|
afb smear REF008618
|
Facility
|
IP
|
$117.00
|
|
|
Service Code
|
CPT 87206
|
| Hospital Charge Code |
22990895
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.52 |
| Max. Negotiated Rate |
$111.15 |
| Rate for Payer: Cash Price |
$70.20
|
| Rate for Payer: Cash Price |
$70.20
|
| Rate for Payer: Cigna Commercial |
$99.45
|
| Rate for Payer: First Health Commercial |
$105.30
|
| Rate for Payer: First Health Workers Compensation |
$10.63
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$105.30
|
| Rate for Payer: GEHA Commercial |
$81.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$105.30
|
| Rate for Payer: Multiplan All |
$106.47
|
| Rate for Payer: OMNI Networks Commercial |
$81.90
|
| Rate for Payer: One Health Plan PPO/POS |
$105.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$111.15
|
| Rate for Payer: Three Rivers Provider Network All |
$87.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$108.81
|
| Rate for Payer: Zelis Auto |
$46.80
|
| Rate for Payer: Zelis Worker's Compensation |
$7.52
|
|
|
AFFINITY HIGH COST SKIN SUBSTITUTE
|
Facility
|
OP
|
$412.00
|
|
|
Service Code
|
CPT Q4159
|
| Hospital Charge Code |
1904159
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$103.00 |
| Max. Negotiated Rate |
$391.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$247.20
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cigna Commercial |
$350.20
|
| Rate for Payer: First Health Commercial |
$370.80
|
| Rate for Payer: First Health Workers Compensation |
$159.07
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$370.80
|
| Rate for Payer: GEHA Commercial |
$225.46
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$370.80
|
| Rate for Payer: Humana ChoiceCare |
$107.12
|
| Rate for Payer: Multiplan All |
$374.92
|
| Rate for Payer: New Mexico Health Connections Medicare |
$247.20
|
| Rate for Payer: OMNI Networks Commercial |
$288.40
|
| Rate for Payer: One Health Plan PPO/POS |
$370.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$391.40
|
| Rate for Payer: Three Rivers Provider Network All |
$309.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$362.56
|
| Rate for Payer: United Healthcare Managed Medicaid |
$103.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$383.16
|
| Rate for Payer: Zelis Auto |
$164.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$206.00
|
| Rate for Payer: Zelis Worker's Compensation |
$112.48
|
|
|
AFFINITY HIGH COST SKIN SUBSTITUTE
|
Facility
|
IP
|
$412.00
|
|
|
Service Code
|
CPT Q4159
|
| Hospital Charge Code |
1904159
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$112.48 |
| Max. Negotiated Rate |
$391.40 |
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cigna Commercial |
$350.20
|
| Rate for Payer: First Health Commercial |
$370.80
|
| Rate for Payer: First Health Workers Compensation |
$159.07
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$370.80
|
| Rate for Payer: GEHA Commercial |
$288.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$370.80
|
| Rate for Payer: Multiplan All |
$374.92
|
| Rate for Payer: OMNI Networks Commercial |
$288.40
|
| Rate for Payer: One Health Plan PPO/POS |
$370.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$391.40
|
| Rate for Payer: Three Rivers Provider Network All |
$309.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$383.16
|
| Rate for Payer: Zelis Auto |
$164.80
|
| Rate for Payer: Zelis Worker's Compensation |
$112.48
|
|
|
afp, maternal serum REF010801
|
Facility
|
IP
|
$233.00
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
2200639
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.28 |
| Max. Negotiated Rate |
$221.35 |
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cigna Commercial |
$198.05
|
| Rate for Payer: First Health Commercial |
$209.70
|
| Rate for Payer: First Health Workers Compensation |
$25.86
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$209.70
|
| Rate for Payer: GEHA Commercial |
$163.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$209.70
|
| Rate for Payer: Multiplan All |
$212.03
|
| Rate for Payer: OMNI Networks Commercial |
$163.10
|
| Rate for Payer: One Health Plan PPO/POS |
$209.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$221.35
|
| Rate for Payer: Three Rivers Provider Network All |
$174.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$216.69
|
| Rate for Payer: Zelis Auto |
$93.20
|
| Rate for Payer: Zelis Worker's Compensation |
$18.28
|
|
|
afp, maternal serum REF010801
|
Facility
|
OP
|
$233.00
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
2200639
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.25 |
| Max. Negotiated Rate |
$221.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$30.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$139.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$30.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$23.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16.77
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cigna Commercial |
$198.05
|
| Rate for Payer: First Health Commercial |
$209.70
|
| Rate for Payer: First Health Workers Compensation |
$25.86
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$209.70
|
| Rate for Payer: GEHA Commercial |
$186.40
|
| Rate for Payer: GEHA Medicare |
$16.77
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$209.70
|
| Rate for Payer: Humana ChoiceCare |
$18.45
|
| Rate for Payer: Humana Medicare Advantage |
$16.77
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$28.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$24.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16.77
|
| Rate for Payer: Multiplan All |
$212.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$28.51
|
| Rate for Payer: OMNI Networks Commercial |
$163.10
|
| Rate for Payer: One Health Plan PPO/POS |
$209.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28.17
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$24.40
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16.77
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$221.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$33.54
|
| Rate for Payer: Three Rivers Provider Network All |
$174.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16.43
|
| Rate for Payer: United Healthcare Commercial |
$198.05
|
| Rate for Payer: United Healthcare Managed Medicaid |
$24.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.77
|
| Rate for Payer: United Payors & United Providers UP&UP |
$216.69
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$16.77
|
| Rate for Payer: Zelis Auto |
$93.20
|
| Rate for Payer: Zelis Medicare |
$14.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$20.12
|
| Rate for Payer: Zelis Worker's Compensation |
$18.28
|
|
|
afp tumor marker REF002253
|
Facility
|
OP
|
$233.00
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
2246072
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.25 |
| Max. Negotiated Rate |
$221.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$30.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$139.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$30.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$23.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$16.77
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cigna Commercial |
$198.05
|
| Rate for Payer: First Health Commercial |
$209.70
|
| Rate for Payer: First Health Workers Compensation |
$25.86
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$209.70
|
| Rate for Payer: GEHA Commercial |
$186.40
|
| Rate for Payer: GEHA Medicare |
$16.77
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$209.70
|
| Rate for Payer: Humana ChoiceCare |
$18.45
|
| Rate for Payer: Humana Medicare Advantage |
$16.77
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$28.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$24.40
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$16.77
|
| Rate for Payer: Multiplan All |
$212.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$28.51
|
| Rate for Payer: OMNI Networks Commercial |
$163.10
|
| Rate for Payer: One Health Plan PPO/POS |
$209.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$28.17
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$24.40
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$16.77
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$221.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$33.54
|
| Rate for Payer: Three Rivers Provider Network All |
$174.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$16.43
|
| Rate for Payer: United Healthcare Commercial |
$198.05
|
| Rate for Payer: United Healthcare Managed Medicaid |
$24.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.77
|
| Rate for Payer: United Payors & United Providers UP&UP |
$216.69
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$16.77
|
| Rate for Payer: Zelis Auto |
$93.20
|
| Rate for Payer: Zelis Medicare |
$14.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$20.12
|
| Rate for Payer: Zelis Worker's Compensation |
$18.28
|
|
|
afp tumor marker REF002253
|
Facility
|
IP
|
$233.00
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
2246072
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.28 |
| Max. Negotiated Rate |
$221.35 |
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cash Price |
$139.80
|
| Rate for Payer: Cigna Commercial |
$198.05
|
| Rate for Payer: First Health Commercial |
$209.70
|
| Rate for Payer: First Health Workers Compensation |
$25.86
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$209.70
|
| Rate for Payer: GEHA Commercial |
$163.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$209.70
|
| Rate for Payer: Multiplan All |
$212.03
|
| Rate for Payer: OMNI Networks Commercial |
$163.10
|
| Rate for Payer: One Health Plan PPO/POS |
$209.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$221.35
|
| Rate for Payer: Three Rivers Provider Network All |
$174.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$216.69
|
| Rate for Payer: Zelis Auto |
$93.20
|
| Rate for Payer: Zelis Worker's Compensation |
$18.28
|
|
|
AIR INJECTION INTO ABDOMEN
|
Facility
|
IP
|
$295.00
|
|
|
Service Code
|
CPT 49400
|
| Hospital Charge Code |
6149400
|
|
Hospital Revenue Code
|
975
|
| 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
|
|
|
AIR INJECTION INTO ABDOMEN
|
Facility
|
OP
|
$295.00
|
|
|
Service Code
|
CPT 49400
|
| Hospital Charge Code |
6149400
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$73.75 |
| Max. Negotiated Rate |
$280.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$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: Great West Healthcare (Cigna) Commercial |
$265.50
|
| Rate for Payer: Humana ChoiceCare |
$76.70
|
| Rate for Payer: Multiplan All |
$268.45
|
| Rate for Payer: New Mexico Health Connections Medicare |
$177.00
|
| 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: TriWest Veterans Administration/VAPC3 |
$259.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$73.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$274.35
|
| Rate for Payer: Zelis Auto |
$118.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$147.50
|
| Rate for Payer: Zelis Worker's Compensation |
$80.53
|
|
|
ALBUMIN 25% 12.5 GM/50 ML VIAL
|
Facility
|
IP
|
$321.00
|
|
|
Service Code
|
CPT P9047
|
| Hospital Charge Code |
3300023
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$87.63 |
| Max. Negotiated Rate |
$304.95 |
| Rate for Payer: Cash Price |
$192.60
|
| Rate for Payer: Cigna Commercial |
$272.85
|
| Rate for Payer: First Health Commercial |
$288.90
|
| Rate for Payer: First Health Workers Compensation |
$123.94
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$288.90
|
| Rate for Payer: GEHA Commercial |
$224.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$288.90
|
| Rate for Payer: Multiplan All |
$292.11
|
| Rate for Payer: OMNI Networks Commercial |
$224.70
|
| Rate for Payer: One Health Plan PPO/POS |
$288.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$304.95
|
| Rate for Payer: Three Rivers Provider Network All |
$240.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$298.53
|
| Rate for Payer: Zelis Auto |
$128.40
|
| Rate for Payer: Zelis Worker's Compensation |
$87.63
|
|
|
ALBUMIN 25% 12.5 GM/50 ML VIAL
|
Facility
|
OP
|
$321.00
|
|
|
Service Code
|
CPT P9047
|
| Hospital Charge Code |
3300023
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$58.39 |
| Max. Negotiated Rate |
$304.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$80.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$192.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$80.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$63.50
|
| Rate for Payer: Cash Price |
$192.60
|
| Rate for Payer: Cash Price |
$192.60
|
| Rate for Payer: Cigna Commercial |
$272.85
|
| Rate for Payer: First Health Commercial |
$288.90
|
| Rate for Payer: First Health Workers Compensation |
$123.94
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$288.90
|
| Rate for Payer: GEHA Commercial |
$58.39
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$288.90
|
| Rate for Payer: Humana ChoiceCare |
$83.46
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$64.80
|
| Rate for Payer: Multiplan All |
$292.11
|
| Rate for Payer: New Mexico Health Connections Medicare |
$192.60
|
| Rate for Payer: OMNI Networks Commercial |
$224.70
|
| Rate for Payer: One Health Plan PPO/POS |
$288.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$74.82
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$64.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$304.95
|
| Rate for Payer: Three Rivers Provider Network All |
$240.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$282.48
|
| Rate for Payer: United Healthcare Managed Medicaid |
$64.80
|
| Rate for Payer: United Payors & United Providers UP&UP |
$298.53
|
| Rate for Payer: Zelis Auto |
$128.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$160.50
|
| Rate for Payer: Zelis Worker's Compensation |
$87.63
|
|
|
ALBUMIN 25% 25 GM/100 ML VIAL
|
Facility
|
OP
|
$533.00
|
|
|
Service Code
|
CPT P9047
|
| Hospital Charge Code |
3302886
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$58.39 |
| Max. Negotiated Rate |
$506.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$80.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$319.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$80.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$63.50
|
| Rate for Payer: Cash Price |
$319.80
|
| Rate for Payer: Cash Price |
$319.80
|
| Rate for Payer: Cigna Commercial |
$453.05
|
| Rate for Payer: First Health Commercial |
$479.70
|
| Rate for Payer: First Health Workers Compensation |
$205.79
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$479.70
|
| Rate for Payer: GEHA Commercial |
$58.39
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$479.70
|
| Rate for Payer: Humana ChoiceCare |
$138.58
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$64.80
|
| Rate for Payer: Multiplan All |
$485.03
|
| Rate for Payer: New Mexico Health Connections Medicare |
$319.80
|
| Rate for Payer: OMNI Networks Commercial |
$373.10
|
| Rate for Payer: One Health Plan PPO/POS |
$479.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$74.82
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$64.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$506.35
|
| Rate for Payer: Three Rivers Provider Network All |
$399.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$469.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$64.80
|
| Rate for Payer: United Payors & United Providers UP&UP |
$495.69
|
| Rate for Payer: Zelis Auto |
$213.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$266.50
|
| Rate for Payer: Zelis Worker's Compensation |
$145.51
|
|
|
ALBUMIN 25% 25 GM/100 ML VIAL
|
Facility
|
IP
|
$533.00
|
|
|
Service Code
|
CPT P9047
|
| Hospital Charge Code |
3302886
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$145.51 |
| Max. Negotiated Rate |
$506.35 |
| Rate for Payer: Cash Price |
$319.80
|
| Rate for Payer: Cigna Commercial |
$453.05
|
| Rate for Payer: First Health Commercial |
$479.70
|
| Rate for Payer: First Health Workers Compensation |
$205.79
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$479.70
|
| Rate for Payer: GEHA Commercial |
$373.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$479.70
|
| Rate for Payer: Multiplan All |
$485.03
|
| Rate for Payer: OMNI Networks Commercial |
$373.10
|
| Rate for Payer: One Health Plan PPO/POS |
$479.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$506.35
|
| Rate for Payer: Three Rivers Provider Network All |
$399.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$495.69
|
| Rate for Payer: Zelis Auto |
$213.20
|
| Rate for Payer: Zelis Worker's Compensation |
$145.51
|
|
|
ALBUMIN 5% - 12.5GM/250ML VIAL
|
Facility
|
IP
|
$321.00
|
|
|
Service Code
|
CPT P9045
|
| Hospital Charge Code |
3300024
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$87.63 |
| Max. Negotiated Rate |
$304.95 |
| Rate for Payer: Cash Price |
$192.60
|
| Rate for Payer: Cigna Commercial |
$272.85
|
| Rate for Payer: First Health Commercial |
$288.90
|
| Rate for Payer: First Health Workers Compensation |
$123.94
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$288.90
|
| Rate for Payer: GEHA Commercial |
$224.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$288.90
|
| Rate for Payer: Multiplan All |
$292.11
|
| Rate for Payer: OMNI Networks Commercial |
$224.70
|
| Rate for Payer: One Health Plan PPO/POS |
$288.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$304.95
|
| Rate for Payer: Three Rivers Provider Network All |
$240.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$298.53
|
| Rate for Payer: Zelis Auto |
$128.40
|
| Rate for Payer: Zelis Worker's Compensation |
$87.63
|
|
|
ALBUMIN 5% - 12.5GM/250ML VIAL
|
Facility
|
OP
|
$321.00
|
|
|
Service Code
|
CPT P9045
|
| Hospital Charge Code |
3300024
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$45.12 |
| Max. Negotiated Rate |
$304.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$81.81
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$192.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$81.81
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$64.81
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$53.08
|
| Rate for Payer: Cash Price |
$192.60
|
| Rate for Payer: Cash Price |
$192.60
|
| Rate for Payer: Cigna Commercial |
$272.85
|
| Rate for Payer: First Health Commercial |
$288.90
|
| Rate for Payer: First Health Workers Compensation |
$123.94
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$288.90
|
| Rate for Payer: GEHA Commercial |
$58.39
|
| Rate for Payer: GEHA Medicare |
$53.08
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$288.90
|
| Rate for Payer: Humana ChoiceCare |
$58.39
|
| Rate for Payer: Humana Medicare Advantage |
$53.08
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$89.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$66.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$53.08
|
| Rate for Payer: Multiplan All |
$292.11
|
| Rate for Payer: New Mexico Health Connections Medicare |
$90.24
|
| Rate for Payer: OMNI Networks Commercial |
$224.70
|
| Rate for Payer: One Health Plan PPO/POS |
$288.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$76.36
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$66.13
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$53.08
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$304.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$106.16
|
| Rate for Payer: Three Rivers Provider Network All |
$240.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$52.02
|
| Rate for Payer: United Healthcare Managed Medicaid |
$66.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53.08
|
| Rate for Payer: United Payors & United Providers UP&UP |
$298.53
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$53.08
|
| Rate for Payer: Zelis Auto |
$128.40
|
| Rate for Payer: Zelis Medicare |
$45.12
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$63.70
|
| Rate for Payer: Zelis Worker's Compensation |
$87.63
|
|
|
albumin body fluid REF315780
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
2200671
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$79.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$14.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$50.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$14.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$7.78
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cigna Commercial |
$71.40
|
| Rate for Payer: First Health Commercial |
$75.60
|
| Rate for Payer: First Health Workers Compensation |
$9.07
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$75.60
|
| Rate for Payer: GEHA Commercial |
$67.20
|
| Rate for Payer: GEHA Medicare |
$7.78
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$75.60
|
| Rate for Payer: Humana ChoiceCare |
$8.56
|
| Rate for Payer: Humana Medicare Advantage |
$7.78
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$13.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$11.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$7.78
|
| Rate for Payer: Multiplan All |
$76.44
|
| Rate for Payer: New Mexico Health Connections Medicare |
$13.23
|
| Rate for Payer: OMNI Networks Commercial |
$58.80
|
| Rate for Payer: One Health Plan PPO/POS |
$75.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13.08
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11.32
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$7.78
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$79.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$15.56
|
| Rate for Payer: Three Rivers Provider Network All |
$63.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$7.62
|
| Rate for Payer: United Healthcare Commercial |
$71.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.78
|
| Rate for Payer: United Payors & United Providers UP&UP |
$78.12
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$7.78
|
| Rate for Payer: Zelis Auto |
$33.60
|
| Rate for Payer: Zelis Medicare |
$6.61
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$9.34
|
| Rate for Payer: Zelis Worker's Compensation |
$6.41
|
|
|
albumin body fluid REF315780
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
2200671
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$79.80 |
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cigna Commercial |
$71.40
|
| Rate for Payer: First Health Commercial |
$75.60
|
| Rate for Payer: First Health Workers Compensation |
$9.07
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$75.60
|
| Rate for Payer: GEHA Commercial |
$58.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$75.60
|
| Rate for Payer: Multiplan All |
$76.44
|
| Rate for Payer: OMNI Networks Commercial |
$58.80
|
| Rate for Payer: One Health Plan PPO/POS |
$75.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$79.80
|
| Rate for Payer: Three Rivers Provider Network All |
$63.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$78.12
|
| Rate for Payer: Zelis Auto |
$33.60
|
| Rate for Payer: Zelis Worker's Compensation |
$6.41
|
|
|
ALBUMIN (Vitros)
|
Facility
|
OP
|
$73.00
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
2232202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$69.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$43.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$4.95
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Cigna Commercial |
$62.05
|
| Rate for Payer: First Health Commercial |
$65.70
|
| Rate for Payer: First Health Workers Compensation |
$8.65
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$65.70
|
| Rate for Payer: GEHA Commercial |
$58.40
|
| Rate for Payer: GEHA Medicare |
$4.95
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$65.70
|
| Rate for Payer: Humana ChoiceCare |
$5.45
|
| Rate for Payer: Humana Medicare Advantage |
$4.95
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$8.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7.20
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$4.95
|
| Rate for Payer: Multiplan All |
$66.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$8.41
|
| Rate for Payer: OMNI Networks Commercial |
$51.10
|
| Rate for Payer: One Health Plan PPO/POS |
$65.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$8.32
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7.20
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$4.95
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$69.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$9.90
|
| Rate for Payer: Three Rivers Provider Network All |
$54.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4.85
|
| Rate for Payer: United Healthcare Commercial |
$62.05
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.95
|
| Rate for Payer: United Payors & United Providers UP&UP |
$67.89
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$4.95
|
| Rate for Payer: Zelis Auto |
$29.20
|
| Rate for Payer: Zelis Medicare |
$4.21
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5.94
|
| Rate for Payer: Zelis Worker's Compensation |
$6.12
|
|
|
ALBUMIN (Vitros)
|
Facility
|
IP
|
$73.00
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
2232202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.12 |
| Max. Negotiated Rate |
$69.35 |
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Cigna Commercial |
$62.05
|
| Rate for Payer: First Health Commercial |
$65.70
|
| Rate for Payer: First Health Workers Compensation |
$8.65
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$65.70
|
| Rate for Payer: GEHA Commercial |
$51.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$65.70
|
| Rate for Payer: Multiplan All |
$66.43
|
| Rate for Payer: OMNI Networks Commercial |
$51.10
|
| Rate for Payer: One Health Plan PPO/POS |
$65.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$69.35
|
| Rate for Payer: Three Rivers Provider Network All |
$54.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$67.89
|
| Rate for Payer: Zelis Auto |
$29.20
|
| Rate for Payer: Zelis Worker's Compensation |
$6.12
|
|
|
ALBUTEROL 0.042% IN 3 mL U.D.
|
Facility
|
IP
|
$7.00
|
|
|
Service Code
|
CPT J7609
|
| Hospital Charge Code |
3303042
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.91 |
| Max. Negotiated Rate |
$6.65 |
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cigna Commercial |
$5.95
|
| Rate for Payer: First Health Commercial |
$6.30
|
| Rate for Payer: First Health Workers Compensation |
$2.70
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6.30
|
| Rate for Payer: GEHA Commercial |
$4.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6.30
|
| Rate for Payer: Multiplan All |
$6.37
|
| Rate for Payer: OMNI Networks Commercial |
$4.90
|
| Rate for Payer: One Health Plan PPO/POS |
$6.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$6.65
|
| Rate for Payer: Three Rivers Provider Network All |
$5.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$6.51
|
| Rate for Payer: Zelis Auto |
$2.80
|
| Rate for Payer: Zelis Worker's Compensation |
$1.91
|
|
|
ALBUTEROL 0.042% IN 3 mL U.D.
|
Facility
|
OP
|
$7.00
|
|
|
Service Code
|
CPT J7609
|
| Hospital Charge Code |
3303042
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.75 |
| Max. Negotiated Rate |
$6.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4.20
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cigna Commercial |
$5.95
|
| Rate for Payer: First Health Commercial |
$6.30
|
| Rate for Payer: First Health Workers Compensation |
$2.70
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6.30
|
| Rate for Payer: GEHA Commercial |
$5.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6.30
|
| Rate for Payer: Humana ChoiceCare |
$1.82
|
| Rate for Payer: Multiplan All |
$6.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4.20
|
| Rate for Payer: OMNI Networks Commercial |
$4.90
|
| Rate for Payer: One Health Plan PPO/POS |
$6.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$6.65
|
| Rate for Payer: Three Rivers Provider Network All |
$5.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$6.51
|
| Rate for Payer: Zelis Auto |
$2.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3.50
|
| Rate for Payer: Zelis Worker's Compensation |
$1.91
|
|
|
ALBUTEROL 90 MCG/PUFF -PER PUFF
|
Facility
|
OP
|
$2.00
|
|
|
Service Code
|
NDC 66993001968
|
| Hospital Charge Code |
3302930
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.50 |
| Max. Negotiated Rate |
$1.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1.20
|
| Rate for Payer: Cash Price |
$1.20
|
| Rate for Payer: Cigna Commercial |
$1.70
|
| Rate for Payer: First Health Commercial |
$1.80
|
| Rate for Payer: First Health Workers Compensation |
$0.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1.80
|
| Rate for Payer: GEHA Commercial |
$1.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1.80
|
| Rate for Payer: Humana ChoiceCare |
$0.52
|
| Rate for Payer: Multiplan All |
$1.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1.20
|
| Rate for Payer: OMNI Networks Commercial |
$1.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1.90
|
| Rate for Payer: Three Rivers Provider Network All |
$1.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$0.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1.86
|
| Rate for Payer: Zelis Auto |
$0.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1.00
|
| Rate for Payer: Zelis Worker's Compensation |
$0.55
|
|
|
ALBUTEROL 90 MCG/PUFF -PER PUFF
|
Facility
|
IP
|
$2.00
|
|
|
Service Code
|
NDC 66993001968
|
| Hospital Charge Code |
3302930
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$1.90 |
| Rate for Payer: Cash Price |
$1.20
|
| Rate for Payer: Cigna Commercial |
$1.70
|
| Rate for Payer: First Health Commercial |
$1.80
|
| Rate for Payer: First Health Workers Compensation |
$0.77
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1.80
|
| Rate for Payer: GEHA Commercial |
$1.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1.80
|
| Rate for Payer: Multiplan All |
$1.82
|
| Rate for Payer: OMNI Networks Commercial |
$1.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1.90
|
| Rate for Payer: Three Rivers Provider Network All |
$1.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1.86
|
| Rate for Payer: Zelis Auto |
$0.80
|
| Rate for Payer: Zelis Worker's Compensation |
$0.55
|
|
|
ALBUTEROL HHN 0.083% U.D.
|
Facility
|
IP
|
$3.00
|
|
|
Service Code
|
CPT J7613
|
| Hospital Charge Code |
3302834
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$2.85 |
| Rate for Payer: Cash Price |
$1.80
|
| Rate for Payer: Cigna Commercial |
$2.55
|
| Rate for Payer: First Health Commercial |
$2.70
|
| Rate for Payer: First Health Workers Compensation |
$1.16
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2.70
|
| Rate for Payer: GEHA Commercial |
$2.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2.70
|
| Rate for Payer: Multiplan All |
$2.73
|
| Rate for Payer: OMNI Networks Commercial |
$2.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2.85
|
| Rate for Payer: Three Rivers Provider Network All |
$2.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2.79
|
| Rate for Payer: Zelis Auto |
$1.20
|
| Rate for Payer: Zelis Worker's Compensation |
$0.82
|
|
|
ALBUTEROL HHN 0.083% U.D.
|
Facility
|
OP
|
$3.00
|
|
|
Service Code
|
CPT J7613
|
| Hospital Charge Code |
3302834
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$2.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1.80
|
| Rate for Payer: Cash Price |
$1.80
|
| Rate for Payer: Cash Price |
$1.80
|
| Rate for Payer: Cigna Commercial |
$2.55
|
| Rate for Payer: First Health Commercial |
$2.70
|
| Rate for Payer: First Health Workers Compensation |
$1.16
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2.70
|
| Rate for Payer: GEHA Commercial |
$0.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2.70
|
| Rate for Payer: Humana ChoiceCare |
$0.78
|
| Rate for Payer: Multiplan All |
$2.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1.80
|
| Rate for Payer: OMNI Networks Commercial |
$2.10
|
| Rate for Payer: One Health Plan PPO/POS |
$2.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2.85
|
| Rate for Payer: Three Rivers Provider Network All |
$2.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2.64
|
| Rate for Payer: United Healthcare Managed Medicaid |
$0.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2.79
|
| Rate for Payer: Zelis Auto |
$1.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1.50
|
| Rate for Payer: Zelis Worker's Compensation |
$0.82
|
|
