|
99205 OFFICE VISIT LEVEL 5 COMPL COMP
|
Facility
|
OP
|
$625.00
|
|
|
Service Code
|
CPT 99205
|
| Hospital Charge Code |
8699205
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$156.25 |
| Max. Negotiated Rate |
$593.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$375.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$531.25
|
| Rate for Payer: First Health Commercial |
$562.50
|
| Rate for Payer: First Health Workers Compensation |
$241.31
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$562.50
|
| Rate for Payer: GEHA Commercial |
$500.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$562.50
|
| Rate for Payer: Humana ChoiceCare |
$162.50
|
| Rate for Payer: Multiplan All |
$568.75
|
| Rate for Payer: New Mexico Health Connections Medicare |
$375.00
|
| Rate for Payer: OMNI Networks Commercial |
$437.50
|
| Rate for Payer: One Health Plan PPO/POS |
$562.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$593.75
|
| Rate for Payer: Three Rivers Provider Network All |
$468.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$550.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$156.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$581.25
|
| Rate for Payer: Zelis Auto |
$250.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$312.50
|
| Rate for Payer: Zelis Worker's Compensation |
$170.62
|
|
|
99205 OFFICE VISIT LEVEL 5 COMPL COMP
|
Facility
|
IP
|
$625.00
|
|
|
Service Code
|
CPT 99205
|
| Hospital Charge Code |
23500006
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$170.62 |
| Max. Negotiated Rate |
$593.75 |
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$531.25
|
| Rate for Payer: First Health Commercial |
$562.50
|
| Rate for Payer: First Health Workers Compensation |
$241.31
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$562.50
|
| Rate for Payer: GEHA Commercial |
$437.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$562.50
|
| Rate for Payer: Multiplan All |
$568.75
|
| Rate for Payer: OMNI Networks Commercial |
$437.50
|
| Rate for Payer: One Health Plan PPO/POS |
$562.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$593.75
|
| Rate for Payer: Three Rivers Provider Network All |
$468.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$581.25
|
| Rate for Payer: Zelis Auto |
$250.00
|
| Rate for Payer: Zelis Worker's Compensation |
$170.62
|
|
|
99205 OFFICE VISIT LEVEL 5 COMPL COMP
|
Facility
|
OP
|
$625.00
|
|
|
Service Code
|
CPT 99205
|
| Hospital Charge Code |
23500006
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$156.25 |
| Max. Negotiated Rate |
$593.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$375.00
|
| Rate for Payer: Cash Price |
$375.00
|
| Rate for Payer: Cigna Commercial |
$531.25
|
| Rate for Payer: First Health Commercial |
$562.50
|
| Rate for Payer: First Health Workers Compensation |
$241.31
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$562.50
|
| Rate for Payer: GEHA Commercial |
$500.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$562.50
|
| Rate for Payer: Humana ChoiceCare |
$162.50
|
| Rate for Payer: Multiplan All |
$568.75
|
| Rate for Payer: New Mexico Health Connections Medicare |
$375.00
|
| Rate for Payer: OMNI Networks Commercial |
$437.50
|
| Rate for Payer: One Health Plan PPO/POS |
$562.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$593.75
|
| Rate for Payer: Three Rivers Provider Network All |
$468.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$550.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$156.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$581.25
|
| Rate for Payer: Zelis Auto |
$250.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$312.50
|
| Rate for Payer: Zelis Worker's Compensation |
$170.62
|
|
|
99211 E/M NURSE VISIT
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
21099211
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$40.20
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$56.95
|
| Rate for Payer: First Health Commercial |
$60.30
|
| Rate for Payer: First Health Workers Compensation |
$25.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$60.30
|
| Rate for Payer: GEHA Commercial |
$53.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$60.30
|
| Rate for Payer: Humana ChoiceCare |
$17.42
|
| Rate for Payer: Multiplan All |
$60.97
|
| Rate for Payer: New Mexico Health Connections Medicare |
$40.20
|
| Rate for Payer: OMNI Networks Commercial |
$46.90
|
| Rate for Payer: One Health Plan PPO/POS |
$60.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$63.65
|
| Rate for Payer: Three Rivers Provider Network All |
$50.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$58.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$62.31
|
| Rate for Payer: Zelis Auto |
$26.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$33.50
|
| Rate for Payer: Zelis Worker's Compensation |
$18.29
|
|
|
99211 E/M NURSE VISIT
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
21099211
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$18.29 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$56.95
|
| Rate for Payer: First Health Commercial |
$60.30
|
| Rate for Payer: First Health Workers Compensation |
$25.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$60.30
|
| Rate for Payer: GEHA Commercial |
$46.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$60.30
|
| Rate for Payer: Multiplan All |
$60.97
|
| Rate for Payer: OMNI Networks Commercial |
$46.90
|
| Rate for Payer: One Health Plan PPO/POS |
$60.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$63.65
|
| Rate for Payer: Three Rivers Provider Network All |
$50.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$62.31
|
| Rate for Payer: Zelis Auto |
$26.80
|
| Rate for Payer: Zelis Worker's Compensation |
$18.29
|
|
|
99211 NURSE'S VISIT ONLY
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
23500007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$40.20
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$56.95
|
| Rate for Payer: First Health Commercial |
$60.30
|
| Rate for Payer: First Health Workers Compensation |
$25.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$60.30
|
| Rate for Payer: GEHA Commercial |
$53.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$60.30
|
| Rate for Payer: Humana ChoiceCare |
$17.42
|
| Rate for Payer: Multiplan All |
$60.97
|
| Rate for Payer: New Mexico Health Connections Medicare |
$40.20
|
| Rate for Payer: OMNI Networks Commercial |
$46.90
|
| Rate for Payer: One Health Plan PPO/POS |
$60.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$63.65
|
| Rate for Payer: Three Rivers Provider Network All |
$50.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$58.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$62.31
|
| Rate for Payer: Zelis Auto |
$26.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$33.50
|
| Rate for Payer: Zelis Worker's Compensation |
$18.29
|
|
|
99211 NURSE'S VISIT ONLY
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
23500007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$18.29 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$56.95
|
| Rate for Payer: First Health Commercial |
$60.30
|
| Rate for Payer: First Health Workers Compensation |
$25.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$60.30
|
| Rate for Payer: GEHA Commercial |
$46.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$60.30
|
| Rate for Payer: Multiplan All |
$60.97
|
| Rate for Payer: OMNI Networks Commercial |
$46.90
|
| Rate for Payer: One Health Plan PPO/POS |
$60.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$63.65
|
| Rate for Payer: Three Rivers Provider Network All |
$50.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$62.31
|
| Rate for Payer: Zelis Auto |
$26.80
|
| Rate for Payer: Zelis Worker's Compensation |
$18.29
|
|
|
99211 NURSE`S VISIT ONLY
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
8499211
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$40.20
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$56.95
|
| Rate for Payer: First Health Commercial |
$60.30
|
| Rate for Payer: First Health Workers Compensation |
$25.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$60.30
|
| Rate for Payer: GEHA Commercial |
$53.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$60.30
|
| Rate for Payer: Humana ChoiceCare |
$17.42
|
| Rate for Payer: Multiplan All |
$60.97
|
| Rate for Payer: New Mexico Health Connections Medicare |
$40.20
|
| Rate for Payer: OMNI Networks Commercial |
$46.90
|
| Rate for Payer: One Health Plan PPO/POS |
$60.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$63.65
|
| Rate for Payer: Three Rivers Provider Network All |
$50.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$58.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$62.31
|
| Rate for Payer: Zelis Auto |
$26.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$33.50
|
| Rate for Payer: Zelis Worker's Compensation |
$18.29
|
|
|
99211 NURSE`S VISIT ONLY
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
8499211
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$18.29 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$56.95
|
| Rate for Payer: First Health Commercial |
$60.30
|
| Rate for Payer: First Health Workers Compensation |
$25.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$60.30
|
| Rate for Payer: GEHA Commercial |
$46.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$60.30
|
| Rate for Payer: Multiplan All |
$60.97
|
| Rate for Payer: OMNI Networks Commercial |
$46.90
|
| Rate for Payer: One Health Plan PPO/POS |
$60.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$63.65
|
| Rate for Payer: Three Rivers Provider Network All |
$50.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$62.31
|
| Rate for Payer: Zelis Auto |
$26.80
|
| Rate for Payer: Zelis Worker's Compensation |
$18.29
|
|
|
99211 NURSE`S VISIT ONLY
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
9299211
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$18.29 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$56.95
|
| Rate for Payer: First Health Commercial |
$60.30
|
| Rate for Payer: First Health Workers Compensation |
$25.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$60.30
|
| Rate for Payer: GEHA Commercial |
$46.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$60.30
|
| Rate for Payer: Multiplan All |
$60.97
|
| Rate for Payer: OMNI Networks Commercial |
$46.90
|
| Rate for Payer: One Health Plan PPO/POS |
$60.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$63.65
|
| Rate for Payer: Three Rivers Provider Network All |
$50.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$62.31
|
| Rate for Payer: Zelis Auto |
$26.80
|
| Rate for Payer: Zelis Worker's Compensation |
$18.29
|
|
|
99211 NURSE`S VISIT ONLY
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
8999211
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$18.29 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Cigna Commercial |
$56.95
|
| Rate for Payer: First Health Commercial |
$60.30
|
| Rate for Payer: First Health Workers Compensation |
$25.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$60.30
|
| Rate for Payer: GEHA Commercial |
$46.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$60.30
|
| Rate for Payer: Multiplan All |
$60.97
|
| Rate for Payer: OMNI Networks Commercial |
$46.90
|
| Rate for Payer: One Health Plan PPO/POS |
$60.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$63.65
|
| Rate for Payer: Three Rivers Provider Network All |
$50.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$62.31
|
| Rate for Payer: Zelis Auto |
$26.80
|
| Rate for Payer: Zelis Worker's Compensation |
$18.29
|
| Rate for Payer: Cash Price |
$40.20
|
|
|
99211 NURSE`S VISIT ONLY
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
9399211
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$18.29 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$56.95
|
| Rate for Payer: First Health Commercial |
$60.30
|
| Rate for Payer: First Health Workers Compensation |
$25.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$60.30
|
| Rate for Payer: GEHA Commercial |
$46.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$60.30
|
| Rate for Payer: Multiplan All |
$60.97
|
| Rate for Payer: OMNI Networks Commercial |
$46.90
|
| Rate for Payer: One Health Plan PPO/POS |
$60.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$63.65
|
| Rate for Payer: Three Rivers Provider Network All |
$50.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$62.31
|
| Rate for Payer: Zelis Auto |
$26.80
|
| Rate for Payer: Zelis Worker's Compensation |
$18.29
|
|
|
99211 NURSE`S VISIT ONLY
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
9299211
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$40.20
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$56.95
|
| Rate for Payer: First Health Commercial |
$60.30
|
| Rate for Payer: First Health Workers Compensation |
$25.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$60.30
|
| Rate for Payer: GEHA Commercial |
$53.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$60.30
|
| Rate for Payer: Humana ChoiceCare |
$17.42
|
| Rate for Payer: Multiplan All |
$60.97
|
| Rate for Payer: New Mexico Health Connections Medicare |
$40.20
|
| Rate for Payer: OMNI Networks Commercial |
$46.90
|
| Rate for Payer: One Health Plan PPO/POS |
$60.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$63.65
|
| Rate for Payer: Three Rivers Provider Network All |
$50.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$58.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$62.31
|
| Rate for Payer: Zelis Auto |
$26.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$33.50
|
| Rate for Payer: Zelis Worker's Compensation |
$18.29
|
|
|
99211 NURSE`S VISIT ONLY
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
10099211
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$39.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$19.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8.26
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$16.80
|
| Rate for Payer: Cimarron Advantage Cimarron Advantage PPO |
$11.56
|
| Rate for Payer: First Health Workers Compensation |
$39.15
|
| Rate for Payer: GEHA Commercial |
$8.26
|
| Rate for Payer: GEHA Medicare |
$8.26
|
| Rate for Payer: Health Net Federal Services Government |
$8.26
|
| Rate for Payer: HealthSmart Commercial |
$11.56
|
| Rate for Payer: HealthSmart Worker's Compensation |
$37.57
|
| Rate for Payer: Humana ChoiceCare |
$9.09
|
| Rate for Payer: Humana Medicare Advantage |
$8.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11.56
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$19.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8.26
|
| Rate for Payer: Multiplan All |
$21.00
|
| Rate for Payer: National Preferred Provider Network Commercial |
$26.60
|
| Rate for Payer: National Preferred Provider Network Worker's Compensation |
$39.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$8.67
|
| Rate for Payer: OMNI Networks Commercial |
$19.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$9.79
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7.09
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17.92
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.26
|
| Rate for Payer: Zelis Medicare |
$7.02
|
| Rate for Payer: Zelis Worker's Compensation |
$27.68
|
|
|
99211 NURSE`S VISIT ONLY
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
9699211
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$33.50 |
| Max. Negotiated Rate |
$127.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$80.40
|
| Rate for Payer: Cash Price |
$80.40
|
| Rate for Payer: Cigna Commercial |
$113.90
|
| Rate for Payer: First Health Commercial |
$120.60
|
| Rate for Payer: First Health Workers Compensation |
$51.74
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$120.60
|
| Rate for Payer: GEHA Commercial |
$107.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$120.60
|
| Rate for Payer: Humana ChoiceCare |
$34.84
|
| Rate for Payer: Multiplan All |
$121.94
|
| Rate for Payer: New Mexico Health Connections Medicare |
$80.40
|
| Rate for Payer: OMNI Networks Commercial |
$93.80
|
| Rate for Payer: One Health Plan PPO/POS |
$120.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$127.30
|
| Rate for Payer: Three Rivers Provider Network All |
$100.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$117.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$33.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$124.62
|
| Rate for Payer: Zelis Auto |
$53.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$67.00
|
| Rate for Payer: Zelis Worker's Compensation |
$36.58
|
|
|
99211 NURSE`S VISIT ONLY
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
8799211
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$40.20
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$56.95
|
| Rate for Payer: First Health Commercial |
$60.30
|
| Rate for Payer: First Health Workers Compensation |
$25.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$60.30
|
| Rate for Payer: GEHA Commercial |
$53.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$60.30
|
| Rate for Payer: Humana ChoiceCare |
$17.42
|
| Rate for Payer: Multiplan All |
$60.97
|
| Rate for Payer: New Mexico Health Connections Medicare |
$40.20
|
| Rate for Payer: OMNI Networks Commercial |
$46.90
|
| Rate for Payer: One Health Plan PPO/POS |
$60.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$63.65
|
| Rate for Payer: Three Rivers Provider Network All |
$50.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$58.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$62.31
|
| Rate for Payer: Zelis Auto |
$26.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$33.50
|
| Rate for Payer: Zelis Worker's Compensation |
$18.29
|
|
|
99211 NURSE`S VISIT ONLY
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
9399211
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$40.20
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$56.95
|
| Rate for Payer: First Health Commercial |
$60.30
|
| Rate for Payer: First Health Workers Compensation |
$25.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$60.30
|
| Rate for Payer: GEHA Commercial |
$53.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$60.30
|
| Rate for Payer: Humana ChoiceCare |
$17.42
|
| Rate for Payer: Multiplan All |
$60.97
|
| Rate for Payer: New Mexico Health Connections Medicare |
$40.20
|
| Rate for Payer: OMNI Networks Commercial |
$46.90
|
| Rate for Payer: One Health Plan PPO/POS |
$60.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$63.65
|
| Rate for Payer: Three Rivers Provider Network All |
$50.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$58.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$62.31
|
| Rate for Payer: Zelis Auto |
$26.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$33.50
|
| Rate for Payer: Zelis Worker's Compensation |
$18.29
|
|
|
99211 NURSE`S VISIT ONLY
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
9699211
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$36.58 |
| Max. Negotiated Rate |
$127.30 |
| Rate for Payer: Cash Price |
$80.40
|
| Rate for Payer: Cigna Commercial |
$113.90
|
| Rate for Payer: First Health Commercial |
$120.60
|
| Rate for Payer: First Health Workers Compensation |
$51.74
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$120.60
|
| Rate for Payer: GEHA Commercial |
$93.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$120.60
|
| Rate for Payer: Multiplan All |
$121.94
|
| Rate for Payer: OMNI Networks Commercial |
$93.80
|
| Rate for Payer: One Health Plan PPO/POS |
$120.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$127.30
|
| Rate for Payer: Three Rivers Provider Network All |
$100.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$124.62
|
| Rate for Payer: Zelis Auto |
$53.60
|
| Rate for Payer: Zelis Worker's Compensation |
$36.58
|
|
|
99211 NURSE`S VISIT ONLY
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
9599211
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$18.29 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$56.95
|
| Rate for Payer: First Health Commercial |
$60.30
|
| Rate for Payer: First Health Workers Compensation |
$25.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$60.30
|
| Rate for Payer: GEHA Commercial |
$46.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$60.30
|
| Rate for Payer: Multiplan All |
$60.97
|
| Rate for Payer: OMNI Networks Commercial |
$46.90
|
| Rate for Payer: One Health Plan PPO/POS |
$60.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$63.65
|
| Rate for Payer: Three Rivers Provider Network All |
$50.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$62.31
|
| Rate for Payer: Zelis Auto |
$26.80
|
| Rate for Payer: Zelis Worker's Compensation |
$18.29
|
|
|
99211 NURSE`S VISIT ONLY
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
9599211
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$40.20
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$56.95
|
| Rate for Payer: First Health Commercial |
$60.30
|
| Rate for Payer: First Health Workers Compensation |
$25.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$60.30
|
| Rate for Payer: GEHA Commercial |
$53.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$60.30
|
| Rate for Payer: Humana ChoiceCare |
$17.42
|
| Rate for Payer: Multiplan All |
$60.97
|
| Rate for Payer: New Mexico Health Connections Medicare |
$40.20
|
| Rate for Payer: OMNI Networks Commercial |
$46.90
|
| Rate for Payer: One Health Plan PPO/POS |
$60.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$63.65
|
| Rate for Payer: Three Rivers Provider Network All |
$50.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$58.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$62.31
|
| Rate for Payer: Zelis Auto |
$26.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$33.50
|
| Rate for Payer: Zelis Worker's Compensation |
$18.29
|
|
|
99211 NURSE`S VISIT ONLY
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
8599211
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$40.20
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$56.95
|
| Rate for Payer: First Health Commercial |
$60.30
|
| Rate for Payer: First Health Workers Compensation |
$25.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$60.30
|
| Rate for Payer: GEHA Commercial |
$53.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$60.30
|
| Rate for Payer: Humana ChoiceCare |
$17.42
|
| Rate for Payer: Multiplan All |
$60.97
|
| Rate for Payer: New Mexico Health Connections Medicare |
$40.20
|
| Rate for Payer: OMNI Networks Commercial |
$46.90
|
| Rate for Payer: One Health Plan PPO/POS |
$60.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$63.65
|
| Rate for Payer: Three Rivers Provider Network All |
$50.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$58.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$62.31
|
| Rate for Payer: Zelis Auto |
$26.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$33.50
|
| Rate for Payer: Zelis Worker's Compensation |
$18.29
|
|
|
99211 NURSE`S VISIT ONLY
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
11099211
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$39.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$19.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8.26
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$16.80
|
| Rate for Payer: Cimarron Advantage Cimarron Advantage PPO |
$11.56
|
| Rate for Payer: First Health Workers Compensation |
$39.15
|
| Rate for Payer: GEHA Commercial |
$8.26
|
| Rate for Payer: GEHA Medicare |
$8.26
|
| Rate for Payer: Health Net Federal Services Government |
$8.26
|
| Rate for Payer: HealthSmart Commercial |
$11.56
|
| Rate for Payer: HealthSmart Worker's Compensation |
$37.57
|
| Rate for Payer: Humana ChoiceCare |
$9.09
|
| Rate for Payer: Humana Medicare Advantage |
$8.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11.56
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$19.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8.26
|
| Rate for Payer: Multiplan All |
$21.00
|
| Rate for Payer: National Preferred Provider Network Commercial |
$26.60
|
| Rate for Payer: National Preferred Provider Network Worker's Compensation |
$39.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$8.67
|
| Rate for Payer: OMNI Networks Commercial |
$19.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$9.79
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7.09
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17.92
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.26
|
| Rate for Payer: Zelis Medicare |
$7.02
|
| Rate for Payer: Zelis Worker's Compensation |
$27.68
|
|
|
99211 NURSE`S VISIT ONLY
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
12099211
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$39.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$17.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8.68
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$19.30
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$8.26
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cigna Commercial |
$16.80
|
| Rate for Payer: Cimarron Advantage Cimarron Advantage PPO |
$11.56
|
| Rate for Payer: First Health Workers Compensation |
$39.15
|
| Rate for Payer: GEHA Commercial |
$8.26
|
| Rate for Payer: GEHA Medicare |
$8.26
|
| Rate for Payer: Health Net Federal Services Government |
$8.26
|
| Rate for Payer: HealthSmart Commercial |
$11.56
|
| Rate for Payer: HealthSmart Worker's Compensation |
$37.57
|
| Rate for Payer: Humana ChoiceCare |
$9.09
|
| Rate for Payer: Humana Medicare Advantage |
$8.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11.56
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$19.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$8.26
|
| Rate for Payer: Multiplan All |
$21.00
|
| Rate for Payer: National Preferred Provider Network Commercial |
$26.60
|
| Rate for Payer: National Preferred Provider Network Worker's Compensation |
$39.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$8.67
|
| Rate for Payer: OMNI Networks Commercial |
$19.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$9.79
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7.09
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$8.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$17.92
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.26
|
| Rate for Payer: Zelis Medicare |
$7.02
|
| Rate for Payer: Zelis Worker's Compensation |
$27.68
|
|
|
99211 NURSE`S VISIT ONLY
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
7699211
|
|
Hospital Revenue Code
|
511
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$40.20
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$56.95
|
| Rate for Payer: First Health Commercial |
$60.30
|
| Rate for Payer: First Health Workers Compensation |
$25.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$60.30
|
| Rate for Payer: GEHA Commercial |
$53.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$60.30
|
| Rate for Payer: Humana ChoiceCare |
$17.42
|
| Rate for Payer: Multiplan All |
$60.97
|
| Rate for Payer: New Mexico Health Connections Medicare |
$40.20
|
| Rate for Payer: OMNI Networks Commercial |
$46.90
|
| Rate for Payer: One Health Plan PPO/POS |
$60.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$63.65
|
| Rate for Payer: Three Rivers Provider Network All |
$50.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$58.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$62.31
|
| Rate for Payer: Zelis Auto |
$26.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$33.50
|
| Rate for Payer: Zelis Worker's Compensation |
$18.29
|
|
|
99211 NURSE`S VISIT ONLY
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
8699211
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$63.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$40.20
|
| Rate for Payer: Cash Price |
$40.20
|
| Rate for Payer: Cigna Commercial |
$56.95
|
| Rate for Payer: First Health Commercial |
$60.30
|
| Rate for Payer: First Health Workers Compensation |
$25.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$60.30
|
| Rate for Payer: GEHA Commercial |
$53.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$60.30
|
| Rate for Payer: Humana ChoiceCare |
$17.42
|
| Rate for Payer: Multiplan All |
$60.97
|
| Rate for Payer: New Mexico Health Connections Medicare |
$40.20
|
| Rate for Payer: OMNI Networks Commercial |
$46.90
|
| Rate for Payer: One Health Plan PPO/POS |
$60.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$63.65
|
| Rate for Payer: Three Rivers Provider Network All |
$50.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$58.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$16.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$62.31
|
| Rate for Payer: Zelis Auto |
$26.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$33.50
|
| Rate for Payer: Zelis Worker's Compensation |
$18.29
|
|
