|
DRAIN ABDOMINAL ABSCESS
|
Facility
|
OP
|
$3,346.00
|
|
|
Service Code
|
CPT 49020
|
| Hospital Charge Code |
6149020
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$836.50 |
| Max. Negotiated Rate |
$3,178.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,007.60
|
| Rate for Payer: Cash Price |
$2,007.60
|
| Rate for Payer: Cigna Commercial |
$2,844.10
|
| Rate for Payer: First Health Commercial |
$3,011.40
|
| Rate for Payer: First Health Workers Compensation |
$1,291.89
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,011.40
|
| Rate for Payer: GEHA Commercial |
$2,676.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,011.40
|
| Rate for Payer: Humana ChoiceCare |
$869.96
|
| Rate for Payer: Multiplan All |
$3,044.86
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,007.60
|
| Rate for Payer: OMNI Networks Commercial |
$2,342.20
|
| Rate for Payer: One Health Plan PPO/POS |
$3,011.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,178.70
|
| Rate for Payer: Three Rivers Provider Network All |
$2,509.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,944.48
|
| Rate for Payer: United Healthcare Managed Medicaid |
$836.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,111.78
|
| Rate for Payer: Zelis Auto |
$1,338.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,673.00
|
| Rate for Payer: Zelis Worker's Compensation |
$913.46
|
|
|
DRAIN ABDOMINAL ABSCESS
|
Facility
|
IP
|
$3,346.00
|
|
|
Service Code
|
CPT 49020
|
| Hospital Charge Code |
6149020
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$913.46 |
| Max. Negotiated Rate |
$3,178.70 |
| Rate for Payer: Cash Price |
$2,007.60
|
| Rate for Payer: Cigna Commercial |
$2,844.10
|
| Rate for Payer: First Health Commercial |
$3,011.40
|
| Rate for Payer: First Health Workers Compensation |
$1,291.89
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,011.40
|
| Rate for Payer: GEHA Commercial |
$2,342.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,011.40
|
| Rate for Payer: Multiplan All |
$3,044.86
|
| Rate for Payer: OMNI Networks Commercial |
$2,342.20
|
| Rate for Payer: One Health Plan PPO/POS |
$3,011.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,178.70
|
| Rate for Payer: Three Rivers Provider Network All |
$2,509.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,111.78
|
| Rate for Payer: Zelis Auto |
$1,338.40
|
| Rate for Payer: Zelis Worker's Compensation |
$913.46
|
|
|
DRAIN ABSCESS AUDITORY CANAL
|
Facility
|
IP
|
$1,125.00
|
|
| Hospital Charge Code |
8169020
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$307.12 |
| Max. Negotiated Rate |
$1,068.75 |
| Rate for Payer: Cash Price |
$675.00
|
| Rate for Payer: Cigna Commercial |
$956.25
|
| Rate for Payer: First Health Commercial |
$1,012.50
|
| Rate for Payer: First Health Workers Compensation |
$434.36
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,012.50
|
| Rate for Payer: GEHA Commercial |
$787.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,012.50
|
| Rate for Payer: Multiplan All |
$1,023.75
|
| Rate for Payer: OMNI Networks Commercial |
$787.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,012.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,068.75
|
| Rate for Payer: Three Rivers Provider Network All |
$843.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,046.25
|
| Rate for Payer: Zelis Auto |
$450.00
|
| Rate for Payer: Zelis Worker's Compensation |
$307.12
|
|
|
DRAIN ABSCESS AUDITORY CANAL
|
Facility
|
OP
|
$1,125.00
|
|
| Hospital Charge Code |
8169020
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$281.25 |
| Max. Negotiated Rate |
$1,068.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$675.00
|
| Rate for Payer: Cash Price |
$675.00
|
| Rate for Payer: Cigna Commercial |
$956.25
|
| Rate for Payer: First Health Commercial |
$1,012.50
|
| Rate for Payer: First Health Workers Compensation |
$434.36
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,012.50
|
| Rate for Payer: GEHA Commercial |
$900.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,012.50
|
| Rate for Payer: Humana ChoiceCare |
$292.50
|
| Rate for Payer: Multiplan All |
$1,023.75
|
| Rate for Payer: New Mexico Health Connections Medicare |
$675.00
|
| Rate for Payer: OMNI Networks Commercial |
$787.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,012.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,068.75
|
| Rate for Payer: Three Rivers Provider Network All |
$843.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$990.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$281.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,046.25
|
| Rate for Payer: Zelis Auto |
$450.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$562.50
|
| Rate for Payer: Zelis Worker's Compensation |
$307.12
|
|
|
DRAIN ABSCESS/HEMATOMA EXTERNAL EAR
|
Facility
|
IP
|
$1,057.00
|
|
| Hospital Charge Code |
8169000
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$288.56 |
| Max. Negotiated Rate |
$1,004.15 |
| Rate for Payer: Cash Price |
$634.20
|
| Rate for Payer: Cigna Commercial |
$898.45
|
| Rate for Payer: First Health Commercial |
$951.30
|
| Rate for Payer: First Health Workers Compensation |
$408.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$951.30
|
| Rate for Payer: GEHA Commercial |
$739.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$951.30
|
| Rate for Payer: Multiplan All |
$961.87
|
| Rate for Payer: OMNI Networks Commercial |
$739.90
|
| Rate for Payer: One Health Plan PPO/POS |
$951.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,004.15
|
| Rate for Payer: Three Rivers Provider Network All |
$792.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$983.01
|
| Rate for Payer: Zelis Auto |
$422.80
|
| Rate for Payer: Zelis Worker's Compensation |
$288.56
|
|
|
DRAIN ABSCESS/HEMATOMA EXTERNAL EAR
|
Facility
|
OP
|
$1,057.00
|
|
| Hospital Charge Code |
8169000
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$264.25 |
| Max. Negotiated Rate |
$1,004.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$634.20
|
| Rate for Payer: Cash Price |
$634.20
|
| Rate for Payer: Cigna Commercial |
$898.45
|
| Rate for Payer: First Health Commercial |
$951.30
|
| Rate for Payer: First Health Workers Compensation |
$408.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$951.30
|
| Rate for Payer: GEHA Commercial |
$845.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$951.30
|
| Rate for Payer: Humana ChoiceCare |
$274.82
|
| Rate for Payer: Multiplan All |
$961.87
|
| Rate for Payer: New Mexico Health Connections Medicare |
$634.20
|
| Rate for Payer: OMNI Networks Commercial |
$739.90
|
| Rate for Payer: One Health Plan PPO/POS |
$951.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,004.15
|
| Rate for Payer: Three Rivers Provider Network All |
$792.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$930.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$264.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$983.01
|
| Rate for Payer: Zelis Auto |
$422.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$528.50
|
| Rate for Payer: Zelis Worker's Compensation |
$288.56
|
|
|
DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM
|
Facility
|
IP
|
$4,676.00
|
|
| Hospital Charge Code |
8130020
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,276.55 |
| Max. Negotiated Rate |
$4,442.20 |
| Rate for Payer: Cash Price |
$2,805.60
|
| Rate for Payer: Cigna Commercial |
$3,974.60
|
| Rate for Payer: First Health Commercial |
$4,208.40
|
| Rate for Payer: First Health Workers Compensation |
$1,805.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,208.40
|
| Rate for Payer: GEHA Commercial |
$3,273.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,208.40
|
| Rate for Payer: Multiplan All |
$4,255.16
|
| Rate for Payer: OMNI Networks Commercial |
$3,273.20
|
| Rate for Payer: One Health Plan PPO/POS |
$4,208.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,442.20
|
| Rate for Payer: Three Rivers Provider Network All |
$3,507.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,348.68
|
| Rate for Payer: Zelis Auto |
$1,870.40
|
| Rate for Payer: Zelis Worker's Compensation |
$1,276.55
|
|
|
DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM
|
Facility
|
OP
|
$4,676.00
|
|
| Hospital Charge Code |
8130020
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,169.00 |
| Max. Negotiated Rate |
$4,442.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,805.60
|
| Rate for Payer: Cash Price |
$2,805.60
|
| Rate for Payer: Cigna Commercial |
$3,974.60
|
| Rate for Payer: First Health Commercial |
$4,208.40
|
| Rate for Payer: First Health Workers Compensation |
$1,805.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,208.40
|
| Rate for Payer: GEHA Commercial |
$3,740.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,208.40
|
| Rate for Payer: Humana ChoiceCare |
$1,215.76
|
| Rate for Payer: Multiplan All |
$4,255.16
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,805.60
|
| Rate for Payer: OMNI Networks Commercial |
$3,273.20
|
| Rate for Payer: One Health Plan PPO/POS |
$4,208.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,442.20
|
| Rate for Payer: Three Rivers Provider Network All |
$3,507.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4,114.88
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,169.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,348.68
|
| Rate for Payer: Zelis Auto |
$1,870.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,338.00
|
| Rate for Payer: Zelis Worker's Compensation |
$1,276.55
|
|
|
DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
OP
|
$3,640.00
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
8226011
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$993.72 |
| Max. Negotiated Rate |
$3,458.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,276.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,184.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,276.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,010.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,538.48
|
| Rate for Payer: Cash Price |
$2,184.00
|
| Rate for Payer: Cash Price |
$2,184.00
|
| Rate for Payer: Cigna Commercial |
$3,094.00
|
| Rate for Payer: First Health Commercial |
$3,276.00
|
| Rate for Payer: First Health Workers Compensation |
$1,405.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,276.00
|
| Rate for Payer: GEHA Commercial |
$2,912.00
|
| Rate for Payer: GEHA Medicare |
$1,538.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,276.00
|
| Rate for Payer: Humana ChoiceCare |
$1,692.33
|
| Rate for Payer: Humana Medicare Advantage |
$1,538.48
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,584.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,031.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,538.48
|
| Rate for Payer: Multiplan All |
$3,312.40
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,615.42
|
| Rate for Payer: OMNI Networks Commercial |
$2,548.00
|
| Rate for Payer: One Health Plan PPO/POS |
$3,276.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,191.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,031.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,538.48
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,458.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,076.96
|
| Rate for Payer: Three Rivers Provider Network All |
$2,730.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,507.71
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,031.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,538.48
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,385.20
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,538.48
|
| Rate for Payer: Zelis Auto |
$1,456.00
|
| Rate for Payer: Zelis Medicare |
$1,307.71
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,846.18
|
| Rate for Payer: Zelis Worker's Compensation |
$993.72
|
|
|
DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
IP
|
$3,640.00
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
8226011
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$993.72 |
| Max. Negotiated Rate |
$3,458.00 |
| Rate for Payer: Cash Price |
$2,184.00
|
| Rate for Payer: Cigna Commercial |
$3,094.00
|
| Rate for Payer: First Health Commercial |
$3,276.00
|
| Rate for Payer: First Health Workers Compensation |
$1,405.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,276.00
|
| Rate for Payer: GEHA Commercial |
$2,548.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,276.00
|
| Rate for Payer: Multiplan All |
$3,312.40
|
| Rate for Payer: OMNI Networks Commercial |
$2,548.00
|
| Rate for Payer: One Health Plan PPO/POS |
$3,276.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,458.00
|
| Rate for Payer: Three Rivers Provider Network All |
$2,730.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,385.20
|
| Rate for Payer: Zelis Auto |
$1,456.00
|
| Rate for Payer: Zelis Worker's Compensation |
$993.72
|
|
|
DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
OP
|
$3,640.00
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
8826011
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$993.72 |
| Max. Negotiated Rate |
$3,458.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,276.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,184.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,276.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,010.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,538.48
|
| Rate for Payer: Cash Price |
$2,184.00
|
| Rate for Payer: Cash Price |
$2,184.00
|
| Rate for Payer: Cigna Commercial |
$3,094.00
|
| Rate for Payer: First Health Commercial |
$3,276.00
|
| Rate for Payer: First Health Workers Compensation |
$1,405.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,276.00
|
| Rate for Payer: GEHA Commercial |
$2,912.00
|
| Rate for Payer: GEHA Medicare |
$1,538.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,276.00
|
| Rate for Payer: Humana ChoiceCare |
$1,692.33
|
| Rate for Payer: Humana Medicare Advantage |
$1,538.48
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,584.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,031.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,538.48
|
| Rate for Payer: Multiplan All |
$3,312.40
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,615.42
|
| Rate for Payer: OMNI Networks Commercial |
$2,548.00
|
| Rate for Payer: One Health Plan PPO/POS |
$3,276.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,191.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,031.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,538.48
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,458.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,076.96
|
| Rate for Payer: Three Rivers Provider Network All |
$2,730.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,507.71
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,031.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,538.48
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,385.20
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,538.48
|
| Rate for Payer: Zelis Auto |
$1,456.00
|
| Rate for Payer: Zelis Medicare |
$1,307.71
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,846.18
|
| Rate for Payer: Zelis Worker's Compensation |
$993.72
|
|
|
DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
IP
|
$3,640.00
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
8826011
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$993.72 |
| Max. Negotiated Rate |
$3,458.00 |
| Rate for Payer: Cash Price |
$2,184.00
|
| Rate for Payer: Cigna Commercial |
$3,094.00
|
| Rate for Payer: First Health Commercial |
$3,276.00
|
| Rate for Payer: First Health Workers Compensation |
$1,405.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,276.00
|
| Rate for Payer: GEHA Commercial |
$2,548.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,276.00
|
| Rate for Payer: Multiplan All |
$3,312.40
|
| Rate for Payer: OMNI Networks Commercial |
$2,548.00
|
| Rate for Payer: One Health Plan PPO/POS |
$3,276.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,458.00
|
| Rate for Payer: Three Rivers Provider Network All |
$2,730.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,385.20
|
| Rate for Payer: Zelis Auto |
$1,456.00
|
| Rate for Payer: Zelis Worker's Compensation |
$993.72
|
|
|
DRAINAGE OF ABDOMEN
|
Facility
|
OP
|
$3,943.00
|
|
|
Service Code
|
CPT 48000
|
| Hospital Charge Code |
6148000
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$985.75 |
| Max. Negotiated Rate |
$3,745.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,365.80
|
| Rate for Payer: Cash Price |
$2,365.80
|
| Rate for Payer: Cigna Commercial |
$3,351.55
|
| Rate for Payer: First Health Commercial |
$3,548.70
|
| Rate for Payer: First Health Workers Compensation |
$1,522.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,548.70
|
| Rate for Payer: GEHA Commercial |
$3,154.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,548.70
|
| Rate for Payer: Humana ChoiceCare |
$1,025.18
|
| Rate for Payer: Multiplan All |
$3,588.13
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,365.80
|
| Rate for Payer: OMNI Networks Commercial |
$2,760.10
|
| Rate for Payer: One Health Plan PPO/POS |
$3,548.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,745.85
|
| Rate for Payer: Three Rivers Provider Network All |
$2,957.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,469.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$985.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,666.99
|
| Rate for Payer: Zelis Auto |
$1,577.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,971.50
|
| Rate for Payer: Zelis Worker's Compensation |
$1,076.44
|
|
|
DRAINAGE OF ABDOMEN
|
Facility
|
IP
|
$3,943.00
|
|
|
Service Code
|
CPT 48000
|
| Hospital Charge Code |
6148000
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,076.44 |
| Max. Negotiated Rate |
$3,745.85 |
| Rate for Payer: Cash Price |
$2,365.80
|
| Rate for Payer: Cigna Commercial |
$3,351.55
|
| Rate for Payer: First Health Commercial |
$3,548.70
|
| Rate for Payer: First Health Workers Compensation |
$1,522.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,548.70
|
| Rate for Payer: GEHA Commercial |
$2,760.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,548.70
|
| Rate for Payer: Multiplan All |
$3,588.13
|
| Rate for Payer: OMNI Networks Commercial |
$2,760.10
|
| Rate for Payer: One Health Plan PPO/POS |
$3,548.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,745.85
|
| Rate for Payer: Three Rivers Provider Network All |
$2,957.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,666.99
|
| Rate for Payer: Zelis Auto |
$1,577.20
|
| Rate for Payer: Zelis Worker's Compensation |
$1,076.44
|
|
|
DRAINAGE OF ARM BURSA
|
Facility
|
IP
|
$479.00
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
6123931
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$130.77 |
| Max. Negotiated Rate |
$455.05 |
| Rate for Payer: Cash Price |
$287.40
|
| Rate for Payer: Cigna Commercial |
$407.15
|
| Rate for Payer: First Health Commercial |
$431.10
|
| Rate for Payer: First Health Workers Compensation |
$184.94
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$431.10
|
| Rate for Payer: GEHA Commercial |
$335.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$431.10
|
| Rate for Payer: Multiplan All |
$435.89
|
| Rate for Payer: OMNI Networks Commercial |
$335.30
|
| Rate for Payer: One Health Plan PPO/POS |
$431.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$455.05
|
| Rate for Payer: Three Rivers Provider Network All |
$359.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$445.47
|
| Rate for Payer: Zelis Auto |
$191.60
|
| Rate for Payer: Zelis Worker's Compensation |
$130.77
|
|
|
DRAINAGE OF ARM BURSA
|
Facility
|
OP
|
$479.00
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
6123931
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$130.77 |
| Max. Negotiated Rate |
$3,076.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,962.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$287.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,962.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,554.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,538.48
|
| Rate for Payer: Cash Price |
$287.40
|
| Rate for Payer: Cash Price |
$287.40
|
| Rate for Payer: Cigna Commercial |
$407.15
|
| Rate for Payer: First Health Commercial |
$431.10
|
| Rate for Payer: First Health Workers Compensation |
$184.94
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$431.10
|
| Rate for Payer: GEHA Commercial |
$383.20
|
| Rate for Payer: GEHA Medicare |
$1,538.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$431.10
|
| Rate for Payer: Humana ChoiceCare |
$1,692.33
|
| Rate for Payer: Humana Medicare Advantage |
$1,538.48
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,584.65
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,586.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,538.48
|
| Rate for Payer: Multiplan All |
$435.89
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,615.42
|
| Rate for Payer: OMNI Networks Commercial |
$335.30
|
| Rate for Payer: One Health Plan PPO/POS |
$431.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,831.34
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,586.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,538.48
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$455.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,076.96
|
| Rate for Payer: Three Rivers Provider Network All |
$359.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,507.71
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,586.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,538.48
|
| Rate for Payer: United Payors & United Providers UP&UP |
$445.47
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,538.48
|
| Rate for Payer: Zelis Auto |
$191.60
|
| Rate for Payer: Zelis Medicare |
$1,307.71
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,846.18
|
| Rate for Payer: Zelis Worker's Compensation |
$130.77
|
|
|
DRAINAGE OF ARM LESION
|
Facility
|
OP
|
$554.00
|
|
|
Service Code
|
CPT 23930
|
| Hospital Charge Code |
6123930
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$151.24 |
| Max. Negotiated Rate |
$5,435.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,962.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$332.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,962.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,554.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,717.63
|
| Rate for Payer: Cash Price |
$332.40
|
| Rate for Payer: Cash Price |
$332.40
|
| Rate for Payer: Cigna Commercial |
$470.90
|
| Rate for Payer: First Health Commercial |
$498.60
|
| Rate for Payer: First Health Workers Compensation |
$213.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$498.60
|
| Rate for Payer: GEHA Commercial |
$443.20
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$498.60
|
| Rate for Payer: Humana ChoiceCare |
$2,989.39
|
| Rate for Payer: Humana Medicare Advantage |
$2,717.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,565.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,586.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,717.63
|
| Rate for Payer: Multiplan All |
$504.14
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$387.80
|
| Rate for Payer: One Health Plan PPO/POS |
$498.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,831.34
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,586.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,717.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$526.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$415.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,663.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,586.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,717.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$515.22
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$221.60
|
| Rate for Payer: Zelis Medicare |
$2,309.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,261.16
|
| Rate for Payer: Zelis Worker's Compensation |
$151.24
|
|
|
DRAINAGE OF ARM LESION
|
Facility
|
IP
|
$554.00
|
|
|
Service Code
|
CPT 23930
|
| Hospital Charge Code |
6123930
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$151.24 |
| Max. Negotiated Rate |
$526.30 |
| Rate for Payer: Cash Price |
$332.40
|
| Rate for Payer: Cigna Commercial |
$470.90
|
| Rate for Payer: First Health Commercial |
$498.60
|
| Rate for Payer: First Health Workers Compensation |
$213.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$498.60
|
| Rate for Payer: GEHA Commercial |
$387.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$498.60
|
| Rate for Payer: Multiplan All |
$504.14
|
| Rate for Payer: OMNI Networks Commercial |
$387.80
|
| Rate for Payer: One Health Plan PPO/POS |
$498.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$526.30
|
| Rate for Payer: Three Rivers Provider Network All |
$415.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$515.22
|
| Rate for Payer: Zelis Auto |
$221.60
|
| Rate for Payer: Zelis Worker's Compensation |
$151.24
|
|
|
DRAINAGE OF BLADDER ABSCESS
|
Facility
|
OP
|
$839.00
|
|
|
Service Code
|
CPT 51080
|
| Hospital Charge Code |
6151080
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$229.05 |
| Max. Negotiated Rate |
$5,435.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,962.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$503.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,962.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,554.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,717.63
|
| Rate for Payer: Cash Price |
$503.40
|
| Rate for Payer: Cash Price |
$503.40
|
| Rate for Payer: Cigna Commercial |
$713.15
|
| Rate for Payer: First Health Commercial |
$755.10
|
| Rate for Payer: First Health Workers Compensation |
$323.94
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$755.10
|
| Rate for Payer: GEHA Commercial |
$671.20
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$755.10
|
| Rate for Payer: Humana ChoiceCare |
$2,989.39
|
| Rate for Payer: Humana Medicare Advantage |
$2,717.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,565.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,586.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,717.63
|
| Rate for Payer: Multiplan All |
$763.49
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$587.30
|
| Rate for Payer: One Health Plan PPO/POS |
$755.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,831.34
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,586.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,717.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$797.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$629.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,663.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,586.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,717.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$780.27
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$335.60
|
| Rate for Payer: Zelis Medicare |
$2,309.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,261.16
|
| Rate for Payer: Zelis Worker's Compensation |
$229.05
|
|
|
DRAINAGE OF BLADDER ABSCESS
|
Facility
|
IP
|
$839.00
|
|
|
Service Code
|
CPT 51080
|
| Hospital Charge Code |
6151080
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$229.05 |
| Max. Negotiated Rate |
$797.05 |
| Rate for Payer: Cash Price |
$503.40
|
| Rate for Payer: Cigna Commercial |
$713.15
|
| Rate for Payer: First Health Commercial |
$755.10
|
| Rate for Payer: First Health Workers Compensation |
$323.94
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$755.10
|
| Rate for Payer: GEHA Commercial |
$587.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$755.10
|
| Rate for Payer: Multiplan All |
$763.49
|
| Rate for Payer: OMNI Networks Commercial |
$587.30
|
| Rate for Payer: One Health Plan PPO/POS |
$755.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$797.05
|
| Rate for Payer: Three Rivers Provider Network All |
$629.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$780.27
|
| Rate for Payer: Zelis Auto |
$335.60
|
| Rate for Payer: Zelis Worker's Compensation |
$229.05
|
|
|
DRAINAGE OF BONE LESION
|
Facility
|
IP
|
$927.00
|
|
|
Service Code
|
CPT 21510
|
| Hospital Charge Code |
6121510
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$253.07 |
| Max. Negotiated Rate |
$880.65 |
| Rate for Payer: Cash Price |
$556.20
|
| Rate for Payer: Cigna Commercial |
$787.95
|
| Rate for Payer: First Health Commercial |
$834.30
|
| Rate for Payer: First Health Workers Compensation |
$357.91
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$834.30
|
| Rate for Payer: GEHA Commercial |
$648.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$834.30
|
| Rate for Payer: Multiplan All |
$843.57
|
| Rate for Payer: OMNI Networks Commercial |
$648.90
|
| Rate for Payer: One Health Plan PPO/POS |
$834.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$880.65
|
| Rate for Payer: Three Rivers Provider Network All |
$695.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$862.11
|
| Rate for Payer: Zelis Auto |
$370.80
|
| Rate for Payer: Zelis Worker's Compensation |
$253.07
|
|
|
DRAINAGE OF BONE LESION
|
Facility
|
OP
|
$927.00
|
|
|
Service Code
|
CPT 21510
|
| Hospital Charge Code |
6121510
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$231.75 |
| Max. Negotiated Rate |
$880.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$556.20
|
| Rate for Payer: Cash Price |
$556.20
|
| Rate for Payer: Cigna Commercial |
$787.95
|
| Rate for Payer: First Health Commercial |
$834.30
|
| Rate for Payer: First Health Workers Compensation |
$357.91
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$834.30
|
| Rate for Payer: GEHA Commercial |
$741.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$834.30
|
| Rate for Payer: Humana ChoiceCare |
$241.02
|
| Rate for Payer: Multiplan All |
$843.57
|
| Rate for Payer: New Mexico Health Connections Medicare |
$556.20
|
| Rate for Payer: OMNI Networks Commercial |
$648.90
|
| Rate for Payer: One Health Plan PPO/POS |
$834.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$880.65
|
| Rate for Payer: Three Rivers Provider Network All |
$695.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$815.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$231.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$862.11
|
| Rate for Payer: Zelis Auto |
$370.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$463.50
|
| Rate for Payer: Zelis Worker's Compensation |
$253.07
|
|
|
DRAINAGE OF BONE LESION
|
Facility
|
IP
|
$1,304.00
|
|
|
Service Code
|
CPT 27303
|
| Hospital Charge Code |
6127303
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$355.99 |
| Max. Negotiated Rate |
$1,238.80 |
| Rate for Payer: Cash Price |
$782.40
|
| Rate for Payer: Cigna Commercial |
$1,108.40
|
| Rate for Payer: First Health Commercial |
$1,173.60
|
| Rate for Payer: First Health Workers Compensation |
$503.47
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,173.60
|
| Rate for Payer: GEHA Commercial |
$912.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,173.60
|
| Rate for Payer: Multiplan All |
$1,186.64
|
| Rate for Payer: OMNI Networks Commercial |
$912.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,173.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,238.80
|
| Rate for Payer: Three Rivers Provider Network All |
$978.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,212.72
|
| Rate for Payer: Zelis Auto |
$521.60
|
| Rate for Payer: Zelis Worker's Compensation |
$355.99
|
|
|
DRAINAGE OF BONE LESION
|
Facility
|
OP
|
$1,304.00
|
|
|
Service Code
|
CPT 27303
|
| Hospital Charge Code |
6127303
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$326.00 |
| Max. Negotiated Rate |
$1,238.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$782.40
|
| Rate for Payer: Cash Price |
$782.40
|
| Rate for Payer: Cigna Commercial |
$1,108.40
|
| Rate for Payer: First Health Commercial |
$1,173.60
|
| Rate for Payer: First Health Workers Compensation |
$503.47
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,173.60
|
| Rate for Payer: GEHA Commercial |
$1,043.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,173.60
|
| Rate for Payer: Humana ChoiceCare |
$339.04
|
| Rate for Payer: Multiplan All |
$1,186.64
|
| Rate for Payer: New Mexico Health Connections Medicare |
$782.40
|
| Rate for Payer: OMNI Networks Commercial |
$912.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,173.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,238.80
|
| Rate for Payer: Three Rivers Provider Network All |
$978.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,147.52
|
| Rate for Payer: United Healthcare Managed Medicaid |
$326.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,212.72
|
| Rate for Payer: Zelis Auto |
$521.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$652.00
|
| Rate for Payer: Zelis Worker's Compensation |
$355.99
|
|
|
DRAINAGE OF BONE LESION
|
Facility
|
OP
|
$1,965.00
|
|
|
Service Code
|
CPT 26992
|
| Hospital Charge Code |
6126992
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$491.25 |
| Max. Negotiated Rate |
$1,866.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,179.00
|
| Rate for Payer: Cash Price |
$1,179.00
|
| Rate for Payer: Cigna Commercial |
$1,670.25
|
| Rate for Payer: First Health Commercial |
$1,768.50
|
| Rate for Payer: First Health Workers Compensation |
$758.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,768.50
|
| Rate for Payer: GEHA Commercial |
$1,572.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,768.50
|
| Rate for Payer: Humana ChoiceCare |
$510.90
|
| Rate for Payer: Multiplan All |
$1,788.15
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,179.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,375.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,768.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,866.75
|
| Rate for Payer: Three Rivers Provider Network All |
$1,473.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,729.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$491.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,827.45
|
| Rate for Payer: Zelis Auto |
$786.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$982.50
|
| Rate for Payer: Zelis Worker's Compensation |
$536.45
|
|
