|
FINE NEEDLE ASPIRATION BX W/FLOUR GDN EA
|
Facility
|
OP
|
$808.00
|
|
|
Service Code
|
CPT 10008
|
| Hospital Charge Code |
8899219
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$202.00 |
| Max. Negotiated Rate |
$767.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$484.80
|
| Rate for Payer: Cash Price |
$484.80
|
| Rate for Payer: Cigna Commercial |
$686.80
|
| Rate for Payer: First Health Commercial |
$727.20
|
| Rate for Payer: First Health Workers Compensation |
$311.97
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$727.20
|
| Rate for Payer: GEHA Commercial |
$646.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$727.20
|
| Rate for Payer: Humana ChoiceCare |
$210.08
|
| Rate for Payer: Multiplan All |
$735.28
|
| Rate for Payer: New Mexico Health Connections Medicare |
$484.80
|
| Rate for Payer: OMNI Networks Commercial |
$565.60
|
| Rate for Payer: One Health Plan PPO/POS |
$727.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$767.60
|
| Rate for Payer: Three Rivers Provider Network All |
$606.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$711.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$202.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$751.44
|
| Rate for Payer: Zelis Auto |
$323.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$404.00
|
| Rate for Payer: Zelis Worker's Compensation |
$220.58
|
|
|
FINE NEEDLE ASPIRATION BX W/FLUOR GDN 1S
|
Facility
|
OP
|
$3,051.00
|
|
|
Service Code
|
CPT 10007
|
| Hospital Charge Code |
2415007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$579.50 |
| Max. Negotiated Rate |
$2,898.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$869.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,830.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$869.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$688.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$681.76
|
| Rate for Payer: Cash Price |
$1,830.60
|
| Rate for Payer: Cash Price |
$1,830.60
|
| Rate for Payer: Cigna Commercial |
$2,593.35
|
| Rate for Payer: First Health Commercial |
$2,745.90
|
| Rate for Payer: First Health Workers Compensation |
$877.43
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,745.90
|
| Rate for Payer: GEHA Commercial |
$2,440.80
|
| Rate for Payer: GEHA Medicare |
$681.76
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,745.90
|
| 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 |
$702.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$681.76
|
| Rate for Payer: Multiplan All |
$2,776.41
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,158.99
|
| Rate for Payer: OMNI Networks Commercial |
$2,135.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,745.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$811.08
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$702.45
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$681.76
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,898.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,363.52
|
| Rate for Payer: Three Rivers Provider Network All |
$2,288.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$668.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$702.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$681.76
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,837.43
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$681.76
|
| Rate for Payer: Zelis Auto |
$1,220.40
|
| Rate for Payer: Zelis Medicare |
$579.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$818.11
|
| Rate for Payer: Zelis Worker's Compensation |
$620.40
|
|
|
FINE NEEDLE ASPIRATION BX W/FLUOR GDN 1S
|
Facility
|
IP
|
$3,051.00
|
|
|
Service Code
|
CPT 10007
|
| Hospital Charge Code |
2415007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$832.92 |
| Max. Negotiated Rate |
$2,898.45 |
| Rate for Payer: Cash Price |
$1,830.60
|
| Rate for Payer: Cigna Commercial |
$2,593.35
|
| Rate for Payer: First Health Commercial |
$2,745.90
|
| Rate for Payer: First Health Workers Compensation |
$1,177.99
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,745.90
|
| Rate for Payer: GEHA Commercial |
$2,135.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,745.90
|
| Rate for Payer: Multiplan All |
$2,776.41
|
| Rate for Payer: OMNI Networks Commercial |
$2,135.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,745.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,898.45
|
| Rate for Payer: Three Rivers Provider Network All |
$2,288.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,837.43
|
| Rate for Payer: Zelis Auto |
$1,220.40
|
| Rate for Payer: Zelis Worker's Compensation |
$832.92
|
|
|
FINE NEEDLE ASPIRATION BX W/MR GDN 1ST L
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
CPT 10011
|
| Hospital Charge Code |
8233971
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$160.52 |
| Max. Negotiated Rate |
$1,363.52 |
| Rate for Payer: GEHA Commercial |
$470.40
|
| Rate for Payer: GEHA Medicare |
$681.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$869.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$352.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$869.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$688.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$681.76
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Cigna Commercial |
$499.80
|
| Rate for Payer: First Health Commercial |
$529.20
|
| Rate for Payer: First Health Workers Compensation |
$227.03
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$529.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$529.20
|
| 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 |
$702.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$681.76
|
| Rate for Payer: Multiplan All |
$535.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,158.99
|
| Rate for Payer: OMNI Networks Commercial |
$411.60
|
| Rate for Payer: One Health Plan PPO/POS |
$529.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$811.08
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$702.45
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$681.76
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$558.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,363.52
|
| Rate for Payer: Three Rivers Provider Network All |
$441.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$668.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$702.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$681.76
|
| Rate for Payer: United Payors & United Providers UP&UP |
$546.84
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$681.76
|
| Rate for Payer: Zelis Auto |
$235.20
|
| Rate for Payer: Zelis Medicare |
$579.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$818.11
|
| Rate for Payer: Zelis Worker's Compensation |
$160.52
|
|
|
FINE NEEDLE ASPIRATION BX W/MR GDN 1ST L
|
Facility
|
OP
|
$588.00
|
|
|
Service Code
|
CPT 10011
|
| Hospital Charge Code |
8899222
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$160.52 |
| Max. Negotiated Rate |
$1,363.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$869.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$352.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$869.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$688.43
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$681.76
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Cigna Commercial |
$499.80
|
| Rate for Payer: First Health Commercial |
$529.20
|
| Rate for Payer: First Health Workers Compensation |
$227.03
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$529.20
|
| Rate for Payer: GEHA Commercial |
$470.40
|
| Rate for Payer: GEHA Medicare |
$681.76
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$529.20
|
| 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 |
$702.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$681.76
|
| Rate for Payer: Multiplan All |
$535.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,158.99
|
| Rate for Payer: OMNI Networks Commercial |
$411.60
|
| Rate for Payer: One Health Plan PPO/POS |
$529.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$811.08
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$702.45
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$681.76
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$558.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,363.52
|
| Rate for Payer: Three Rivers Provider Network All |
$441.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$668.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$702.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$681.76
|
| Rate for Payer: United Payors & United Providers UP&UP |
$546.84
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$681.76
|
| Rate for Payer: Zelis Auto |
$235.20
|
| Rate for Payer: Zelis Medicare |
$579.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$818.11
|
| Rate for Payer: Zelis Worker's Compensation |
$160.52
|
|
|
FINE NEEDLE ASPIRATION BX W/MR GDN 1ST L
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
CPT 10011
|
| Hospital Charge Code |
8899222
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$160.52 |
| Max. Negotiated Rate |
$558.60 |
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Cigna Commercial |
$499.80
|
| Rate for Payer: First Health Commercial |
$529.20
|
| Rate for Payer: First Health Workers Compensation |
$227.03
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$529.20
|
| Rate for Payer: GEHA Commercial |
$411.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$529.20
|
| Rate for Payer: Multiplan All |
$535.08
|
| Rate for Payer: OMNI Networks Commercial |
$411.60
|
| Rate for Payer: One Health Plan PPO/POS |
$529.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$558.60
|
| Rate for Payer: Three Rivers Provider Network All |
$441.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$546.84
|
| Rate for Payer: Zelis Auto |
$235.20
|
| Rate for Payer: Zelis Worker's Compensation |
$160.52
|
|
|
FINE NEEDLE ASPIRATION BX W/MR GDN 1ST L
|
Facility
|
IP
|
$588.00
|
|
|
Service Code
|
CPT 10011
|
| Hospital Charge Code |
8233971
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$160.52 |
| Max. Negotiated Rate |
$558.60 |
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Cigna Commercial |
$499.80
|
| Rate for Payer: First Health Commercial |
$529.20
|
| Rate for Payer: First Health Workers Compensation |
$227.03
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$529.20
|
| Rate for Payer: GEHA Commercial |
$411.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$529.20
|
| Rate for Payer: Multiplan All |
$535.08
|
| Rate for Payer: OMNI Networks Commercial |
$411.60
|
| Rate for Payer: One Health Plan PPO/POS |
$529.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$558.60
|
| Rate for Payer: Three Rivers Provider Network All |
$441.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$546.84
|
| Rate for Payer: Zelis Auto |
$235.20
|
| Rate for Payer: Zelis Worker's Compensation |
$160.52
|
|
|
FINE NEEDLE ASPIRATION BX W/MR GDN EA AD
|
Facility
|
OP
|
$441.00
|
|
|
Service Code
|
CPT 10012
|
| Hospital Charge Code |
8233972
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$110.25 |
| Max. Negotiated Rate |
$418.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$264.60
|
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cigna Commercial |
$374.85
|
| Rate for Payer: First Health Commercial |
$396.90
|
| Rate for Payer: First Health Workers Compensation |
$170.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$396.90
|
| Rate for Payer: GEHA Commercial |
$352.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$396.90
|
| Rate for Payer: Humana ChoiceCare |
$114.66
|
| Rate for Payer: Multiplan All |
$401.31
|
| Rate for Payer: New Mexico Health Connections Medicare |
$264.60
|
| Rate for Payer: OMNI Networks Commercial |
$308.70
|
| Rate for Payer: One Health Plan PPO/POS |
$396.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$418.95
|
| Rate for Payer: Three Rivers Provider Network All |
$330.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$388.08
|
| Rate for Payer: United Healthcare Managed Medicaid |
$110.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$410.13
|
| Rate for Payer: Zelis Auto |
$176.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$220.50
|
| Rate for Payer: Zelis Worker's Compensation |
$120.39
|
|
|
FINE NEEDLE ASPIRATION BX W/MR GDN EA AD
|
Facility
|
OP
|
$441.00
|
|
|
Service Code
|
CPT 10012
|
| Hospital Charge Code |
8899223
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$110.25 |
| Max. Negotiated Rate |
$418.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$264.60
|
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cigna Commercial |
$374.85
|
| Rate for Payer: First Health Commercial |
$396.90
|
| Rate for Payer: First Health Workers Compensation |
$170.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$396.90
|
| Rate for Payer: GEHA Commercial |
$352.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$396.90
|
| Rate for Payer: Humana ChoiceCare |
$114.66
|
| Rate for Payer: Multiplan All |
$401.31
|
| Rate for Payer: New Mexico Health Connections Medicare |
$264.60
|
| Rate for Payer: OMNI Networks Commercial |
$308.70
|
| Rate for Payer: One Health Plan PPO/POS |
$396.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$418.95
|
| Rate for Payer: Three Rivers Provider Network All |
$330.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$388.08
|
| Rate for Payer: United Healthcare Managed Medicaid |
$110.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$410.13
|
| Rate for Payer: Zelis Auto |
$176.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$220.50
|
| Rate for Payer: Zelis Worker's Compensation |
$120.39
|
|
|
FINE NEEDLE ASPIRATION BX W/MR GDN EA AD
|
Facility
|
IP
|
$441.00
|
|
|
Service Code
|
CPT 10012
|
| Hospital Charge Code |
8899223
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$120.39 |
| Max. Negotiated Rate |
$418.95 |
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cigna Commercial |
$374.85
|
| Rate for Payer: First Health Commercial |
$396.90
|
| Rate for Payer: First Health Workers Compensation |
$170.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$396.90
|
| Rate for Payer: GEHA Commercial |
$308.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$396.90
|
| Rate for Payer: Multiplan All |
$401.31
|
| Rate for Payer: OMNI Networks Commercial |
$308.70
|
| Rate for Payer: One Health Plan PPO/POS |
$396.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$418.95
|
| Rate for Payer: Three Rivers Provider Network All |
$330.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$410.13
|
| Rate for Payer: Zelis Auto |
$176.40
|
| Rate for Payer: Zelis Worker's Compensation |
$120.39
|
|
|
FINE NEEDLE ASPIRATION BX W/MR GDN EA AD
|
Facility
|
IP
|
$441.00
|
|
|
Service Code
|
CPT 10012
|
| Hospital Charge Code |
8233972
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$120.39 |
| Max. Negotiated Rate |
$418.95 |
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cigna Commercial |
$374.85
|
| Rate for Payer: First Health Commercial |
$396.90
|
| Rate for Payer: First Health Workers Compensation |
$170.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$396.90
|
| Rate for Payer: GEHA Commercial |
$308.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$396.90
|
| Rate for Payer: Multiplan All |
$401.31
|
| Rate for Payer: OMNI Networks Commercial |
$308.70
|
| Rate for Payer: One Health Plan PPO/POS |
$396.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$418.95
|
| Rate for Payer: Three Rivers Provider Network All |
$330.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$410.13
|
| Rate for Payer: Zelis Auto |
$176.40
|
| Rate for Payer: Zelis Worker's Compensation |
$120.39
|
|
|
FINE NEEDLE ASPIRATION BX W/O IMG GDN 1S
|
Facility
|
OP
|
$875.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
8100061
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$121.04 |
| Max. Negotiated Rate |
$831.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$152.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$525.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$152.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$121.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$387.14
|
| Rate for Payer: Cash Price |
$525.00
|
| Rate for Payer: Cash Price |
$525.00
|
| Rate for Payer: Cigna Commercial |
$743.75
|
| Rate for Payer: First Health Commercial |
$787.50
|
| Rate for Payer: First Health Workers Compensation |
$337.84
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$787.50
|
| Rate for Payer: GEHA Commercial |
$700.00
|
| Rate for Payer: GEHA Medicare |
$387.14
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$787.50
|
| 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 |
$123.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$387.14
|
| Rate for Payer: Multiplan All |
$796.25
|
| Rate for Payer: New Mexico Health Connections Medicare |
$658.14
|
| Rate for Payer: OMNI Networks Commercial |
$612.50
|
| Rate for Payer: One Health Plan PPO/POS |
$787.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$142.60
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$123.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$387.14
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$831.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$774.28
|
| Rate for Payer: Three Rivers Provider Network All |
$656.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$379.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$123.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$387.14
|
| Rate for Payer: United Payors & United Providers UP&UP |
$813.75
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$387.14
|
| Rate for Payer: Zelis Auto |
$350.00
|
| Rate for Payer: Zelis Medicare |
$329.07
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$464.57
|
| Rate for Payer: Zelis Worker's Compensation |
$238.88
|
|
|
FINE NEEDLE ASPIRATION BX W/O IMG GDN 1S
|
Facility
|
IP
|
$295.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
20310021
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$80.53 |
| Max. Negotiated Rate |
$280.25 |
| Rate for Payer: Cash Price |
$177.00
|
| Rate for Payer: Cigna Commercial |
$250.75
|
| Rate for Payer: First Health Commercial |
$265.50
|
| Rate for Payer: First Health Workers Compensation |
$113.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$265.50
|
| Rate for Payer: GEHA Commercial |
$206.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$265.50
|
| Rate for Payer: Multiplan All |
$268.45
|
| Rate for Payer: OMNI Networks Commercial |
$206.50
|
| Rate for Payer: One Health Plan PPO/POS |
$265.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$280.25
|
| Rate for Payer: Three Rivers Provider Network All |
$221.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$274.35
|
| Rate for Payer: Zelis Auto |
$118.00
|
| Rate for Payer: Zelis Worker's Compensation |
$80.53
|
|
|
FINE NEEDLE ASPIRATION BX W/O IMG GDN 1S
|
Facility
|
IP
|
$295.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
7910021
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$80.53 |
| Max. Negotiated Rate |
$280.25 |
| Rate for Payer: Cash Price |
$177.00
|
| Rate for Payer: Cigna Commercial |
$250.75
|
| Rate for Payer: First Health Commercial |
$265.50
|
| Rate for Payer: First Health Workers Compensation |
$113.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$265.50
|
| Rate for Payer: GEHA Commercial |
$206.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$265.50
|
| Rate for Payer: Multiplan All |
$268.45
|
| Rate for Payer: OMNI Networks Commercial |
$206.50
|
| Rate for Payer: One Health Plan PPO/POS |
$265.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$280.25
|
| Rate for Payer: Three Rivers Provider Network All |
$221.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$274.35
|
| Rate for Payer: Zelis Auto |
$118.00
|
| Rate for Payer: Zelis Worker's Compensation |
$80.53
|
|
|
FINE NEEDLE ASPIRATION BX W/O IMG GDN 1S
|
Facility
|
OP
|
$295.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
8300001
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$80.53 |
| Max. Negotiated Rate |
$774.28 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$152.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$177.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$152.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$121.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$387.14
|
| Rate for Payer: Cash Price |
$177.00
|
| Rate for Payer: Cash Price |
$177.00
|
| Rate for Payer: Cigna Commercial |
$250.75
|
| Rate for Payer: First Health Commercial |
$265.50
|
| Rate for Payer: First Health Workers Compensation |
$113.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$265.50
|
| Rate for Payer: GEHA Commercial |
$236.00
|
| Rate for Payer: GEHA Medicare |
$387.14
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$265.50
|
| 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 |
$123.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$387.14
|
| Rate for Payer: Multiplan All |
$268.45
|
| Rate for Payer: New Mexico Health Connections Medicare |
$658.14
|
| Rate for Payer: OMNI Networks Commercial |
$206.50
|
| Rate for Payer: One Health Plan PPO/POS |
$265.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$142.60
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$123.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$387.14
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$280.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$774.28
|
| Rate for Payer: Three Rivers Provider Network All |
$221.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$379.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$123.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$387.14
|
| Rate for Payer: United Payors & United Providers UP&UP |
$274.35
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$387.14
|
| Rate for Payer: Zelis Auto |
$118.00
|
| Rate for Payer: Zelis Medicare |
$329.07
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$464.57
|
| Rate for Payer: Zelis Worker's Compensation |
$80.53
|
|
|
FINE NEEDLE ASPIRATION BX W/O IMG GDN 1S
|
Facility
|
OP
|
$295.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
20310021
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$80.53 |
| Max. Negotiated Rate |
$774.28 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$152.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$177.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$152.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$121.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$387.14
|
| Rate for Payer: Cash Price |
$177.00
|
| Rate for Payer: Cash Price |
$177.00
|
| Rate for Payer: Cigna Commercial |
$250.75
|
| Rate for Payer: First Health Commercial |
$265.50
|
| Rate for Payer: First Health Workers Compensation |
$113.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$265.50
|
| Rate for Payer: GEHA Commercial |
$236.00
|
| Rate for Payer: GEHA Medicare |
$387.14
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$265.50
|
| 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 |
$123.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$387.14
|
| Rate for Payer: Multiplan All |
$268.45
|
| Rate for Payer: New Mexico Health Connections Medicare |
$658.14
|
| Rate for Payer: OMNI Networks Commercial |
$206.50
|
| Rate for Payer: One Health Plan PPO/POS |
$265.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$142.60
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$123.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$387.14
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$280.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$774.28
|
| Rate for Payer: Three Rivers Provider Network All |
$221.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$379.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$123.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$387.14
|
| Rate for Payer: United Payors & United Providers UP&UP |
$274.35
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$387.14
|
| Rate for Payer: Zelis Auto |
$118.00
|
| Rate for Payer: Zelis Medicare |
$329.07
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$464.57
|
| Rate for Payer: Zelis Worker's Compensation |
$80.53
|
|
|
FINE NEEDLE ASPIRATION BX W/O IMG GDN 1S
|
Facility
|
IP
|
$177.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
21600141
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$48.32 |
| Max. Negotiated Rate |
$168.15 |
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cigna Commercial |
$150.45
|
| Rate for Payer: First Health Commercial |
$159.30
|
| Rate for Payer: First Health Workers Compensation |
$68.34
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$159.30
|
| Rate for Payer: GEHA Commercial |
$123.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$159.30
|
| Rate for Payer: Multiplan All |
$161.07
|
| Rate for Payer: OMNI Networks Commercial |
$123.90
|
| Rate for Payer: One Health Plan PPO/POS |
$159.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$168.15
|
| Rate for Payer: Three Rivers Provider Network All |
$132.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$164.61
|
| Rate for Payer: Zelis Auto |
$70.80
|
| Rate for Payer: Zelis Worker's Compensation |
$48.32
|
|
|
FINE NEEDLE ASPIRATION BX W/O IMG GDN 1S
|
Facility
|
IP
|
$875.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
8100061
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$238.88 |
| Max. Negotiated Rate |
$831.25 |
| Rate for Payer: Cash Price |
$525.00
|
| Rate for Payer: Cigna Commercial |
$743.75
|
| Rate for Payer: First Health Commercial |
$787.50
|
| Rate for Payer: First Health Workers Compensation |
$337.84
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$787.50
|
| Rate for Payer: GEHA Commercial |
$612.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$787.50
|
| Rate for Payer: Multiplan All |
$796.25
|
| Rate for Payer: OMNI Networks Commercial |
$612.50
|
| Rate for Payer: One Health Plan PPO/POS |
$787.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$831.25
|
| Rate for Payer: Three Rivers Provider Network All |
$656.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$813.75
|
| Rate for Payer: Zelis Auto |
$350.00
|
| Rate for Payer: Zelis Worker's Compensation |
$238.88
|
|
|
FINE NEEDLE ASPIRATION BX W/O IMG GDN 1S
|
Facility
|
IP
|
$295.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
8300001
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$80.53 |
| Max. Negotiated Rate |
$280.25 |
| Rate for Payer: Cash Price |
$177.00
|
| Rate for Payer: Cigna Commercial |
$250.75
|
| Rate for Payer: First Health Commercial |
$265.50
|
| Rate for Payer: First Health Workers Compensation |
$113.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$265.50
|
| Rate for Payer: GEHA Commercial |
$206.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$265.50
|
| Rate for Payer: Multiplan All |
$268.45
|
| Rate for Payer: OMNI Networks Commercial |
$206.50
|
| Rate for Payer: One Health Plan PPO/POS |
$265.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$280.25
|
| Rate for Payer: Three Rivers Provider Network All |
$221.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$274.35
|
| Rate for Payer: Zelis Auto |
$118.00
|
| Rate for Payer: Zelis Worker's Compensation |
$80.53
|
|
|
FINE NEEDLE ASPIRATION BX W/O IMG GDN 1S
|
Facility
|
OP
|
$295.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
7910021
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$80.53 |
| Max. Negotiated Rate |
$774.28 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$152.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$177.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$152.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$121.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$387.14
|
| Rate for Payer: Cash Price |
$177.00
|
| Rate for Payer: Cash Price |
$177.00
|
| Rate for Payer: Cigna Commercial |
$250.75
|
| Rate for Payer: First Health Commercial |
$265.50
|
| Rate for Payer: First Health Workers Compensation |
$113.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$265.50
|
| Rate for Payer: GEHA Commercial |
$236.00
|
| Rate for Payer: GEHA Medicare |
$387.14
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$265.50
|
| 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 |
$123.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$387.14
|
| Rate for Payer: Multiplan All |
$268.45
|
| Rate for Payer: New Mexico Health Connections Medicare |
$658.14
|
| Rate for Payer: OMNI Networks Commercial |
$206.50
|
| Rate for Payer: One Health Plan PPO/POS |
$265.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$142.60
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$123.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$387.14
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$280.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$774.28
|
| Rate for Payer: Three Rivers Provider Network All |
$221.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$379.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$123.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$387.14
|
| Rate for Payer: United Payors & United Providers UP&UP |
$274.35
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$387.14
|
| Rate for Payer: Zelis Auto |
$118.00
|
| Rate for Payer: Zelis Medicare |
$329.07
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$464.57
|
| Rate for Payer: Zelis Worker's Compensation |
$80.53
|
|
|
FINE NEEDLE ASPIRATION BX W/O IMG GDN 1S
|
Facility
|
OP
|
$177.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
6110021
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$48.32 |
| Max. Negotiated Rate |
$774.28 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$152.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$106.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$152.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$121.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$387.14
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cigna Commercial |
$150.45
|
| Rate for Payer: First Health Commercial |
$159.30
|
| Rate for Payer: First Health Workers Compensation |
$68.34
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$159.30
|
| Rate for Payer: GEHA Commercial |
$141.60
|
| Rate for Payer: GEHA Medicare |
$387.14
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$159.30
|
| 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 |
$123.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$387.14
|
| Rate for Payer: Multiplan All |
$161.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$658.14
|
| Rate for Payer: OMNI Networks Commercial |
$123.90
|
| Rate for Payer: One Health Plan PPO/POS |
$159.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$142.60
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$123.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$387.14
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$168.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$774.28
|
| Rate for Payer: Three Rivers Provider Network All |
$132.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$379.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$123.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$387.14
|
| Rate for Payer: United Payors & United Providers UP&UP |
$164.61
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$387.14
|
| Rate for Payer: Zelis Auto |
$70.80
|
| Rate for Payer: Zelis Medicare |
$329.07
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$464.57
|
| Rate for Payer: Zelis Worker's Compensation |
$48.32
|
|
|
FINE NEEDLE ASPIRATION BX W/O IMG GDN 1S
|
Facility
|
IP
|
$177.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
6110021
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$48.32 |
| Max. Negotiated Rate |
$168.15 |
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cigna Commercial |
$150.45
|
| Rate for Payer: First Health Commercial |
$159.30
|
| Rate for Payer: First Health Workers Compensation |
$68.34
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$159.30
|
| Rate for Payer: GEHA Commercial |
$123.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$159.30
|
| Rate for Payer: Multiplan All |
$161.07
|
| Rate for Payer: OMNI Networks Commercial |
$123.90
|
| Rate for Payer: One Health Plan PPO/POS |
$159.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$168.15
|
| Rate for Payer: Three Rivers Provider Network All |
$132.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$164.61
|
| Rate for Payer: Zelis Auto |
$70.80
|
| Rate for Payer: Zelis Worker's Compensation |
$48.32
|
|
|
FINE NEEDLE ASPIRATION BX W/O IMG GDN 1S
|
Facility
|
OP
|
$177.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
21600141
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$48.32 |
| Max. Negotiated Rate |
$774.28 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$152.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$106.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$152.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$121.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$387.14
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cigna Commercial |
$150.45
|
| Rate for Payer: First Health Commercial |
$159.30
|
| Rate for Payer: First Health Workers Compensation |
$68.34
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$159.30
|
| Rate for Payer: GEHA Commercial |
$141.60
|
| Rate for Payer: GEHA Medicare |
$387.14
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$159.30
|
| 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 |
$123.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$387.14
|
| Rate for Payer: Multiplan All |
$161.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$658.14
|
| Rate for Payer: OMNI Networks Commercial |
$123.90
|
| Rate for Payer: One Health Plan PPO/POS |
$159.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$142.60
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$123.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$387.14
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$168.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$774.28
|
| Rate for Payer: Three Rivers Provider Network All |
$132.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$379.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$123.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$387.14
|
| Rate for Payer: United Payors & United Providers UP&UP |
$164.61
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$387.14
|
| Rate for Payer: Zelis Auto |
$70.80
|
| Rate for Payer: Zelis Medicare |
$329.07
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$464.57
|
| Rate for Payer: Zelis Worker's Compensation |
$48.32
|
|
|
FINE NEEDLE ASPIRATION BX W/O IMG GDN EA
|
Facility
|
OP
|
$161.00
|
|
|
Service Code
|
CPT 10004
|
| Hospital Charge Code |
21600294
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$40.25 |
| Max. Negotiated Rate |
$152.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$96.60
|
| Rate for Payer: Cash Price |
$96.60
|
| Rate for Payer: Cigna Commercial |
$136.85
|
| Rate for Payer: First Health Commercial |
$144.90
|
| Rate for Payer: First Health Workers Compensation |
$62.16
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$144.90
|
| Rate for Payer: GEHA Commercial |
$128.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$144.90
|
| Rate for Payer: Humana ChoiceCare |
$41.86
|
| Rate for Payer: Multiplan All |
$146.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$96.60
|
| Rate for Payer: OMNI Networks Commercial |
$112.70
|
| Rate for Payer: One Health Plan PPO/POS |
$144.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$152.95
|
| Rate for Payer: Three Rivers Provider Network All |
$120.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$141.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$40.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$149.73
|
| Rate for Payer: Zelis Auto |
$64.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$80.50
|
| Rate for Payer: Zelis Worker's Compensation |
$43.95
|
|
|
FINE NEEDLE ASPIRATION BX W/O IMG GDN EA
|
Facility
|
OP
|
$161.00
|
|
|
Service Code
|
CPT 10004
|
| Hospital Charge Code |
20300143
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$40.25 |
| Max. Negotiated Rate |
$152.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$96.60
|
| Rate for Payer: Cash Price |
$96.60
|
| Rate for Payer: Cigna Commercial |
$136.85
|
| Rate for Payer: First Health Commercial |
$144.90
|
| Rate for Payer: First Health Workers Compensation |
$62.16
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$144.90
|
| Rate for Payer: GEHA Commercial |
$128.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$144.90
|
| Rate for Payer: Humana ChoiceCare |
$41.86
|
| Rate for Payer: Multiplan All |
$146.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$96.60
|
| Rate for Payer: OMNI Networks Commercial |
$112.70
|
| Rate for Payer: One Health Plan PPO/POS |
$144.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$152.95
|
| Rate for Payer: Three Rivers Provider Network All |
$120.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$141.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$40.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$149.73
|
| Rate for Payer: Zelis Auto |
$64.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$80.50
|
| Rate for Payer: Zelis Worker's Compensation |
$43.95
|
|
