Three Rivers Provider Network All |
$352.78
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$283.06
|
| Rate for Payer: United Healthcare Managed Medicaid |
$278.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$288.84
|
| Rate for Payer: United Payors & United Providers UP&UP |
$437.44
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$288.84
|
| Rate for Payer: Zelis Auto |
$188.15
|
| Rate for Payer: Zelis Medicare |
$245.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$346.61
|
| Rate for Payer: Zelis Worker's Compensation |
$128.41
|
|
|
COLPOSCOPY CERVIX UPPR/ADJCNT VAG W/C BX
|
Facility
|
IP
|
$470.37
|
|
|
Service Code
|
CPT 57455
|
| Hospital Charge Code |
23557455
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$128.41 |
| Max. Negotiated Rate |
$446.85 |
| Rate for Payer: Cash Price |
$282.22
|
| Rate for Payer: Cigna Commercial |
$399.81
|
| Rate for Payer: First Health Commercial |
$423.33
|
| Rate for Payer: First Health Workers Compensation |
$181.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$423.33
|
| Rate for Payer: GEHA Commercial |
$329.26
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$423.33
|
| Rate for Payer: Multiplan All |
$428.04
|
| Rate for Payer: OMNI Networks Commercial |
$329.26
|
| Rate for Payer: One Health Plan PPO/POS |
$423.33
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$446.85
|
| Rate for Payer: Three Rivers Provider Network All |
$352.78
|
| Rate for Payer: United Payors & United Providers UP&UP |
$437.44
|
| Rate for Payer: Zelis Auto |
$188.15
|
| Rate for Payer: Zelis Worker's Compensation |
$128.41
|
|
