|
EXCISION INTERDIGITAL MORTON NEUROMA SIN
|
Facility
|
OP
|
$7,522.50
|
|
|
Service Code
|
CPT 28080
|
| Hospital Charge Code |
1928080
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,318.15 |
| Max. Negotiated Rate |
$7,146.38 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,208.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,513.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,208.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,749.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,550.77
|
| Rate for Payer: Cash Price |
$4,513.50
|
| Rate for Payer: Cash Price |
$4,513.50
|
| Rate for Payer: Cigna Commercial |
$6,394.12
|
| Rate for Payer: First Health Commercial |
$6,770.25
|
| Rate for Payer: First Health Workers Compensation |
$2,904.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6,770.25
|
| Rate for Payer: GEHA Commercial |
$6,018.00
|
| Rate for Payer: GEHA Medicare |
$1,550.77
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6,770.25
|
| Rate for Payer: Humana ChoiceCare |
$1,705.85
|
| Rate for Payer: Humana Medicare Advantage |
$1,550.77
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,605.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,785.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,550.77
|
| Rate for Payer: Multiplan All |
$6,845.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,636.31
|
| Rate for Payer: OMNI Networks Commercial |
$5,265.75
|
| Rate for Payer: One Health Plan PPO/POS |
$6,770.25
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,061.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,785.30
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,550.77
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$7,146.38
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,101.54
|
| Rate for Payer: Three Rivers Provider Network All |
$5,641.88
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,519.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,785.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,550.77
|
| Rate for Payer: United Payors & United Providers UP&UP |
$6,995.93
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,550.77
|
| Rate for Payer: Zelis Auto |
$3,009.00
|
| Rate for Payer: Zelis Medicare |
$1,318.15
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,860.92
|
| Rate for Payer: Zelis Worker's Compensation |
$2,053.64
|
|
|
EXCISION INTERDIGITAL MORTON NEUROMA SIN
|
Facility
|
IP
|
$7,522.50
|
|
|
Service Code
|
CPT 28080
|
| Hospital Charge Code |
1928080
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,053.64 |
| Max. Negotiated Rate |
$7,146.38 |
| Rate for Payer: Cash Price |
$4,513.50
|
| Rate for Payer: Cigna Commercial |
$6,394.12
|
| Rate for Payer: First Health Commercial |
$6,770.25
|
| Rate for Payer: First Health Workers Compensation |
$2,904.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6,770.25
|
| Rate for Payer: GEHA Commercial |
$5,265.75
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6,770.25
|
| Rate for Payer: Multiplan All |
$6,845.48
|
| Rate for Payer: OMNI Networks Commercial |
$5,265.75
|
| Rate for Payer: One Health Plan PPO/POS |
$6,770.25
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$7,146.38
|
| Rate for Payer: Three Rivers Provider Network All |
$5,641.88
|
| Rate for Payer: United Payors & United Providers UP&UP |
$6,995.93
|
| Rate for Payer: Zelis Auto |
$3,009.00
|
| Rate for Payer: Zelis Worker's Compensation |
$2,053.64
|
|
|
EXCISION LEG/ANKLE TUMOR < 3CM
|
Facility
|
OP
|
$910.83
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
8227618
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$248.66 |
| Max. Negotiated Rate |
$3,139.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,769.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$546.50
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,769.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,401.53
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,569.98
|
| Rate for Payer: Cash Price |
$546.50
|
| Rate for Payer: Cash Price |
$546.50
|
| Rate for Payer: Cigna Commercial |
$774.21
|
| Rate for Payer: First Health Commercial |
$819.75
|
| Rate for Payer: First Health Workers Compensation |
$351.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$819.75
|
| Rate for Payer: GEHA Commercial |
$728.66
|
| Rate for Payer: GEHA Medicare |
$1,569.98
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$819.75
|
| Rate for Payer: Humana ChoiceCare |
$1,726.98
|
| Rate for Payer: Humana Medicare Advantage |
$1,569.98
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,637.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,430.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,569.98
|
| Rate for Payer: Multiplan All |
$828.86
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,668.97
|
| Rate for Payer: OMNI Networks Commercial |
$637.58
|
| Rate for Payer: One Health Plan PPO/POS |
$819.75
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,651.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,430.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,569.98
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$865.29
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,139.96
|
| Rate for Payer: Three Rivers Provider Network All |
$683.12
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,538.58
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,430.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,569.98
|
| Rate for Payer: United Payors & United Providers UP&UP |
$847.07
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,569.98
|
| Rate for Payer: Zelis Auto |
$364.33
|
| Rate for Payer: Zelis Medicare |
$1,334.48
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,883.98
|
| Rate for Payer: Zelis Worker's Compensation |
$248.66
|
|
|
EXCISION LEG/ANKLE TUMOR < 3CM
|
Facility
|
IP
|
$910.83
|
|
|
Service Code
|
CPT 27618
|
| Hospital Charge Code |
8227618
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$248.66 |
| Max. Negotiated Rate |
$865.29 |
| Rate for Payer: Cash Price |
$546.50
|
| Rate for Payer: Cigna Commercial |
$774.21
|
| Rate for Payer: First Health Commercial |
$819.75
|
| Rate for Payer: First Health Workers Compensation |
$351.67
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$819.75
|
| Rate for Payer: GEHA Commercial |
$637.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$819.75
|
| Rate for Payer: Multiplan All |
$828.86
|
| Rate for Payer: OMNI Networks Commercial |
$637.58
|
| Rate for Payer: One Health Plan PPO/POS |
$819.75
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$865.29
|
| Rate for Payer: Three Rivers Provider Network All |
$683.12
|
| Rate for Payer: United Payors & United Providers UP&UP |
$847.07
|
| Rate for Payer: Zelis Auto |
$364.33
|
| Rate for Payer: Zelis Worker's Compensation |
$248.66
|
|
|
EXCISION LESION MOUTH ROOF
|
Facility
|
IP
|
$432.00
|
|
|
Service Code
|
CPT 42104
|
| Hospital Charge Code |
6142104
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$117.94 |
| Max. Negotiated Rate |
$410.40 |
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cigna Commercial |
$367.20
|
| Rate for Payer: First Health Commercial |
$388.80
|
| Rate for Payer: First Health Workers Compensation |
$166.80
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$388.80
|
| Rate for Payer: GEHA Commercial |
$302.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$388.80
|
| Rate for Payer: Multiplan All |
$393.12
|
| Rate for Payer: OMNI Networks Commercial |
$302.40
|
| Rate for Payer: One Health Plan PPO/POS |
$388.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$410.40
|
| Rate for Payer: Three Rivers Provider Network All |
$324.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$401.76
|
| Rate for Payer: Zelis Auto |
$172.80
|
| Rate for Payer: Zelis Worker's Compensation |
$117.94
|
|
|
EXCISION LESION MOUTH ROOF
|
Facility
|
OP
|
$432.00
|
|
|
Service Code
|
CPT 42104
|
| Hospital Charge Code |
6142104
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$117.94 |
| Max. Negotiated Rate |
$6,284.94 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,737.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$259.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,737.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,376.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,142.47
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cigna Commercial |
$367.20
|
| Rate for Payer: First Health Commercial |
$388.80
|
| Rate for Payer: First Health Workers Compensation |
$166.80
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$388.80
|
| Rate for Payer: GEHA Commercial |
$345.60
|
| Rate for Payer: GEHA Medicare |
$3,142.47
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$388.80
|
| Rate for Payer: Humana ChoiceCare |
$3,456.72
|
| Rate for Payer: Humana Medicare Advantage |
$3,142.47
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,279.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,404.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,142.47
|
| Rate for Payer: Multiplan All |
$393.12
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,342.20
|
| Rate for Payer: OMNI Networks Commercial |
$302.40
|
| Rate for Payer: One Health Plan PPO/POS |
$388.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,622.00
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,404.77
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,142.47
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$410.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,284.94
|
| Rate for Payer: Three Rivers Provider Network All |
$324.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,079.62
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,404.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,142.47
|
| Rate for Payer: United Payors & United Providers UP&UP |
$401.76
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,142.47
|
| Rate for Payer: Zelis Auto |
$172.80
|
| Rate for Payer: Zelis Medicare |
$2,671.10
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,770.96
|
| Rate for Payer: Zelis Worker's Compensation |
$117.94
|
|
|
EXCISION MALIGNANT LESION S/N/H/F/G >4.0
|
Facility
|
OP
|
$926.00
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
6111626
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$5,546.54 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,364.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$555.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,364.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,873.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,773.27
|
| Rate for Payer: Cash Price |
$555.60
|
| Rate for Payer: Cash Price |
$555.60
|
| Rate for Payer: Cigna Commercial |
$787.10
|
| Rate for Payer: First Health Commercial |
$833.40
|
| Rate for Payer: First Health Workers Compensation |
$357.53
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$833.40
|
| Rate for Payer: GEHA Commercial |
$740.80
|
| Rate for Payer: GEHA Medicare |
$2,773.27
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$833.40
|
| Rate for Payer: Humana ChoiceCare |
$3,050.60
|
| Rate for Payer: Humana Medicare Advantage |
$2,773.27
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,659.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,911.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,773.27
|
| Rate for Payer: Multiplan All |
$842.66
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,714.56
|
| Rate for Payer: OMNI Networks Commercial |
$648.20
|
| Rate for Payer: One Health Plan PPO/POS |
$833.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,207.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,911.49
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,773.27
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$879.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,546.54
|
| Rate for Payer: Three Rivers Provider Network All |
$694.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,717.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,911.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,773.27
|
| Rate for Payer: United Payors & United Providers UP&UP |
$861.18
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,773.27
|
| Rate for Payer: Zelis Auto |
$370.40
|
| Rate for Payer: Zelis Medicare |
$2,357.28
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,327.92
|
| Rate for Payer: Zelis Worker's Compensation |
$252.80
|
|
|
EXCISION MALIGNANT LESION S/N/H/F/G >4.0
|
Facility
|
IP
|
$1,245.00
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
20399229
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$339.88 |
| Max. Negotiated Rate |
$1,182.75 |
| Rate for Payer: Cash Price |
$747.00
|
| Rate for Payer: Cigna Commercial |
$1,058.25
|
| Rate for Payer: First Health Commercial |
$1,120.50
|
| Rate for Payer: First Health Workers Compensation |
$480.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,120.50
|
| Rate for Payer: GEHA Commercial |
$871.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,120.50
|
| Rate for Payer: Multiplan All |
$1,132.95
|
| Rate for Payer: OMNI Networks Commercial |
$871.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,120.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,182.75
|
| Rate for Payer: Three Rivers Provider Network All |
$933.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,157.85
|
| Rate for Payer: Zelis Auto |
$498.00
|
| Rate for Payer: Zelis Worker's Compensation |
$339.88
|
|
|
EXCISION MALIGNANT LESION S/N/H/F/G >4.0
|
Facility
|
OP
|
$1,245.00
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
20399229
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$339.88 |
| Max. Negotiated Rate |
$5,546.54 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,364.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$747.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,364.74
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,873.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,773.27
|
| Rate for Payer: Cash Price |
$747.00
|
| Rate for Payer: Cash Price |
$747.00
|
| Rate for Payer: Cigna Commercial |
$1,058.25
|
| Rate for Payer: First Health Commercial |
$1,120.50
|
| Rate for Payer: First Health Workers Compensation |
$480.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,120.50
|
| Rate for Payer: GEHA Commercial |
$996.00
|
| Rate for Payer: GEHA Medicare |
$2,773.27
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,120.50
|
| Rate for Payer: Humana ChoiceCare |
$3,050.60
|
| Rate for Payer: Humana Medicare Advantage |
$2,773.27
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,659.09
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,911.49
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,773.27
|
| Rate for Payer: Multiplan All |
$1,132.95
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,714.56
|
| Rate for Payer: OMNI Networks Commercial |
$871.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,120.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,207.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,911.49
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,773.27
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,182.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,546.54
|
| Rate for Payer: Three Rivers Provider Network All |
$933.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,717.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,911.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,773.27
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,157.85
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,773.27
|
| Rate for Payer: Zelis Auto |
$498.00
|
| Rate for Payer: Zelis Medicare |
$2,357.28
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,327.92
|
| Rate for Payer: Zelis Worker's Compensation |
$339.88
|
|
|
EXCISION MALIGNANT LESION S/N/H/F/G >4.0
|
Facility
|
IP
|
$926.00
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
6111626
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$879.70 |
| Rate for Payer: Cash Price |
$555.60
|
| Rate for Payer: Cigna Commercial |
$787.10
|
| Rate for Payer: First Health Commercial |
$833.40
|
| Rate for Payer: First Health Workers Compensation |
$357.53
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$833.40
|
| Rate for Payer: GEHA Commercial |
$648.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$833.40
|
| Rate for Payer: Multiplan All |
$842.66
|
| Rate for Payer: OMNI Networks Commercial |
$648.20
|
| Rate for Payer: One Health Plan PPO/POS |
$833.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$879.70
|
| Rate for Payer: Three Rivers Provider Network All |
$694.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$861.18
|
| Rate for Payer: Zelis Auto |
$370.40
|
| Rate for Payer: Zelis Worker's Compensation |
$252.80
|
|
|
EXCISION MALIGNANT LESION S/N/H/F/G .6-1
|
Facility
|
IP
|
$466.00
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
6111621
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$127.22 |
| Max. Negotiated Rate |
$442.70 |
| Rate for Payer: Cash Price |
$279.60
|
| Rate for Payer: Cigna Commercial |
$396.10
|
| Rate for Payer: First Health Commercial |
$419.40
|
| Rate for Payer: First Health Workers Compensation |
$179.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$419.40
|
| Rate for Payer: GEHA Commercial |
$326.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$419.40
|
| Rate for Payer: Multiplan All |
$424.06
|
| Rate for Payer: OMNI Networks Commercial |
$326.20
|
| Rate for Payer: One Health Plan PPO/POS |
$419.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$442.70
|
| Rate for Payer: Three Rivers Provider Network All |
$349.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$433.38
|
| Rate for Payer: Zelis Auto |
$186.40
|
| Rate for Payer: Zelis Worker's Compensation |
$127.22
|
|
|
EXCISION MALIGNANT LESION S/N/H/F/G .6-1
|
Facility
|
IP
|
$691.00
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
9400088
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$188.64 |
| Max. Negotiated Rate |
$656.45 |
| Rate for Payer: Cash Price |
$414.60
|
| Rate for Payer: Cigna Commercial |
$587.35
|
| Rate for Payer: First Health Commercial |
$621.90
|
| Rate for Payer: First Health Workers Compensation |
$266.80
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$621.90
|
| Rate for Payer: GEHA Commercial |
$483.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$621.90
|
| Rate for Payer: Multiplan All |
$628.81
|
| Rate for Payer: OMNI Networks Commercial |
$483.70
|
| Rate for Payer: One Health Plan PPO/POS |
$621.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$656.45
|
| Rate for Payer: Three Rivers Provider Network All |
$518.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$642.63
|
| Rate for Payer: Zelis Auto |
$276.40
|
| Rate for Payer: Zelis Worker's Compensation |
$188.64
|
|
|
EXCISION MALIGNANT LESION S/N/H/F/G .6-1
|
Facility
|
OP
|
$691.00
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
9400088
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$188.64 |
| Max. Negotiated Rate |
$1,363.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$441.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$414.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$441.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$349.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$681.76
|
| Rate for Payer: Cash Price |
$414.60
|
| Rate for Payer: Cash Price |
$414.60
|
| Rate for Payer: Cigna Commercial |
$587.35
|
| Rate for Payer: First Health Commercial |
$621.90
|
| Rate for Payer: First Health Workers Compensation |
$266.80
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$621.90
|
| Rate for Payer: GEHA Commercial |
$552.80
|
| Rate for Payer: GEHA Medicare |
$681.76
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$621.90
|
| Rate for Payer: Humana ChoiceCare |
$749.94
|
| Rate for Payer: Humana Medicare Advantage |
$681.76
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,145.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$356.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$681.76
|
| Rate for Payer: Multiplan All |
$628.81
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,158.99
|
| Rate for Payer: OMNI Networks Commercial |
$483.70
|
| Rate for Payer: One Health Plan PPO/POS |
$621.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$411.68
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$356.55
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$681.76
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$656.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,363.52
|
| Rate for Payer: Three Rivers Provider Network All |
$518.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$668.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$356.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$681.76
|
| Rate for Payer: United Payors & United Providers UP&UP |
$642.63
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$681.76
|
| Rate for Payer: Zelis Auto |
$276.40
|
| Rate for Payer: Zelis Medicare |
$579.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$818.11
|
| Rate for Payer: Zelis Worker's Compensation |
$188.64
|
|
|
EXCISION MALIGNANT LESION S/N/H/F/G .6-1
|
Facility
|
OP
|
$466.00
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
6111621
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$127.22 |
| Max. Negotiated Rate |
$1,363.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$441.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$279.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$441.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$349.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$681.76
|
| Rate for Payer: Cash Price |
$279.60
|
| Rate for Payer: Cash Price |
$279.60
|
| Rate for Payer: Cigna Commercial |
$396.10
|
| Rate for Payer: First Health Commercial |
$419.40
|
| Rate for Payer: First Health Workers Compensation |
$179.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$419.40
|
| Rate for Payer: GEHA Commercial |
$372.80
|
| Rate for Payer: GEHA Medicare |
$681.76
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$419.40
|
| Rate for Payer: Humana ChoiceCare |
$749.94
|
| Rate for Payer: Humana Medicare Advantage |
$681.76
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,145.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$356.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$681.76
|
| Rate for Payer: Multiplan All |
$424.06
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,158.99
|
| Rate for Payer: OMNI Networks Commercial |
$326.20
|
| Rate for Payer: One Health Plan PPO/POS |
$419.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$411.68
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$356.55
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$681.76
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$442.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,363.52
|
| Rate for Payer: Three Rivers Provider Network All |
$349.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$668.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$356.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$681.76
|
| Rate for Payer: United Payors & United Providers UP&UP |
$433.38
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$681.76
|
| Rate for Payer: Zelis Auto |
$186.40
|
| Rate for Payer: Zelis Medicare |
$579.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$818.11
|
| Rate for Payer: Zelis Worker's Compensation |
$127.22
|
|
|
EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM
|
Facility
|
IP
|
$362.00
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
20311600
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$343.90 |
| Rate for Payer: Cash Price |
$217.20
|
| Rate for Payer: Cigna Commercial |
$307.70
|
| Rate for Payer: First Health Commercial |
$325.80
|
| Rate for Payer: First Health Workers Compensation |
$139.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$325.80
|
| Rate for Payer: GEHA Commercial |
$253.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$325.80
|
| Rate for Payer: Multiplan All |
$329.42
|
| Rate for Payer: OMNI Networks Commercial |
$253.40
|
| Rate for Payer: One Health Plan PPO/POS |
$325.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$343.90
|
| Rate for Payer: Three Rivers Provider Network All |
$271.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$336.66
|
| Rate for Payer: Zelis Auto |
$144.80
|
| Rate for Payer: Zelis Worker's Compensation |
$98.83
|
|
|
EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM
|
Facility
|
OP
|
$362.00
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
20311600
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$1,363.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$217.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$657.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$681.76
|
| Rate for Payer: Cash Price |
$217.20
|
| Rate for Payer: Cash Price |
$217.20
|
| Rate for Payer: Cigna Commercial |
$307.70
|
| Rate for Payer: First Health Commercial |
$325.80
|
| Rate for Payer: First Health Workers Compensation |
$139.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$325.80
|
| Rate for Payer: GEHA Commercial |
$289.60
|
| Rate for Payer: GEHA Medicare |
$681.76
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$325.80
|
| Rate for Payer: Humana ChoiceCare |
$749.94
|
| Rate for Payer: Humana Medicare Advantage |
$681.76
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,145.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$670.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$681.76
|
| Rate for Payer: Multiplan All |
$329.42
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,158.99
|
| Rate for Payer: OMNI Networks Commercial |
$253.40
|
| Rate for Payer: One Health Plan PPO/POS |
$325.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$774.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$670.42
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$681.76
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$343.90
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,363.52
|
| Rate for Payer: Three Rivers Provider Network All |
$271.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$668.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$670.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$681.76
|
| Rate for Payer: United Payors & United Providers UP&UP |
$336.66
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$681.76
|
| Rate for Payer: Zelis Auto |
$144.80
|
| Rate for Payer: Zelis Medicare |
$579.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$818.11
|
| Rate for Payer: Zelis Worker's Compensation |
$98.83
|
|
|
EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2
|
Facility
|
IP
|
$499.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
20311602
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$136.23 |
| Max. Negotiated Rate |
$474.05 |
| Rate for Payer: Cash Price |
$299.40
|
| Rate for Payer: Cigna Commercial |
$424.15
|
| Rate for Payer: First Health Commercial |
$449.10
|
| Rate for Payer: First Health Workers Compensation |
$192.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$449.10
|
| Rate for Payer: GEHA Commercial |
$349.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$449.10
|
| Rate for Payer: Multiplan All |
$454.09
|
| Rate for Payer: OMNI Networks Commercial |
$349.30
|
| Rate for Payer: One Health Plan PPO/POS |
$449.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$474.05
|
| Rate for Payer: Three Rivers Provider Network All |
$374.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$464.07
|
| Rate for Payer: Zelis Auto |
$199.60
|
| Rate for Payer: Zelis Worker's Compensation |
$136.23
|
|
|
EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2
|
Facility
|
OP
|
$499.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
20311602
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$136.23 |
| Max. Negotiated Rate |
$774.28 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$441.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$299.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$441.09
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$349.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$387.14
|
| Rate for Payer: Cash Price |
$299.40
|
| Rate for Payer: Cash Price |
$299.40
|
| Rate for Payer: Cigna Commercial |
$424.15
|
| Rate for Payer: First Health Commercial |
$449.10
|
| Rate for Payer: First Health Workers Compensation |
$192.66
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$449.10
|
| Rate for Payer: GEHA Commercial |
$399.20
|
| Rate for Payer: GEHA Medicare |
$387.14
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$449.10
|
| Rate for Payer: Humana ChoiceCare |
$425.85
|
| Rate for Payer: Humana Medicare Advantage |
$387.14
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$650.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$356.55
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$387.14
|
| Rate for Payer: Multiplan All |
$454.09
|
| Rate for Payer: New Mexico Health Connections Medicare |
$658.14
|
| Rate for Payer: OMNI Networks Commercial |
$349.30
|
| Rate for Payer: One Health Plan PPO/POS |
$449.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$411.68
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$356.55
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$387.14
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$474.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$774.28
|
| Rate for Payer: Three Rivers Provider Network All |
$374.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$379.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$356.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$387.14
|
| Rate for Payer: United Payors & United Providers UP&UP |
$464.07
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$387.14
|
| Rate for Payer: Zelis Auto |
$199.60
|
| Rate for Payer: Zelis Medicare |
$329.07
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$464.57
|
| Rate for Payer: Zelis Worker's Compensation |
$136.23
|
|
|
EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3
|
Facility
|
IP
|
$856.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
20300131
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$233.69 |
| Max. Negotiated Rate |
$813.20 |
| Rate for Payer: Cash Price |
$513.60
|
| Rate for Payer: Cigna Commercial |
$727.60
|
| Rate for Payer: First Health Commercial |
$770.40
|
| Rate for Payer: First Health Workers Compensation |
$330.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$770.40
|
| Rate for Payer: GEHA Commercial |
$599.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$770.40
|
| Rate for Payer: Multiplan All |
$778.96
|
| Rate for Payer: OMNI Networks Commercial |
$599.20
|
| Rate for Payer: One Health Plan PPO/POS |
$770.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$813.20
|
| Rate for Payer: Three Rivers Provider Network All |
$642.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$796.08
|
| Rate for Payer: Zelis Auto |
$342.40
|
| Rate for Payer: Zelis Worker's Compensation |
$233.69
|
|
|
EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3
|
Facility
|
OP
|
$4,111.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
1911603
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$579.50 |
| Max. Negotiated Rate |
$3,905.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,466.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$657.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$681.76
|
| Rate for Payer: Cash Price |
$2,466.60
|
| Rate for Payer: Cash Price |
$2,466.60
|
| Rate for Payer: Cigna Commercial |
$3,494.35
|
| Rate for Payer: First Health Commercial |
$3,699.90
|
| Rate for Payer: First Health Workers Compensation |
$1,587.26
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,699.90
|
| Rate for Payer: GEHA Commercial |
$3,288.80
|
| Rate for Payer: GEHA Medicare |
$681.76
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,699.90
|
| Rate for Payer: Humana ChoiceCare |
$749.94
|
| Rate for Payer: Humana Medicare Advantage |
$681.76
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,145.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$670.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$681.76
|
| Rate for Payer: Multiplan All |
$3,741.01
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,158.99
|
| Rate for Payer: OMNI Networks Commercial |
$2,877.70
|
| Rate for Payer: One Health Plan PPO/POS |
$3,699.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$774.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$670.42
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$681.76
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,905.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,363.52
|
| Rate for Payer: Three Rivers Provider Network All |
$3,083.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$668.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$670.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$681.76
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,823.23
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$681.76
|
| Rate for Payer: Zelis Auto |
$1,644.40
|
| Rate for Payer: Zelis Medicare |
$579.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$818.11
|
| Rate for Payer: Zelis Worker's Compensation |
$1,122.30
|
|
|
EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3
|
Facility
|
IP
|
$609.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
6111603
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$166.26 |
| Max. Negotiated Rate |
$578.55 |
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Cigna Commercial |
$517.65
|
| Rate for Payer: First Health Commercial |
$548.10
|
| Rate for Payer: First Health Workers Compensation |
$235.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$548.10
|
| Rate for Payer: GEHA Commercial |
$426.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$548.10
|
| Rate for Payer: Multiplan All |
$554.19
|
| Rate for Payer: OMNI Networks Commercial |
$426.30
|
| Rate for Payer: One Health Plan PPO/POS |
$548.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$578.55
|
| Rate for Payer: Three Rivers Provider Network All |
$456.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$566.37
|
| Rate for Payer: Zelis Auto |
$243.60
|
| Rate for Payer: Zelis Worker's Compensation |
$166.26
|
|
|
EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3
|
Facility
|
OP
|
$856.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
20300131
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$233.69 |
| Max. Negotiated Rate |
$1,363.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$513.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$657.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$681.76
|
| Rate for Payer: Cash Price |
$513.60
|
| Rate for Payer: Cash Price |
$513.60
|
| Rate for Payer: Cigna Commercial |
$727.60
|
| Rate for Payer: First Health Commercial |
$770.40
|
| Rate for Payer: First Health Workers Compensation |
$330.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$770.40
|
| Rate for Payer: GEHA Commercial |
$684.80
|
| Rate for Payer: GEHA Medicare |
$681.76
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$770.40
|
| Rate for Payer: Humana ChoiceCare |
$749.94
|
| Rate for Payer: Humana Medicare Advantage |
$681.76
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,145.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$670.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$681.76
|
| Rate for Payer: Multiplan All |
$778.96
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,158.99
|
| Rate for Payer: OMNI Networks Commercial |
$599.20
|
| Rate for Payer: One Health Plan PPO/POS |
$770.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$774.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$670.42
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$681.76
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$813.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,363.52
|
| Rate for Payer: Three Rivers Provider Network All |
$642.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$668.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$670.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$681.76
|
| Rate for Payer: United Payors & United Providers UP&UP |
$796.08
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$681.76
|
| Rate for Payer: Zelis Auto |
$342.40
|
| Rate for Payer: Zelis Medicare |
$579.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$818.11
|
| Rate for Payer: Zelis Worker's Compensation |
$233.69
|
|
|
EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3
|
Facility
|
IP
|
$4,111.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
1911603
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,122.30 |
| Max. Negotiated Rate |
$3,905.45 |
| Rate for Payer: Cash Price |
$2,466.60
|
| Rate for Payer: Cigna Commercial |
$3,494.35
|
| Rate for Payer: First Health Commercial |
$3,699.90
|
| Rate for Payer: First Health Workers Compensation |
$1,587.26
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,699.90
|
| Rate for Payer: GEHA Commercial |
$2,877.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,699.90
|
| Rate for Payer: Multiplan All |
$3,741.01
|
| Rate for Payer: OMNI Networks Commercial |
$2,877.70
|
| Rate for Payer: One Health Plan PPO/POS |
$3,699.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,905.45
|
| Rate for Payer: Three Rivers Provider Network All |
$3,083.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,823.23
|
| Rate for Payer: Zelis Auto |
$1,644.40
|
| Rate for Payer: Zelis Worker's Compensation |
$1,122.30
|
|
|
EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3
|
Facility
|
OP
|
$609.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
6111603
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$166.26 |
| Max. Negotiated Rate |
$1,363.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$365.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$829.38
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$657.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$681.76
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Cash Price |
$365.40
|
| Rate for Payer: Cigna Commercial |
$517.65
|
| Rate for Payer: First Health Commercial |
$548.10
|
| Rate for Payer: First Health Workers Compensation |
$235.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$548.10
|
| Rate for Payer: GEHA Commercial |
$487.20
|
| Rate for Payer: GEHA Medicare |
$681.76
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$548.10
|
| Rate for Payer: Humana ChoiceCare |
$749.94
|
| Rate for Payer: Humana Medicare Advantage |
$681.76
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,145.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$670.42
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$681.76
|
| Rate for Payer: Multiplan All |
$554.19
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,158.99
|
| Rate for Payer: OMNI Networks Commercial |
$426.30
|
| Rate for Payer: One Health Plan PPO/POS |
$548.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$774.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$670.42
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$681.76
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$578.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,363.52
|
| Rate for Payer: Three Rivers Provider Network All |
$456.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$668.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$670.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$681.76
|
| Rate for Payer: United Payors & United Providers UP&UP |
$566.37
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$681.76
|
| Rate for Payer: Zelis Auto |
$243.60
|
| Rate for Payer: Zelis Medicare |
$579.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$818.11
|
| Rate for Payer: Zelis Worker's Compensation |
$166.26
|
|
|
EXCISION NAIL MATRIX PERMANENT REMOVAL
|
Facility
|
IP
|
$464.00
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
20300023
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$126.67 |
| Max. Negotiated Rate |
$440.80 |
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cigna Commercial |
$394.40
|
| Rate for Payer: First Health Commercial |
$417.60
|
| Rate for Payer: First Health Workers Compensation |
$179.15
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$417.60
|
| Rate for Payer: GEHA Commercial |
$324.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$417.60
|
| Rate for Payer: Multiplan All |
$422.24
|
| Rate for Payer: OMNI Networks Commercial |
$324.80
|
| Rate for Payer: One Health Plan PPO/POS |
$417.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$440.80
|
| Rate for Payer: Three Rivers Provider Network All |
$348.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$431.52
|
| Rate for Payer: Zelis Auto |
$185.60
|
| Rate for Payer: Zelis Worker's Compensation |
$126.67
|
|
