|
INCISION & DRAINAGE COMPLEX PO WOUND INF
|
Facility
|
IP
|
$553.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
6110180
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$150.97 |
| Max. Negotiated Rate |
$525.35 |
| Rate for Payer: Cash Price |
$331.80
|
| Rate for Payer: Cigna Commercial |
$470.05
|
| Rate for Payer: First Health Commercial |
$497.70
|
| Rate for Payer: First Health Workers Compensation |
$213.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$497.70
|
| Rate for Payer: GEHA Commercial |
$387.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$497.70
|
| Rate for Payer: Multiplan All |
$503.23
|
| Rate for Payer: OMNI Networks Commercial |
$387.10
|
| Rate for Payer: One Health Plan PPO/POS |
$497.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$525.35
|
| Rate for Payer: Three Rivers Provider Network All |
$414.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$514.29
|
| Rate for Payer: Zelis Auto |
$221.20
|
| Rate for Payer: Zelis Worker's Compensation |
$150.97
|
|
|
INCISION & DRAINAGE PILONIDAL CYST COMPL
|
Facility
|
IP
|
$826.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
20300011
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$225.50 |
| Max. Negotiated Rate |
$784.70 |
| Rate for Payer: Cash Price |
$495.60
|
| Rate for Payer: Cigna Commercial |
$702.10
|
| Rate for Payer: First Health Commercial |
$743.40
|
| Rate for Payer: First Health Workers Compensation |
$318.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$743.40
|
| Rate for Payer: GEHA Commercial |
$578.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$743.40
|
| Rate for Payer: Multiplan All |
$751.66
|
| Rate for Payer: OMNI Networks Commercial |
$578.20
|
| Rate for Payer: One Health Plan PPO/POS |
$743.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$784.70
|
| Rate for Payer: Three Rivers Provider Network All |
$619.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$768.18
|
| Rate for Payer: Zelis Auto |
$330.40
|
| Rate for Payer: Zelis Worker's Compensation |
$225.50
|
|
|
INCISION & DRAINAGE PILONIDAL CYST COMPL
|
Facility
|
IP
|
$3,724.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
1900011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,016.65 |
| Max. Negotiated Rate |
$3,537.80 |
| Rate for Payer: Cash Price |
$2,234.40
|
| Rate for Payer: Cigna Commercial |
$3,165.40
|
| Rate for Payer: First Health Commercial |
$3,351.60
|
| Rate for Payer: First Health Workers Compensation |
$1,437.84
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,351.60
|
| Rate for Payer: GEHA Commercial |
$2,606.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,351.60
|
| Rate for Payer: Multiplan All |
$3,388.84
|
| Rate for Payer: OMNI Networks Commercial |
$2,606.80
|
| Rate for Payer: One Health Plan PPO/POS |
$3,351.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,537.80
|
| Rate for Payer: Three Rivers Provider Network All |
$2,793.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,463.32
|
| Rate for Payer: Zelis Auto |
$1,489.60
|
| Rate for Payer: Zelis Worker's Compensation |
$1,016.65
|
|
|
INCISION & DRAINAGE PILONIDAL CYST COMPL
|
Facility
|
OP
|
$3,724.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
1900011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$567.88 |
| Max. Negotiated Rate |
$3,537.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,276.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,234.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,276.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,010.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$668.09
|
| Rate for Payer: Cash Price |
$2,234.40
|
| Rate for Payer: Cash Price |
$2,234.40
|
| Rate for Payer: Cigna Commercial |
$3,165.40
|
| Rate for Payer: First Health Commercial |
$3,351.60
|
| Rate for Payer: First Health Workers Compensation |
$1,437.84
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,351.60
|
| Rate for Payer: GEHA Commercial |
$2,979.20
|
| Rate for Payer: GEHA Medicare |
$668.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,351.60
|
| Rate for Payer: Humana ChoiceCare |
$734.90
|
| Rate for Payer: Humana Medicare Advantage |
$668.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,122.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,031.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$668.09
|
| Rate for Payer: Multiplan All |
$3,388.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,135.75
|
| Rate for Payer: OMNI Networks Commercial |
$2,606.80
|
| Rate for Payer: One Health Plan PPO/POS |
$3,351.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,191.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,031.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$668.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,537.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,336.18
|
| Rate for Payer: Three Rivers Provider Network All |
$2,793.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$654.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,031.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$668.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,463.32
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$668.09
|
| Rate for Payer: Zelis Auto |
$1,489.60
|
| Rate for Payer: Zelis Medicare |
$567.88
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$801.71
|
| Rate for Payer: Zelis Worker's Compensation |
$1,016.65
|
|
|
INCISION & DRAINAGE PILONIDAL CYST COMPL
|
Facility
|
OP
|
$826.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
21600220
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$225.50 |
| Max. Negotiated Rate |
$1,336.18 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,276.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$495.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,276.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,010.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$668.09
|
| Rate for Payer: Cash Price |
$495.60
|
| Rate for Payer: Cash Price |
$495.60
|
| Rate for Payer: Cigna Commercial |
$702.10
|
| Rate for Payer: First Health Commercial |
$743.40
|
| Rate for Payer: First Health Workers Compensation |
$318.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$743.40
|
| Rate for Payer: GEHA Commercial |
$660.80
|
| Rate for Payer: GEHA Medicare |
$668.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$743.40
|
| Rate for Payer: Humana ChoiceCare |
$734.90
|
| Rate for Payer: Humana Medicare Advantage |
$668.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,122.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,031.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$668.09
|
| Rate for Payer: Multiplan All |
$751.66
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,135.75
|
| Rate for Payer: OMNI Networks Commercial |
$578.20
|
| Rate for Payer: One Health Plan PPO/POS |
$743.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,191.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,031.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$668.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$784.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,336.18
|
| Rate for Payer: Three Rivers Provider Network All |
$619.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$654.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,031.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$668.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$768.18
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$668.09
|
| Rate for Payer: Zelis Auto |
$330.40
|
| Rate for Payer: Zelis Medicare |
$567.88
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$801.71
|
| Rate for Payer: Zelis Worker's Compensation |
$225.50
|
|
|
INCISION & DRAINAGE PILONIDAL CYST COMPL
|
Facility
|
OP
|
$518.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
6110081
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$141.41 |
| Max. Negotiated Rate |
$1,336.18 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,276.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$310.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,276.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,010.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$668.09
|
| Rate for Payer: Cash Price |
$310.80
|
| Rate for Payer: Cash Price |
$310.80
|
| Rate for Payer: Cigna Commercial |
$440.30
|
| Rate for Payer: First Health Commercial |
$466.20
|
| Rate for Payer: First Health Workers Compensation |
$200.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$466.20
|
| Rate for Payer: GEHA Commercial |
$414.40
|
| Rate for Payer: GEHA Medicare |
$668.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$466.20
|
| Rate for Payer: Humana ChoiceCare |
$734.90
|
| Rate for Payer: Humana Medicare Advantage |
$668.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,122.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,031.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$668.09
|
| Rate for Payer: Multiplan All |
$471.38
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,135.75
|
| Rate for Payer: OMNI Networks Commercial |
$362.60
|
| Rate for Payer: One Health Plan PPO/POS |
$466.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,191.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,031.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$668.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$492.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,336.18
|
| Rate for Payer: Three Rivers Provider Network All |
$388.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$654.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,031.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$668.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$481.74
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$668.09
|
| Rate for Payer: Zelis Auto |
$207.20
|
| Rate for Payer: Zelis Medicare |
$567.88
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$801.71
|
| Rate for Payer: Zelis Worker's Compensation |
$141.41
|
|
|
INCISION & DRAINAGE PILONIDAL CYST COMPL
|
Facility
|
OP
|
$826.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
20300011
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$225.50 |
| Max. Negotiated Rate |
$1,336.18 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,276.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$495.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,276.17
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,010.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$668.09
|
| Rate for Payer: Cash Price |
$495.60
|
| Rate for Payer: Cash Price |
$495.60
|
| Rate for Payer: Cigna Commercial |
$702.10
|
| Rate for Payer: First Health Commercial |
$743.40
|
| Rate for Payer: First Health Workers Compensation |
$318.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$743.40
|
| Rate for Payer: GEHA Commercial |
$660.80
|
| Rate for Payer: GEHA Medicare |
$668.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$743.40
|
| Rate for Payer: Humana ChoiceCare |
$734.90
|
| Rate for Payer: Humana Medicare Advantage |
$668.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,122.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,031.57
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$668.09
|
| Rate for Payer: Multiplan All |
$751.66
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,135.75
|
| Rate for Payer: OMNI Networks Commercial |
$578.20
|
| Rate for Payer: One Health Plan PPO/POS |
$743.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,191.09
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,031.57
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$668.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$784.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,336.18
|
| Rate for Payer: Three Rivers Provider Network All |
$619.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$654.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,031.57
|
| Rate for Payer: United Healthcare Medicare Advantage |
$668.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$768.18
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$668.09
|
| Rate for Payer: Zelis Auto |
$330.40
|
| Rate for Payer: Zelis Medicare |
$567.88
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$801.71
|
| Rate for Payer: Zelis Worker's Compensation |
$225.50
|
|
|
INCISION & DRAINAGE PILONIDAL CYST COMPL
|
Facility
|
IP
|
$518.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
6110081
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$141.41 |
| Max. Negotiated Rate |
$492.10 |
| Rate for Payer: Cash Price |
$310.80
|
| Rate for Payer: Cigna Commercial |
$440.30
|
| Rate for Payer: First Health Commercial |
$466.20
|
| Rate for Payer: First Health Workers Compensation |
$200.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$466.20
|
| Rate for Payer: GEHA Commercial |
$362.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$466.20
|
| Rate for Payer: Multiplan All |
$471.38
|
| Rate for Payer: OMNI Networks Commercial |
$362.60
|
| Rate for Payer: One Health Plan PPO/POS |
$466.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$492.10
|
| Rate for Payer: Three Rivers Provider Network All |
$388.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$481.74
|
| Rate for Payer: Zelis Auto |
$207.20
|
| Rate for Payer: Zelis Worker's Compensation |
$141.41
|
|
|
INCISION & DRAINAGE PILONIDAL CYST COMPL
|
Facility
|
IP
|
$826.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
21600220
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$225.50 |
| Max. Negotiated Rate |
$784.70 |
| Rate for Payer: Cash Price |
$495.60
|
| Rate for Payer: Cigna Commercial |
$702.10
|
| Rate for Payer: First Health Commercial |
$743.40
|
| Rate for Payer: First Health Workers Compensation |
$318.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$743.40
|
| Rate for Payer: GEHA Commercial |
$578.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$743.40
|
| Rate for Payer: Multiplan All |
$751.66
|
| Rate for Payer: OMNI Networks Commercial |
$578.20
|
| Rate for Payer: One Health Plan PPO/POS |
$743.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$784.70
|
| Rate for Payer: Three Rivers Provider Network All |
$619.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$768.18
|
| Rate for Payer: Zelis Auto |
$330.40
|
| Rate for Payer: Zelis Worker's Compensation |
$225.50
|
|
|
INCISION & DRAINAGE PILONIDAL CYST SIMPL
|
Facility
|
IP
|
$1,228.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
1900010
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$335.24 |
| Max. Negotiated Rate |
$1,166.60 |
| Rate for Payer: Cash Price |
$736.80
|
| Rate for Payer: Cigna Commercial |
$1,043.80
|
| Rate for Payer: First Health Commercial |
$1,105.20
|
| Rate for Payer: First Health Workers Compensation |
$474.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,105.20
|
| Rate for Payer: GEHA Commercial |
$859.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,105.20
|
| Rate for Payer: Multiplan All |
$1,117.48
|
| Rate for Payer: OMNI Networks Commercial |
$859.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,105.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,166.60
|
| Rate for Payer: Three Rivers Provider Network All |
$921.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,142.04
|
| Rate for Payer: Zelis Auto |
$491.20
|
| Rate for Payer: Zelis Worker's Compensation |
$335.24
|
|
|
INCISION & DRAINAGE PILONIDAL CYST SIMPL
|
Facility
|
OP
|
$545.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
20300010
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$116.60 |
| Max. Negotiated Rate |
$1,336.18 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$147.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$327.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$147.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$116.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$668.09
|
| Rate for Payer: Cash Price |
$327.00
|
| Rate for Payer: Cash Price |
$327.00
|
| Rate for Payer: Cigna Commercial |
$463.25
|
| Rate for Payer: First Health Commercial |
$490.50
|
| Rate for Payer: First Health Workers Compensation |
$210.42
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$490.50
|
| Rate for Payer: GEHA Commercial |
$436.00
|
| Rate for Payer: GEHA Medicare |
$668.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$490.50
|
| Rate for Payer: Humana ChoiceCare |
$734.90
|
| Rate for Payer: Humana Medicare Advantage |
$668.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,122.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$118.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$668.09
|
| Rate for Payer: Multiplan All |
$495.95
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,135.75
|
| Rate for Payer: OMNI Networks Commercial |
$381.50
|
| Rate for Payer: One Health Plan PPO/POS |
$490.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$137.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$118.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$668.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$517.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,336.18
|
| Rate for Payer: Three Rivers Provider Network All |
$408.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$654.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$118.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$668.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$506.85
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$668.09
|
| Rate for Payer: Zelis Auto |
$218.00
|
| Rate for Payer: Zelis Medicare |
$567.88
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$801.71
|
| Rate for Payer: Zelis Worker's Compensation |
$148.78
|
|
|
INCISION & DRAINAGE PILONIDAL CYST SIMPL
|
Facility
|
OP
|
$1,228.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
1900010
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.60 |
| Max. Negotiated Rate |
$1,336.18 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$147.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$736.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$147.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$116.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$668.09
|
| Rate for Payer: Cash Price |
$736.80
|
| Rate for Payer: Cash Price |
$736.80
|
| Rate for Payer: Cigna Commercial |
$1,043.80
|
| Rate for Payer: First Health Commercial |
$1,105.20
|
| Rate for Payer: First Health Workers Compensation |
$474.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,105.20
|
| Rate for Payer: GEHA Commercial |
$982.40
|
| Rate for Payer: GEHA Medicare |
$668.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,105.20
|
| Rate for Payer: Humana ChoiceCare |
$734.90
|
| Rate for Payer: Humana Medicare Advantage |
$668.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,122.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$118.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$668.09
|
| Rate for Payer: Multiplan All |
$1,117.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,135.75
|
| Rate for Payer: OMNI Networks Commercial |
$859.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,105.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$137.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$118.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$668.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,166.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,336.18
|
| Rate for Payer: Three Rivers Provider Network All |
$921.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$654.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$118.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$668.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,142.04
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$668.09
|
| Rate for Payer: Zelis Auto |
$491.20
|
| Rate for Payer: Zelis Medicare |
$567.88
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$801.71
|
| Rate for Payer: Zelis Worker's Compensation |
$335.24
|
|
|
INCISION & DRAINAGE PILONIDAL CYST SIMPL
|
Facility
|
IP
|
$545.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
20300010
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$148.78 |
| Max. Negotiated Rate |
$517.75 |
| Rate for Payer: Cash Price |
$327.00
|
| Rate for Payer: Cigna Commercial |
$463.25
|
| Rate for Payer: First Health Commercial |
$490.50
|
| Rate for Payer: First Health Workers Compensation |
$210.42
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$490.50
|
| Rate for Payer: GEHA Commercial |
$381.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$490.50
|
| Rate for Payer: Multiplan All |
$495.95
|
| Rate for Payer: OMNI Networks Commercial |
$381.50
|
| Rate for Payer: One Health Plan PPO/POS |
$490.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$517.75
|
| Rate for Payer: Three Rivers Provider Network All |
$408.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$506.85
|
| Rate for Payer: Zelis Auto |
$218.00
|
| Rate for Payer: Zelis Worker's Compensation |
$148.78
|
|
|
INCISION & DRAINAGE PILONIDAL CYST SIMPL
|
Facility
|
OP
|
$313.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
6110080
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$85.45 |
| Max. Negotiated Rate |
$1,336.18 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$147.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$187.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$147.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$116.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$668.09
|
| Rate for Payer: Cash Price |
$187.80
|
| Rate for Payer: Cash Price |
$187.80
|
| Rate for Payer: Cigna Commercial |
$266.05
|
| Rate for Payer: First Health Commercial |
$281.70
|
| Rate for Payer: First Health Workers Compensation |
$120.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$281.70
|
| Rate for Payer: GEHA Commercial |
$250.40
|
| Rate for Payer: GEHA Medicare |
$668.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$281.70
|
| Rate for Payer: Humana ChoiceCare |
$734.90
|
| Rate for Payer: Humana Medicare Advantage |
$668.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,122.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$118.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$668.09
|
| Rate for Payer: Multiplan All |
$284.83
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,135.75
|
| Rate for Payer: OMNI Networks Commercial |
$219.10
|
| Rate for Payer: One Health Plan PPO/POS |
$281.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$137.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$118.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$668.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$297.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,336.18
|
| Rate for Payer: Three Rivers Provider Network All |
$234.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$654.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$118.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$668.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$291.09
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$668.09
|
| Rate for Payer: Zelis Auto |
$125.20
|
| Rate for Payer: Zelis Medicare |
$567.88
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$801.71
|
| Rate for Payer: Zelis Worker's Compensation |
$85.45
|
|
|
INCISION & DRAINAGE PILONIDAL CYST SIMPL
|
Facility
|
OP
|
$313.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
21600092
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$85.45 |
| Max. Negotiated Rate |
$1,336.18 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$147.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$187.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$147.18
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$116.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$668.09
|
| Rate for Payer: Cash Price |
$187.80
|
| Rate for Payer: Cash Price |
$187.80
|
| Rate for Payer: Cigna Commercial |
$266.05
|
| Rate for Payer: First Health Commercial |
$281.70
|
| Rate for Payer: First Health Workers Compensation |
$120.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$281.70
|
| Rate for Payer: GEHA Commercial |
$250.40
|
| Rate for Payer: GEHA Medicare |
$668.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$281.70
|
| Rate for Payer: Humana ChoiceCare |
$734.90
|
| Rate for Payer: Humana Medicare Advantage |
$668.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,122.39
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$118.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$668.09
|
| Rate for Payer: Multiplan All |
$284.83
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,135.75
|
| Rate for Payer: OMNI Networks Commercial |
$219.10
|
| Rate for Payer: One Health Plan PPO/POS |
$281.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$137.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$118.97
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$668.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$297.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,336.18
|
| Rate for Payer: Three Rivers Provider Network All |
$234.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$654.73
|
| Rate for Payer: United Healthcare Managed Medicaid |
$118.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$668.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$291.09
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$668.09
|
| Rate for Payer: Zelis Auto |
$125.20
|
| Rate for Payer: Zelis Medicare |
$567.88
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$801.71
|
| Rate for Payer: Zelis Worker's Compensation |
$85.45
|
|
|
INCISION & DRAINAGE PILONIDAL CYST SIMPL
|
Facility
|
IP
|
$313.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
21600092
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$85.45 |
| Max. Negotiated Rate |
$297.35 |
| Rate for Payer: Cash Price |
$187.80
|
| Rate for Payer: Cigna Commercial |
$266.05
|
| Rate for Payer: First Health Commercial |
$281.70
|
| Rate for Payer: First Health Workers Compensation |
$120.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$281.70
|
| Rate for Payer: GEHA Commercial |
$219.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$281.70
|
| Rate for Payer: Multiplan All |
$284.83
|
| Rate for Payer: OMNI Networks Commercial |
$219.10
|
| Rate for Payer: One Health Plan PPO/POS |
$281.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$297.35
|
| Rate for Payer: Three Rivers Provider Network All |
$234.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$291.09
|
| Rate for Payer: Zelis Auto |
$125.20
|
| Rate for Payer: Zelis Worker's Compensation |
$85.45
|
|
|
INCISION & DRAINAGE PILONIDAL CYST SIMPL
|
Facility
|
IP
|
$1,615.00
|
|
| Hospital Charge Code |
8110080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$440.89 |
| Max. Negotiated Rate |
$1,534.25 |
| Rate for Payer: Cash Price |
$969.00
|
| Rate for Payer: Cigna Commercial |
$1,372.75
|
| Rate for Payer: First Health Commercial |
$1,453.50
|
| Rate for Payer: First Health Workers Compensation |
$623.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,453.50
|
| Rate for Payer: GEHA Commercial |
$1,130.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,453.50
|
| Rate for Payer: Multiplan All |
$1,469.65
|
| Rate for Payer: OMNI Networks Commercial |
$1,130.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,453.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,534.25
|
| Rate for Payer: Three Rivers Provider Network All |
$1,211.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,501.95
|
| Rate for Payer: Zelis Auto |
$646.00
|
| Rate for Payer: Zelis Worker's Compensation |
$440.89
|
|
|
INCISION & DRAINAGE PILONIDAL CYST SIMPL
|
Facility
|
IP
|
$313.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
6110080
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$85.45 |
| Max. Negotiated Rate |
$297.35 |
| Rate for Payer: Cash Price |
$187.80
|
| Rate for Payer: Cigna Commercial |
$266.05
|
| Rate for Payer: First Health Commercial |
$281.70
|
| Rate for Payer: First Health Workers Compensation |
$120.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$281.70
|
| Rate for Payer: GEHA Commercial |
$219.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$281.70
|
| Rate for Payer: Multiplan All |
$284.83
|
| Rate for Payer: OMNI Networks Commercial |
$219.10
|
| Rate for Payer: One Health Plan PPO/POS |
$281.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$297.35
|
| Rate for Payer: Three Rivers Provider Network All |
$234.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$291.09
|
| Rate for Payer: Zelis Auto |
$125.20
|
| Rate for Payer: Zelis Worker's Compensation |
$85.45
|
|
|
INCISION & DRAINAGE PILONIDAL CYST SIMPL
|
Facility
|
OP
|
$1,615.00
|
|
| Hospital Charge Code |
8110080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$403.75 |
| Max. Negotiated Rate |
$1,534.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$969.00
|
| Rate for Payer: Cash Price |
$969.00
|
| Rate for Payer: Cigna Commercial |
$1,372.75
|
| Rate for Payer: First Health Commercial |
$1,453.50
|
| Rate for Payer: First Health Workers Compensation |
$623.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,453.50
|
| Rate for Payer: GEHA Commercial |
$1,292.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,453.50
|
| Rate for Payer: Humana ChoiceCare |
$419.90
|
| Rate for Payer: Multiplan All |
$1,469.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$969.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,130.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,453.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,534.25
|
| Rate for Payer: Three Rivers Provider Network All |
$1,211.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,421.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$403.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,501.95
|
| Rate for Payer: Zelis Auto |
$646.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$807.50
|
| Rate for Payer: Zelis Worker's Compensation |
$440.89
|
|
|
INCISION, EXTENSOR TENDON SHEATH, WRIST (EG, DE QUERVAINS DISEASE)
|
Facility
|
OP
|
$3,039.30
|
|
|
Service Code
|
CPT 25000
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,291.70 |
| Max. Negotiated Rate |
$3,039.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,225.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,225.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,763.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,519.65
|
| Rate for Payer: First Health Workers Compensation |
$1,955.79
|
| Rate for Payer: GEHA Medicare |
$1,519.65
|
| Rate for Payer: Humana ChoiceCare |
$1,671.62
|
| Rate for Payer: Humana Medicare Advantage |
$1,519.65
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,553.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,799.28
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,519.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,583.41
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,077.52
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,799.28
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,519.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,039.30
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,489.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,799.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,519.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,519.65
|
| Rate for Payer: Zelis Medicare |
$1,291.70
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,823.58
|
| Rate for Payer: Zelis Worker's Compensation |
$1,382.88
|
|
|
INCISION/FIXATION OF FEMUR
|
Facility
|
OP
|
$2,836.00
|
|
|
Service Code
|
CPT 27165
|
| Hospital Charge Code |
6127165
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$709.00 |
| Max. Negotiated Rate |
$2,694.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,701.60
|
| Rate for Payer: Cash Price |
$1,701.60
|
| Rate for Payer: Cigna Commercial |
$2,410.60
|
| Rate for Payer: First Health Commercial |
$2,552.40
|
| Rate for Payer: First Health Workers Compensation |
$1,094.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,552.40
|
| Rate for Payer: GEHA Commercial |
$2,268.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,552.40
|
| Rate for Payer: Humana ChoiceCare |
$737.36
|
| Rate for Payer: Multiplan All |
$2,580.76
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,701.60
|
| Rate for Payer: OMNI Networks Commercial |
$1,985.20
|
| Rate for Payer: One Health Plan PPO/POS |
$2,552.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,694.20
|
| Rate for Payer: Three Rivers Provider Network All |
$2,127.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,495.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$709.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,637.48
|
| Rate for Payer: Zelis Auto |
$1,134.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,418.00
|
| Rate for Payer: Zelis Worker's Compensation |
$774.23
|
|
|
INCISION/FIXATION OF FEMUR
|
Facility
|
IP
|
$2,836.00
|
|
|
Service Code
|
CPT 27165
|
| Hospital Charge Code |
6127165
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$774.23 |
| Max. Negotiated Rate |
$2,694.20 |
| Rate for Payer: Cash Price |
$1,701.60
|
| Rate for Payer: Cigna Commercial |
$2,410.60
|
| Rate for Payer: First Health Commercial |
$2,552.40
|
| Rate for Payer: First Health Workers Compensation |
$1,094.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,552.40
|
| Rate for Payer: GEHA Commercial |
$1,985.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,552.40
|
| Rate for Payer: Multiplan All |
$2,580.76
|
| Rate for Payer: OMNI Networks Commercial |
$1,985.20
|
| Rate for Payer: One Health Plan PPO/POS |
$2,552.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,694.20
|
| Rate for Payer: Three Rivers Provider Network All |
$2,127.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,637.48
|
| Rate for Payer: Zelis Auto |
$1,134.40
|
| Rate for Payer: Zelis Worker's Compensation |
$774.23
|
|
|
INCISION OF ACHILLES TENDON
|
Facility
|
IP
|
$565.00
|
|
|
Service Code
|
CPT 27605
|
| Hospital Charge Code |
6127605
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$154.25 |
| Max. Negotiated Rate |
$536.75 |
| Rate for Payer: Cash Price |
$339.00
|
| Rate for Payer: Cigna Commercial |
$480.25
|
| Rate for Payer: First Health Commercial |
$508.50
|
| Rate for Payer: First Health Workers Compensation |
$218.15
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$508.50
|
| Rate for Payer: GEHA Commercial |
$395.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$508.50
|
| Rate for Payer: Multiplan All |
$514.15
|
| Rate for Payer: OMNI Networks Commercial |
$395.50
|
| Rate for Payer: One Health Plan PPO/POS |
$508.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$536.75
|
| Rate for Payer: Three Rivers Provider Network All |
$423.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$525.45
|
| Rate for Payer: Zelis Auto |
$226.00
|
| Rate for Payer: Zelis Worker's Compensation |
$154.25
|
|
|
INCISION OF ACHILLES TENDON
|
Facility
|
OP
|
$565.00
|
|
|
Service Code
|
CPT 27605
|
| Hospital Charge Code |
6127605
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$154.25 |
| Max. Negotiated Rate |
$3,039.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,208.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$339.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,208.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,749.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,519.65
|
| Rate for Payer: Cash Price |
$339.00
|
| Rate for Payer: Cash Price |
$339.00
|
| Rate for Payer: Cigna Commercial |
$480.25
|
| Rate for Payer: First Health Commercial |
$508.50
|
| Rate for Payer: First Health Workers Compensation |
$218.15
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$508.50
|
| Rate for Payer: GEHA Commercial |
$452.00
|
| Rate for Payer: GEHA Medicare |
$1,519.65
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$508.50
|
| Rate for Payer: Humana ChoiceCare |
$1,671.62
|
| Rate for Payer: Humana Medicare Advantage |
$1,519.65
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,553.01
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,785.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,519.65
|
| Rate for Payer: Multiplan All |
$514.15
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,583.41
|
| Rate for Payer: OMNI Networks Commercial |
$395.50
|
| Rate for Payer: One Health Plan PPO/POS |
$508.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,061.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,785.30
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,519.65
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$536.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,039.30
|
| Rate for Payer: Three Rivers Provider Network All |
$423.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,489.26
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,785.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,519.65
|
| Rate for Payer: United Payors & United Providers UP&UP |
$525.45
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,519.65
|
| Rate for Payer: Zelis Auto |
$226.00
|
| Rate for Payer: Zelis Medicare |
$1,291.70
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,823.58
|
| Rate for Payer: Zelis Worker's Compensation |
$154.25
|
|
|
INCISION OF ACHILLES TENDON
|
Facility
|
OP
|
$793.11
|
|
|
Service Code
|
CPT 27606
|
| Hospital Charge Code |
6127606
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$216.52 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,225.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$475.87
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,225.91
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,763.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$475.87
|
| Rate for Payer: Cash Price |
$475.87
|
| Rate for Payer: Cigna Commercial |
$674.14
|
| Rate for Payer: First Health Commercial |
$713.80
|
| Rate for Payer: First Health Workers Compensation |
$306.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$713.80
|
| Rate for Payer: GEHA Commercial |
$634.49
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$713.80
|
| Rate for Payer: Humana ChoiceCare |
$3,388.98
|
| Rate for Payer: Humana Medicare Advantage |
$3,080.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,175.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,799.28
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$721.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$555.18
|
| Rate for Payer: One Health Plan PPO/POS |
$713.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,077.52
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,799.28
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$753.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$594.83
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,799.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$737.59
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$317.24
|
| Rate for Payer: Zelis Medicare |
$2,618.76
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,697.07
|
| Rate for Payer: Zelis Worker's Compensation |
$216.52
|
|
