|
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
|
IP
|
$161.00
|
|
|
Service Code
|
CPT 10004
|
| Hospital Charge Code |
21600294
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$43.95 |
| Max. Negotiated Rate |
$152.95 |
| 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 |
$112.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$144.90
|
| Rate for Payer: Multiplan All |
$146.51
|
| 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: United Payors & United Providers UP&UP |
$149.73
|
| Rate for Payer: Zelis Auto |
$64.40
|
| Rate for Payer: Zelis Worker's Compensation |
$43.95
|
|
|
FINE NEEDLE ASPIRATION BX W/O IMG GDN EA
|
Facility
|
IP
|
$161.00
|
|
|
Service Code
|
CPT 10004
|
| Hospital Charge Code |
20300143
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$43.95 |
| Max. Negotiated Rate |
$152.95 |
| 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 |
$112.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$144.90
|
| Rate for Payer: Multiplan All |
$146.51
|
| 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: United Payors & United Providers UP&UP |
$149.73
|
| Rate for Payer: Zelis Auto |
$64.40
|
| 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 |
7210004
|
|
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
|
IP
|
$161.00
|
|
|
Service Code
|
CPT 10004
|
| Hospital Charge Code |
8511114
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$43.95 |
| Max. Negotiated Rate |
$152.95 |
| 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 |
$112.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$144.90
|
| Rate for Payer: Multiplan All |
$146.51
|
| 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: United Payors & United Providers UP&UP |
$149.73
|
| Rate for Payer: Zelis Auto |
$64.40
|
| Rate for Payer: Zelis Worker's Compensation |
$43.95
|
|
|
FINE NEEDLE ASPIRATION BX W/O IMG GDN EA
|
Facility
|
IP
|
$161.00
|
|
|
Service Code
|
CPT 10004
|
| Hospital Charge Code |
7210004
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$43.95 |
| Max. Negotiated Rate |
$152.95 |
| Rate for Payer: One Health Plan PPO/POS |
$144.90
|
| 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 |
$112.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$144.90
|
| Rate for Payer: Multiplan All |
$146.51
|
| Rate for Payer: OMNI Networks Commercial |
$112.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$152.95
|
| Rate for Payer: Three Rivers Provider Network All |
$120.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$149.73
|
| Rate for Payer: Zelis Auto |
$64.40
|
| Rate for Payer: Zelis Worker's Compensation |
$43.95
|
|
|
FINE NEEDLE ASPIRATION BX W/US GDN 1ST L
|
Facility
|
OP
|
$1,615.00
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
8899216
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$440.89 |
| Max. Negotiated Rate |
$1,534.25 |
| 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 |
$969.00
|
| 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 |
$969.00
|
| Rate for Payer: Cash Price |
$969.00
|
| Rate for Payer: Cigna Commercial |
$1,372.75
|
| Rate for Payer: First Health Commercial |
$1,453.50
|
| Rate for Payer: First Health Workers Compensation |
$623.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,453.50
|
| Rate for Payer: GEHA Commercial |
$1,292.00
|
| Rate for Payer: GEHA Medicare |
$681.76
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,453.50
|
| 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 |
$1,469.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,158.99
|
| Rate for Payer: OMNI Networks Commercial |
$1,130.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,453.50
|
| 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 |
$1,534.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,363.52
|
| Rate for Payer: Three Rivers Provider Network All |
$1,211.25
|
| 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 |
$1,501.95
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$681.76
|
| Rate for Payer: Zelis Auto |
$646.00
|
| Rate for Payer: Zelis Medicare |
$579.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$818.11
|
| Rate for Payer: Zelis Worker's Compensation |
$440.89
|
|
|
FINE NEEDLE ASPIRATION BX W/US GDN 1ST L
|
Facility
|
OP
|
$1,615.00
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
21099501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$440.89 |
| Max. Negotiated Rate |
$1,534.25 |
| 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 |
$969.00
|
| 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 |
$969.00
|
| Rate for Payer: Cash Price |
$969.00
|
| Rate for Payer: Cigna Commercial |
$1,372.75
|
| Rate for Payer: First Health Commercial |
$1,453.50
|
| Rate for Payer: First Health Workers Compensation |
$623.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,453.50
|
| Rate for Payer: GEHA Commercial |
$1,292.00
|
| Rate for Payer: GEHA Medicare |
$681.76
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,453.50
|
| 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 |
$1,469.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,158.99
|
| Rate for Payer: OMNI Networks Commercial |
$1,130.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,453.50
|
| 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 |
$1,534.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,363.52
|
| Rate for Payer: Three Rivers Provider Network All |
$1,211.25
|
| 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 |
$1,501.95
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$681.76
|
| Rate for Payer: Zelis Auto |
$646.00
|
| Rate for Payer: Zelis Medicare |
$579.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$818.11
|
| Rate for Payer: Zelis Worker's Compensation |
$440.89
|
|
|
FINE NEEDLE ASPIRATION BX W/US GDN 1ST L
|
Facility
|
IP
|
$1,615.00
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
8899216
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$440.89 |
| Max. Negotiated Rate |
$1,534.25 |
| Rate for Payer: Cash Price |
$969.00
|
| Rate for Payer: Cigna Commercial |
$1,372.75
|
| Rate for Payer: First Health Commercial |
$1,453.50
|
| Rate for Payer: First Health Workers Compensation |
$623.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,453.50
|
| Rate for Payer: GEHA Commercial |
$1,130.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,453.50
|
| Rate for Payer: Multiplan All |
$1,469.65
|
| Rate for Payer: OMNI Networks Commercial |
$1,130.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,453.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,534.25
|
| Rate for Payer: Three Rivers Provider Network All |
$1,211.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,501.95
|
| Rate for Payer: Zelis Auto |
$646.00
|
| Rate for Payer: Zelis Worker's Compensation |
$440.89
|
|
|
FINE NEEDLE ASPIRATION BX W/US GDN 1ST L
|
Facility
|
IP
|
$1,615.00
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
8999218
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$440.89 |
| Max. Negotiated Rate |
$1,534.25 |
| Rate for Payer: Cash Price |
$969.00
|
| Rate for Payer: Cigna Commercial |
$1,372.75
|
| Rate for Payer: First Health Commercial |
$1,453.50
|
| Rate for Payer: First Health Workers Compensation |
$623.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,453.50
|
| Rate for Payer: GEHA Commercial |
$1,130.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,453.50
|
| Rate for Payer: Multiplan All |
$1,469.65
|
| Rate for Payer: OMNI Networks Commercial |
$1,130.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,453.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,534.25
|
| Rate for Payer: Three Rivers Provider Network All |
$1,211.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,501.95
|
| Rate for Payer: Zelis Auto |
$646.00
|
| Rate for Payer: Zelis Worker's Compensation |
$440.89
|
|
|
FINE NEEDLE ASPIRATION BX W/US GDN 1ST L
|
Facility
|
OP
|
$1,615.00
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
8999218
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$440.89 |
| Max. Negotiated Rate |
$1,534.25 |
| 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 |
$969.00
|
| 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 |
$969.00
|
| Rate for Payer: Cash Price |
$969.00
|
| Rate for Payer: Cigna Commercial |
$1,372.75
|
| Rate for Payer: First Health Commercial |
$1,453.50
|
| Rate for Payer: First Health Workers Compensation |
$623.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,453.50
|
| Rate for Payer: GEHA Commercial |
$1,292.00
|
| Rate for Payer: GEHA Medicare |
$681.76
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,453.50
|
| 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 |
$1,469.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,158.99
|
| Rate for Payer: OMNI Networks Commercial |
$1,130.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,453.50
|
| 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 |
$1,534.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,363.52
|
| Rate for Payer: Three Rivers Provider Network All |
$1,211.25
|
| 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 |
$1,501.95
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$681.76
|
| Rate for Payer: Zelis Auto |
$646.00
|
| Rate for Payer: Zelis Medicare |
$579.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$818.11
|
| Rate for Payer: Zelis Worker's Compensation |
$440.89
|
|
|
FINE NEEDLE ASPIRATION BX W/US GDN 1ST L
|
Facility
|
IP
|
$1,615.00
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
21099501
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$440.89 |
| Max. Negotiated Rate |
$1,534.25 |
| Rate for Payer: Cash Price |
$969.00
|
| Rate for Payer: Cigna Commercial |
$1,372.75
|
| Rate for Payer: First Health Commercial |
$1,453.50
|
| Rate for Payer: First Health Workers Compensation |
$623.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,453.50
|
| Rate for Payer: GEHA Commercial |
$1,130.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,453.50
|
| Rate for Payer: Multiplan All |
$1,469.65
|
| Rate for Payer: OMNI Networks Commercial |
$1,130.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,453.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,534.25
|
| Rate for Payer: Three Rivers Provider Network All |
$1,211.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,501.95
|
| Rate for Payer: Zelis Auto |
$646.00
|
| Rate for Payer: Zelis Worker's Compensation |
$440.89
|
|
|
FINE NEEDLE ASPIRATION BX W/US GDN EA AD
|
Facility
|
OP
|
$808.00
|
|
|
Service Code
|
CPT 10006
|
| Hospital Charge Code |
8899217
|
|
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/US GDN EA AD
|
Facility
|
IP
|
$808.00
|
|
|
Service Code
|
CPT 10006
|
| Hospital Charge Code |
21099502
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$220.58 |
| Max. Negotiated Rate |
$767.60 |
| 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 |
$565.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$727.20
|
| Rate for Payer: Multiplan All |
$735.28
|
| 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: United Payors & United Providers UP&UP |
$751.44
|
| Rate for Payer: Zelis Auto |
$323.20
|
| Rate for Payer: Zelis Worker's Compensation |
$220.58
|
|
|
FINE NEEDLE ASPIRATION BX W/US GDN EA AD
|
Facility
|
IP
|
$808.00
|
|
|
Service Code
|
CPT 10006
|
| Hospital Charge Code |
8999219
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$220.58 |
| Max. Negotiated Rate |
$767.60 |
| 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 |
$565.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$727.20
|
| Rate for Payer: Multiplan All |
$735.28
|
| 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: United Payors & United Providers UP&UP |
$751.44
|
| Rate for Payer: Zelis Auto |
$323.20
|
| Rate for Payer: Zelis Worker's Compensation |
$220.58
|
|
|
FINE NEEDLE ASPIRATION BX W/US GDN EA AD
|
Facility
|
IP
|
$808.00
|
|
|
Service Code
|
CPT 10006
|
| Hospital Charge Code |
8899217
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$220.58 |
| Max. Negotiated Rate |
$767.60 |
| 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 |
$565.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$727.20
|
| Rate for Payer: Multiplan All |
$735.28
|
| 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: United Payors & United Providers UP&UP |
$751.44
|
| Rate for Payer: Zelis Auto |
$323.20
|
| Rate for Payer: Zelis Worker's Compensation |
$220.58
|
|
|
FINE NEEDLE ASPIRATION BX W/US GDN EA AD
|
Facility
|
OP
|
$808.00
|
|
|
Service Code
|
CPT 10006
|
| Hospital Charge Code |
8999219
|
|
Hospital Revenue Code
|
510
|
| 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/US GDN EA AD
|
Facility
|
OP
|
$808.00
|
|
|
Service Code
|
CPT 10006
|
| Hospital Charge Code |
21099502
|
|
Hospital Revenue Code
|
510
|
| 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
|
|
|
FINGER SPLNT APPLC; DYNAMIC
|
Facility
|
IP
|
$272.00
|
|
| Hospital Charge Code |
8129131
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$74.26 |
| Max. Negotiated Rate |
$258.40 |
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cigna Commercial |
$231.20
|
| Rate for Payer: First Health Commercial |
$244.80
|
| Rate for Payer: First Health Workers Compensation |
$105.02
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$244.80
|
| Rate for Payer: GEHA Commercial |
$190.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$244.80
|
| Rate for Payer: Multiplan All |
$247.52
|
| Rate for Payer: OMNI Networks Commercial |
$190.40
|
| Rate for Payer: One Health Plan PPO/POS |
$244.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$258.40
|
| Rate for Payer: Three Rivers Provider Network All |
$204.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$252.96
|
| Rate for Payer: Zelis Auto |
$108.80
|
| Rate for Payer: Zelis Worker's Compensation |
$74.26
|
|
|
FINGER SPLNT APPLC; DYNAMIC
|
Facility
|
OP
|
$272.00
|
|
| Hospital Charge Code |
8129131
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$68.00 |
| Max. Negotiated Rate |
$258.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cigna Commercial |
$231.20
|
| Rate for Payer: First Health Commercial |
$244.80
|
| Rate for Payer: First Health Workers Compensation |
$105.02
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$244.80
|
| Rate for Payer: GEHA Commercial |
$217.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$244.80
|
| Rate for Payer: Humana ChoiceCare |
$70.72
|
| Rate for Payer: Multiplan All |
$247.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$163.20
|
| Rate for Payer: OMNI Networks Commercial |
$190.40
|
| Rate for Payer: One Health Plan PPO/POS |
$244.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$258.40
|
| Rate for Payer: Three Rivers Provider Network All |
$204.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$239.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$68.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$252.96
|
| Rate for Payer: Zelis Auto |
$108.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$136.00
|
| Rate for Payer: Zelis Worker's Compensation |
$74.26
|
|
|
FINGER TENDON TRANSFER
|
Facility
|
IP
|
$1,732.00
|
|
|
Service Code
|
CPT 26497
|
| Hospital Charge Code |
6126497
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$472.84 |
| Max. Negotiated Rate |
$1,645.40 |
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cigna Commercial |
$1,472.20
|
| Rate for Payer: First Health Commercial |
$1,558.80
|
| Rate for Payer: First Health Workers Compensation |
$668.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,558.80
|
| Rate for Payer: GEHA Commercial |
$1,212.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,558.80
|
| Rate for Payer: Multiplan All |
$1,576.12
|
| Rate for Payer: OMNI Networks Commercial |
$1,212.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,558.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,645.40
|
| Rate for Payer: Three Rivers Provider Network All |
$1,299.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,610.76
|
| Rate for Payer: Zelis Auto |
$692.80
|
| Rate for Payer: Zelis Worker's Compensation |
$472.84
|
|
|
FINGER TENDON TRANSFER
|
Facility
|
OP
|
$2,303.00
|
|
|
Service Code
|
CPT 26498
|
| Hospital Charge Code |
6126498
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$628.72 |
| Max. Negotiated Rate |
$6,287.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,855.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,381.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,855.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,261.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,143.96
|
| Rate for Payer: Cash Price |
$1,381.80
|
| Rate for Payer: Cash Price |
$1,381.80
|
| Rate for Payer: Cigna Commercial |
$1,957.55
|
| Rate for Payer: First Health Commercial |
$2,072.70
|
| Rate for Payer: First Health Workers Compensation |
$889.19
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,072.70
|
| Rate for Payer: GEHA Commercial |
$1,842.40
|
| Rate for Payer: GEHA Medicare |
$3,143.96
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,072.70
|
| Rate for Payer: Humana ChoiceCare |
$3,458.36
|
| Rate for Payer: Humana Medicare Advantage |
$3,143.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,281.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,307.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,143.96
|
| Rate for Payer: Multiplan All |
$2,095.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,344.73
|
| Rate for Payer: OMNI Networks Commercial |
$1,612.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2,072.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,664.73
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,307.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,143.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,187.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,287.92
|
| Rate for Payer: Three Rivers Provider Network All |
$1,727.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,081.08
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,307.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,143.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,141.79
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,143.96
|
| Rate for Payer: Zelis Auto |
$921.20
|
| Rate for Payer: Zelis Medicare |
$2,672.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,772.75
|
| Rate for Payer: Zelis Worker's Compensation |
$628.72
|
|
|
FINGER TENDON TRANSFER
|
Facility
|
OP
|
$1,732.00
|
|
|
Service Code
|
CPT 26497
|
| Hospital Charge Code |
6126497
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$472.84 |
| Max. Negotiated Rate |
$6,287.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,855.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,039.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,855.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,261.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,143.96
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cigna Commercial |
$1,472.20
|
| Rate for Payer: First Health Commercial |
$1,558.80
|
| Rate for Payer: First Health Workers Compensation |
$668.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,558.80
|
| Rate for Payer: GEHA Commercial |
$1,385.60
|
| Rate for Payer: GEHA Medicare |
$3,143.96
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,558.80
|
| Rate for Payer: Humana ChoiceCare |
$3,458.36
|
| Rate for Payer: Humana Medicare Advantage |
$3,143.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,281.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,307.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,143.96
|
| Rate for Payer: Multiplan All |
$1,576.12
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,344.73
|
| Rate for Payer: OMNI Networks Commercial |
$1,212.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,558.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,664.73
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,307.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,143.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,645.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,287.92
|
| Rate for Payer: Three Rivers Provider Network All |
$1,299.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,081.08
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,307.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,143.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,610.76
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,143.96
|
| Rate for Payer: Zelis Auto |
$692.80
|
| Rate for Payer: Zelis Medicare |
$2,672.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,772.75
|
| Rate for Payer: Zelis Worker's Compensation |
$472.84
|
|
|
FINGER TENDON TRANSFER
|
Facility
|
IP
|
$2,303.00
|
|
|
Service Code
|
CPT 26498
|
| Hospital Charge Code |
6126498
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$628.72 |
| Max. Negotiated Rate |
$2,187.85 |
| Rate for Payer: Cash Price |
$1,381.80
|
| Rate for Payer: Cigna Commercial |
$1,957.55
|
| Rate for Payer: First Health Commercial |
$2,072.70
|
| Rate for Payer: First Health Workers Compensation |
$889.19
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,072.70
|
| Rate for Payer: GEHA Commercial |
$1,612.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,072.70
|
| Rate for Payer: Multiplan All |
$2,095.73
|
| Rate for Payer: OMNI Networks Commercial |
$1,612.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2,072.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,187.85
|
| Rate for Payer: Three Rivers Provider Network All |
$1,727.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,141.79
|
| Rate for Payer: Zelis Auto |
$921.20
|
| Rate for Payer: Zelis Worker's Compensation |
$628.72
|
|
|
FISSURECTOMY, INCLUDING SPHINCTEROTOMY, WHEN PERFORMED
|
Facility
|
OP
|
$5,314.64
|
|
|
Service Code
|
CPT 46200
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,919.98 |
| Max. Negotiated Rate |
$5,314.64 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,423.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,423.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,919.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,657.32
|
| Rate for Payer: First Health Workers Compensation |
$3,419.97
|
| Rate for Payer: GEHA Medicare |
$2,657.32
|
| Rate for Payer: Humana ChoiceCare |
$2,923.05
|
| Rate for Payer: Humana Medicare Advantage |
$2,657.32
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,464.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,959.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,657.32
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,517.44
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,262.04
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,959.08
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,657.32
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,314.64
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,604.17
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,959.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,657.32
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,657.32
|
| Rate for Payer: Zelis Medicare |
$2,258.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,188.78
|
| Rate for Payer: Zelis Worker's Compensation |
$2,418.16
|
|
