|
IMPLT PHALANGEAL ANATOEMIC 23MM
|
Facility
|
IP
|
$3,785.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
7002115
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,514.00 |
| Max. Negotiated Rate |
$3,595.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,028.00
|
| Rate for Payer: Cash Price |
$2,271.00
|
| Rate for Payer: Cash Price |
$2,271.00
|
| Rate for Payer: Cigna Commercial |
$3,217.25
|
| Rate for Payer: First Health Commercial |
$3,406.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,406.50
|
| Rate for Payer: GEHA Commercial |
$2,649.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,406.50
|
| Rate for Payer: Multiplan All |
$3,444.35
|
| Rate for Payer: OMNI Networks Commercial |
$2,649.50
|
| Rate for Payer: One Health Plan PPO/POS |
$3,406.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,595.75
|
| Rate for Payer: Three Rivers Provider Network All |
$2,838.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,520.05
|
| Rate for Payer: Zelis Auto |
$1,514.00
|
|
|
IMPLT PIN 2X45MM
|
Facility
|
IP
|
$428.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7002702
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.20 |
| Max. Negotiated Rate |
$406.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$342.40
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cigna Commercial |
$363.80
|
| Rate for Payer: First Health Commercial |
$385.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$385.20
|
| Rate for Payer: GEHA Commercial |
$299.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$385.20
|
| Rate for Payer: Multiplan All |
$389.48
|
| Rate for Payer: OMNI Networks Commercial |
$299.60
|
| Rate for Payer: One Health Plan PPO/POS |
$385.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$406.60
|
| Rate for Payer: Three Rivers Provider Network All |
$321.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$398.04
|
| Rate for Payer: Zelis Auto |
$171.20
|
|
|
IMPLT PIN 2X45MM
|
Facility
|
OP
|
$428.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7002702
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$107.00 |
| Max. Negotiated Rate |
$406.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cigna Commercial |
$363.80
|
| Rate for Payer: First Health Commercial |
$385.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$385.20
|
| Rate for Payer: GEHA Commercial |
$342.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$385.20
|
| Rate for Payer: Humana ChoiceCare |
$111.28
|
| Rate for Payer: Multiplan All |
$389.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$256.80
|
| Rate for Payer: OMNI Networks Commercial |
$299.60
|
| Rate for Payer: One Health Plan PPO/POS |
$385.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$406.60
|
| Rate for Payer: Three Rivers Provider Network All |
$321.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$376.64
|
| Rate for Payer: United Healthcare Managed Medicaid |
$107.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$398.04
|
| Rate for Payer: Zelis Auto |
$171.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$214.00
|
|
|
IMPLT PIN 4.0X120MM
|
Facility
|
OP
|
$749.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000292
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$187.25 |
| Max. Negotiated Rate |
$711.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$449.40
|
| Rate for Payer: Cash Price |
$449.40
|
| Rate for Payer: Cash Price |
$449.40
|
| Rate for Payer: Cigna Commercial |
$636.65
|
| Rate for Payer: First Health Commercial |
$674.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$674.10
|
| Rate for Payer: GEHA Commercial |
$599.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$674.10
|
| Rate for Payer: Humana ChoiceCare |
$194.74
|
| Rate for Payer: Multiplan All |
$681.59
|
| Rate for Payer: New Mexico Health Connections Medicare |
$449.40
|
| Rate for Payer: OMNI Networks Commercial |
$524.30
|
| Rate for Payer: One Health Plan PPO/POS |
$674.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$711.55
|
| Rate for Payer: Three Rivers Provider Network All |
$561.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$659.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$187.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$696.57
|
| Rate for Payer: Zelis Auto |
$299.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$374.50
|
|
|
IMPLT PIN 4.0X120MM
|
Facility
|
IP
|
$749.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000292
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$299.60 |
| Max. Negotiated Rate |
$711.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$599.20
|
| Rate for Payer: Cash Price |
$449.40
|
| Rate for Payer: Cash Price |
$449.40
|
| Rate for Payer: Cigna Commercial |
$636.65
|
| Rate for Payer: First Health Commercial |
$674.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$674.10
|
| Rate for Payer: GEHA Commercial |
$524.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$674.10
|
| Rate for Payer: Multiplan All |
$681.59
|
| Rate for Payer: OMNI Networks Commercial |
$524.30
|
| Rate for Payer: One Health Plan PPO/POS |
$674.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$711.55
|
| Rate for Payer: Three Rivers Provider Network All |
$561.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$696.57
|
| Rate for Payer: Zelis Auto |
$299.60
|
|
|
IMPLT PIN ACCESS 3.2MM STEINMANN
|
Facility
|
OP
|
$887.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000303
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$221.75 |
| Max. Negotiated Rate |
$842.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$532.20
|
| Rate for Payer: Cash Price |
$532.20
|
| Rate for Payer: Cash Price |
$532.20
|
| Rate for Payer: Cigna Commercial |
$753.95
|
| Rate for Payer: First Health Commercial |
$798.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$798.30
|
| Rate for Payer: GEHA Commercial |
$709.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$798.30
|
| Rate for Payer: Humana ChoiceCare |
$230.62
|
| Rate for Payer: Multiplan All |
$807.17
|
| Rate for Payer: New Mexico Health Connections Medicare |
$532.20
|
| Rate for Payer: OMNI Networks Commercial |
$620.90
|
| Rate for Payer: One Health Plan PPO/POS |
$798.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$842.65
|
| Rate for Payer: Three Rivers Provider Network All |
$665.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$780.56
|
| Rate for Payer: United Healthcare Managed Medicaid |
$221.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$824.91
|
| Rate for Payer: Zelis Auto |
$354.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$443.50
|
|
|
IMPLT PIN ACCESS 3.2MM STEINMANN
|
Facility
|
IP
|
$887.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000303
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$354.80 |
| Max. Negotiated Rate |
$842.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$709.60
|
| Rate for Payer: Cash Price |
$532.20
|
| Rate for Payer: Cash Price |
$532.20
|
| Rate for Payer: Cigna Commercial |
$753.95
|
| Rate for Payer: First Health Commercial |
$798.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$798.30
|
| Rate for Payer: GEHA Commercial |
$620.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$798.30
|
| Rate for Payer: Multiplan All |
$807.17
|
| Rate for Payer: OMNI Networks Commercial |
$620.90
|
| Rate for Payer: One Health Plan PPO/POS |
$798.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$842.65
|
| Rate for Payer: Three Rivers Provider Network All |
$665.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$824.91
|
| Rate for Payer: Zelis Auto |
$354.80
|
|
|
IMPLT PIN APEX,1.65X45MM
|
Facility
|
OP
|
$556.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000294
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$139.00 |
| Max. Negotiated Rate |
$528.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$333.60
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cigna Commercial |
$472.60
|
| Rate for Payer: First Health Commercial |
$500.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$500.40
|
| Rate for Payer: GEHA Commercial |
$444.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$500.40
|
| Rate for Payer: Humana ChoiceCare |
$144.56
|
| Rate for Payer: Multiplan All |
$505.96
|
| Rate for Payer: New Mexico Health Connections Medicare |
$333.60
|
| Rate for Payer: OMNI Networks Commercial |
$389.20
|
| Rate for Payer: One Health Plan PPO/POS |
$500.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$528.20
|
| Rate for Payer: Three Rivers Provider Network All |
$417.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$489.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$139.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$517.08
|
| Rate for Payer: Zelis Auto |
$222.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$278.00
|
|
|
IMPLT PIN APEX,1.65X45MM
|
Facility
|
IP
|
$556.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000294
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$222.40 |
| Max. Negotiated Rate |
$528.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$444.80
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cigna Commercial |
$472.60
|
| Rate for Payer: First Health Commercial |
$500.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$500.40
|
| Rate for Payer: GEHA Commercial |
$389.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$500.40
|
| Rate for Payer: Multiplan All |
$505.96
|
| Rate for Payer: OMNI Networks Commercial |
$389.20
|
| Rate for Payer: One Health Plan PPO/POS |
$500.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$528.20
|
| Rate for Payer: Three Rivers Provider Network All |
$417.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$517.08
|
| Rate for Payer: Zelis Auto |
$222.40
|
|
|
IMPLT PIN APEX 180X5X50MM
|
Facility
|
OP
|
$979.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7002588
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$244.75 |
| Max. Negotiated Rate |
$930.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$587.40
|
| Rate for Payer: Cash Price |
$587.40
|
| Rate for Payer: Cash Price |
$587.40
|
| Rate for Payer: Cigna Commercial |
$832.15
|
| Rate for Payer: First Health Commercial |
$881.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$881.10
|
| Rate for Payer: GEHA Commercial |
$783.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$881.10
|
| Rate for Payer: Humana ChoiceCare |
$254.54
|
| Rate for Payer: Multiplan All |
$890.89
|
| Rate for Payer: New Mexico Health Connections Medicare |
$587.40
|
| Rate for Payer: OMNI Networks Commercial |
$685.30
|
| Rate for Payer: One Health Plan PPO/POS |
$881.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$930.05
|
| Rate for Payer: Three Rivers Provider Network All |
$734.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$861.52
|
| Rate for Payer: United Healthcare Managed Medicaid |
$244.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$910.47
|
| Rate for Payer: Zelis Auto |
$391.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$489.50
|
|
|
IMPLT PIN APEX 180X5X50MM
|
Facility
|
IP
|
$979.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7002588
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$391.60 |
| Max. Negotiated Rate |
$930.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$783.20
|
| Rate for Payer: Cash Price |
$587.40
|
| Rate for Payer: Cash Price |
$587.40
|
| Rate for Payer: Cigna Commercial |
$832.15
|
| Rate for Payer: First Health Commercial |
$881.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$881.10
|
| Rate for Payer: GEHA Commercial |
$685.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$881.10
|
| Rate for Payer: Multiplan All |
$890.89
|
| Rate for Payer: OMNI Networks Commercial |
$685.30
|
| Rate for Payer: One Health Plan PPO/POS |
$881.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$930.05
|
| Rate for Payer: Three Rivers Provider Network All |
$734.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$910.47
|
| Rate for Payer: Zelis Auto |
$391.60
|
|
|
IMPLT PIN APEX 2.0X45MM
|
Facility
|
OP
|
$556.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000304
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$139.00 |
| Max. Negotiated Rate |
$528.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$333.60
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cigna Commercial |
$472.60
|
| Rate for Payer: First Health Commercial |
$500.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$500.40
|
| Rate for Payer: GEHA Commercial |
$444.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$500.40
|
| Rate for Payer: Humana ChoiceCare |
$144.56
|
| Rate for Payer: Multiplan All |
$505.96
|
| Rate for Payer: New Mexico Health Connections Medicare |
$333.60
|
| Rate for Payer: OMNI Networks Commercial |
$389.20
|
| Rate for Payer: One Health Plan PPO/POS |
$500.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$528.20
|
| Rate for Payer: Three Rivers Provider Network All |
$417.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$489.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$139.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$517.08
|
| Rate for Payer: Zelis Auto |
$222.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$278.00
|
|
|
IMPLT PIN APEX 2.0X45MM
|
Facility
|
IP
|
$556.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000304
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$222.40 |
| Max. Negotiated Rate |
$528.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$444.80
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cigna Commercial |
$472.60
|
| Rate for Payer: First Health Commercial |
$500.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$500.40
|
| Rate for Payer: GEHA Commercial |
$389.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$500.40
|
| Rate for Payer: Multiplan All |
$505.96
|
| Rate for Payer: OMNI Networks Commercial |
$389.20
|
| Rate for Payer: One Health Plan PPO/POS |
$500.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$528.20
|
| Rate for Payer: Three Rivers Provider Network All |
$417.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$517.08
|
| Rate for Payer: Zelis Auto |
$222.40
|
|
|
IMPLT PIN APEX 2X45MM
|
Facility
|
OP
|
$428.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7002703
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$107.00 |
| Max. Negotiated Rate |
$406.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cigna Commercial |
$363.80
|
| Rate for Payer: First Health Commercial |
$385.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$385.20
|
| Rate for Payer: GEHA Commercial |
$342.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$385.20
|
| Rate for Payer: Humana ChoiceCare |
$111.28
|
| Rate for Payer: Multiplan All |
$389.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$256.80
|
| Rate for Payer: OMNI Networks Commercial |
$299.60
|
| Rate for Payer: One Health Plan PPO/POS |
$385.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$406.60
|
| Rate for Payer: Three Rivers Provider Network All |
$321.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$376.64
|
| Rate for Payer: United Healthcare Managed Medicaid |
$107.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$398.04
|
| Rate for Payer: Zelis Auto |
$171.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$214.00
|
|
|
IMPLT PIN APEX 2X45MM
|
Facility
|
IP
|
$428.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7002703
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.20 |
| Max. Negotiated Rate |
$406.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$342.40
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cigna Commercial |
$363.80
|
| Rate for Payer: First Health Commercial |
$385.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$385.20
|
| Rate for Payer: GEHA Commercial |
$299.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$385.20
|
| Rate for Payer: Multiplan All |
$389.48
|
| Rate for Payer: OMNI Networks Commercial |
$299.60
|
| Rate for Payer: One Health Plan PPO/POS |
$385.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$406.60
|
| Rate for Payer: Three Rivers Provider Network All |
$321.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$398.04
|
| Rate for Payer: Zelis Auto |
$171.20
|
|
|
IMPLT PIN APEX 4MM
|
Facility
|
OP
|
$719.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7002608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$179.75 |
| Max. Negotiated Rate |
$683.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$431.40
|
| Rate for Payer: Cash Price |
$431.40
|
| Rate for Payer: Cash Price |
$431.40
|
| Rate for Payer: Cigna Commercial |
$611.15
|
| Rate for Payer: First Health Commercial |
$647.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$647.10
|
| Rate for Payer: GEHA Commercial |
$575.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$647.10
|
| Rate for Payer: Humana ChoiceCare |
$186.94
|
| Rate for Payer: Multiplan All |
$654.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$431.40
|
| Rate for Payer: OMNI Networks Commercial |
$503.30
|
| Rate for Payer: One Health Plan PPO/POS |
$647.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$683.05
|
| Rate for Payer: Three Rivers Provider Network All |
$539.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$632.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$179.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$668.67
|
| Rate for Payer: Zelis Auto |
$287.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$359.50
|
|
|
IMPLT PIN APEX 4MM
|
Facility
|
IP
|
$719.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7002608
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$287.60 |
| Max. Negotiated Rate |
$683.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$575.20
|
| Rate for Payer: Cash Price |
$431.40
|
| Rate for Payer: Cash Price |
$431.40
|
| Rate for Payer: Cigna Commercial |
$611.15
|
| Rate for Payer: First Health Commercial |
$647.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$647.10
|
| Rate for Payer: GEHA Commercial |
$503.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$647.10
|
| Rate for Payer: Multiplan All |
$654.29
|
| Rate for Payer: OMNI Networks Commercial |
$503.30
|
| Rate for Payer: One Health Plan PPO/POS |
$647.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$683.05
|
| Rate for Payer: Three Rivers Provider Network All |
$539.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$668.67
|
| Rate for Payer: Zelis Auto |
$287.60
|
|
|
IMPLT PIN APEX 5MM x 200MM
|
Facility
|
OP
|
$719.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000293
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$179.75 |
| Max. Negotiated Rate |
$683.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$431.40
|
| Rate for Payer: Cash Price |
$431.40
|
| Rate for Payer: Cash Price |
$431.40
|
| Rate for Payer: Cigna Commercial |
$611.15
|
| Rate for Payer: First Health Commercial |
$647.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$647.10
|
| Rate for Payer: GEHA Commercial |
$575.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$647.10
|
| Rate for Payer: Humana ChoiceCare |
$186.94
|
| Rate for Payer: Multiplan All |
$654.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$431.40
|
| Rate for Payer: OMNI Networks Commercial |
$503.30
|
| Rate for Payer: One Health Plan PPO/POS |
$647.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$683.05
|
| Rate for Payer: Three Rivers Provider Network All |
$539.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$632.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$179.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$668.67
|
| Rate for Payer: Zelis Auto |
$287.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$359.50
|
|
|
IMPLT PIN APEX 5MM x 200MM
|
Facility
|
IP
|
$719.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000293
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$287.60 |
| Max. Negotiated Rate |
$683.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$575.20
|
| Rate for Payer: Cash Price |
$431.40
|
| Rate for Payer: Cash Price |
$431.40
|
| Rate for Payer: Cigna Commercial |
$611.15
|
| Rate for Payer: First Health Commercial |
$647.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$647.10
|
| Rate for Payer: GEHA Commercial |
$503.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$647.10
|
| Rate for Payer: Multiplan All |
$654.29
|
| Rate for Payer: OMNI Networks Commercial |
$503.30
|
| Rate for Payer: One Health Plan PPO/POS |
$647.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$683.05
|
| Rate for Payer: Three Rivers Provider Network All |
$539.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$668.67
|
| Rate for Payer: Zelis Auto |
$287.60
|
|
|
IMPLT PIN BEATH 2.4MM
|
Facility
|
IP
|
$266.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7002564
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$106.40 |
| Max. Negotiated Rate |
$252.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$212.80
|
| Rate for Payer: Cash Price |
$159.60
|
| Rate for Payer: Cash Price |
$159.60
|
| Rate for Payer: Cigna Commercial |
$226.10
|
| Rate for Payer: First Health Commercial |
$239.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$239.40
|
| Rate for Payer: GEHA Commercial |
$186.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$239.40
|
| Rate for Payer: Multiplan All |
$242.06
|
| Rate for Payer: OMNI Networks Commercial |
$186.20
|
| Rate for Payer: One Health Plan PPO/POS |
$239.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$252.70
|
| Rate for Payer: Three Rivers Provider Network All |
$199.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$247.38
|
| Rate for Payer: Zelis Auto |
$106.40
|
|
|
IMPLT PIN BEATH 2.4MM
|
Facility
|
OP
|
$266.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7002564
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$66.50 |
| Max. Negotiated Rate |
$252.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$159.60
|
| Rate for Payer: Cash Price |
$159.60
|
| Rate for Payer: Cash Price |
$159.60
|
| Rate for Payer: Cigna Commercial |
$226.10
|
| Rate for Payer: First Health Commercial |
$239.40
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$239.40
|
| Rate for Payer: GEHA Commercial |
$212.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$239.40
|
| Rate for Payer: Humana ChoiceCare |
$69.16
|
| Rate for Payer: Multiplan All |
$242.06
|
| Rate for Payer: New Mexico Health Connections Medicare |
$159.60
|
| Rate for Payer: OMNI Networks Commercial |
$186.20
|
| Rate for Payer: One Health Plan PPO/POS |
$239.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$252.70
|
| Rate for Payer: Three Rivers Provider Network All |
$199.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$234.08
|
| Rate for Payer: United Healthcare Managed Medicaid |
$66.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$247.38
|
| Rate for Payer: Zelis Auto |
$106.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$133.00
|
|
|
IMPLT PIN BONE 3.2X140MM
|
Facility
|
OP
|
$819.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7001139
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$204.75 |
| Max. Negotiated Rate |
$778.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$491.40
|
| Rate for Payer: Cash Price |
$491.40
|
| Rate for Payer: Cash Price |
$491.40
|
| Rate for Payer: Cigna Commercial |
$696.15
|
| Rate for Payer: First Health Commercial |
$737.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$737.10
|
| Rate for Payer: GEHA Commercial |
$655.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$737.10
|
| Rate for Payer: Humana ChoiceCare |
$212.94
|
| Rate for Payer: Multiplan All |
$745.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$491.40
|
| Rate for Payer: OMNI Networks Commercial |
$573.30
|
| Rate for Payer: One Health Plan PPO/POS |
$737.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$778.05
|
| Rate for Payer: Three Rivers Provider Network All |
$614.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$720.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$204.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$761.67
|
| Rate for Payer: Zelis Auto |
$327.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$409.50
|
|
|
IMPLT PIN BONE 3.2X140MM
|
Facility
|
IP
|
$819.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7001139
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$327.60 |
| Max. Negotiated Rate |
$778.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$655.20
|
| Rate for Payer: Cash Price |
$491.40
|
| Rate for Payer: Cash Price |
$491.40
|
| Rate for Payer: Cigna Commercial |
$696.15
|
| Rate for Payer: First Health Commercial |
$737.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$737.10
|
| Rate for Payer: GEHA Commercial |
$573.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$737.10
|
| Rate for Payer: Multiplan All |
$745.29
|
| Rate for Payer: OMNI Networks Commercial |
$573.30
|
| Rate for Payer: One Health Plan PPO/POS |
$737.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$778.05
|
| Rate for Payer: Three Rivers Provider Network All |
$614.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$761.67
|
| Rate for Payer: Zelis Auto |
$327.60
|
|
|
IMPLT PIN BONE 3.2X80MM
|
Facility
|
OP
|
$819.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000295
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$204.75 |
| Max. Negotiated Rate |
$778.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$491.40
|
| Rate for Payer: Cash Price |
$491.40
|
| Rate for Payer: Cash Price |
$491.40
|
| Rate for Payer: Cigna Commercial |
$696.15
|
| Rate for Payer: First Health Commercial |
$737.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$737.10
|
| Rate for Payer: GEHA Commercial |
$655.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$737.10
|
| Rate for Payer: Humana ChoiceCare |
$212.94
|
| Rate for Payer: Multiplan All |
$745.29
|
| Rate for Payer: New Mexico Health Connections Medicare |
$491.40
|
| Rate for Payer: OMNI Networks Commercial |
$573.30
|
| Rate for Payer: One Health Plan PPO/POS |
$737.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$778.05
|
| Rate for Payer: Three Rivers Provider Network All |
$614.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$720.72
|
| Rate for Payer: United Healthcare Managed Medicaid |
$204.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$761.67
|
| Rate for Payer: Zelis Auto |
$327.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$409.50
|
|
|
IMPLT PIN BONE 3.2X80MM
|
Facility
|
IP
|
$819.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000295
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$327.60 |
| Max. Negotiated Rate |
$778.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$655.20
|
| Rate for Payer: Cash Price |
$491.40
|
| Rate for Payer: Cash Price |
$491.40
|
| Rate for Payer: Cigna Commercial |
$696.15
|
| Rate for Payer: First Health Commercial |
$737.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$737.10
|
| Rate for Payer: GEHA Commercial |
$573.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$737.10
|
| Rate for Payer: Multiplan All |
$745.29
|
| Rate for Payer: OMNI Networks Commercial |
$573.30
|
| Rate for Payer: One Health Plan PPO/POS |
$737.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$778.05
|
| Rate for Payer: Three Rivers Provider Network All |
$614.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$761.67
|
| Rate for Payer: Zelis Auto |
$327.60
|
|
