|
I&D OF BARTHOLINS GLAND ABSCESS
|
Facility
|
OP
|
$277.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
6156420
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$75.62 |
| Max. Negotiated Rate |
$382.04 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$154.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$166.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$154.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$122.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$191.02
|
| Rate for Payer: Cash Price |
$166.20
|
| Rate for Payer: Cash Price |
$166.20
|
| Rate for Payer: Cigna Commercial |
$235.45
|
| Rate for Payer: First Health Commercial |
$249.30
|
| Rate for Payer: First Health Workers Compensation |
$106.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$249.30
|
| Rate for Payer: GEHA Commercial |
$221.60
|
| Rate for Payer: GEHA Medicare |
$191.02
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$249.30
|
| Rate for Payer: Humana ChoiceCare |
$210.12
|
| Rate for Payer: Humana Medicare Advantage |
$191.02
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$320.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$124.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$191.02
|
| Rate for Payer: Multiplan All |
$252.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$324.73
|
| Rate for Payer: OMNI Networks Commercial |
$193.90
|
| Rate for Payer: One Health Plan PPO/POS |
$249.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$144.17
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$124.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$191.02
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$263.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$382.04
|
| Rate for Payer: Three Rivers Provider Network All |
$207.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$187.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$124.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$191.02
|
| Rate for Payer: United Payors & United Providers UP&UP |
$257.61
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$191.02
|
| Rate for Payer: Zelis Auto |
$110.80
|
| Rate for Payer: Zelis Medicare |
$162.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$229.22
|
| Rate for Payer: Zelis Worker's Compensation |
$75.62
|
|
|
I&D OF BARTHOLINS GLAND ABSCESS
|
Facility
|
IP
|
$855.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
21656420
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$233.41 |
| Max. Negotiated Rate |
$812.25 |
| Rate for Payer: Cash Price |
$513.00
|
| Rate for Payer: Cigna Commercial |
$726.75
|
| Rate for Payer: First Health Commercial |
$769.50
|
| Rate for Payer: First Health Workers Compensation |
$330.12
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$769.50
|
| Rate for Payer: GEHA Commercial |
$598.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$769.50
|
| Rate for Payer: Multiplan All |
$778.05
|
| Rate for Payer: OMNI Networks Commercial |
$598.50
|
| Rate for Payer: One Health Plan PPO/POS |
$769.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$812.25
|
| Rate for Payer: Three Rivers Provider Network All |
$641.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$795.15
|
| Rate for Payer: Zelis Auto |
$342.00
|
| Rate for Payer: Zelis Worker's Compensation |
$233.41
|
|
|
I&D OF BARTHOLINS GLAND ABSCESS
|
Facility
|
OP
|
$855.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
21656420
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$122.37 |
| Max. Negotiated Rate |
$812.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$154.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$513.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$154.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$122.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$191.02
|
| Rate for Payer: Cash Price |
$513.00
|
| Rate for Payer: Cash Price |
$513.00
|
| Rate for Payer: Cigna Commercial |
$726.75
|
| Rate for Payer: First Health Commercial |
$769.50
|
| Rate for Payer: First Health Workers Compensation |
$330.12
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$769.50
|
| Rate for Payer: GEHA Commercial |
$684.00
|
| Rate for Payer: GEHA Medicare |
$191.02
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$769.50
|
| Rate for Payer: Humana ChoiceCare |
$210.12
|
| Rate for Payer: Humana Medicare Advantage |
$191.02
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$320.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$124.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$191.02
|
| Rate for Payer: Multiplan All |
$778.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$324.73
|
| Rate for Payer: OMNI Networks Commercial |
$598.50
|
| Rate for Payer: One Health Plan PPO/POS |
$769.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$144.17
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$124.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$191.02
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$812.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$382.04
|
| Rate for Payer: Three Rivers Provider Network All |
$641.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$187.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$124.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$191.02
|
| Rate for Payer: United Payors & United Providers UP&UP |
$795.15
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$191.02
|
| Rate for Payer: Zelis Auto |
$342.00
|
| Rate for Payer: Zelis Medicare |
$162.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$229.22
|
| Rate for Payer: Zelis Worker's Compensation |
$233.41
|
|
|
I&D OF BARTHOLINS GLAND ABSCESS
|
Facility
|
IP
|
$277.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
6156420
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$75.62 |
| Max. Negotiated Rate |
$263.15 |
| Rate for Payer: Cash Price |
$166.20
|
| Rate for Payer: Cigna Commercial |
$235.45
|
| Rate for Payer: First Health Commercial |
$249.30
|
| Rate for Payer: First Health Workers Compensation |
$106.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$249.30
|
| Rate for Payer: GEHA Commercial |
$193.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$249.30
|
| Rate for Payer: Multiplan All |
$252.07
|
| Rate for Payer: OMNI Networks Commercial |
$193.90
|
| Rate for Payer: One Health Plan PPO/POS |
$249.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$263.15
|
| Rate for Payer: Three Rivers Provider Network All |
$207.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$257.61
|
| Rate for Payer: Zelis Auto |
$110.80
|
| Rate for Payer: Zelis Worker's Compensation |
$75.62
|
|
|
I&D OF BARTHOLINS GLAND ABSCESS
|
Facility
|
IP
|
$369.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
8511766
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$100.74 |
| Max. Negotiated Rate |
$350.55 |
| Rate for Payer: Cash Price |
$221.40
|
| Rate for Payer: Cigna Commercial |
$313.65
|
| Rate for Payer: First Health Commercial |
$332.10
|
| Rate for Payer: First Health Workers Compensation |
$142.47
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$332.10
|
| Rate for Payer: GEHA Commercial |
$258.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$332.10
|
| Rate for Payer: Multiplan All |
$335.79
|
| Rate for Payer: OMNI Networks Commercial |
$258.30
|
| Rate for Payer: One Health Plan PPO/POS |
$332.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$350.55
|
| Rate for Payer: Three Rivers Provider Network All |
$276.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$343.17
|
| Rate for Payer: Zelis Auto |
$147.60
|
| Rate for Payer: Zelis Worker's Compensation |
$100.74
|
|
|
I&D OF BARTHOLINS GLAND ABSCESS
|
Facility
|
IP
|
$705.00
|
|
| Hospital Charge Code |
8156420
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$192.47 |
| Max. Negotiated Rate |
$669.75 |
| Rate for Payer: Cash Price |
$423.00
|
| Rate for Payer: Cigna Commercial |
$599.25
|
| Rate for Payer: First Health Commercial |
$634.50
|
| Rate for Payer: First Health Workers Compensation |
$272.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$634.50
|
| Rate for Payer: GEHA Commercial |
$493.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$634.50
|
| Rate for Payer: Multiplan All |
$641.55
|
| Rate for Payer: OMNI Networks Commercial |
$493.50
|
| Rate for Payer: One Health Plan PPO/POS |
$634.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$669.75
|
| Rate for Payer: Three Rivers Provider Network All |
$528.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$655.65
|
| Rate for Payer: Zelis Auto |
$282.00
|
| Rate for Payer: Zelis Worker's Compensation |
$192.47
|
|
|
I&D OF BARTHOLINS GLAND ABSCESS
|
Facility
|
OP
|
$705.00
|
|
| Hospital Charge Code |
8156420
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$176.25 |
| Max. Negotiated Rate |
$669.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$423.00
|
| Rate for Payer: Cash Price |
$423.00
|
| Rate for Payer: Cigna Commercial |
$599.25
|
| Rate for Payer: First Health Commercial |
$634.50
|
| Rate for Payer: First Health Workers Compensation |
$272.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$634.50
|
| Rate for Payer: GEHA Commercial |
$564.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$634.50
|
| Rate for Payer: Humana ChoiceCare |
$183.30
|
| Rate for Payer: Multiplan All |
$641.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$423.00
|
| Rate for Payer: OMNI Networks Commercial |
$493.50
|
| Rate for Payer: One Health Plan PPO/POS |
$634.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$669.75
|
| Rate for Payer: Three Rivers Provider Network All |
$528.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$620.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$176.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$655.65
|
| Rate for Payer: Zelis Auto |
$282.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$352.50
|
| Rate for Payer: Zelis Worker's Compensation |
$192.47
|
|
|
I&D PERIANAL ABSCESS SUPERFICIAL
|
Facility
|
IP
|
$1,798.00
|
|
| Hospital Charge Code |
8146050
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$490.85 |
| Max. Negotiated Rate |
$1,708.10 |
| Rate for Payer: Cash Price |
$1,078.80
|
| Rate for Payer: Cigna Commercial |
$1,528.30
|
| Rate for Payer: First Health Commercial |
$1,618.20
|
| Rate for Payer: First Health Workers Compensation |
$694.21
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,618.20
|
| Rate for Payer: GEHA Commercial |
$1,258.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,618.20
|
| Rate for Payer: Multiplan All |
$1,636.18
|
| Rate for Payer: OMNI Networks Commercial |
$1,258.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,618.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,708.10
|
| Rate for Payer: Three Rivers Provider Network All |
$1,348.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,672.14
|
| Rate for Payer: Zelis Auto |
$719.20
|
| Rate for Payer: Zelis Worker's Compensation |
$490.85
|
|
|
I&D PERIANAL ABSCESS SUPERFICIAL
|
Facility
|
OP
|
$298.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
6146050
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$81.35 |
| Max. Negotiated Rate |
$1,731.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,427.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$178.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,427.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,130.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$865.71
|
| Rate for Payer: Cash Price |
$178.80
|
| Rate for Payer: Cash Price |
$178.80
|
| Rate for Payer: Cigna Commercial |
$253.30
|
| Rate for Payer: First Health Commercial |
$268.20
|
| Rate for Payer: First Health Workers Compensation |
$115.06
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$268.20
|
| Rate for Payer: GEHA Commercial |
$238.40
|
| Rate for Payer: GEHA Medicare |
$865.71
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$268.20
|
| Rate for Payer: Humana ChoiceCare |
$952.28
|
| Rate for Payer: Humana Medicare Advantage |
$865.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,454.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,153.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$865.71
|
| Rate for Payer: Multiplan All |
$271.18
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,471.71
|
| Rate for Payer: OMNI Networks Commercial |
$208.60
|
| Rate for Payer: One Health Plan PPO/POS |
$268.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,331.92
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,153.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$865.71
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$283.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,731.42
|
| Rate for Payer: Three Rivers Provider Network All |
$223.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$848.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,153.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$865.71
|
| Rate for Payer: United Payors & United Providers UP&UP |
$277.14
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$865.71
|
| Rate for Payer: Zelis Auto |
$119.20
|
| Rate for Payer: Zelis Medicare |
$735.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,038.85
|
| Rate for Payer: Zelis Worker's Compensation |
$81.35
|
|
|
I&D PERIANAL ABSCESS SUPERFICIAL
|
Facility
|
OP
|
$298.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
21600091
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$81.35 |
| Max. Negotiated Rate |
$1,731.42 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,427.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$178.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,427.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,130.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$865.71
|
| Rate for Payer: Cash Price |
$178.80
|
| Rate for Payer: Cash Price |
$178.80
|
| Rate for Payer: Cigna Commercial |
$253.30
|
| Rate for Payer: First Health Commercial |
$268.20
|
| Rate for Payer: First Health Workers Compensation |
$115.06
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$268.20
|
| Rate for Payer: GEHA Commercial |
$238.40
|
| Rate for Payer: GEHA Medicare |
$865.71
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$268.20
|
| Rate for Payer: Humana ChoiceCare |
$952.28
|
| Rate for Payer: Humana Medicare Advantage |
$865.71
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,454.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,153.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$865.71
|
| Rate for Payer: Multiplan All |
$271.18
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,471.71
|
| Rate for Payer: OMNI Networks Commercial |
$208.60
|
| Rate for Payer: One Health Plan PPO/POS |
$268.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,331.92
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,153.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$865.71
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$283.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,731.42
|
| Rate for Payer: Three Rivers Provider Network All |
$223.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$848.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,153.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$865.71
|
| Rate for Payer: United Payors & United Providers UP&UP |
$277.14
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$865.71
|
| Rate for Payer: Zelis Auto |
$119.20
|
| Rate for Payer: Zelis Medicare |
$735.85
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,038.85
|
| Rate for Payer: Zelis Worker's Compensation |
$81.35
|
|
|
I&D PERIANAL ABSCESS SUPERFICIAL
|
Facility
|
IP
|
$298.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
21600091
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$81.35 |
| Max. Negotiated Rate |
$283.10 |
| Rate for Payer: Cash Price |
$178.80
|
| Rate for Payer: Cigna Commercial |
$253.30
|
| Rate for Payer: First Health Commercial |
$268.20
|
| Rate for Payer: First Health Workers Compensation |
$115.06
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$268.20
|
| Rate for Payer: GEHA Commercial |
$208.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$268.20
|
| Rate for Payer: Multiplan All |
$271.18
|
| Rate for Payer: OMNI Networks Commercial |
$208.60
|
| Rate for Payer: One Health Plan PPO/POS |
$268.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$283.10
|
| Rate for Payer: Three Rivers Provider Network All |
$223.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$277.14
|
| Rate for Payer: Zelis Auto |
$119.20
|
| Rate for Payer: Zelis Worker's Compensation |
$81.35
|
|
|
I&D PERIANAL ABSCESS SUPERFICIAL
|
Facility
|
IP
|
$298.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
6146050
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$81.35 |
| Max. Negotiated Rate |
$283.10 |
| Rate for Payer: Cash Price |
$178.80
|
| Rate for Payer: Cigna Commercial |
$253.30
|
| Rate for Payer: First Health Commercial |
$268.20
|
| Rate for Payer: First Health Workers Compensation |
$115.06
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$268.20
|
| Rate for Payer: GEHA Commercial |
$208.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$268.20
|
| Rate for Payer: Multiplan All |
$271.18
|
| Rate for Payer: OMNI Networks Commercial |
$208.60
|
| Rate for Payer: One Health Plan PPO/POS |
$268.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$283.10
|
| Rate for Payer: Three Rivers Provider Network All |
$223.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$277.14
|
| Rate for Payer: Zelis Auto |
$119.20
|
| Rate for Payer: Zelis Worker's Compensation |
$81.35
|
|
|
I&D PERIANAL ABSCESS SUPERFICIAL
|
Facility
|
OP
|
$1,798.00
|
|
| Hospital Charge Code |
8146050
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$449.50 |
| Max. Negotiated Rate |
$1,708.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,078.80
|
| Rate for Payer: Cash Price |
$1,078.80
|
| Rate for Payer: Cigna Commercial |
$1,528.30
|
| Rate for Payer: First Health Commercial |
$1,618.20
|
| Rate for Payer: First Health Workers Compensation |
$694.21
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,618.20
|
| Rate for Payer: GEHA Commercial |
$1,438.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,618.20
|
| Rate for Payer: Humana ChoiceCare |
$467.48
|
| Rate for Payer: Multiplan All |
$1,636.18
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,078.80
|
| Rate for Payer: OMNI Networks Commercial |
$1,258.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,618.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,708.10
|
| Rate for Payer: Three Rivers Provider Network All |
$1,348.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,582.24
|
| Rate for Payer: United Healthcare Managed Medicaid |
$449.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,672.14
|
| Rate for Payer: Zelis Auto |
$719.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$899.00
|
| Rate for Payer: Zelis Worker's Compensation |
$490.85
|
|
|
I&D P-SPINE C/T/CERV-THOR
|
Facility
|
OP
|
$1,980.00
|
|
|
Service Code
|
CPT 22010
|
| Hospital Charge Code |
6122010
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$495.00 |
| Max. Negotiated Rate |
$1,881.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,188.00
|
| Rate for Payer: Cash Price |
$1,188.00
|
| Rate for Payer: Cigna Commercial |
$1,683.00
|
| Rate for Payer: First Health Commercial |
$1,782.00
|
| Rate for Payer: First Health Workers Compensation |
$764.48
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,782.00
|
| Rate for Payer: GEHA Commercial |
$1,584.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,782.00
|
| Rate for Payer: Humana ChoiceCare |
$514.80
|
| Rate for Payer: Multiplan All |
$1,801.80
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,188.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,386.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,782.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,881.00
|
| Rate for Payer: Three Rivers Provider Network All |
$1,485.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,742.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$495.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,841.40
|
| Rate for Payer: Zelis Auto |
$792.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$990.00
|
| Rate for Payer: Zelis Worker's Compensation |
$540.54
|
|
|
I&D P-SPINE C/T/CERV-THOR
|
Facility
|
IP
|
$1,980.00
|
|
|
Service Code
|
CPT 22010
|
| Hospital Charge Code |
6122010
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$540.54 |
| Max. Negotiated Rate |
$1,881.00 |
| Rate for Payer: Cash Price |
$1,188.00
|
| Rate for Payer: Cigna Commercial |
$1,683.00
|
| Rate for Payer: First Health Commercial |
$1,782.00
|
| Rate for Payer: First Health Workers Compensation |
$764.48
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,782.00
|
| Rate for Payer: GEHA Commercial |
$1,386.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,782.00
|
| Rate for Payer: Multiplan All |
$1,801.80
|
| Rate for Payer: OMNI Networks Commercial |
$1,386.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,782.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,881.00
|
| Rate for Payer: Three Rivers Provider Network All |
$1,485.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,841.40
|
| Rate for Payer: Zelis Auto |
$792.00
|
| Rate for Payer: Zelis Worker's Compensation |
$540.54
|
|
|
I & D SOFT TISSUE ABSCESS SUBFASC
|
Facility
|
OP
|
$5,325.00
|
|
|
Service Code
|
CPT 20005
|
| Hospital Charge Code |
8120005
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,331.25 |
| Max. Negotiated Rate |
$5,058.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,195.00
|
| Rate for Payer: Cash Price |
$3,195.00
|
| Rate for Payer: Cigna Commercial |
$4,526.25
|
| Rate for Payer: First Health Commercial |
$4,792.50
|
| Rate for Payer: First Health Workers Compensation |
$2,055.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,792.50
|
| Rate for Payer: GEHA Commercial |
$4,260.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,792.50
|
| Rate for Payer: Humana ChoiceCare |
$1,384.50
|
| Rate for Payer: Multiplan All |
$4,845.75
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,195.00
|
| Rate for Payer: OMNI Networks Commercial |
$3,727.50
|
| Rate for Payer: One Health Plan PPO/POS |
$4,792.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,058.75
|
| Rate for Payer: Three Rivers Provider Network All |
$3,993.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4,686.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,331.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,952.25
|
| Rate for Payer: Zelis Auto |
$2,130.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,662.50
|
| Rate for Payer: Zelis Worker's Compensation |
$1,453.72
|
|
|
I & D SOFT TISSUE ABSCESS SUBFASC
|
Facility
|
IP
|
$5,325.00
|
|
|
Service Code
|
CPT 20005
|
| Hospital Charge Code |
8120005
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,453.72 |
| Max. Negotiated Rate |
$5,058.75 |
| Rate for Payer: Cash Price |
$3,195.00
|
| Rate for Payer: Cigna Commercial |
$4,526.25
|
| Rate for Payer: First Health Commercial |
$4,792.50
|
| Rate for Payer: First Health Workers Compensation |
$2,055.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,792.50
|
| Rate for Payer: GEHA Commercial |
$3,727.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,792.50
|
| Rate for Payer: Multiplan All |
$4,845.75
|
| Rate for Payer: OMNI Networks Commercial |
$3,727.50
|
| Rate for Payer: One Health Plan PPO/POS |
$4,792.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,058.75
|
| Rate for Payer: Three Rivers Provider Network All |
$3,993.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,952.25
|
| Rate for Payer: Zelis Auto |
$2,130.00
|
| Rate for Payer: Zelis Worker's Compensation |
$1,453.72
|
|
|
I & D VAG HEMATOMA NON-OB
|
Facility
|
OP
|
$947.61
|
|
|
Service Code
|
CPT 57023
|
| Hospital Charge Code |
6157023
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$258.70 |
| Max. Negotiated Rate |
$5,435.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,962.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$568.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,962.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,554.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,717.63
|
| Rate for Payer: Cash Price |
$568.57
|
| Rate for Payer: Cash Price |
$568.57
|
| Rate for Payer: Cigna Commercial |
$805.47
|
| Rate for Payer: First Health Commercial |
$852.85
|
| Rate for Payer: First Health Workers Compensation |
$365.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$852.85
|
| Rate for Payer: GEHA Commercial |
$758.09
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$852.85
|
| Rate for Payer: Humana ChoiceCare |
$2,989.39
|
| Rate for Payer: Humana Medicare Advantage |
$2,717.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,565.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,586.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,717.63
|
| Rate for Payer: Multiplan All |
$862.33
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$663.33
|
| Rate for Payer: One Health Plan PPO/POS |
$852.85
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,831.34
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,586.07
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,717.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$900.23
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$710.71
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,663.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,586.07
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,717.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$881.28
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$379.04
|
| Rate for Payer: Zelis Medicare |
$2,309.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,261.16
|
| Rate for Payer: Zelis Worker's Compensation |
$258.70
|
|
|
I & D VAG HEMATOMA NON-OB
|
Facility
|
IP
|
$947.61
|
|
|
Service Code
|
CPT 57023
|
| Hospital Charge Code |
6157023
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$258.70 |
| Max. Negotiated Rate |
$900.23 |
| Rate for Payer: Cash Price |
$568.57
|
| Rate for Payer: Cigna Commercial |
$805.47
|
| Rate for Payer: First Health Commercial |
$852.85
|
| Rate for Payer: First Health Workers Compensation |
$365.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$852.85
|
| Rate for Payer: GEHA Commercial |
$663.33
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$852.85
|
| Rate for Payer: Multiplan All |
$862.33
|
| Rate for Payer: OMNI Networks Commercial |
$663.33
|
| Rate for Payer: One Health Plan PPO/POS |
$852.85
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$900.23
|
| Rate for Payer: Three Rivers Provider Network All |
$710.71
|
| Rate for Payer: United Payors & United Providers UP&UP |
$881.28
|
| Rate for Payer: Zelis Auto |
$379.04
|
| Rate for Payer: Zelis Worker's Compensation |
$258.70
|
|
|
I & D VAGINAL HEMATOMA PP
|
Facility
|
OP
|
$517.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
6157022
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$141.14 |
| Max. Negotiated Rate |
$5,435.26 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,276.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$310.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,276.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,010.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,717.63
|
| Rate for Payer: Cash Price |
$310.20
|
| Rate for Payer: Cash Price |
$310.20
|
| Rate for Payer: Cigna Commercial |
$439.45
|
| Rate for Payer: First Health Commercial |
$465.30
|
| Rate for Payer: First Health Workers Compensation |
$199.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$465.30
|
| Rate for Payer: GEHA Commercial |
$413.60
|
| Rate for Payer: GEHA Medicare |
$2,717.63
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$465.30
|
| Rate for Payer: Humana ChoiceCare |
$2,989.39
|
| Rate for Payer: Humana Medicare Advantage |
$2,717.63
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,565.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,031.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,717.63
|
| Rate for Payer: Multiplan All |
$470.47
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,619.97
|
| Rate for Payer: OMNI Networks Commercial |
$361.90
|
| Rate for Payer: One Health Plan PPO/POS |
$465.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,191.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,031.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,717.63
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$491.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,435.26
|
| Rate for Payer: Three Rivers Provider Network All |
$387.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,663.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,031.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,717.63
|
| Rate for Payer: United Payors & United Providers UP&UP |
$480.81
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,717.63
|
| Rate for Payer: Zelis Auto |
$206.80
|
| Rate for Payer: Zelis Medicare |
$2,309.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,261.16
|
| Rate for Payer: Zelis Worker's Compensation |
$141.14
|
|
|
I & D VAGINAL HEMATOMA PP
|
Facility
|
IP
|
$517.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
6157022
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$141.14 |
| Max. Negotiated Rate |
$491.15 |
| Rate for Payer: Cash Price |
$310.20
|
| Rate for Payer: Cigna Commercial |
$439.45
|
| Rate for Payer: First Health Commercial |
$465.30
|
| Rate for Payer: First Health Workers Compensation |
$199.61
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$465.30
|
| Rate for Payer: GEHA Commercial |
$361.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$465.30
|
| Rate for Payer: Multiplan All |
$470.47
|
| Rate for Payer: OMNI Networks Commercial |
$361.90
|
| Rate for Payer: One Health Plan PPO/POS |
$465.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$491.15
|
| Rate for Payer: Three Rivers Provider Network All |
$387.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$480.81
|
| Rate for Payer: Zelis Auto |
$206.80
|
| Rate for Payer: Zelis Worker's Compensation |
$141.14
|
|
|
I&D VULVA/PERINEAL ABSCESS
|
Facility
|
IP
|
$422.88
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
21600094
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Cash Price |
$253.73
|
| Rate for Payer: Cigna Commercial |
$359.45
|
| Rate for Payer: First Health Commercial |
$380.59
|
| Rate for Payer: First Health Workers Compensation |
$163.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$380.59
|
| Rate for Payer: GEHA Commercial |
$296.02
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$380.59
|
| Rate for Payer: Multiplan All |
$384.82
|
| Rate for Payer: OMNI Networks Commercial |
$296.02
|
| Rate for Payer: One Health Plan PPO/POS |
$380.59
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$401.74
|
| Rate for Payer: Three Rivers Provider Network All |
$317.16
|
| Rate for Payer: United Payors & United Providers UP&UP |
$393.28
|
| Rate for Payer: Zelis Auto |
$169.15
|
| Rate for Payer: Zelis Worker's Compensation |
$115.45
|
|
|
I&D VULVA/PERINEAL ABSCESS
|
Facility
|
IP
|
$422.88
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
6156405
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Cash Price |
$253.73
|
| Rate for Payer: Cigna Commercial |
$359.45
|
| Rate for Payer: First Health Commercial |
$380.59
|
| Rate for Payer: First Health Workers Compensation |
$163.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$380.59
|
| Rate for Payer: GEHA Commercial |
$296.02
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$380.59
|
| Rate for Payer: Multiplan All |
$384.82
|
| Rate for Payer: OMNI Networks Commercial |
$296.02
|
| Rate for Payer: One Health Plan PPO/POS |
$380.59
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$401.74
|
| Rate for Payer: Three Rivers Provider Network All |
$317.16
|
| Rate for Payer: United Payors & United Providers UP&UP |
$393.28
|
| Rate for Payer: Zelis Auto |
$169.15
|
| Rate for Payer: Zelis Worker's Compensation |
$115.45
|
|
|
I&D VULVA/PERINEAL ABSCESS
|
Facility
|
OP
|
$422.88
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
6156405
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$577.68 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$154.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$253.73
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$154.47
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$122.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$288.84
|
| Rate for Payer: Cash Price |
$253.73
|
| Rate for Payer: Cash Price |
$253.73
|
| Rate for Payer: Cigna Commercial |
$359.45
|
| Rate for Payer: First Health Commercial |
$380.59
|
| Rate for Payer: First Health Workers Compensation |
$163.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$380.59
|
| Rate for Payer: GEHA Commercial |
$338.30
|
| Rate for Payer: GEHA Medicare |
$288.84
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$380.59
|
| Rate for Payer: Humana ChoiceCare |
$317.72
|
| Rate for Payer: Humana Medicare Advantage |
$288.84
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$485.25
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$124.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$288.84
|
| Rate for Payer: Multiplan All |
$384.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$491.03
|
| Rate for Payer: OMNI Networks Commercial |
$296.02
|
| Rate for Payer: One Health Plan PPO/POS |
$380.59
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$144.17
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$124.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$288.84
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$401.74
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$577.68
|
| Rate for Payer: Three Rivers Provider Network All |
$317.16
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$283.06
|
| Rate for Payer: United Healthcare Managed Medicaid |
$124.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$288.84
|
| Rate for Payer: United Payors & United Providers UP&UP |
$393.28
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$288.84
|
| Rate for Payer: Zelis Auto |
$169.15
|
| Rate for Payer: Zelis Medicare |
$245.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$346.61
|
| Rate for Payer: Zelis Worker's Compensation |
$115.45
|
|
|
I&D VULVA/PERINEAL ABSCESS
|
Facility
|
OP
|
$1,606.00
|
|
| Hospital Charge Code |
8156405
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$401.50 |
| Max. Negotiated Rate |
$1,525.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$963.60
|
| Rate for Payer: Cash Price |
$963.60
|
| Rate for Payer: Cigna Commercial |
$1,365.10
|
| Rate for Payer: First Health Commercial |
$1,445.40
|
| Rate for Payer: First Health Workers Compensation |
$620.08
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,445.40
|
| Rate for Payer: GEHA Commercial |
$1,284.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,445.40
|
| Rate for Payer: Humana ChoiceCare |
$417.56
|
| Rate for Payer: Multiplan All |
$1,461.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$963.60
|
| Rate for Payer: OMNI Networks Commercial |
$1,124.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,445.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,525.70
|
| Rate for Payer: Three Rivers Provider Network All |
$1,204.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,413.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$401.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,493.58
|
| Rate for Payer: Zelis Auto |
$642.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$803.00
|
| Rate for Payer: Zelis Worker's Compensation |
$438.44
|
|
