|
INCISION OF STOMACH NERVES
|
Facility
|
IP
|
$1,936.00
|
|
|
Service Code
|
CPT 64755
|
| Hospital Charge Code |
6164755
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$528.53 |
| Max. Negotiated Rate |
$1,839.20 |
| Rate for Payer: Cash Price |
$1,161.60
|
| Rate for Payer: Cigna Commercial |
$1,645.60
|
| Rate for Payer: First Health Commercial |
$1,742.40
|
| Rate for Payer: First Health Workers Compensation |
$747.49
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,742.40
|
| Rate for Payer: GEHA Commercial |
$1,355.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,742.40
|
| Rate for Payer: Multiplan All |
$1,761.76
|
| Rate for Payer: OMNI Networks Commercial |
$1,355.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,742.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,839.20
|
| Rate for Payer: Three Rivers Provider Network All |
$1,452.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,800.48
|
| Rate for Payer: Zelis Auto |
$774.40
|
| Rate for Payer: Zelis Worker's Compensation |
$528.53
|
|
|
INCISION OF TENDON & MUSCLE
|
Facility
|
OP
|
$1,278.00
|
|
|
Service Code
|
CPT 23405
|
| Hospital Charge Code |
6123405
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$348.89 |
| Max. Negotiated Rate |
$13,566.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,212.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$766.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,212.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,544.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,783.26
|
| Rate for Payer: Cash Price |
$766.80
|
| Rate for Payer: Cash Price |
$766.80
|
| Rate for Payer: Cigna Commercial |
$1,086.30
|
| Rate for Payer: First Health Commercial |
$1,150.20
|
| Rate for Payer: First Health Workers Compensation |
$493.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,150.20
|
| Rate for Payer: GEHA Commercial |
$1,022.40
|
| Rate for Payer: GEHA Medicare |
$6,783.26
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,150.20
|
| Rate for Payer: Humana ChoiceCare |
$7,461.59
|
| Rate for Payer: Humana Medicare Advantage |
$6,783.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,395.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,596.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,783.26
|
| Rate for Payer: Multiplan All |
$1,162.98
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,531.54
|
| Rate for Payer: OMNI Networks Commercial |
$894.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,150.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,998.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,596.69
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,783.26
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,214.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,566.52
|
| Rate for Payer: Three Rivers Provider Network All |
$958.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,647.59
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,596.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,783.26
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,188.54
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,783.26
|
| Rate for Payer: Zelis Auto |
$511.20
|
| Rate for Payer: Zelis Medicare |
$5,765.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,139.91
|
| Rate for Payer: Zelis Worker's Compensation |
$348.89
|
|
|
INCISION OF TENDON & MUSCLE
|
Facility
|
IP
|
$1,278.00
|
|
|
Service Code
|
CPT 23405
|
| Hospital Charge Code |
6123405
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$348.89 |
| Max. Negotiated Rate |
$1,214.10 |
| Rate for Payer: Cash Price |
$766.80
|
| Rate for Payer: Cigna Commercial |
$1,086.30
|
| Rate for Payer: First Health Commercial |
$1,150.20
|
| Rate for Payer: First Health Workers Compensation |
$493.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,150.20
|
| Rate for Payer: GEHA Commercial |
$894.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,150.20
|
| Rate for Payer: Multiplan All |
$1,162.98
|
| Rate for Payer: OMNI Networks Commercial |
$894.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,150.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,214.10
|
| Rate for Payer: Three Rivers Provider Network All |
$958.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,188.54
|
| Rate for Payer: Zelis Auto |
$511.20
|
| Rate for Payer: Zelis Worker's Compensation |
$348.89
|
|
|
INCISION OF TENDON SHEATH
|
Facility
|
IP
|
$844.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
6125000
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$230.41 |
| Max. Negotiated Rate |
$801.80 |
| Rate for Payer: Cash Price |
$506.40
|
| Rate for Payer: Cigna Commercial |
$717.40
|
| Rate for Payer: First Health Commercial |
$759.60
|
| Rate for Payer: First Health Workers Compensation |
$325.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$759.60
|
| Rate for Payer: GEHA Commercial |
$590.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$759.60
|
| Rate for Payer: Multiplan All |
$768.04
|
| Rate for Payer: OMNI Networks Commercial |
$590.80
|
| Rate for Payer: One Health Plan PPO/POS |
$759.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$801.80
|
| Rate for Payer: Three Rivers Provider Network All |
$633.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$784.92
|
| Rate for Payer: Zelis Auto |
$337.60
|
| Rate for Payer: Zelis Worker's Compensation |
$230.41
|
|
|
INCISION OF TENDON SHEATH
|
Facility
|
OP
|
$844.00
|
|
|
Service Code
|
CPT 25000
|
| Hospital Charge Code |
6125000
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$230.41 |
| 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 Community HMO |
$506.40
|
| 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: Cash Price |
$506.40
|
| Rate for Payer: Cash Price |
$506.40
|
| Rate for Payer: Cigna Commercial |
$717.40
|
| Rate for Payer: First Health Commercial |
$759.60
|
| Rate for Payer: First Health Workers Compensation |
$325.87
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$759.60
|
| Rate for Payer: GEHA Commercial |
$675.20
|
| Rate for Payer: GEHA Medicare |
$1,519.65
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$759.60
|
| 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: Multiplan All |
$768.04
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,583.41
|
| Rate for Payer: OMNI Networks Commercial |
$590.80
|
| Rate for Payer: One Health Plan PPO/POS |
$759.60
|
| 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 Commercial |
$801.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,039.30
|
| Rate for Payer: Three Rivers Provider Network All |
$633.00
|
| 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: United Payors & United Providers UP&UP |
$784.92
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,519.65
|
| Rate for Payer: Zelis Auto |
$337.60
|
| 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 |
$230.41
|
|
|
INCISION OF THIGH
|
Facility
|
IP
|
$1,593.00
|
|
|
Service Code
|
CPT 27448
|
| Hospital Charge Code |
6127448
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$434.89 |
| Max. Negotiated Rate |
$1,513.35 |
| Rate for Payer: Cash Price |
$955.80
|
| Rate for Payer: Cigna Commercial |
$1,354.05
|
| Rate for Payer: First Health Commercial |
$1,433.70
|
| Rate for Payer: First Health Workers Compensation |
$615.06
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,433.70
|
| Rate for Payer: GEHA Commercial |
$1,115.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,433.70
|
| Rate for Payer: Multiplan All |
$1,449.63
|
| Rate for Payer: OMNI Networks Commercial |
$1,115.10
|
| Rate for Payer: One Health Plan PPO/POS |
$1,433.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,513.35
|
| Rate for Payer: Three Rivers Provider Network All |
$1,194.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,481.49
|
| Rate for Payer: Zelis Auto |
$637.20
|
| Rate for Payer: Zelis Worker's Compensation |
$434.89
|
|
|
INCISION OF THIGH
|
Facility
|
OP
|
$2,079.00
|
|
|
Service Code
|
CPT 27450
|
| Hospital Charge Code |
6127450
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$519.75 |
| Max. Negotiated Rate |
$1,975.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,247.40
|
| Rate for Payer: Cash Price |
$1,247.40
|
| Rate for Payer: Cigna Commercial |
$1,767.15
|
| Rate for Payer: First Health Commercial |
$1,871.10
|
| Rate for Payer: First Health Workers Compensation |
$802.70
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,871.10
|
| Rate for Payer: GEHA Commercial |
$1,663.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,871.10
|
| Rate for Payer: Humana ChoiceCare |
$540.54
|
| Rate for Payer: Multiplan All |
$1,891.89
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,247.40
|
| Rate for Payer: OMNI Networks Commercial |
$1,455.30
|
| Rate for Payer: One Health Plan PPO/POS |
$1,871.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,975.05
|
| Rate for Payer: Three Rivers Provider Network All |
$1,559.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,829.52
|
| Rate for Payer: United Healthcare Managed Medicaid |
$519.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,933.47
|
| Rate for Payer: Zelis Auto |
$831.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,039.50
|
| Rate for Payer: Zelis Worker's Compensation |
$567.57
|
|
|
INCISION OF THIGH
|
Facility
|
OP
|
$1,593.00
|
|
|
Service Code
|
CPT 27448
|
| Hospital Charge Code |
6127448
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$398.25 |
| Max. Negotiated Rate |
$1,513.35 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$955.80
|
| Rate for Payer: Cash Price |
$955.80
|
| Rate for Payer: Cigna Commercial |
$1,354.05
|
| Rate for Payer: First Health Commercial |
$1,433.70
|
| Rate for Payer: First Health Workers Compensation |
$615.06
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,433.70
|
| Rate for Payer: GEHA Commercial |
$1,274.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,433.70
|
| Rate for Payer: Humana ChoiceCare |
$414.18
|
| Rate for Payer: Multiplan All |
$1,449.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$955.80
|
| Rate for Payer: OMNI Networks Commercial |
$1,115.10
|
| Rate for Payer: One Health Plan PPO/POS |
$1,433.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,513.35
|
| Rate for Payer: Three Rivers Provider Network All |
$1,194.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,401.84
|
| Rate for Payer: United Healthcare Managed Medicaid |
$398.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,481.49
|
| Rate for Payer: Zelis Auto |
$637.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$796.50
|
| Rate for Payer: Zelis Worker's Compensation |
$434.89
|
|
|
INCISION OF THIGH
|
Facility
|
IP
|
$2,079.00
|
|
|
Service Code
|
CPT 27450
|
| Hospital Charge Code |
6127450
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$567.57 |
| Max. Negotiated Rate |
$1,975.05 |
| Rate for Payer: Cash Price |
$1,247.40
|
| Rate for Payer: Cigna Commercial |
$1,767.15
|
| Rate for Payer: First Health Commercial |
$1,871.10
|
| Rate for Payer: First Health Workers Compensation |
$802.70
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,871.10
|
| Rate for Payer: GEHA Commercial |
$1,455.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,871.10
|
| Rate for Payer: Multiplan All |
$1,891.89
|
| Rate for Payer: OMNI Networks Commercial |
$1,455.30
|
| Rate for Payer: One Health Plan PPO/POS |
$1,871.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,975.05
|
| Rate for Payer: Three Rivers Provider Network All |
$1,559.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,933.47
|
| Rate for Payer: Zelis Auto |
$831.60
|
| Rate for Payer: Zelis Worker's Compensation |
$567.57
|
|
|
INCISION OF THIGH TENDON
|
Facility
|
IP
|
$899.00
|
|
|
Service Code
|
CPT 27306
|
| Hospital Charge Code |
6127306
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$245.43 |
| Max. Negotiated Rate |
$854.05 |
| Rate for Payer: Cash Price |
$539.40
|
| Rate for Payer: Cigna Commercial |
$764.15
|
| Rate for Payer: First Health Commercial |
$809.10
|
| Rate for Payer: First Health Workers Compensation |
$347.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$809.10
|
| Rate for Payer: GEHA Commercial |
$629.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$809.10
|
| Rate for Payer: Multiplan All |
$818.09
|
| Rate for Payer: OMNI Networks Commercial |
$629.30
|
| Rate for Payer: One Health Plan PPO/POS |
$809.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$854.05
|
| Rate for Payer: Three Rivers Provider Network All |
$674.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$836.07
|
| Rate for Payer: Zelis Auto |
$359.60
|
| Rate for Payer: Zelis Worker's Compensation |
$245.43
|
|
|
INCISION OF THIGH TENDON
|
Facility
|
IP
|
$910.00
|
|
|
Service Code
|
CPT 27390
|
| Hospital Charge Code |
6127390
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$248.43 |
| Max. Negotiated Rate |
$864.50 |
| Rate for Payer: Cash Price |
$546.00
|
| Rate for Payer: Cigna Commercial |
$773.50
|
| Rate for Payer: First Health Commercial |
$819.00
|
| Rate for Payer: First Health Workers Compensation |
$351.35
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$819.00
|
| Rate for Payer: GEHA Commercial |
$637.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$819.00
|
| Rate for Payer: Multiplan All |
$828.10
|
| Rate for Payer: OMNI Networks Commercial |
$637.00
|
| Rate for Payer: One Health Plan PPO/POS |
$819.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$864.50
|
| Rate for Payer: Three Rivers Provider Network All |
$682.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$846.30
|
| Rate for Payer: Zelis Auto |
$364.00
|
| Rate for Payer: Zelis Worker's Compensation |
$248.43
|
|
|
INCISION OF THIGH TENDON
|
Facility
|
OP
|
$910.00
|
|
|
Service Code
|
CPT 27390
|
| Hospital Charge Code |
6127390
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$248.43 |
| 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 |
$546.00
|
| 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 |
$546.00
|
| Rate for Payer: Cash Price |
$546.00
|
| Rate for Payer: Cigna Commercial |
$773.50
|
| Rate for Payer: First Health Commercial |
$819.00
|
| Rate for Payer: First Health Workers Compensation |
$351.35
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$819.00
|
| Rate for Payer: GEHA Commercial |
$728.00
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$819.00
|
| 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 |
$828.10
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$637.00
|
| Rate for Payer: One Health Plan PPO/POS |
$819.00
|
| 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 |
$864.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$682.50
|
| 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 |
$846.30
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$364.00
|
| 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 |
$248.43
|
|
|
INCISION OF THIGH TENDON
|
Facility
|
OP
|
$899.00
|
|
|
Service Code
|
CPT 27306
|
| Hospital Charge Code |
6127306
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$245.43 |
| 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 |
$539.40
|
| 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 |
$539.40
|
| Rate for Payer: Cash Price |
$539.40
|
| Rate for Payer: Cigna Commercial |
$764.15
|
| Rate for Payer: First Health Commercial |
$809.10
|
| Rate for Payer: First Health Workers Compensation |
$347.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$809.10
|
| Rate for Payer: GEHA Commercial |
$719.20
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$809.10
|
| 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 |
$818.09
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$629.30
|
| Rate for Payer: One Health Plan PPO/POS |
$809.10
|
| 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 |
$854.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$674.25
|
| 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 |
$836.07
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$359.60
|
| 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 |
$245.43
|
|
|
INCISION OF THIGH TENDONS
|
Facility
|
IP
|
$1,177.00
|
|
|
Service Code
|
CPT 27391
|
| Hospital Charge Code |
6127391
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$321.32 |
| Max. Negotiated Rate |
$1,118.15 |
| Rate for Payer: Cash Price |
$706.20
|
| Rate for Payer: Cigna Commercial |
$1,000.45
|
| Rate for Payer: First Health Commercial |
$1,059.30
|
| Rate for Payer: First Health Workers Compensation |
$454.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,059.30
|
| Rate for Payer: GEHA Commercial |
$823.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,059.30
|
| Rate for Payer: Multiplan All |
$1,071.07
|
| Rate for Payer: OMNI Networks Commercial |
$823.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,059.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,118.15
|
| Rate for Payer: Three Rivers Provider Network All |
$882.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,094.61
|
| Rate for Payer: Zelis Auto |
$470.80
|
| Rate for Payer: Zelis Worker's Compensation |
$321.32
|
|
|
INCISION OF THIGH TENDONS
|
Facility
|
OP
|
$1,177.00
|
|
|
Service Code
|
CPT 27391
|
| Hospital Charge Code |
6127391
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$321.32 |
| 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 |
$706.20
|
| 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 |
$706.20
|
| Rate for Payer: Cash Price |
$706.20
|
| Rate for Payer: Cigna Commercial |
$1,000.45
|
| Rate for Payer: First Health Commercial |
$1,059.30
|
| Rate for Payer: First Health Workers Compensation |
$454.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,059.30
|
| Rate for Payer: GEHA Commercial |
$941.60
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,059.30
|
| 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 |
$1,071.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$823.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,059.30
|
| 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 |
$1,118.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$882.75
|
| 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 |
$1,094.61
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$470.80
|
| 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 |
$321.32
|
|
|
INCISION OF THIGH TENDONS
|
Facility
|
IP
|
$940.00
|
|
|
Service Code
|
CPT 27307
|
| Hospital Charge Code |
6127307
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$256.62 |
| Max. Negotiated Rate |
$893.00 |
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cigna Commercial |
$799.00
|
| Rate for Payer: First Health Commercial |
$846.00
|
| Rate for Payer: First Health Workers Compensation |
$362.93
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$846.00
|
| Rate for Payer: GEHA Commercial |
$658.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$846.00
|
| Rate for Payer: Multiplan All |
$855.40
|
| Rate for Payer: OMNI Networks Commercial |
$658.00
|
| Rate for Payer: One Health Plan PPO/POS |
$846.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$893.00
|
| Rate for Payer: Three Rivers Provider Network All |
$705.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$874.20
|
| Rate for Payer: Zelis Auto |
$376.00
|
| Rate for Payer: Zelis Worker's Compensation |
$256.62
|
|
|
INCISION OF THIGH TENDONS
|
Facility
|
OP
|
$1,451.00
|
|
|
Service Code
|
CPT 27392
|
| Hospital Charge Code |
6127392
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$396.12 |
| 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 |
$870.60
|
| 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 |
$870.60
|
| Rate for Payer: Cash Price |
$870.60
|
| Rate for Payer: Cigna Commercial |
$1,233.35
|
| Rate for Payer: First Health Commercial |
$1,305.90
|
| Rate for Payer: First Health Workers Compensation |
$560.23
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,305.90
|
| Rate for Payer: GEHA Commercial |
$1,160.80
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,305.90
|
| 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 |
$1,320.41
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$1,015.70
|
| Rate for Payer: One Health Plan PPO/POS |
$1,305.90
|
| 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 |
$1,378.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$1,088.25
|
| 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 |
$1,349.43
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$580.40
|
| 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 |
$396.12
|
|
|
INCISION OF THIGH TENDONS
|
Facility
|
OP
|
$940.00
|
|
|
Service Code
|
CPT 27307
|
| Hospital Charge Code |
6127307
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$256.62 |
| 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 |
$564.00
|
| 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 |
$564.00
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cigna Commercial |
$799.00
|
| Rate for Payer: First Health Commercial |
$846.00
|
| Rate for Payer: First Health Workers Compensation |
$362.93
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$846.00
|
| Rate for Payer: GEHA Commercial |
$752.00
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$846.00
|
| 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 |
$855.40
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$658.00
|
| Rate for Payer: One Health Plan PPO/POS |
$846.00
|
| 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 |
$893.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$705.00
|
| 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 |
$874.20
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$376.00
|
| 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 |
$256.62
|
|
|
INCISION OF THIGH TENDONS
|
Facility
|
IP
|
$1,451.00
|
|
|
Service Code
|
CPT 27392
|
| Hospital Charge Code |
6127392
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$396.12 |
| Max. Negotiated Rate |
$1,378.45 |
| Rate for Payer: Cash Price |
$870.60
|
| Rate for Payer: Cigna Commercial |
$1,233.35
|
| Rate for Payer: First Health Commercial |
$1,305.90
|
| Rate for Payer: First Health Workers Compensation |
$560.23
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,305.90
|
| Rate for Payer: GEHA Commercial |
$1,015.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,305.90
|
| Rate for Payer: Multiplan All |
$1,320.41
|
| Rate for Payer: OMNI Networks Commercial |
$1,015.70
|
| Rate for Payer: One Health Plan PPO/POS |
$1,305.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,378.45
|
| Rate for Payer: Three Rivers Provider Network All |
$1,088.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,349.43
|
| Rate for Payer: Zelis Auto |
$580.40
|
| Rate for Payer: Zelis Worker's Compensation |
$396.12
|
|
|
INCISION OF TIBIA
|
Facility
|
IP
|
$2,219.31
|
|
|
Service Code
|
CPT 27705
|
| Hospital Charge Code |
6127705
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$605.87 |
| Max. Negotiated Rate |
$2,108.34 |
| Rate for Payer: Cash Price |
$1,331.59
|
| Rate for Payer: Cigna Commercial |
$1,886.41
|
| Rate for Payer: First Health Commercial |
$1,997.38
|
| Rate for Payer: First Health Workers Compensation |
$856.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,997.38
|
| Rate for Payer: GEHA Commercial |
$1,553.52
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,997.38
|
| Rate for Payer: Multiplan All |
$2,019.57
|
| Rate for Payer: OMNI Networks Commercial |
$1,553.52
|
| Rate for Payer: One Health Plan PPO/POS |
$1,997.38
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,108.34
|
| Rate for Payer: Three Rivers Provider Network All |
$1,664.48
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,063.96
|
| Rate for Payer: Zelis Auto |
$887.72
|
| Rate for Payer: Zelis Worker's Compensation |
$605.87
|
|
|
INCISION OF TIBIA
|
Facility
|
OP
|
$2,219.31
|
|
|
Service Code
|
CPT 27705
|
| Hospital Charge Code |
6127705
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$605.87 |
| Max. Negotiated Rate |
$13,566.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,709.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,331.59
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,709.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,730.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,783.26
|
| Rate for Payer: Cash Price |
$1,331.59
|
| Rate for Payer: Cash Price |
$1,331.59
|
| Rate for Payer: Cigna Commercial |
$1,886.41
|
| Rate for Payer: First Health Commercial |
$1,997.38
|
| Rate for Payer: First Health Workers Compensation |
$856.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,997.38
|
| Rate for Payer: GEHA Commercial |
$1,775.45
|
| Rate for Payer: GEHA Medicare |
$6,783.26
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,997.38
|
| Rate for Payer: Humana ChoiceCare |
$7,461.59
|
| Rate for Payer: Humana Medicare Advantage |
$6,783.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,395.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,806.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,783.26
|
| Rate for Payer: Multiplan All |
$2,019.57
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,531.54
|
| Rate for Payer: OMNI Networks Commercial |
$1,553.52
|
| Rate for Payer: One Health Plan PPO/POS |
$1,997.38
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,395.55
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,806.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,783.26
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,108.34
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,566.52
|
| Rate for Payer: Three Rivers Provider Network All |
$1,664.48
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,647.59
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,806.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,783.26
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,063.96
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,783.26
|
| Rate for Payer: Zelis Auto |
$887.72
|
| Rate for Payer: Zelis Medicare |
$5,765.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,139.91
|
| Rate for Payer: Zelis Worker's Compensation |
$605.87
|
|
|
INCISION OF TIBIA & FIBULA
|
Facility
|
OP
|
$2,410.00
|
|
|
Service Code
|
CPT 27709
|
| Hospital Charge Code |
6127709
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$657.93 |
| Max. Negotiated Rate |
$24,435.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,212.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,446.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,212.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,544.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,217.56
|
| Rate for Payer: Cash Price |
$1,446.00
|
| Rate for Payer: Cash Price |
$1,446.00
|
| Rate for Payer: Cigna Commercial |
$2,048.50
|
| Rate for Payer: First Health Commercial |
$2,169.00
|
| Rate for Payer: First Health Workers Compensation |
$930.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,169.00
|
| Rate for Payer: GEHA Commercial |
$1,928.00
|
| Rate for Payer: GEHA Medicare |
$12,217.56
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,169.00
|
| Rate for Payer: Humana ChoiceCare |
$13,439.32
|
| Rate for Payer: Humana Medicare Advantage |
$12,217.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,525.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,596.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,217.56
|
| Rate for Payer: Multiplan All |
$2,193.10
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,769.85
|
| Rate for Payer: OMNI Networks Commercial |
$1,687.00
|
| Rate for Payer: One Health Plan PPO/POS |
$2,169.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,998.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,596.69
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,217.56
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,289.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,435.12
|
| Rate for Payer: Three Rivers Provider Network All |
$1,807.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,973.21
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,596.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,217.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,241.30
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$12,217.56
|
| Rate for Payer: Zelis Auto |
$964.00
|
| Rate for Payer: Zelis Medicare |
$10,384.93
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,661.07
|
| Rate for Payer: Zelis Worker's Compensation |
$657.93
|
|
|
INCISION OF TIBIA & FIBULA
|
Facility
|
IP
|
$2,410.00
|
|
|
Service Code
|
CPT 27709
|
| Hospital Charge Code |
6127709
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$657.93 |
| Max. Negotiated Rate |
$2,289.50 |
| Rate for Payer: Cash Price |
$1,446.00
|
| Rate for Payer: Cigna Commercial |
$2,048.50
|
| Rate for Payer: First Health Commercial |
$2,169.00
|
| Rate for Payer: First Health Workers Compensation |
$930.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,169.00
|
| Rate for Payer: GEHA Commercial |
$1,687.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,169.00
|
| Rate for Payer: Multiplan All |
$2,193.10
|
| Rate for Payer: OMNI Networks Commercial |
$1,687.00
|
| Rate for Payer: One Health Plan PPO/POS |
$2,169.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,289.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,807.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,241.30
|
| Rate for Payer: Zelis Auto |
$964.00
|
| Rate for Payer: Zelis Worker's Compensation |
$657.93
|
|
|
INCISION OF TOE TENDON
|
Facility
|
OP
|
$616.00
|
|
|
Service Code
|
CPT 28232
|
| Hospital Charge Code |
6128232
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$168.17 |
| 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 |
$369.60
|
| 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 |
$369.60
|
| Rate for Payer: Cash Price |
$369.60
|
| Rate for Payer: Cigna Commercial |
$523.60
|
| Rate for Payer: First Health Commercial |
$554.40
|
| Rate for Payer: First Health Workers Compensation |
$237.84
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$554.40
|
| Rate for Payer: GEHA Commercial |
$492.80
|
| Rate for Payer: GEHA Medicare |
$1,519.65
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$554.40
|
| 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 |
$560.56
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,583.41
|
| Rate for Payer: OMNI Networks Commercial |
$431.20
|
| Rate for Payer: One Health Plan PPO/POS |
$554.40
|
| 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 |
$585.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,039.30
|
| Rate for Payer: Three Rivers Provider Network All |
$462.00
|
| 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 |
$572.88
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,519.65
|
| Rate for Payer: Zelis Auto |
$246.40
|
| 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 |
$168.17
|
|
|
INCISION OF TOE TENDON
|
Facility
|
OP
|
$529.00
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
6128010
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$144.42 |
| 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 |
$317.40
|
| 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 |
$317.40
|
| Rate for Payer: Cash Price |
$317.40
|
| Rate for Payer: Cigna Commercial |
$449.65
|
| Rate for Payer: First Health Commercial |
$476.10
|
| Rate for Payer: First Health Workers Compensation |
$204.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$476.10
|
| Rate for Payer: GEHA Commercial |
$423.20
|
| Rate for Payer: GEHA Medicare |
$1,519.65
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$476.10
|
| 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 |
$481.39
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,583.41
|
| Rate for Payer: OMNI Networks Commercial |
$370.30
|
| Rate for Payer: One Health Plan PPO/POS |
$476.10
|
| 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 |
$502.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$3,039.30
|
| Rate for Payer: Three Rivers Provider Network All |
$396.75
|
| 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 |
$491.97
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,519.65
|
| Rate for Payer: Zelis Auto |
$211.60
|
| 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 |
$144.42
|
|
