|
IMPLT NAIL GAMMA 10X360X120
|
Facility
|
OP
|
$5,361.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,340.25 |
| Max. Negotiated Rate |
$5,092.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,216.60
|
| Rate for Payer: Cash Price |
$3,216.60
|
| Rate for Payer: Cash Price |
$3,216.60
|
| Rate for Payer: Cigna Commercial |
$4,556.85
|
| Rate for Payer: First Health Commercial |
$4,824.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,824.90
|
| Rate for Payer: GEHA Commercial |
$4,288.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,824.90
|
| Rate for Payer: Humana ChoiceCare |
$1,393.86
|
| Rate for Payer: Multiplan All |
$4,878.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,216.60
|
| Rate for Payer: OMNI Networks Commercial |
$3,752.70
|
| Rate for Payer: One Health Plan PPO/POS |
$4,824.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,092.95
|
| Rate for Payer: Three Rivers Provider Network All |
$4,020.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4,717.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,340.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,985.73
|
| Rate for Payer: Zelis Auto |
$2,144.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,680.50
|
|
|
IMPLT NAIL GAMMA 10X360X120
|
Facility
|
IP
|
$5,361.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,144.40 |
| Max. Negotiated Rate |
$5,092.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,288.80
|
| Rate for Payer: Cash Price |
$3,216.60
|
| Rate for Payer: Cash Price |
$3,216.60
|
| Rate for Payer: Cigna Commercial |
$4,556.85
|
| Rate for Payer: First Health Commercial |
$4,824.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,824.90
|
| Rate for Payer: GEHA Commercial |
$3,752.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,824.90
|
| Rate for Payer: Multiplan All |
$4,878.51
|
| Rate for Payer: OMNI Networks Commercial |
$3,752.70
|
| Rate for Payer: One Health Plan PPO/POS |
$4,824.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,092.95
|
| Rate for Payer: Three Rivers Provider Network All |
$4,020.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,985.73
|
| Rate for Payer: Zelis Auto |
$2,144.40
|
|
|
IMPLT NAIL GAMMA 10X380MMX125
|
Facility
|
IP
|
$5,361.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009071
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,144.40 |
| Max. Negotiated Rate |
$5,092.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,288.80
|
| Rate for Payer: Cash Price |
$3,216.60
|
| Rate for Payer: Cash Price |
$3,216.60
|
| Rate for Payer: Cigna Commercial |
$4,556.85
|
| Rate for Payer: First Health Commercial |
$4,824.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,824.90
|
| Rate for Payer: GEHA Commercial |
$3,752.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,824.90
|
| Rate for Payer: Multiplan All |
$4,878.51
|
| Rate for Payer: OMNI Networks Commercial |
$3,752.70
|
| Rate for Payer: One Health Plan PPO/POS |
$4,824.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,092.95
|
| Rate for Payer: Three Rivers Provider Network All |
$4,020.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,985.73
|
| Rate for Payer: Zelis Auto |
$2,144.40
|
|
|
IMPLT NAIL GAMMA 10X380MMX125
|
Facility
|
OP
|
$5,361.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009071
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,340.25 |
| Max. Negotiated Rate |
$5,092.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,216.60
|
| Rate for Payer: Cash Price |
$3,216.60
|
| Rate for Payer: Cash Price |
$3,216.60
|
| Rate for Payer: Cigna Commercial |
$4,556.85
|
| Rate for Payer: First Health Commercial |
$4,824.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,824.90
|
| Rate for Payer: GEHA Commercial |
$4,288.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,824.90
|
| Rate for Payer: Humana ChoiceCare |
$1,393.86
|
| Rate for Payer: Multiplan All |
$4,878.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,216.60
|
| Rate for Payer: OMNI Networks Commercial |
$3,752.70
|
| Rate for Payer: One Health Plan PPO/POS |
$4,824.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,092.95
|
| Rate for Payer: Three Rivers Provider Network All |
$4,020.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4,717.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,340.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,985.73
|
| Rate for Payer: Zelis Auto |
$2,144.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,680.50
|
|
|
IMPLT NAIL GAMMA 10X380X120
|
Facility
|
OP
|
$5,361.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,340.25 |
| Max. Negotiated Rate |
$5,092.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,216.60
|
| Rate for Payer: Cash Price |
$3,216.60
|
| Rate for Payer: Cash Price |
$3,216.60
|
| Rate for Payer: Cigna Commercial |
$4,556.85
|
| Rate for Payer: First Health Commercial |
$4,824.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,824.90
|
| Rate for Payer: GEHA Commercial |
$4,288.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,824.90
|
| Rate for Payer: Humana ChoiceCare |
$1,393.86
|
| Rate for Payer: Multiplan All |
$4,878.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,216.60
|
| Rate for Payer: OMNI Networks Commercial |
$3,752.70
|
| Rate for Payer: One Health Plan PPO/POS |
$4,824.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,092.95
|
| Rate for Payer: Three Rivers Provider Network All |
$4,020.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4,717.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,340.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,985.73
|
| Rate for Payer: Zelis Auto |
$2,144.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,680.50
|
|
|
IMPLT NAIL GAMMA 10X380X120
|
Facility
|
OP
|
$5,361.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,340.25 |
| Max. Negotiated Rate |
$5,092.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,216.60
|
| Rate for Payer: Cash Price |
$3,216.60
|
| Rate for Payer: Cash Price |
$3,216.60
|
| Rate for Payer: Cigna Commercial |
$4,556.85
|
| Rate for Payer: First Health Commercial |
$4,824.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,824.90
|
| Rate for Payer: GEHA Commercial |
$4,288.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,824.90
|
| Rate for Payer: Humana ChoiceCare |
$1,393.86
|
| Rate for Payer: Multiplan All |
$4,878.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,216.60
|
| Rate for Payer: OMNI Networks Commercial |
$3,752.70
|
| Rate for Payer: One Health Plan PPO/POS |
$4,824.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,092.95
|
| Rate for Payer: Three Rivers Provider Network All |
$4,020.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4,717.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,340.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,985.73
|
| Rate for Payer: Zelis Auto |
$2,144.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,680.50
|
|
|
IMPLT NAIL GAMMA 10X380X120
|
Facility
|
IP
|
$5,361.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,144.40 |
| Max. Negotiated Rate |
$5,092.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,288.80
|
| Rate for Payer: Cash Price |
$3,216.60
|
| Rate for Payer: Cash Price |
$3,216.60
|
| Rate for Payer: Cigna Commercial |
$4,556.85
|
| Rate for Payer: First Health Commercial |
$4,824.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,824.90
|
| Rate for Payer: GEHA Commercial |
$3,752.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,824.90
|
| Rate for Payer: Multiplan All |
$4,878.51
|
| Rate for Payer: OMNI Networks Commercial |
$3,752.70
|
| Rate for Payer: One Health Plan PPO/POS |
$4,824.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,092.95
|
| Rate for Payer: Three Rivers Provider Network All |
$4,020.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,985.73
|
| Rate for Payer: Zelis Auto |
$2,144.40
|
|
|
IMPLT NAIL GAMMA 10X380X120
|
Facility
|
IP
|
$5,361.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,144.40 |
| Max. Negotiated Rate |
$5,092.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,288.80
|
| Rate for Payer: Cash Price |
$3,216.60
|
| Rate for Payer: Cash Price |
$3,216.60
|
| Rate for Payer: Cigna Commercial |
$4,556.85
|
| Rate for Payer: First Health Commercial |
$4,824.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,824.90
|
| Rate for Payer: GEHA Commercial |
$3,752.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,824.90
|
| Rate for Payer: Multiplan All |
$4,878.51
|
| Rate for Payer: OMNI Networks Commercial |
$3,752.70
|
| Rate for Payer: One Health Plan PPO/POS |
$4,824.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,092.95
|
| Rate for Payer: Three Rivers Provider Network All |
$4,020.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,985.73
|
| Rate for Payer: Zelis Auto |
$2,144.40
|
|
|
IMPLT NAIL GAMMA 10X400X125
|
Facility
|
IP
|
$6,675.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009187
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,670.00 |
| Max. Negotiated Rate |
$6,341.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,340.00
|
| Rate for Payer: Cash Price |
$4,005.00
|
| Rate for Payer: Cash Price |
$4,005.00
|
| Rate for Payer: Cigna Commercial |
$5,673.75
|
| Rate for Payer: First Health Commercial |
$6,007.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6,007.50
|
| Rate for Payer: GEHA Commercial |
$4,672.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6,007.50
|
| Rate for Payer: Multiplan All |
$6,074.25
|
| Rate for Payer: OMNI Networks Commercial |
$4,672.50
|
| Rate for Payer: One Health Plan PPO/POS |
$6,007.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$6,341.25
|
| Rate for Payer: Three Rivers Provider Network All |
$5,006.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$6,207.75
|
| Rate for Payer: Zelis Auto |
$2,670.00
|
|
|
IMPLT NAIL GAMMA 10X400X125
|
Facility
|
IP
|
$6,675.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009188
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,670.00 |
| Max. Negotiated Rate |
$6,341.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,340.00
|
| Rate for Payer: Cash Price |
$4,005.00
|
| Rate for Payer: Cash Price |
$4,005.00
|
| Rate for Payer: Cigna Commercial |
$5,673.75
|
| Rate for Payer: First Health Commercial |
$6,007.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6,007.50
|
| Rate for Payer: GEHA Commercial |
$4,672.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6,007.50
|
| Rate for Payer: Multiplan All |
$6,074.25
|
| Rate for Payer: OMNI Networks Commercial |
$4,672.50
|
| Rate for Payer: One Health Plan PPO/POS |
$6,007.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$6,341.25
|
| Rate for Payer: Three Rivers Provider Network All |
$5,006.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$6,207.75
|
| Rate for Payer: Zelis Auto |
$2,670.00
|
|
|
IMPLT NAIL GAMMA 10X400X125
|
Facility
|
OP
|
$6,675.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009187
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,668.75 |
| Max. Negotiated Rate |
$6,341.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,005.00
|
| Rate for Payer: Cash Price |
$4,005.00
|
| Rate for Payer: Cash Price |
$4,005.00
|
| Rate for Payer: Cigna Commercial |
$5,673.75
|
| Rate for Payer: First Health Commercial |
$6,007.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6,007.50
|
| Rate for Payer: GEHA Commercial |
$5,340.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6,007.50
|
| Rate for Payer: Humana ChoiceCare |
$1,735.50
|
| Rate for Payer: Multiplan All |
$6,074.25
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,005.00
|
| Rate for Payer: OMNI Networks Commercial |
$4,672.50
|
| Rate for Payer: One Health Plan PPO/POS |
$6,007.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$6,341.25
|
| Rate for Payer: Three Rivers Provider Network All |
$5,006.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,874.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,668.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$6,207.75
|
| Rate for Payer: Zelis Auto |
$2,670.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,337.50
|
|
|
IMPLT NAIL GAMMA 10X400X125
|
Facility
|
OP
|
$6,675.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009188
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,668.75 |
| Max. Negotiated Rate |
$6,341.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,005.00
|
| Rate for Payer: Cash Price |
$4,005.00
|
| Rate for Payer: Cash Price |
$4,005.00
|
| Rate for Payer: Cigna Commercial |
$5,673.75
|
| Rate for Payer: First Health Commercial |
$6,007.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6,007.50
|
| Rate for Payer: GEHA Commercial |
$5,340.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6,007.50
|
| Rate for Payer: Humana ChoiceCare |
$1,735.50
|
| Rate for Payer: Multiplan All |
$6,074.25
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,005.00
|
| Rate for Payer: OMNI Networks Commercial |
$4,672.50
|
| Rate for Payer: One Health Plan PPO/POS |
$6,007.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$6,341.25
|
| Rate for Payer: Three Rivers Provider Network All |
$5,006.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,874.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,668.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$6,207.75
|
| Rate for Payer: Zelis Auto |
$2,670.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,337.50
|
|
|
IMPLT NAIL GAMMA 11X180MMX120 DEGREE
|
Facility
|
OP
|
$4,336.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7001119
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,084.00 |
| Max. Negotiated Rate |
$4,119.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,601.60
|
| Rate for Payer: Cash Price |
$2,601.60
|
| Rate for Payer: Cash Price |
$2,601.60
|
| Rate for Payer: Cigna Commercial |
$3,685.60
|
| Rate for Payer: First Health Commercial |
$3,902.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,902.40
|
| Rate for Payer: GEHA Commercial |
$3,468.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,902.40
|
| Rate for Payer: Humana ChoiceCare |
$1,127.36
|
| Rate for Payer: Multiplan All |
$3,945.76
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,601.60
|
| Rate for Payer: OMNI Networks Commercial |
$3,035.20
|
| Rate for Payer: One Health Plan PPO/POS |
$3,902.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,119.20
|
| Rate for Payer: Three Rivers Provider Network All |
$3,252.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,815.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,084.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,032.48
|
| Rate for Payer: Zelis Auto |
$1,734.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,168.00
|
|
|
IMPLT NAIL GAMMA 11X180MMX120 DEGREE
|
Facility
|
IP
|
$4,336.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7001119
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,734.40 |
| Max. Negotiated Rate |
$4,119.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,468.80
|
| Rate for Payer: Cash Price |
$2,601.60
|
| Rate for Payer: Cash Price |
$2,601.60
|
| Rate for Payer: Cigna Commercial |
$3,685.60
|
| Rate for Payer: First Health Commercial |
$3,902.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,902.40
|
| Rate for Payer: GEHA Commercial |
$3,035.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,902.40
|
| Rate for Payer: Multiplan All |
$3,945.76
|
| Rate for Payer: OMNI Networks Commercial |
$3,035.20
|
| Rate for Payer: One Health Plan PPO/POS |
$3,902.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,119.20
|
| Rate for Payer: Three Rivers Provider Network All |
$3,252.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,032.48
|
| Rate for Payer: Zelis Auto |
$1,734.40
|
|
|
IMPLT NAIL GAMMA 11X180MMX125 DEGREE
|
Facility
|
IP
|
$4,336.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000227
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,734.40 |
| Max. Negotiated Rate |
$4,119.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,468.80
|
| Rate for Payer: Cash Price |
$2,601.60
|
| Rate for Payer: Cash Price |
$2,601.60
|
| Rate for Payer: Cigna Commercial |
$3,685.60
|
| Rate for Payer: First Health Commercial |
$3,902.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,902.40
|
| Rate for Payer: GEHA Commercial |
$3,035.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,902.40
|
| Rate for Payer: Multiplan All |
$3,945.76
|
| Rate for Payer: OMNI Networks Commercial |
$3,035.20
|
| Rate for Payer: One Health Plan PPO/POS |
$3,902.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,119.20
|
| Rate for Payer: Three Rivers Provider Network All |
$3,252.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,032.48
|
| Rate for Payer: Zelis Auto |
$1,734.40
|
|
|
IMPLT NAIL GAMMA 11X180MMX125 DEGREE
|
Facility
|
OP
|
$4,336.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000227
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,084.00 |
| Max. Negotiated Rate |
$4,119.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,601.60
|
| Rate for Payer: Cash Price |
$2,601.60
|
| Rate for Payer: Cash Price |
$2,601.60
|
| Rate for Payer: Cigna Commercial |
$3,685.60
|
| Rate for Payer: First Health Commercial |
$3,902.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,902.40
|
| Rate for Payer: GEHA Commercial |
$3,468.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,902.40
|
| Rate for Payer: Humana ChoiceCare |
$1,127.36
|
| Rate for Payer: Multiplan All |
$3,945.76
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,601.60
|
| Rate for Payer: OMNI Networks Commercial |
$3,035.20
|
| Rate for Payer: One Health Plan PPO/POS |
$3,902.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,119.20
|
| Rate for Payer: Three Rivers Provider Network All |
$3,252.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,815.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,084.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,032.48
|
| Rate for Payer: Zelis Auto |
$1,734.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,168.00
|
|
|
IMPLT NAIL GAMMA 11X200MM 120DEG
|
Facility
|
IP
|
$5,811.42
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,324.57 |
| Max. Negotiated Rate |
$5,520.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,649.14
|
| Rate for Payer: Cash Price |
$3,486.85
|
| Rate for Payer: Cash Price |
$3,486.85
|
| Rate for Payer: Cigna Commercial |
$4,939.71
|
| Rate for Payer: First Health Commercial |
$5,230.28
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$5,230.28
|
| Rate for Payer: GEHA Commercial |
$4,067.99
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$5,230.28
|
| Rate for Payer: Multiplan All |
$5,288.39
|
| Rate for Payer: OMNI Networks Commercial |
$4,067.99
|
| Rate for Payer: One Health Plan PPO/POS |
$5,230.28
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,520.85
|
| Rate for Payer: Three Rivers Provider Network All |
$4,358.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5,404.62
|
| Rate for Payer: Zelis Auto |
$2,324.57
|
|
|
IMPLT NAIL GAMMA 11X200MM 120DEG
|
Facility
|
OP
|
$5,811.42
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,452.86 |
| Max. Negotiated Rate |
$5,520.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,486.85
|
| Rate for Payer: Cash Price |
$3,486.85
|
| Rate for Payer: Cash Price |
$3,486.85
|
| Rate for Payer: Cigna Commercial |
$4,939.71
|
| Rate for Payer: First Health Commercial |
$5,230.28
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$5,230.28
|
| Rate for Payer: GEHA Commercial |
$4,649.14
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$5,230.28
|
| Rate for Payer: Humana ChoiceCare |
$1,510.97
|
| Rate for Payer: Multiplan All |
$5,288.39
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,486.85
|
| Rate for Payer: OMNI Networks Commercial |
$4,067.99
|
| Rate for Payer: One Health Plan PPO/POS |
$5,230.28
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,520.85
|
| Rate for Payer: Three Rivers Provider Network All |
$4,358.56
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,114.05
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,452.86
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5,404.62
|
| Rate for Payer: Zelis Auto |
$2,324.57
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,905.71
|
|
|
IMPLT NAIL GAMMA 11X200MM 125DEG
|
Facility
|
IP
|
$5,811.42
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009255
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,324.57 |
| Max. Negotiated Rate |
$5,520.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,649.14
|
| Rate for Payer: Cash Price |
$3,486.85
|
| Rate for Payer: Cash Price |
$3,486.85
|
| Rate for Payer: Cigna Commercial |
$4,939.71
|
| Rate for Payer: First Health Commercial |
$5,230.28
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$5,230.28
|
| Rate for Payer: GEHA Commercial |
$4,067.99
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$5,230.28
|
| Rate for Payer: Multiplan All |
$5,288.39
|
| Rate for Payer: OMNI Networks Commercial |
$4,067.99
|
| Rate for Payer: One Health Plan PPO/POS |
$5,230.28
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,520.85
|
| Rate for Payer: Three Rivers Provider Network All |
$4,358.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5,404.62
|
| Rate for Payer: Zelis Auto |
$2,324.57
|
|
|
IMPLT NAIL GAMMA 11X200MM 125DEG
|
Facility
|
OP
|
$5,811.42
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009255
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,452.86 |
| Max. Negotiated Rate |
$5,520.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,486.85
|
| Rate for Payer: Cash Price |
$3,486.85
|
| Rate for Payer: Cash Price |
$3,486.85
|
| Rate for Payer: Cigna Commercial |
$4,939.71
|
| Rate for Payer: First Health Commercial |
$5,230.28
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$5,230.28
|
| Rate for Payer: GEHA Commercial |
$4,649.14
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$5,230.28
|
| Rate for Payer: Humana ChoiceCare |
$1,510.97
|
| Rate for Payer: Multiplan All |
$5,288.39
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,486.85
|
| Rate for Payer: OMNI Networks Commercial |
$4,067.99
|
| Rate for Payer: One Health Plan PPO/POS |
$5,230.28
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,520.85
|
| Rate for Payer: Three Rivers Provider Network All |
$4,358.56
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,114.05
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,452.86
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5,404.62
|
| Rate for Payer: Zelis Auto |
$2,324.57
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,905.71
|
|
|
IMPLT NAIL GAMMA 11X200MM 130DEG
|
Facility
|
OP
|
$5,811.42
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,452.86 |
| Max. Negotiated Rate |
$5,520.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,486.85
|
| Rate for Payer: Cash Price |
$3,486.85
|
| Rate for Payer: Cash Price |
$3,486.85
|
| Rate for Payer: Cigna Commercial |
$4,939.71
|
| Rate for Payer: First Health Commercial |
$5,230.28
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$5,230.28
|
| Rate for Payer: GEHA Commercial |
$4,649.14
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$5,230.28
|
| Rate for Payer: Humana ChoiceCare |
$1,510.97
|
| Rate for Payer: Multiplan All |
$5,288.39
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,486.85
|
| Rate for Payer: OMNI Networks Commercial |
$4,067.99
|
| Rate for Payer: One Health Plan PPO/POS |
$5,230.28
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,520.85
|
| Rate for Payer: Three Rivers Provider Network All |
$4,358.56
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,114.05
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,452.86
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5,404.62
|
| Rate for Payer: Zelis Auto |
$2,324.57
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,905.71
|
|
|
IMPLT NAIL GAMMA 11X200MM 130DEG
|
Facility
|
IP
|
$5,811.42
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,324.57 |
| Max. Negotiated Rate |
$5,520.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,649.14
|
| Rate for Payer: Cash Price |
$3,486.85
|
| Rate for Payer: Cash Price |
$3,486.85
|
| Rate for Payer: Cigna Commercial |
$4,939.71
|
| Rate for Payer: First Health Commercial |
$5,230.28
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$5,230.28
|
| Rate for Payer: GEHA Commercial |
$4,067.99
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$5,230.28
|
| Rate for Payer: Multiplan All |
$5,288.39
|
| Rate for Payer: OMNI Networks Commercial |
$4,067.99
|
| Rate for Payer: One Health Plan PPO/POS |
$5,230.28
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,520.85
|
| Rate for Payer: Three Rivers Provider Network All |
$4,358.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5,404.62
|
| Rate for Payer: Zelis Auto |
$2,324.57
|
|
|
IMPLT NAIL GAMMA 11X300X125
|
Facility
|
OP
|
$6,675.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009189
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,668.75 |
| Max. Negotiated Rate |
$6,341.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$4,005.00
|
| Rate for Payer: Cash Price |
$4,005.00
|
| Rate for Payer: Cash Price |
$4,005.00
|
| Rate for Payer: Cigna Commercial |
$5,673.75
|
| Rate for Payer: First Health Commercial |
$6,007.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6,007.50
|
| Rate for Payer: GEHA Commercial |
$5,340.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6,007.50
|
| Rate for Payer: Humana ChoiceCare |
$1,735.50
|
| Rate for Payer: Multiplan All |
$6,074.25
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,005.00
|
| Rate for Payer: OMNI Networks Commercial |
$4,672.50
|
| Rate for Payer: One Health Plan PPO/POS |
$6,007.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$6,341.25
|
| Rate for Payer: Three Rivers Provider Network All |
$5,006.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,874.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,668.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$6,207.75
|
| Rate for Payer: Zelis Auto |
$2,670.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,337.50
|
|
|
IMPLT NAIL GAMMA 11X300X125
|
Facility
|
IP
|
$6,675.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009189
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,670.00 |
| Max. Negotiated Rate |
$6,341.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$5,340.00
|
| Rate for Payer: Cash Price |
$4,005.00
|
| Rate for Payer: Cash Price |
$4,005.00
|
| Rate for Payer: Cigna Commercial |
$5,673.75
|
| Rate for Payer: First Health Commercial |
$6,007.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$6,007.50
|
| Rate for Payer: GEHA Commercial |
$4,672.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$6,007.50
|
| Rate for Payer: Multiplan All |
$6,074.25
|
| Rate for Payer: OMNI Networks Commercial |
$4,672.50
|
| Rate for Payer: One Health Plan PPO/POS |
$6,007.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$6,341.25
|
| Rate for Payer: Three Rivers Provider Network All |
$5,006.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$6,207.75
|
| Rate for Payer: Zelis Auto |
$2,670.00
|
|
|
IMPLT NAIL GAMMA 11X320X125
|
Facility
|
OP
|
$5,008.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7009077
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,252.00 |
| Max. Negotiated Rate |
$4,757.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,004.80
|
| Rate for Payer: Cash Price |
$3,004.80
|
| Rate for Payer: Cash Price |
$3,004.80
|
| Rate for Payer: Cigna Commercial |
$4,256.80
|
| Rate for Payer: First Health Commercial |
$4,507.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,507.20
|
| Rate for Payer: GEHA Commercial |
$4,006.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,507.20
|
| Rate for Payer: Humana ChoiceCare |
$1,302.08
|
| Rate for Payer: Multiplan All |
$4,557.28
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,004.80
|
| Rate for Payer: OMNI Networks Commercial |
$3,505.60
|
| Rate for Payer: One Health Plan PPO/POS |
$4,507.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,757.60
|
| Rate for Payer: Three Rivers Provider Network All |
$3,756.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4,407.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,252.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,657.44
|
| Rate for Payer: Zelis Auto |
$2,003.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,504.00
|
|
