|
CULTURE GENITAL
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299050
|
|
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 group b strep REF188130
|
Facility
|
OP
|
$179.00
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
2207081
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.64 |
| Max. Negotiated Rate |
$170.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11.94
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$107.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11.94
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9.46
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$107.40
|
| Rate for Payer: Cash Price |
$107.40
|
| Rate for Payer: Cigna Commercial |
$152.15
|
| Rate for Payer: First Health Commercial |
$161.10
|
| Rate for Payer: First Health Workers Compensation |
$10.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$161.10
|
| Rate for Payer: GEHA Commercial |
$143.20
|
| Rate for Payer: GEHA Medicare |
$6.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$161.10
|
| Rate for Payer: Humana ChoiceCare |
$7.29
|
| Rate for Payer: Humana Medicare Advantage |
$6.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11.14
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6.63
|
| Rate for Payer: Multiplan All |
$162.89
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11.27
|
| Rate for Payer: OMNI Networks Commercial |
$125.30
|
| Rate for Payer: One Health Plan PPO/POS |
$161.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11.14
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9.65
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$170.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13.26
|
| Rate for Payer: Three Rivers Provider Network All |
$134.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6.50
|
| Rate for Payer: United Healthcare Commercial |
$152.15
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$166.47
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6.63
|
| Rate for Payer: Zelis Auto |
$71.60
|
| Rate for Payer: Zelis Medicare |
$5.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7.96
|
| Rate for Payer: Zelis Worker's Compensation |
$7.64
|
|
|
culture group b strep REF188130
|
Facility
|
IP
|
$179.00
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
2207081
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.64 |
| Max. Negotiated Rate |
$170.05 |
| Rate for Payer: Cash Price |
$107.40
|
| Rate for Payer: Cash Price |
$107.40
|
| Rate for Payer: Cigna Commercial |
$152.15
|
| Rate for Payer: First Health Commercial |
$161.10
|
| Rate for Payer: First Health Workers Compensation |
$10.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$161.10
|
| Rate for Payer: GEHA Commercial |
$125.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$161.10
|
| Rate for Payer: Multiplan All |
$162.89
|
| Rate for Payer: OMNI Networks Commercial |
$125.30
|
| Rate for Payer: One Health Plan PPO/POS |
$161.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$170.05
|
| Rate for Payer: Three Rivers Provider Network All |
$134.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$166.47
|
| Rate for Payer: Zelis Auto |
$71.60
|
| Rate for Payer: Zelis Worker's Compensation |
$7.64
|
|
|
CULTURE MRSA
|
Facility
|
OP
|
$179.00
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
2247367
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.64 |
| Max. Negotiated Rate |
$170.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11.94
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$107.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11.94
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9.46
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$107.40
|
| Rate for Payer: Cash Price |
$107.40
|
| Rate for Payer: Cigna Commercial |
$152.15
|
| Rate for Payer: First Health Commercial |
$161.10
|
| Rate for Payer: First Health Workers Compensation |
$10.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$161.10
|
| Rate for Payer: GEHA Commercial |
$143.20
|
| Rate for Payer: GEHA Medicare |
$6.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$161.10
|
| Rate for Payer: Humana ChoiceCare |
$7.29
|
| Rate for Payer: Humana Medicare Advantage |
$6.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11.14
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6.63
|
| Rate for Payer: Multiplan All |
$162.89
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11.27
|
| Rate for Payer: OMNI Networks Commercial |
$125.30
|
| Rate for Payer: One Health Plan PPO/POS |
$161.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11.14
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9.65
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$170.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13.26
|
| Rate for Payer: Three Rivers Provider Network All |
$134.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6.50
|
| Rate for Payer: United Healthcare Commercial |
$152.15
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$166.47
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6.63
|
| Rate for Payer: Zelis Auto |
$71.60
|
| Rate for Payer: Zelis Medicare |
$5.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7.96
|
| Rate for Payer: Zelis Worker's Compensation |
$7.64
|
|
|
CULTURE MRSA
|
Facility
|
IP
|
$179.00
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
2247367
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.64 |
| Max. Negotiated Rate |
$170.05 |
| Rate for Payer: Cash Price |
$107.40
|
| Rate for Payer: Cash Price |
$107.40
|
| Rate for Payer: Cigna Commercial |
$152.15
|
| Rate for Payer: First Health Commercial |
$161.10
|
| Rate for Payer: First Health Workers Compensation |
$10.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$161.10
|
| Rate for Payer: GEHA Commercial |
$125.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$161.10
|
| Rate for Payer: Multiplan All |
$162.89
|
| Rate for Payer: OMNI Networks Commercial |
$125.30
|
| Rate for Payer: One Health Plan PPO/POS |
$161.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$170.05
|
| Rate for Payer: Three Rivers Provider Network All |
$134.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$166.47
|
| Rate for Payer: Zelis Auto |
$71.60
|
| Rate for Payer: Zelis Worker's Compensation |
$7.64
|
|
|
CULTURE NASAL
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299055
|
|
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 NASAL
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299055
|
|
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 SPUTUM
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2207022
|
|
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 SPUTUM
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2207022
|
|
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 STREP A CONF
|
Facility
|
OP
|
$179.00
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
2287081
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.64 |
| Max. Negotiated Rate |
$170.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11.94
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$107.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11.94
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$9.46
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$107.40
|
| Rate for Payer: Cash Price |
$107.40
|
| Rate for Payer: Cigna Commercial |
$152.15
|
| Rate for Payer: First Health Commercial |
$161.10
|
| Rate for Payer: First Health Workers Compensation |
$10.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$161.10
|
| Rate for Payer: GEHA Commercial |
$143.20
|
| Rate for Payer: GEHA Medicare |
$6.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$161.10
|
| Rate for Payer: Humana ChoiceCare |
$7.29
|
| Rate for Payer: Humana Medicare Advantage |
$6.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11.14
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$9.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6.63
|
| Rate for Payer: Multiplan All |
$162.89
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11.27
|
| Rate for Payer: OMNI Networks Commercial |
$125.30
|
| Rate for Payer: One Health Plan PPO/POS |
$161.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$11.14
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$9.65
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$170.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13.26
|
| Rate for Payer: Three Rivers Provider Network All |
$134.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6.50
|
| Rate for Payer: United Healthcare Commercial |
$152.15
|
| Rate for Payer: United Healthcare Managed Medicaid |
$9.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$166.47
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6.63
|
| Rate for Payer: Zelis Auto |
$71.60
|
| Rate for Payer: Zelis Medicare |
$5.64
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$7.96
|
| Rate for Payer: Zelis Worker's Compensation |
$7.64
|
|
|
CULTURE STREP A CONF
|
Facility
|
IP
|
$179.00
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
2287081
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.64 |
| Max. Negotiated Rate |
$170.05 |
| Rate for Payer: Cash Price |
$107.40
|
| Rate for Payer: Cash Price |
$107.40
|
| Rate for Payer: Cigna Commercial |
$152.15
|
| Rate for Payer: First Health Commercial |
$161.10
|
| Rate for Payer: First Health Workers Compensation |
$10.81
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$161.10
|
| Rate for Payer: GEHA Commercial |
$125.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$161.10
|
| Rate for Payer: Multiplan All |
$162.89
|
| Rate for Payer: OMNI Networks Commercial |
$125.30
|
| Rate for Payer: One Health Plan PPO/POS |
$161.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$170.05
|
| Rate for Payer: Three Rivers Provider Network All |
$134.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$166.47
|
| Rate for Payer: Zelis Auto |
$71.60
|
| Rate for Payer: Zelis Worker's Compensation |
$7.64
|
|
|
CULTURE SUBQ TISSUE
|
Facility
|
IP
|
$230.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299076
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$218.50 |
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cigna Commercial |
$195.50
|
| Rate for Payer: First Health Commercial |
$207.00
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$207.00
|
| Rate for Payer: GEHA Commercial |
$161.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$207.00
|
| Rate for Payer: Multiplan All |
$209.30
|
| Rate for Payer: OMNI Networks Commercial |
$161.00
|
| Rate for Payer: One Health Plan PPO/POS |
$207.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$218.50
|
| Rate for Payer: Three Rivers Provider Network All |
$172.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$213.90
|
| Rate for Payer: Zelis Auto |
$92.00
|
| Rate for Payer: Zelis Worker's Compensation |
$9.50
|
|
|
CULTURE SUBQ TISSUE
|
Facility
|
OP
|
$230.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299076
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$218.50 |
| 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 |
$138.00
|
| 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 |
$138.00
|
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cigna Commercial |
$195.50
|
| Rate for Payer: First Health Commercial |
$207.00
|
| Rate for Payer: First Health Workers Compensation |
$13.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$207.00
|
| Rate for Payer: GEHA Commercial |
$184.00
|
| Rate for Payer: GEHA Medicare |
$8.62
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$207.00
|
| 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 |
$209.30
|
| Rate for Payer: New Mexico Health Connections Medicare |
$14.65
|
| Rate for Payer: OMNI Networks Commercial |
$161.00
|
| Rate for Payer: One Health Plan PPO/POS |
$207.00
|
| 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 |
$218.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17.24
|
| Rate for Payer: Three Rivers Provider Network All |
$172.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8.45
|
| Rate for Payer: United Healthcare Commercial |
$195.50
|
| 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 |
$213.90
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$8.62
|
| Rate for Payer: Zelis Auto |
$92.00
|
| 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 SURGICAL AEROBIC
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2207085
|
|
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 SURGICAL AEROBIC
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2207085
|
|
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 THROAT AGH
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
22990756
|
|
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 THROAT AGH
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
22990756
|
|
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 TISSUE BONE MARROW
|
Facility
|
IP
|
$963.00
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
2200155
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$136.32 |
| Max. Negotiated Rate |
$914.85 |
| Rate for Payer: Cash Price |
$577.80
|
| Rate for Payer: Cash Price |
$577.80
|
| Rate for Payer: Cigna Commercial |
$818.55
|
| Rate for Payer: First Health Commercial |
$866.70
|
| Rate for Payer: First Health Workers Compensation |
$192.79
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$866.70
|
| Rate for Payer: GEHA Commercial |
$674.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$866.70
|
| Rate for Payer: Multiplan All |
$876.33
|
| Rate for Payer: OMNI Networks Commercial |
$674.10
|
| Rate for Payer: One Health Plan PPO/POS |
$866.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$914.85
|
| Rate for Payer: Three Rivers Provider Network All |
$722.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$895.59
|
| Rate for Payer: Zelis Auto |
$385.20
|
| Rate for Payer: Zelis Worker's Compensation |
$136.32
|
|
|
CULTURE TISSUE BONE MARROW
|
Facility
|
OP
|
$963.00
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
2200155
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$122.19 |
| Max. Negotiated Rate |
$914.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$258.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$577.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$258.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$204.97
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$143.75
|
| Rate for Payer: Cash Price |
$577.80
|
| Rate for Payer: Cash Price |
$577.80
|
| Rate for Payer: Cigna Commercial |
$818.55
|
| Rate for Payer: First Health Commercial |
$866.70
|
| Rate for Payer: First Health Workers Compensation |
$192.79
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$866.70
|
| Rate for Payer: GEHA Commercial |
$770.40
|
| Rate for Payer: GEHA Medicare |
$143.75
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$866.70
|
| Rate for Payer: Humana ChoiceCare |
$158.12
|
| Rate for Payer: Humana Medicare Advantage |
$143.75
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$241.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$209.14
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$143.75
|
| Rate for Payer: Multiplan All |
$876.33
|
| Rate for Payer: New Mexico Health Connections Medicare |
$244.38
|
| Rate for Payer: OMNI Networks Commercial |
$674.10
|
| Rate for Payer: One Health Plan PPO/POS |
$866.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$241.49
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$209.14
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$143.75
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$914.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$287.50
|
| Rate for Payer: Three Rivers Provider Network All |
$722.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$140.88
|
| Rate for Payer: United Healthcare Commercial |
$818.55
|
| Rate for Payer: United Healthcare Managed Medicaid |
$209.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$143.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$895.59
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$143.75
|
| Rate for Payer: Zelis Auto |
$385.20
|
| Rate for Payer: Zelis Medicare |
$122.19
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$172.50
|
| Rate for Payer: Zelis Worker's Compensation |
$136.32
|
|
|
culture upper respiratory REF008342
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
22003424
|
|
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 upper respiratory REF008342
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
22003424
|
|
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 URINE
|
Facility
|
IP
|
$203.00
|
|
|
Service Code
|
CPT 87086
|
| Hospital Charge Code |
2239386
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.29 |
| Max. Negotiated Rate |
$192.85 |
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cigna Commercial |
$172.55
|
| Rate for Payer: First Health Commercial |
$182.70
|
| Rate for Payer: First Health Workers Compensation |
$13.14
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$182.70
|
| Rate for Payer: GEHA Commercial |
$142.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$182.70
|
| Rate for Payer: Multiplan All |
$184.73
|
| Rate for Payer: OMNI Networks Commercial |
$142.10
|
| Rate for Payer: One Health Plan PPO/POS |
$182.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$192.85
|
| Rate for Payer: Three Rivers Provider Network All |
$152.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$188.79
|
| Rate for Payer: Zelis Auto |
$81.20
|
| Rate for Payer: Zelis Worker's Compensation |
$9.29
|
|
|
CULTURE URINE
|
Facility
|
OP
|
$203.00
|
|
|
Service Code
|
CPT 87086
|
| Hospital Charge Code |
2239386
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.86 |
| Max. Negotiated Rate |
$192.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$14.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$121.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$14.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8.07
|
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cigna Commercial |
$172.55
|
| Rate for Payer: First Health Commercial |
$182.70
|
| Rate for Payer: First Health Workers Compensation |
$13.14
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$182.70
|
| Rate for Payer: GEHA Commercial |
$162.40
|
| Rate for Payer: GEHA Medicare |
$8.07
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$182.70
|
| Rate for Payer: Humana ChoiceCare |
$8.88
|
| Rate for Payer: Humana Medicare Advantage |
$8.07
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13.56
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8.07
|
| Rate for Payer: Multiplan All |
$184.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13.72
|
| Rate for Payer: OMNI Networks Commercial |
$142.10
|
| Rate for Payer: One Health Plan PPO/POS |
$182.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13.55
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11.74
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8.07
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$192.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$16.14
|
| Rate for Payer: Three Rivers Provider Network All |
$152.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7.91
|
| Rate for Payer: United Healthcare Commercial |
$172.55
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11.74
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.07
|
| Rate for Payer: United Payors & United Providers UP&UP |
$188.79
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$8.07
|
| Rate for Payer: Zelis Auto |
$81.20
|
| Rate for Payer: Zelis Medicare |
$6.86
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9.68
|
| Rate for Payer: Zelis Worker's Compensation |
$9.29
|
|
|
CULTURE WOUND
|
Facility
|
IP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299056
|
|
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 WOUND
|
Facility
|
OP
|
$276.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
2299056
|
|
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
|
|
