|
IMPLT SCREW LOCKING 2.7X08MM
|
Facility
|
IP
|
$652.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006225
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$260.80 |
| Max. Negotiated Rate |
$619.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$521.60
|
| Rate for Payer: Cash Price |
$391.20
|
| Rate for Payer: Cash Price |
$391.20
|
| Rate for Payer: Cigna Commercial |
$554.20
|
| Rate for Payer: First Health Commercial |
$586.80
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$586.80
|
| Rate for Payer: GEHA Commercial |
$456.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$586.80
|
| Rate for Payer: Multiplan All |
$593.32
|
| Rate for Payer: OMNI Networks Commercial |
$456.40
|
| Rate for Payer: One Health Plan PPO/POS |
$586.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$619.40
|
| Rate for Payer: Three Rivers Provider Network All |
$489.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$606.36
|
| Rate for Payer: Zelis Auto |
$260.80
|
|
|
IMPLT SCREW LOCKING 2.7X10MM
|
Facility
|
IP
|
$811.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006113
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$324.40 |
| Max. Negotiated Rate |
$770.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$648.80
|
| Rate for Payer: Cash Price |
$486.60
|
| Rate for Payer: Cash Price |
$486.60
|
| Rate for Payer: Cigna Commercial |
$689.35
|
| Rate for Payer: First Health Commercial |
$729.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$729.90
|
| Rate for Payer: GEHA Commercial |
$567.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$729.90
|
| Rate for Payer: Multiplan All |
$738.01
|
| Rate for Payer: OMNI Networks Commercial |
$567.70
|
| Rate for Payer: One Health Plan PPO/POS |
$729.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$770.45
|
| Rate for Payer: Three Rivers Provider Network All |
$608.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$754.23
|
| Rate for Payer: Zelis Auto |
$324.40
|
|
|
IMPLT SCREW LOCKING 2.7X10MM
|
Facility
|
OP
|
$691.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7001507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$172.75 |
| Max. Negotiated Rate |
$656.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$414.60
|
| Rate for Payer: Cash Price |
$414.60
|
| Rate for Payer: Cash Price |
$414.60
|
| Rate for Payer: Cigna Commercial |
$587.35
|
| Rate for Payer: First Health Commercial |
$621.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$621.90
|
| Rate for Payer: GEHA Commercial |
$552.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$621.90
|
| Rate for Payer: Humana ChoiceCare |
$179.66
|
| Rate for Payer: Multiplan All |
$628.81
|
| Rate for Payer: New Mexico Health Connections Medicare |
$414.60
|
| Rate for Payer: OMNI Networks Commercial |
$483.70
|
| Rate for Payer: One Health Plan PPO/POS |
$621.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$656.45
|
| Rate for Payer: Three Rivers Provider Network All |
$518.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$608.08
|
| Rate for Payer: United Healthcare Managed Medicaid |
$172.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$642.63
|
| Rate for Payer: Zelis Auto |
$276.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$345.50
|
|
|
IMPLT SCREW LOCKING 2.7X10MM
|
Facility
|
OP
|
$763.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000943
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$190.75 |
| Max. Negotiated Rate |
$724.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$457.80
|
| Rate for Payer: Cash Price |
$457.80
|
| Rate for Payer: Cash Price |
$457.80
|
| Rate for Payer: Cigna Commercial |
$648.55
|
| Rate for Payer: First Health Commercial |
$686.70
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$686.70
|
| Rate for Payer: GEHA Commercial |
$610.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$686.70
|
| Rate for Payer: Humana ChoiceCare |
$198.38
|
| Rate for Payer: Multiplan All |
$694.33
|
| Rate for Payer: New Mexico Health Connections Medicare |
$457.80
|
| Rate for Payer: OMNI Networks Commercial |
$534.10
|
| Rate for Payer: One Health Plan PPO/POS |
$686.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$724.85
|
| Rate for Payer: Three Rivers Provider Network All |
$572.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$671.44
|
| Rate for Payer: United Healthcare Managed Medicaid |
$190.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$709.59
|
| Rate for Payer: Zelis Auto |
$305.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$381.50
|
|
|
IMPLT SCREW LOCKING 2.7X10MM
|
Facility
|
IP
|
$691.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7001507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$276.40 |
| Max. Negotiated Rate |
$656.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$552.80
|
| Rate for Payer: Cash Price |
$414.60
|
| Rate for Payer: Cash Price |
$414.60
|
| Rate for Payer: Cigna Commercial |
$587.35
|
| Rate for Payer: First Health Commercial |
$621.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$621.90
|
| Rate for Payer: GEHA Commercial |
$483.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$621.90
|
| Rate for Payer: Multiplan All |
$628.81
|
| Rate for Payer: OMNI Networks Commercial |
$483.70
|
| Rate for Payer: One Health Plan PPO/POS |
$621.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$656.45
|
| Rate for Payer: Three Rivers Provider Network All |
$518.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$642.63
|
| Rate for Payer: Zelis Auto |
$276.40
|
|
|
IMPLT SCREW LOCKING 2.7X10MM
|
Facility
|
IP
|
$763.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000943
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$305.20 |
| Max. Negotiated Rate |
$724.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$610.40
|
| Rate for Payer: Cash Price |
$457.80
|
| Rate for Payer: Cash Price |
$457.80
|
| Rate for Payer: Cigna Commercial |
$648.55
|
| Rate for Payer: First Health Commercial |
$686.70
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$686.70
|
| Rate for Payer: GEHA Commercial |
$534.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$686.70
|
| Rate for Payer: Multiplan All |
$694.33
|
| Rate for Payer: OMNI Networks Commercial |
$534.10
|
| Rate for Payer: One Health Plan PPO/POS |
$686.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$724.85
|
| Rate for Payer: Three Rivers Provider Network All |
$572.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$709.59
|
| Rate for Payer: Zelis Auto |
$305.20
|
|
|
IMPLT SCREW LOCKING 2.7X10MM
|
Facility
|
OP
|
$811.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006113
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$202.75 |
| Max. Negotiated Rate |
$770.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$486.60
|
| Rate for Payer: Cash Price |
$486.60
|
| Rate for Payer: Cash Price |
$486.60
|
| Rate for Payer: Cigna Commercial |
$689.35
|
| Rate for Payer: First Health Commercial |
$729.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$729.90
|
| Rate for Payer: GEHA Commercial |
$648.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$729.90
|
| Rate for Payer: Humana ChoiceCare |
$210.86
|
| Rate for Payer: Multiplan All |
$738.01
|
| Rate for Payer: New Mexico Health Connections Medicare |
$486.60
|
| Rate for Payer: OMNI Networks Commercial |
$567.70
|
| Rate for Payer: One Health Plan PPO/POS |
$729.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$770.45
|
| Rate for Payer: Three Rivers Provider Network All |
$608.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$713.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$202.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$754.23
|
| Rate for Payer: Zelis Auto |
$324.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$405.50
|
|
|
IMPLT SCREW LOCKING 2.7X12MM
|
Facility
|
OP
|
$691.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7001508
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$172.75 |
| Max. Negotiated Rate |
$656.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$414.60
|
| Rate for Payer: Cash Price |
$414.60
|
| Rate for Payer: Cash Price |
$414.60
|
| Rate for Payer: Cigna Commercial |
$587.35
|
| Rate for Payer: First Health Commercial |
$621.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$621.90
|
| Rate for Payer: GEHA Commercial |
$552.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$621.90
|
| Rate for Payer: Humana ChoiceCare |
$179.66
|
| Rate for Payer: Multiplan All |
$628.81
|
| Rate for Payer: New Mexico Health Connections Medicare |
$414.60
|
| Rate for Payer: OMNI Networks Commercial |
$483.70
|
| Rate for Payer: One Health Plan PPO/POS |
$621.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$656.45
|
| Rate for Payer: Three Rivers Provider Network All |
$518.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$608.08
|
| Rate for Payer: United Healthcare Managed Medicaid |
$172.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$642.63
|
| Rate for Payer: Zelis Auto |
$276.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$345.50
|
|
|
IMPLT SCREW LOCKING 2.7X12MM
|
Facility
|
OP
|
$774.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000567
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$193.50 |
| Max. Negotiated Rate |
$735.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$464.40
|
| Rate for Payer: Cash Price |
$464.40
|
| Rate for Payer: Cash Price |
$464.40
|
| Rate for Payer: Cigna Commercial |
$657.90
|
| Rate for Payer: First Health Commercial |
$696.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$696.60
|
| Rate for Payer: GEHA Commercial |
$619.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$696.60
|
| Rate for Payer: Humana ChoiceCare |
$201.24
|
| Rate for Payer: Multiplan All |
$704.34
|
| Rate for Payer: New Mexico Health Connections Medicare |
$464.40
|
| Rate for Payer: OMNI Networks Commercial |
$541.80
|
| Rate for Payer: One Health Plan PPO/POS |
$696.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$735.30
|
| Rate for Payer: Three Rivers Provider Network All |
$580.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$681.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$193.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$719.82
|
| Rate for Payer: Zelis Auto |
$309.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$387.00
|
|
|
IMPLT SCREW LOCKING 2.7X12MM
|
Facility
|
IP
|
$691.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7001508
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$276.40 |
| Max. Negotiated Rate |
$656.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$552.80
|
| Rate for Payer: Cash Price |
$414.60
|
| Rate for Payer: Cash Price |
$414.60
|
| Rate for Payer: Cigna Commercial |
$587.35
|
| Rate for Payer: First Health Commercial |
$621.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$621.90
|
| Rate for Payer: GEHA Commercial |
$483.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$621.90
|
| Rate for Payer: Multiplan All |
$628.81
|
| Rate for Payer: OMNI Networks Commercial |
$483.70
|
| Rate for Payer: One Health Plan PPO/POS |
$621.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$656.45
|
| Rate for Payer: Three Rivers Provider Network All |
$518.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$642.63
|
| Rate for Payer: Zelis Auto |
$276.40
|
|
|
IMPLT SCREW LOCKING 2.7X12MM
|
Facility
|
IP
|
$774.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000567
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$309.60 |
| Max. Negotiated Rate |
$735.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$619.20
|
| Rate for Payer: Cash Price |
$464.40
|
| Rate for Payer: Cash Price |
$464.40
|
| Rate for Payer: Cigna Commercial |
$657.90
|
| Rate for Payer: First Health Commercial |
$696.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$696.60
|
| Rate for Payer: GEHA Commercial |
$541.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$696.60
|
| Rate for Payer: Multiplan All |
$704.34
|
| Rate for Payer: OMNI Networks Commercial |
$541.80
|
| Rate for Payer: One Health Plan PPO/POS |
$696.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$735.30
|
| Rate for Payer: Three Rivers Provider Network All |
$580.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$719.82
|
| Rate for Payer: Zelis Auto |
$309.60
|
|
|
IMPLT SCREW LOCKING 2.7X12MM
|
Facility
|
IP
|
$811.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006170
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$324.40 |
| Max. Negotiated Rate |
$770.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$648.80
|
| Rate for Payer: Cash Price |
$486.60
|
| Rate for Payer: Cash Price |
$486.60
|
| Rate for Payer: Cigna Commercial |
$689.35
|
| Rate for Payer: First Health Commercial |
$729.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$729.90
|
| Rate for Payer: GEHA Commercial |
$567.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$729.90
|
| Rate for Payer: Multiplan All |
$738.01
|
| Rate for Payer: OMNI Networks Commercial |
$567.70
|
| Rate for Payer: One Health Plan PPO/POS |
$729.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$770.45
|
| Rate for Payer: Three Rivers Provider Network All |
$608.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$754.23
|
| Rate for Payer: Zelis Auto |
$324.40
|
|
|
IMPLT SCREW LOCKING 2.7X12MM
|
Facility
|
OP
|
$811.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006170
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$202.75 |
| Max. Negotiated Rate |
$770.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$486.60
|
| Rate for Payer: Cash Price |
$486.60
|
| Rate for Payer: Cash Price |
$486.60
|
| Rate for Payer: Cigna Commercial |
$689.35
|
| Rate for Payer: First Health Commercial |
$729.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$729.90
|
| Rate for Payer: GEHA Commercial |
$648.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$729.90
|
| Rate for Payer: Humana ChoiceCare |
$210.86
|
| Rate for Payer: Multiplan All |
$738.01
|
| Rate for Payer: New Mexico Health Connections Medicare |
$486.60
|
| Rate for Payer: OMNI Networks Commercial |
$567.70
|
| Rate for Payer: One Health Plan PPO/POS |
$729.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$770.45
|
| Rate for Payer: Three Rivers Provider Network All |
$608.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$713.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$202.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$754.23
|
| Rate for Payer: Zelis Auto |
$324.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$405.50
|
|
|
IMPLT SCREW LOCKING2.7X12MM
|
Facility
|
IP
|
$964.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000601
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$385.60 |
| Max. Negotiated Rate |
$915.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$771.20
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cigna Commercial |
$819.40
|
| Rate for Payer: First Health Commercial |
$867.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$867.60
|
| Rate for Payer: GEHA Commercial |
$674.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$867.60
|
| Rate for Payer: Multiplan All |
$877.24
|
| Rate for Payer: OMNI Networks Commercial |
$674.80
|
| Rate for Payer: One Health Plan PPO/POS |
$867.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$915.80
|
| Rate for Payer: Three Rivers Provider Network All |
$723.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$896.52
|
| Rate for Payer: Zelis Auto |
$385.60
|
|
|
IMPLT SCREW LOCKING2.7X12MM
|
Facility
|
OP
|
$964.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000601
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.00 |
| Max. Negotiated Rate |
$915.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cigna Commercial |
$819.40
|
| Rate for Payer: First Health Commercial |
$867.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$867.60
|
| Rate for Payer: GEHA Commercial |
$771.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$867.60
|
| Rate for Payer: Humana ChoiceCare |
$250.64
|
| Rate for Payer: Multiplan All |
$877.24
|
| Rate for Payer: New Mexico Health Connections Medicare |
$578.40
|
| Rate for Payer: OMNI Networks Commercial |
$674.80
|
| Rate for Payer: One Health Plan PPO/POS |
$867.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$915.80
|
| Rate for Payer: Three Rivers Provider Network All |
$723.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$848.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$241.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$896.52
|
| Rate for Payer: Zelis Auto |
$385.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$482.00
|
|
|
IMPLT SCREW LOCKING 2.7X14MM
|
Facility
|
IP
|
$964.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000910
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$385.60 |
| Max. Negotiated Rate |
$915.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$771.20
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cigna Commercial |
$819.40
|
| Rate for Payer: First Health Commercial |
$867.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$867.60
|
| Rate for Payer: GEHA Commercial |
$674.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$867.60
|
| Rate for Payer: Multiplan All |
$877.24
|
| Rate for Payer: OMNI Networks Commercial |
$674.80
|
| Rate for Payer: One Health Plan PPO/POS |
$867.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$915.80
|
| Rate for Payer: Three Rivers Provider Network All |
$723.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$896.52
|
| Rate for Payer: Zelis Auto |
$385.60
|
|
|
IMPLT SCREW LOCKING 2.7X14MM
|
Facility
|
OP
|
$818.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006168
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$204.50 |
| Max. Negotiated Rate |
$777.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$490.80
|
| Rate for Payer: Cash Price |
$490.80
|
| Rate for Payer: Cash Price |
$490.80
|
| Rate for Payer: Cigna Commercial |
$695.30
|
| Rate for Payer: First Health Commercial |
$736.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$736.20
|
| Rate for Payer: GEHA Commercial |
$654.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$736.20
|
| Rate for Payer: Humana ChoiceCare |
$212.68
|
| Rate for Payer: Multiplan All |
$744.38
|
| Rate for Payer: New Mexico Health Connections Medicare |
$490.80
|
| Rate for Payer: OMNI Networks Commercial |
$572.60
|
| Rate for Payer: One Health Plan PPO/POS |
$736.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$777.10
|
| Rate for Payer: Three Rivers Provider Network All |
$613.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$719.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$204.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$760.74
|
| Rate for Payer: Zelis Auto |
$327.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$409.00
|
|
|
IMPLT SCREW LOCKING 2.7X14MM
|
Facility
|
OP
|
$811.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006191
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$202.75 |
| Max. Negotiated Rate |
$770.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$486.60
|
| Rate for Payer: Cash Price |
$486.60
|
| Rate for Payer: Cash Price |
$486.60
|
| Rate for Payer: Cigna Commercial |
$689.35
|
| Rate for Payer: First Health Commercial |
$729.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$729.90
|
| Rate for Payer: GEHA Commercial |
$648.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$729.90
|
| Rate for Payer: Humana ChoiceCare |
$210.86
|
| Rate for Payer: Multiplan All |
$738.01
|
| Rate for Payer: New Mexico Health Connections Medicare |
$486.60
|
| Rate for Payer: OMNI Networks Commercial |
$567.70
|
| Rate for Payer: One Health Plan PPO/POS |
$729.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$770.45
|
| Rate for Payer: Three Rivers Provider Network All |
$608.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$713.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$202.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$754.23
|
| Rate for Payer: Zelis Auto |
$324.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$405.50
|
|
|
IMPLT SCREW LOCKING 2.7X14MM
|
Facility
|
IP
|
$774.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7001084
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$309.60 |
| Max. Negotiated Rate |
$735.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$619.20
|
| Rate for Payer: Cash Price |
$464.40
|
| Rate for Payer: Cash Price |
$464.40
|
| Rate for Payer: Cigna Commercial |
$657.90
|
| Rate for Payer: First Health Commercial |
$696.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$696.60
|
| Rate for Payer: GEHA Commercial |
$541.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$696.60
|
| Rate for Payer: Multiplan All |
$704.34
|
| Rate for Payer: OMNI Networks Commercial |
$541.80
|
| Rate for Payer: One Health Plan PPO/POS |
$696.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$735.30
|
| Rate for Payer: Three Rivers Provider Network All |
$580.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$719.82
|
| Rate for Payer: Zelis Auto |
$309.60
|
|
|
IMPLT SCREW LOCKING 2.7X14MM
|
Facility
|
OP
|
$829.04
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006247
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$207.26 |
| Max. Negotiated Rate |
$787.59 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$497.42
|
| Rate for Payer: Cash Price |
$497.42
|
| Rate for Payer: Cash Price |
$497.42
|
| Rate for Payer: Cigna Commercial |
$704.68
|
| Rate for Payer: First Health Commercial |
$746.14
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$746.14
|
| Rate for Payer: GEHA Commercial |
$663.23
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$746.14
|
| Rate for Payer: Humana ChoiceCare |
$215.55
|
| Rate for Payer: Multiplan All |
$754.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$497.42
|
| Rate for Payer: OMNI Networks Commercial |
$580.33
|
| Rate for Payer: One Health Plan PPO/POS |
$746.14
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$787.59
|
| Rate for Payer: Three Rivers Provider Network All |
$621.78
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$729.56
|
| Rate for Payer: United Healthcare Managed Medicaid |
$207.26
|
| Rate for Payer: United Payors & United Providers UP&UP |
$771.01
|
| Rate for Payer: Zelis Auto |
$331.62
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$414.52
|
|
|
IMPLT SCREW LOCKING 2.7X14MM
|
Facility
|
IP
|
$829.04
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006247
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.62 |
| Max. Negotiated Rate |
$787.59 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$663.23
|
| Rate for Payer: Cash Price |
$497.42
|
| Rate for Payer: Cash Price |
$497.42
|
| Rate for Payer: Cigna Commercial |
$704.68
|
| Rate for Payer: First Health Commercial |
$746.14
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$746.14
|
| Rate for Payer: GEHA Commercial |
$580.33
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$746.14
|
| Rate for Payer: Multiplan All |
$754.43
|
| Rate for Payer: OMNI Networks Commercial |
$580.33
|
| Rate for Payer: One Health Plan PPO/POS |
$746.14
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$787.59
|
| Rate for Payer: Three Rivers Provider Network All |
$621.78
|
| Rate for Payer: United Payors & United Providers UP&UP |
$771.01
|
| Rate for Payer: Zelis Auto |
$331.62
|
|
|
IMPLT SCREW LOCKING 2.7X14MM
|
Facility
|
IP
|
$818.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006168
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$327.20 |
| Max. Negotiated Rate |
$777.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$654.40
|
| Rate for Payer: Cash Price |
$490.80
|
| Rate for Payer: Cash Price |
$490.80
|
| Rate for Payer: Cigna Commercial |
$695.30
|
| Rate for Payer: First Health Commercial |
$736.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$736.20
|
| Rate for Payer: GEHA Commercial |
$572.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$736.20
|
| Rate for Payer: Multiplan All |
$744.38
|
| Rate for Payer: OMNI Networks Commercial |
$572.60
|
| Rate for Payer: One Health Plan PPO/POS |
$736.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$777.10
|
| Rate for Payer: Three Rivers Provider Network All |
$613.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$760.74
|
| Rate for Payer: Zelis Auto |
$327.20
|
|
|
IMPLT SCREW LOCKING 2.7X14MM
|
Facility
|
IP
|
$895.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7001509
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$358.00 |
| Max. Negotiated Rate |
$850.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$716.00
|
| Rate for Payer: Cash Price |
$537.00
|
| Rate for Payer: Cash Price |
$537.00
|
| Rate for Payer: Cigna Commercial |
$760.75
|
| Rate for Payer: First Health Commercial |
$805.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$805.50
|
| Rate for Payer: GEHA Commercial |
$626.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$805.50
|
| Rate for Payer: Multiplan All |
$814.45
|
| Rate for Payer: OMNI Networks Commercial |
$626.50
|
| Rate for Payer: One Health Plan PPO/POS |
$805.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$850.25
|
| Rate for Payer: Three Rivers Provider Network All |
$671.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$832.35
|
| Rate for Payer: Zelis Auto |
$358.00
|
|
|
IMPLT SCREW LOCKING 2.7X14MM
|
Facility
|
IP
|
$811.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7006191
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$324.40 |
| Max. Negotiated Rate |
$770.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$648.80
|
| Rate for Payer: Cash Price |
$486.60
|
| Rate for Payer: Cash Price |
$486.60
|
| Rate for Payer: Cigna Commercial |
$689.35
|
| Rate for Payer: First Health Commercial |
$729.90
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$729.90
|
| Rate for Payer: GEHA Commercial |
$567.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$729.90
|
| Rate for Payer: Multiplan All |
$738.01
|
| Rate for Payer: OMNI Networks Commercial |
$567.70
|
| Rate for Payer: One Health Plan PPO/POS |
$729.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$770.45
|
| Rate for Payer: Three Rivers Provider Network All |
$608.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$754.23
|
| Rate for Payer: Zelis Auto |
$324.40
|
|
|
IMPLT SCREW LOCKING 2.7X14MM
|
Facility
|
OP
|
$964.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
7000910
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.00 |
| Max. Negotiated Rate |
$915.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cash Price |
$578.40
|
| Rate for Payer: Cigna Commercial |
$819.40
|
| Rate for Payer: First Health Commercial |
$867.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$867.60
|
| Rate for Payer: GEHA Commercial |
$771.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$867.60
|
| Rate for Payer: Humana ChoiceCare |
$250.64
|
| Rate for Payer: Multiplan All |
$877.24
|
| Rate for Payer: New Mexico Health Connections Medicare |
$578.40
|
| Rate for Payer: OMNI Networks Commercial |
$674.80
|
| Rate for Payer: One Health Plan PPO/POS |
$867.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$915.80
|
| Rate for Payer: Three Rivers Provider Network All |
$723.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$848.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$241.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$896.52
|
| Rate for Payer: Zelis Auto |
$385.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$482.00
|
|
