|
CULTURE BLOOD (SEPSIS) set 1
|
Facility
|
OP
|
$201.00
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
2207043
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.77 |
| Max. Negotiated Rate |
$190.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$18.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$120.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$18.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10.32
|
| Rate for Payer: Cash Price |
$120.60
|
| Rate for Payer: Cash Price |
$120.60
|
| Rate for Payer: Cigna Commercial |
$170.85
|
| Rate for Payer: First Health Commercial |
$180.90
|
| Rate for Payer: First Health Workers Compensation |
$16.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$180.90
|
| Rate for Payer: GEHA Commercial |
$160.80
|
| Rate for Payer: GEHA Medicare |
$10.32
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$180.90
|
| Rate for Payer: Humana ChoiceCare |
$11.35
|
| Rate for Payer: Humana Medicare Advantage |
$10.32
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$17.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10.32
|
| Rate for Payer: Multiplan All |
$182.91
|
| Rate for Payer: New Mexico Health Connections Medicare |
$17.54
|
| Rate for Payer: OMNI Networks Commercial |
$140.70
|
| Rate for Payer: One Health Plan PPO/POS |
$180.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$17.33
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15.01
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10.32
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$190.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20.64
|
| Rate for Payer: Three Rivers Provider Network All |
$150.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10.11
|
| Rate for Payer: United Healthcare Commercial |
$170.85
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.32
|
| Rate for Payer: United Payors & United Providers UP&UP |
$186.93
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$10.32
|
| Rate for Payer: Zelis Auto |
$80.40
|
| Rate for Payer: Zelis Medicare |
$8.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12.38
|
| Rate for Payer: Zelis Worker's Compensation |
$12.01
|
|
|
CULTURE BLOOD (SEPSIS) set 1
|
Facility
|
IP
|
$201.00
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
2207043
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.01 |
| Max. Negotiated Rate |
$190.95 |
| Rate for Payer: Cash Price |
$120.60
|
| Rate for Payer: Cash Price |
$120.60
|
| Rate for Payer: Cigna Commercial |
$170.85
|
| Rate for Payer: First Health Commercial |
$180.90
|
| Rate for Payer: First Health Workers Compensation |
$16.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$180.90
|
| Rate for Payer: GEHA Commercial |
$140.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$180.90
|
| Rate for Payer: Multiplan All |
$182.91
|
| Rate for Payer: OMNI Networks Commercial |
$140.70
|
| Rate for Payer: One Health Plan PPO/POS |
$180.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$190.95
|
| Rate for Payer: Three Rivers Provider Network All |
$150.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$186.93
|
| Rate for Payer: Zelis Auto |
$80.40
|
| Rate for Payer: Zelis Worker's Compensation |
$12.01
|
|
|
CULTURE BLOOD (SEPSIS) set 2
|
Facility
|
OP
|
$201.00
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
2207044
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.77 |
| Max. Negotiated Rate |
$190.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$18.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$120.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$18.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$14.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$10.32
|
| Rate for Payer: Cash Price |
$120.60
|
| Rate for Payer: Cash Price |
$120.60
|
| Rate for Payer: Cigna Commercial |
$170.85
|
| Rate for Payer: First Health Commercial |
$180.90
|
| Rate for Payer: First Health Workers Compensation |
$16.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$180.90
|
| Rate for Payer: GEHA Commercial |
$160.80
|
| Rate for Payer: GEHA Medicare |
$10.32
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$180.90
|
| Rate for Payer: Humana ChoiceCare |
$11.35
|
| Rate for Payer: Humana Medicare Advantage |
$10.32
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$17.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$15.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$10.32
|
| Rate for Payer: Multiplan All |
$182.91
|
| Rate for Payer: New Mexico Health Connections Medicare |
$17.54
|
| Rate for Payer: OMNI Networks Commercial |
$140.70
|
| Rate for Payer: One Health Plan PPO/POS |
$180.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$17.33
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$15.01
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$10.32
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$190.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$20.64
|
| Rate for Payer: Three Rivers Provider Network All |
$150.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$10.11
|
| Rate for Payer: United Healthcare Commercial |
$170.85
|
| Rate for Payer: United Healthcare Managed Medicaid |
$15.01
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.32
|
| Rate for Payer: United Payors & United Providers UP&UP |
$186.93
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$10.32
|
| Rate for Payer: Zelis Auto |
$80.40
|
| Rate for Payer: Zelis Medicare |
$8.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$12.38
|
| Rate for Payer: Zelis Worker's Compensation |
$12.01
|
|
|
CULTURE BLOOD (SEPSIS) set 2
|
Facility
|
IP
|
$201.00
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
2207044
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.01 |
| Max. Negotiated Rate |
$190.95 |
| Rate for Payer: Cash Price |
$120.60
|
| Rate for Payer: Cash Price |
$120.60
|
| Rate for Payer: Cigna Commercial |
$170.85
|
| Rate for Payer: First Health Commercial |
$180.90
|
| Rate for Payer: First Health Workers Compensation |
$16.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$180.90
|
| Rate for Payer: GEHA Commercial |
$140.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$180.90
|
| Rate for Payer: Multiplan All |
$182.91
|
| Rate for Payer: OMNI Networks Commercial |
$140.70
|
| Rate for Payer: One Health Plan PPO/POS |
$180.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$190.95
|
| Rate for Payer: Three Rivers Provider Network All |
$150.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$186.93
|
| Rate for Payer: Zelis Auto |
$80.40
|
| Rate for Payer: Zelis Worker's Compensation |
$12.01
|
|
|
CULTURE BONE
|
Facility
|
IP
|
$178.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299075
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$169.10 |
| Rate for Payer: Cash Price |
$106.80
|
| Rate for Payer: Cash Price |
$106.80
|
| Rate for Payer: Cigna Commercial |
$151.30
|
| Rate for Payer: First Health Commercial |
$160.20
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$160.20
|
| Rate for Payer: GEHA Commercial |
$124.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$160.20
|
| Rate for Payer: Multiplan All |
$161.98
|
| Rate for Payer: OMNI Networks Commercial |
$124.60
|
| Rate for Payer: One Health Plan PPO/POS |
$160.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$169.10
|
| Rate for Payer: Three Rivers Provider Network All |
$133.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$165.54
|
| Rate for Payer: Zelis Auto |
$71.20
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
|
CULTURE BONE
|
Facility
|
OP
|
$178.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299075
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$169.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$106.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$106.80
|
| Rate for Payer: Cash Price |
$106.80
|
| Rate for Payer: Cigna Commercial |
$151.30
|
| Rate for Payer: First Health Commercial |
$160.20
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$160.20
|
| Rate for Payer: GEHA Commercial |
$142.40
|
| Rate for Payer: GEHA Medicare |
$8.62
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$160.20
|
| Rate for Payer: Humana ChoiceCare |
$9.48
|
| Rate for Payer: Humana Medicare Advantage |
$8.62
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8.62
|
| Rate for Payer: Multiplan All |
$161.98
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14.65
|
| Rate for Payer: OMNI Networks Commercial |
$124.60
|
| Rate for Payer: One Health Plan PPO/POS |
$160.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8.62
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$169.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17.24
|
| Rate for Payer: Three Rivers Provider Network All |
$133.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8.45
|
| Rate for Payer: United Healthcare Commercial |
$151.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.62
|
| Rate for Payer: United Payors & United Providers UP&UP |
$165.54
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$8.62
|
| Rate for Payer: Zelis Auto |
$71.20
|
| Rate for Payer: Zelis Medicare |
$7.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10.34
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
|
culture b pertussis nasophar REF180224
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2200500
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cigna Commercial |
$234.60
|
| Rate for Payer: First Health Commercial |
$248.40
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$248.40
|
| Rate for Payer: GEHA Commercial |
$193.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$248.40
|
| Rate for Payer: Multiplan All |
$251.16
|
| Rate for Payer: OMNI Networks Commercial |
$193.20
|
| Rate for Payer: One Health Plan PPO/POS |
$248.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$262.20
|
| Rate for Payer: Three Rivers Provider Network All |
$207.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$256.68
|
| Rate for Payer: Zelis Auto |
$110.40
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
|
culture b pertussis nasophar REF180224
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2200500
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$165.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cigna Commercial |
$234.60
|
| Rate for Payer: First Health Commercial |
$248.40
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$248.40
|
| Rate for Payer: GEHA Commercial |
$220.80
|
| Rate for Payer: GEHA Medicare |
$8.62
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$248.40
|
| Rate for Payer: Humana ChoiceCare |
$9.48
|
| Rate for Payer: Humana Medicare Advantage |
$8.62
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8.62
|
| Rate for Payer: Multiplan All |
$251.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14.65
|
| Rate for Payer: OMNI Networks Commercial |
$193.20
|
| Rate for Payer: One Health Plan PPO/POS |
$248.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8.62
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$262.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17.24
|
| Rate for Payer: Three Rivers Provider Network All |
$207.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8.45
|
| Rate for Payer: United Healthcare Commercial |
$234.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.62
|
| Rate for Payer: United Payors & United Providers UP&UP |
$256.68
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$8.62
|
| Rate for Payer: Zelis Auto |
$110.40
|
| Rate for Payer: Zelis Medicare |
$7.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10.34
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
|
CULTURE CATHETER TIP
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299057
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$165.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cigna Commercial |
$234.60
|
| Rate for Payer: First Health Commercial |
$248.40
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$248.40
|
| Rate for Payer: GEHA Commercial |
$220.80
|
| Rate for Payer: GEHA Medicare |
$8.62
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$248.40
|
| Rate for Payer: Humana ChoiceCare |
$9.48
|
| Rate for Payer: Humana Medicare Advantage |
$8.62
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8.62
|
| Rate for Payer: Multiplan All |
$251.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14.65
|
| Rate for Payer: OMNI Networks Commercial |
$193.20
|
| Rate for Payer: One Health Plan PPO/POS |
$248.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8.62
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$262.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17.24
|
| Rate for Payer: Three Rivers Provider Network All |
$207.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8.45
|
| Rate for Payer: United Healthcare Commercial |
$234.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.62
|
| Rate for Payer: United Payors & United Providers UP&UP |
$256.68
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$8.62
|
| Rate for Payer: Zelis Auto |
$110.40
|
| Rate for Payer: Zelis Medicare |
$7.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10.34
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
|
CULTURE CATHETER TIP
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299057
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cigna Commercial |
$234.60
|
| Rate for Payer: First Health Commercial |
$248.40
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$248.40
|
| Rate for Payer: GEHA Commercial |
$193.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$248.40
|
| Rate for Payer: Multiplan All |
$251.16
|
| Rate for Payer: OMNI Networks Commercial |
$193.20
|
| Rate for Payer: One Health Plan PPO/POS |
$248.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$262.20
|
| Rate for Payer: Three Rivers Provider Network All |
$207.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$256.68
|
| Rate for Payer: Zelis Auto |
$110.40
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
|
CULTURE CERVIX
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299049
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cigna Commercial |
$234.60
|
| Rate for Payer: First Health Commercial |
$248.40
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$248.40
|
| Rate for Payer: GEHA Commercial |
$193.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$248.40
|
| Rate for Payer: Multiplan All |
$251.16
|
| Rate for Payer: OMNI Networks Commercial |
$193.20
|
| Rate for Payer: One Health Plan PPO/POS |
$248.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$262.20
|
| Rate for Payer: Three Rivers Provider Network All |
$207.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$256.68
|
| Rate for Payer: Zelis Auto |
$110.40
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
|
CULTURE CERVIX
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299049
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$165.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cigna Commercial |
$234.60
|
| Rate for Payer: First Health Commercial |
$248.40
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$248.40
|
| Rate for Payer: GEHA Commercial |
$220.80
|
| Rate for Payer: GEHA Medicare |
$8.62
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$248.40
|
| Rate for Payer: Humana ChoiceCare |
$9.48
|
| Rate for Payer: Humana Medicare Advantage |
$8.62
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8.62
|
| Rate for Payer: Multiplan All |
$251.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14.65
|
| Rate for Payer: OMNI Networks Commercial |
$193.20
|
| Rate for Payer: One Health Plan PPO/POS |
$248.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8.62
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$262.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17.24
|
| Rate for Payer: Three Rivers Provider Network All |
$207.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8.45
|
| Rate for Payer: United Healthcare Commercial |
$234.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.62
|
| Rate for Payer: United Payors & United Providers UP&UP |
$256.68
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$8.62
|
| Rate for Payer: Zelis Auto |
$110.40
|
| Rate for Payer: Zelis Medicare |
$7.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10.34
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
|
CULTURE CSF
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299051
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$165.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cigna Commercial |
$234.60
|
| Rate for Payer: First Health Commercial |
$248.40
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$248.40
|
| Rate for Payer: GEHA Commercial |
$220.80
|
| Rate for Payer: GEHA Medicare |
$8.62
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$248.40
|
| Rate for Payer: Humana ChoiceCare |
$9.48
|
| Rate for Payer: Humana Medicare Advantage |
$8.62
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8.62
|
| Rate for Payer: Multiplan All |
$251.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14.65
|
| Rate for Payer: OMNI Networks Commercial |
$193.20
|
| Rate for Payer: One Health Plan PPO/POS |
$248.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8.62
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$262.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17.24
|
| Rate for Payer: Three Rivers Provider Network All |
$207.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8.45
|
| Rate for Payer: United Healthcare Commercial |
$234.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.62
|
| Rate for Payer: United Payors & United Providers UP&UP |
$256.68
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$8.62
|
| Rate for Payer: Zelis Auto |
$110.40
|
| Rate for Payer: Zelis Medicare |
$7.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10.34
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
|
CULTURE CSF
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299051
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cigna Commercial |
$234.60
|
| Rate for Payer: First Health Commercial |
$248.40
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$248.40
|
| Rate for Payer: GEHA Commercial |
$193.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$248.40
|
| Rate for Payer: Multiplan All |
$251.16
|
| Rate for Payer: OMNI Networks Commercial |
$193.20
|
| Rate for Payer: One Health Plan PPO/POS |
$248.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$262.20
|
| Rate for Payer: Three Rivers Provider Network All |
$207.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$256.68
|
| Rate for Payer: Zelis Auto |
$110.40
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
|
CULTURE EAR
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299054
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$165.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cigna Commercial |
$234.60
|
| Rate for Payer: First Health Commercial |
$248.40
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$248.40
|
| Rate for Payer: GEHA Commercial |
$220.80
|
| Rate for Payer: GEHA Medicare |
$8.62
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$248.40
|
| Rate for Payer: Humana ChoiceCare |
$9.48
|
| Rate for Payer: Humana Medicare Advantage |
$8.62
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8.62
|
| Rate for Payer: Multiplan All |
$251.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14.65
|
| Rate for Payer: OMNI Networks Commercial |
$193.20
|
| Rate for Payer: One Health Plan PPO/POS |
$248.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8.62
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$262.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17.24
|
| Rate for Payer: Three Rivers Provider Network All |
$207.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8.45
|
| Rate for Payer: United Healthcare Commercial |
$234.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.62
|
| Rate for Payer: United Payors & United Providers UP&UP |
$256.68
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$8.62
|
| Rate for Payer: Zelis Auto |
$110.40
|
| Rate for Payer: Zelis Medicare |
$7.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10.34
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
|
CULTURE EAR
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299054
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cigna Commercial |
$234.60
|
| Rate for Payer: First Health Commercial |
$248.40
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$248.40
|
| Rate for Payer: GEHA Commercial |
$193.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$248.40
|
| Rate for Payer: Multiplan All |
$251.16
|
| Rate for Payer: OMNI Networks Commercial |
$193.20
|
| Rate for Payer: One Health Plan PPO/POS |
$248.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$262.20
|
| Rate for Payer: Three Rivers Provider Network All |
$207.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$256.68
|
| Rate for Payer: Zelis Auto |
$110.40
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
|
CULTURE ESCHERICHIA COLI O157
|
Facility
|
IP
|
$14.00
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
2299204
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$13.30 |
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cigna Commercial |
$11.90
|
| Rate for Payer: First Health Commercial |
$12.60
|
| Rate for Payer: First Health Workers Compensation |
$11.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$12.60
|
| Rate for Payer: GEHA Commercial |
$9.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$12.60
|
| Rate for Payer: Multiplan All |
$12.74
|
| Rate for Payer: OMNI Networks Commercial |
$9.80
|
| Rate for Payer: One Health Plan PPO/POS |
$12.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$13.30
|
| Rate for Payer: Three Rivers Provider Network All |
$10.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$13.02
|
| Rate for Payer: Zelis Auto |
$5.60
|
| Rate for Payer: Zelis Worker's Compensation |
$8.25
|
|
|
CULTURE ESCHERICHIA COLI O157
|
Facility
|
OP
|
$14.00
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
2299204
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$18.88 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$17.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$8.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$17.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13.46
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cash Price |
$8.40
|
| Rate for Payer: Cigna Commercial |
$11.90
|
| Rate for Payer: First Health Commercial |
$12.60
|
| Rate for Payer: First Health Workers Compensation |
$11.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$12.60
|
| Rate for Payer: GEHA Commercial |
$11.20
|
| Rate for Payer: GEHA Medicare |
$9.44
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$12.60
|
| Rate for Payer: Humana ChoiceCare |
$10.38
|
| Rate for Payer: Humana Medicare Advantage |
$9.44
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$15.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9.44
|
| Rate for Payer: Multiplan All |
$12.74
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16.05
|
| Rate for Payer: OMNI Networks Commercial |
$9.80
|
| Rate for Payer: One Health Plan PPO/POS |
$12.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15.86
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13.74
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9.44
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$13.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$18.88
|
| Rate for Payer: Three Rivers Provider Network All |
$10.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9.25
|
| Rate for Payer: United Healthcare Commercial |
$11.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.44
|
| Rate for Payer: United Payors & United Providers UP&UP |
$13.02
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$9.44
|
| Rate for Payer: Zelis Auto |
$5.60
|
| Rate for Payer: Zelis Medicare |
$8.02
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11.33
|
| Rate for Payer: Zelis Worker's Compensation |
$8.25
|
|
|
CULTURE EYE
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299053
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$165.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cigna Commercial |
$234.60
|
| Rate for Payer: First Health Commercial |
$248.40
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$248.40
|
| Rate for Payer: GEHA Commercial |
$220.80
|
| Rate for Payer: GEHA Medicare |
$8.62
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$248.40
|
| Rate for Payer: Humana ChoiceCare |
$9.48
|
| Rate for Payer: Humana Medicare Advantage |
$8.62
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8.62
|
| Rate for Payer: Multiplan All |
$251.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14.65
|
| Rate for Payer: OMNI Networks Commercial |
$193.20
|
| Rate for Payer: One Health Plan PPO/POS |
$248.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8.62
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$262.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17.24
|
| Rate for Payer: Three Rivers Provider Network All |
$207.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8.45
|
| Rate for Payer: United Healthcare Commercial |
$234.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.62
|
| Rate for Payer: United Payors & United Providers UP&UP |
$256.68
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$8.62
|
| Rate for Payer: Zelis Auto |
$110.40
|
| Rate for Payer: Zelis Medicare |
$7.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10.34
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
|
CULTURE EYE
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299053
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cigna Commercial |
$234.60
|
| Rate for Payer: First Health Commercial |
$248.40
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$248.40
|
| Rate for Payer: GEHA Commercial |
$193.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$248.40
|
| Rate for Payer: Multiplan All |
$251.16
|
| Rate for Payer: OMNI Networks Commercial |
$193.20
|
| Rate for Payer: One Health Plan PPO/POS |
$248.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$262.20
|
| Rate for Payer: Three Rivers Provider Network All |
$207.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$256.68
|
| Rate for Payer: Zelis Auto |
$110.40
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
|
CULTURE FLUID
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299052
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$165.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cigna Commercial |
$234.60
|
| Rate for Payer: First Health Commercial |
$248.40
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$248.40
|
| Rate for Payer: GEHA Commercial |
$220.80
|
| Rate for Payer: GEHA Medicare |
$8.62
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$248.40
|
| Rate for Payer: Humana ChoiceCare |
$9.48
|
| Rate for Payer: Humana Medicare Advantage |
$8.62
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8.62
|
| Rate for Payer: Multiplan All |
$251.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14.65
|
| Rate for Payer: OMNI Networks Commercial |
$193.20
|
| Rate for Payer: One Health Plan PPO/POS |
$248.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8.62
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$262.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17.24
|
| Rate for Payer: Three Rivers Provider Network All |
$207.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8.45
|
| Rate for Payer: United Healthcare Commercial |
$234.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.62
|
| Rate for Payer: United Payors & United Providers UP&UP |
$256.68
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$8.62
|
| Rate for Payer: Zelis Auto |
$110.40
|
| Rate for Payer: Zelis Medicare |
$7.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10.34
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
|
CULTURE FLUID
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299052
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cigna Commercial |
$234.60
|
| Rate for Payer: First Health Commercial |
$248.40
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$248.40
|
| Rate for Payer: GEHA Commercial |
$193.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$248.40
|
| Rate for Payer: Multiplan All |
$251.16
|
| Rate for Payer: OMNI Networks Commercial |
$193.20
|
| Rate for Payer: One Health Plan PPO/POS |
$248.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$262.20
|
| Rate for Payer: Three Rivers Provider Network All |
$207.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$256.68
|
| Rate for Payer: Zelis Auto |
$110.40
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
|
culture fungus REF008482
|
Facility
|
OP
|
$254.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
2299265
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.55 |
| Max. Negotiated Rate |
$241.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$13.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$152.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$13.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$10.99
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7.71
|
| Rate for Payer: Cash Price |
$152.40
|
| Rate for Payer: Cash Price |
$152.40
|
| Rate for Payer: Cigna Commercial |
$215.90
|
| Rate for Payer: First Health Commercial |
$228.60
|
| Rate for Payer: First Health Workers Compensation |
$14.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$228.60
|
| Rate for Payer: GEHA Commercial |
$203.20
|
| Rate for Payer: GEHA Medicare |
$7.71
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$228.60
|
| Rate for Payer: Humana ChoiceCare |
$8.48
|
| Rate for Payer: Humana Medicare Advantage |
$7.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$12.95
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11.22
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7.71
|
| Rate for Payer: Multiplan All |
$231.14
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13.11
|
| Rate for Payer: OMNI Networks Commercial |
$177.80
|
| Rate for Payer: One Health Plan PPO/POS |
$228.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$12.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11.22
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7.71
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$241.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15.42
|
| Rate for Payer: Three Rivers Provider Network All |
$190.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7.56
|
| Rate for Payer: United Healthcare Commercial |
$215.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.71
|
| Rate for Payer: United Payors & United Providers UP&UP |
$236.22
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$7.71
|
| Rate for Payer: Zelis Auto |
$101.60
|
| Rate for Payer: Zelis Medicare |
$6.55
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9.25
|
| Rate for Payer: Zelis Worker's Compensation |
$10.26
|
|
|
culture fungus REF008482
|
Facility
|
IP
|
$254.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
2299265
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.26 |
| Max. Negotiated Rate |
$241.30 |
| Rate for Payer: Cash Price |
$152.40
|
| Rate for Payer: Cash Price |
$152.40
|
| Rate for Payer: Cigna Commercial |
$215.90
|
| Rate for Payer: First Health Commercial |
$228.60
|
| Rate for Payer: First Health Workers Compensation |
$14.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$228.60
|
| Rate for Payer: GEHA Commercial |
$177.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$228.60
|
| Rate for Payer: Multiplan All |
$231.14
|
| Rate for Payer: OMNI Networks Commercial |
$177.80
|
| Rate for Payer: One Health Plan PPO/POS |
$228.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$241.30
|
| Rate for Payer: Three Rivers Provider Network All |
$190.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$236.22
|
| Rate for Payer: Zelis Auto |
$101.60
|
| Rate for Payer: Zelis Worker's Compensation |
$10.26
|
|
|
CULTURE GENITAL
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299050
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$262.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$165.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$15.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$12.29
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cigna Commercial |
$234.60
|
| Rate for Payer: First Health Commercial |
$248.40
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$248.40
|
| Rate for Payer: GEHA Commercial |
$220.80
|
| Rate for Payer: GEHA Medicare |
$8.62
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$248.40
|
| Rate for Payer: Humana ChoiceCare |
$9.48
|
| Rate for Payer: Humana Medicare Advantage |
$8.62
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$14.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$12.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8.62
|
| Rate for Payer: Multiplan All |
$251.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14.65
|
| Rate for Payer: OMNI Networks Commercial |
$193.20
|
| Rate for Payer: One Health Plan PPO/POS |
$248.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$14.48
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$12.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8.62
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$262.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17.24
|
| Rate for Payer: Three Rivers Provider Network All |
$207.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8.45
|
| Rate for Payer: United Healthcare Commercial |
$234.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$12.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.62
|
| Rate for Payer: United Payors & United Providers UP&UP |
$256.68
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$8.62
|
| Rate for Payer: Zelis Auto |
$110.40
|
| Rate for Payer: Zelis Medicare |
$7.33
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$10.34
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
