|
INSERT TUN IP CATH W/PORT
|
Facility
|
OP
|
$927.00
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
6149419
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$253.07 |
| Max. Negotiated Rate |
$10,265.86 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,132.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$556.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,132.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,481.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,132.93
|
| Rate for Payer: Cash Price |
$556.20
|
| Rate for Payer: Cash Price |
$556.20
|
| Rate for Payer: Cigna Commercial |
$787.95
|
| Rate for Payer: First Health Commercial |
$834.30
|
| Rate for Payer: First Health Workers Compensation |
$357.91
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$834.30
|
| Rate for Payer: GEHA Commercial |
$741.60
|
| Rate for Payer: GEHA Medicare |
$5,132.93
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$834.30
|
| Rate for Payer: Humana ChoiceCare |
$5,646.22
|
| Rate for Payer: Humana Medicare Advantage |
$5,132.93
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$8,623.32
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,531.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,132.93
|
| Rate for Payer: Multiplan All |
$843.57
|
| Rate for Payer: New Mexico Health Connections Medicare |
$8,725.98
|
| Rate for Payer: OMNI Networks Commercial |
$648.90
|
| Rate for Payer: One Health Plan PPO/POS |
$834.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,923.38
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,531.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,132.93
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$880.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10,265.86
|
| Rate for Payer: Three Rivers Provider Network All |
$695.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,030.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,531.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,132.93
|
| Rate for Payer: United Payors & United Providers UP&UP |
$862.11
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,132.93
|
| Rate for Payer: Zelis Auto |
$370.80
|
| Rate for Payer: Zelis Medicare |
$4,362.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,159.52
|
| Rate for Payer: Zelis Worker's Compensation |
$253.07
|
|
|
INSERT TUNNELED CV CATH
|
Facility
|
IP
|
$6,365.00
|
|
| Hospital Charge Code |
8136558
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,737.64 |
| Max. Negotiated Rate |
$6,046.75 |
| Rate for Payer: Cash Price |
$3,819.00
|
| Rate for Payer: Cigna Commercial |
$5,410.25
|
| Rate for Payer: First Health Commercial |
$5,728.50
|
| Rate for Payer: First Health Workers Compensation |
$2,457.53
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$5,728.50
|
| Rate for Payer: GEHA Commercial |
$4,455.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$5,728.50
|
| Rate for Payer: Multiplan All |
$5,792.15
|
| Rate for Payer: OMNI Networks Commercial |
$4,455.50
|
| Rate for Payer: One Health Plan PPO/POS |
$5,728.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$6,046.75
|
| Rate for Payer: Three Rivers Provider Network All |
$4,773.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5,919.45
|
| Rate for Payer: Zelis Auto |
$2,546.00
|
| Rate for Payer: Zelis Worker's Compensation |
$1,737.64
|
|
|
INSERT TUNNELED CV CATH
|
Facility
|
OP
|
$6,365.00
|
|
| Hospital Charge Code |
8136558
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,591.25 |
| Max. Negotiated Rate |
$6,046.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,819.00
|
| Rate for Payer: Cash Price |
$3,819.00
|
| Rate for Payer: Cigna Commercial |
$5,410.25
|
| Rate for Payer: First Health Commercial |
$5,728.50
|
| Rate for Payer: First Health Workers Compensation |
$2,457.53
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$5,728.50
|
| Rate for Payer: GEHA Commercial |
$5,092.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$5,728.50
|
| Rate for Payer: Humana ChoiceCare |
$1,654.90
|
| Rate for Payer: Multiplan All |
$5,792.15
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,819.00
|
| Rate for Payer: OMNI Networks Commercial |
$4,455.50
|
| Rate for Payer: One Health Plan PPO/POS |
$5,728.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$6,046.75
|
| Rate for Payer: Three Rivers Provider Network All |
$4,773.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,601.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,591.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5,919.45
|
| Rate for Payer: Zelis Auto |
$2,546.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,182.50
|
| Rate for Payer: Zelis Worker's Compensation |
$1,737.64
|
|
|
INSERT URETERAL SUPPORT
|
Facility
|
IP
|
$2,052.00
|
|
|
Service Code
|
CPT 50605
|
| Hospital Charge Code |
6150605
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$560.20 |
| Max. Negotiated Rate |
$1,949.40 |
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Cigna Commercial |
$1,744.20
|
| Rate for Payer: First Health Commercial |
$1,846.80
|
| Rate for Payer: First Health Workers Compensation |
$792.28
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,846.80
|
| Rate for Payer: GEHA Commercial |
$1,436.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,846.80
|
| Rate for Payer: Multiplan All |
$1,867.32
|
| Rate for Payer: OMNI Networks Commercial |
$1,436.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,846.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,949.40
|
| Rate for Payer: Three Rivers Provider Network All |
$1,539.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,908.36
|
| Rate for Payer: Zelis Auto |
$820.80
|
| Rate for Payer: Zelis Worker's Compensation |
$560.20
|
|
|
INSERT URETERAL SUPPORT
|
Facility
|
OP
|
$2,052.00
|
|
|
Service Code
|
CPT 50605
|
| Hospital Charge Code |
6150605
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$513.00 |
| Max. Negotiated Rate |
$1,949.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,231.20
|
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Cigna Commercial |
$1,744.20
|
| Rate for Payer: First Health Commercial |
$1,846.80
|
| Rate for Payer: First Health Workers Compensation |
$792.28
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,846.80
|
| Rate for Payer: GEHA Commercial |
$1,641.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,846.80
|
| Rate for Payer: Humana ChoiceCare |
$533.52
|
| Rate for Payer: Multiplan All |
$1,867.32
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,231.20
|
| Rate for Payer: OMNI Networks Commercial |
$1,436.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,846.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,949.40
|
| Rate for Payer: Three Rivers Provider Network All |
$1,539.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,805.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$513.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,908.36
|
| Rate for Payer: Zelis Auto |
$820.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,026.00
|
| Rate for Payer: Zelis Worker's Compensation |
$560.20
|
|
|
INSERT URO/VES NCK SPHINCTER
|
Facility
|
OP
|
$1,547.00
|
|
|
Service Code
|
CPT 53445
|
| Hospital Charge Code |
6153445
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$422.33 |
| Max. Negotiated Rate |
$38,225.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$16,614.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$928.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$16,614.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$13,161.79
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$19,112.87
|
| Rate for Payer: Cash Price |
$928.20
|
| Rate for Payer: Cash Price |
$928.20
|
| Rate for Payer: Cigna Commercial |
$1,314.95
|
| Rate for Payer: First Health Commercial |
$1,392.30
|
| Rate for Payer: First Health Workers Compensation |
$597.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,392.30
|
| Rate for Payer: GEHA Commercial |
$1,237.60
|
| Rate for Payer: GEHA Medicare |
$19,112.87
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,392.30
|
| Rate for Payer: Humana ChoiceCare |
$21,024.16
|
| Rate for Payer: Humana Medicare Advantage |
$19,112.87
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$32,109.62
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$13,429.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$19,112.87
|
| Rate for Payer: Multiplan All |
$1,407.77
|
| Rate for Payer: New Mexico Health Connections Medicare |
$32,491.88
|
| Rate for Payer: OMNI Networks Commercial |
$1,082.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,392.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$15,506.61
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$13,429.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$19,112.87
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,469.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$38,225.74
|
| Rate for Payer: Three Rivers Provider Network All |
$1,160.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18,730.61
|
| Rate for Payer: United Healthcare Managed Medicaid |
$13,429.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,112.87
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,438.71
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$19,112.87
|
| Rate for Payer: Zelis Auto |
$618.80
|
| Rate for Payer: Zelis Medicare |
$16,245.94
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$22,935.44
|
| Rate for Payer: Zelis Worker's Compensation |
$422.33
|
|
|
INSERT URO/VES NCK SPHINCTER
|
Facility
|
IP
|
$1,547.00
|
|
|
Service Code
|
CPT 53445
|
| Hospital Charge Code |
6153445
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$422.33 |
| Max. Negotiated Rate |
$1,469.65 |
| Rate for Payer: Cash Price |
$928.20
|
| Rate for Payer: Cigna Commercial |
$1,314.95
|
| Rate for Payer: First Health Commercial |
$1,392.30
|
| Rate for Payer: First Health Workers Compensation |
$597.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,392.30
|
| Rate for Payer: GEHA Commercial |
$1,082.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,392.30
|
| Rate for Payer: Multiplan All |
$1,407.77
|
| Rate for Payer: OMNI Networks Commercial |
$1,082.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,392.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,469.65
|
| Rate for Payer: Three Rivers Provider Network All |
$1,160.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,438.71
|
| Rate for Payer: Zelis Auto |
$618.80
|
| Rate for Payer: Zelis Worker's Compensation |
$422.33
|
|
|
INSERT UTERI TANDEM/OVOIDS
|
Facility
|
IP
|
$745.00
|
|
|
Service Code
|
CPT 57155
|
| Hospital Charge Code |
6157155
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$203.38 |
| Max. Negotiated Rate |
$707.75 |
| Rate for Payer: Cash Price |
$447.00
|
| Rate for Payer: Cigna Commercial |
$633.25
|
| Rate for Payer: First Health Commercial |
$670.50
|
| Rate for Payer: First Health Workers Compensation |
$287.64
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$670.50
|
| Rate for Payer: GEHA Commercial |
$521.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$670.50
|
| Rate for Payer: Multiplan All |
$677.95
|
| Rate for Payer: OMNI Networks Commercial |
$521.50
|
| Rate for Payer: One Health Plan PPO/POS |
$670.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$707.75
|
| Rate for Payer: Three Rivers Provider Network All |
$558.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$692.85
|
| Rate for Payer: Zelis Auto |
$298.00
|
| Rate for Payer: Zelis Worker's Compensation |
$203.38
|
|
|
INSERT UTERI TANDEM/OVOIDS
|
Facility
|
OP
|
$745.00
|
|
|
Service Code
|
CPT 57155
|
| Hospital Charge Code |
6157155
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$203.38 |
| Max. Negotiated Rate |
$9,374.72 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$687.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$447.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$687.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$544.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$4,687.36
|
| Rate for Payer: Cash Price |
$447.00
|
| Rate for Payer: Cash Price |
$447.00
|
| Rate for Payer: Cigna Commercial |
$633.25
|
| Rate for Payer: First Health Commercial |
$670.50
|
| Rate for Payer: First Health Workers Compensation |
$287.64
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$670.50
|
| Rate for Payer: GEHA Commercial |
$596.00
|
| Rate for Payer: GEHA Medicare |
$4,687.36
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$670.50
|
| Rate for Payer: Humana ChoiceCare |
$5,156.10
|
| Rate for Payer: Humana Medicare Advantage |
$4,687.36
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$7,874.76
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$555.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$4,687.36
|
| Rate for Payer: Multiplan All |
$677.95
|
| Rate for Payer: New Mexico Health Connections Medicare |
$7,968.51
|
| Rate for Payer: OMNI Networks Commercial |
$521.50
|
| Rate for Payer: One Health Plan PPO/POS |
$670.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$641.23
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$555.35
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$4,687.36
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$707.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$9,374.72
|
| Rate for Payer: Three Rivers Provider Network All |
$558.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4,593.61
|
| Rate for Payer: United Healthcare Managed Medicaid |
$555.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,687.36
|
| Rate for Payer: United Payors & United Providers UP&UP |
$692.85
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$4,687.36
|
| Rate for Payer: Zelis Auto |
$298.00
|
| Rate for Payer: Zelis Medicare |
$3,984.26
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,624.83
|
| Rate for Payer: Zelis Worker's Compensation |
$203.38
|
|
|
INSERT VAD ARTERY ACCESS
|
Facility
|
OP
|
$939.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
6133990
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$234.75 |
| Max. Negotiated Rate |
$892.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$563.40
|
| Rate for Payer: Cash Price |
$563.40
|
| Rate for Payer: Cigna Commercial |
$798.15
|
| Rate for Payer: First Health Commercial |
$845.10
|
| Rate for Payer: First Health Workers Compensation |
$362.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$845.10
|
| Rate for Payer: GEHA Commercial |
$751.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$845.10
|
| Rate for Payer: Humana ChoiceCare |
$244.14
|
| Rate for Payer: Multiplan All |
$854.49
|
| Rate for Payer: New Mexico Health Connections Medicare |
$563.40
|
| Rate for Payer: OMNI Networks Commercial |
$657.30
|
| Rate for Payer: One Health Plan PPO/POS |
$845.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$892.05
|
| Rate for Payer: Three Rivers Provider Network All |
$704.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$826.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$234.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$873.27
|
| Rate for Payer: Zelis Auto |
$375.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$469.50
|
| Rate for Payer: Zelis Worker's Compensation |
$256.35
|
|
|
INSERT VAD ARTERY ACCESS
|
Facility
|
IP
|
$939.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
6133990
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$256.35 |
| Max. Negotiated Rate |
$892.05 |
| Rate for Payer: Cash Price |
$563.40
|
| Rate for Payer: Cigna Commercial |
$798.15
|
| Rate for Payer: First Health Commercial |
$845.10
|
| Rate for Payer: First Health Workers Compensation |
$362.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$845.10
|
| Rate for Payer: GEHA Commercial |
$657.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$845.10
|
| Rate for Payer: Multiplan All |
$854.49
|
| Rate for Payer: OMNI Networks Commercial |
$657.30
|
| Rate for Payer: One Health Plan PPO/POS |
$845.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$892.05
|
| Rate for Payer: Three Rivers Provider Network All |
$704.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$873.27
|
| Rate for Payer: Zelis Auto |
$375.60
|
| Rate for Payer: Zelis Worker's Compensation |
$256.35
|
|
|
INSERT VAD ART&VEIN ACCESS
|
Facility
|
OP
|
$1,366.00
|
|
|
Service Code
|
CPT 33991
|
| Hospital Charge Code |
6133991
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$341.50 |
| Max. Negotiated Rate |
$1,297.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$819.60
|
| Rate for Payer: Cash Price |
$819.60
|
| Rate for Payer: Cigna Commercial |
$1,161.10
|
| Rate for Payer: First Health Commercial |
$1,229.40
|
| Rate for Payer: First Health Workers Compensation |
$527.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,229.40
|
| Rate for Payer: GEHA Commercial |
$1,092.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,229.40
|
| Rate for Payer: Humana ChoiceCare |
$355.16
|
| Rate for Payer: Multiplan All |
$1,243.06
|
| Rate for Payer: New Mexico Health Connections Medicare |
$819.60
|
| Rate for Payer: OMNI Networks Commercial |
$956.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,229.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,297.70
|
| Rate for Payer: Three Rivers Provider Network All |
$1,024.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,202.08
|
| Rate for Payer: United Healthcare Managed Medicaid |
$341.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,270.38
|
| Rate for Payer: Zelis Auto |
$546.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$683.00
|
| Rate for Payer: Zelis Worker's Compensation |
$372.92
|
|
|
INSERT VAD ART&VEIN ACCESS
|
Facility
|
IP
|
$1,366.00
|
|
|
Service Code
|
CPT 33991
|
| Hospital Charge Code |
6133991
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$372.92 |
| Max. Negotiated Rate |
$1,297.70 |
| Rate for Payer: Cash Price |
$819.60
|
| Rate for Payer: Cigna Commercial |
$1,161.10
|
| Rate for Payer: First Health Commercial |
$1,229.40
|
| Rate for Payer: First Health Workers Compensation |
$527.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,229.40
|
| Rate for Payer: GEHA Commercial |
$956.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,229.40
|
| Rate for Payer: Multiplan All |
$1,243.06
|
| Rate for Payer: OMNI Networks Commercial |
$956.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,229.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,297.70
|
| Rate for Payer: Three Rivers Provider Network All |
$1,024.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,270.38
|
| Rate for Payer: Zelis Auto |
$546.40
|
| Rate for Payer: Zelis Worker's Compensation |
$372.92
|
|
|
INSERT XLPE SIZE 5-6 9MM
|
Facility
|
IP
|
$3,045.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
7002236
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,218.00 |
| Max. Negotiated Rate |
$2,892.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,436.00
|
| Rate for Payer: Cash Price |
$1,827.00
|
| Rate for Payer: Cash Price |
$1,827.00
|
| Rate for Payer: Cigna Commercial |
$2,588.25
|
| Rate for Payer: First Health Commercial |
$2,740.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,740.50
|
| Rate for Payer: GEHA Commercial |
$2,131.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,740.50
|
| Rate for Payer: Multiplan All |
$2,770.95
|
| Rate for Payer: OMNI Networks Commercial |
$2,131.50
|
| Rate for Payer: One Health Plan PPO/POS |
$2,740.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,892.75
|
| Rate for Payer: Three Rivers Provider Network All |
$2,283.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,831.85
|
| Rate for Payer: Zelis Auto |
$1,218.00
|
|
|
INSERT XLPE SIZE 5-6 9MM
|
Facility
|
OP
|
$3,045.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
7002236
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$761.25 |
| Max. Negotiated Rate |
$2,892.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,827.00
|
| Rate for Payer: Cash Price |
$1,827.00
|
| Rate for Payer: Cash Price |
$1,827.00
|
| Rate for Payer: Cigna Commercial |
$2,588.25
|
| Rate for Payer: First Health Commercial |
$2,740.50
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,740.50
|
| Rate for Payer: GEHA Commercial |
$2,436.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,740.50
|
| Rate for Payer: Humana ChoiceCare |
$791.70
|
| Rate for Payer: Multiplan All |
$2,770.95
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,827.00
|
| Rate for Payer: OMNI Networks Commercial |
$2,131.50
|
| Rate for Payer: One Health Plan PPO/POS |
$2,740.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,892.75
|
| Rate for Payer: Three Rivers Provider Network All |
$2,283.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,679.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$761.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,831.85
|
| Rate for Payer: Zelis Auto |
$1,218.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,522.50
|
|
|
INSETION OF MONITORING CATHETER
|
Facility
|
OP
|
$4,348.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
2693503
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,187.00 |
| Max. Negotiated Rate |
$4,130.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,804.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,608.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,804.15
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,429.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$1,475.05
|
| Rate for Payer: Cash Price |
$2,608.80
|
| Rate for Payer: Cash Price |
$2,608.80
|
| Rate for Payer: Cigna Commercial |
$3,695.80
|
| Rate for Payer: First Health Commercial |
$3,913.20
|
| Rate for Payer: First Health Workers Compensation |
$1,678.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,913.20
|
| Rate for Payer: GEHA Commercial |
$3,478.40
|
| Rate for Payer: GEHA Medicare |
$1,475.05
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,913.20
|
| Rate for Payer: Humana ChoiceCare |
$1,622.56
|
| Rate for Payer: Humana Medicare Advantage |
$1,475.05
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$2,478.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,458.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$1,475.05
|
| Rate for Payer: Multiplan All |
$3,956.68
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,507.59
|
| Rate for Payer: OMNI Networks Commercial |
$3,043.60
|
| Rate for Payer: One Health Plan PPO/POS |
$3,913.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,683.88
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,458.36
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$1,475.05
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,130.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$2,950.10
|
| Rate for Payer: Three Rivers Provider Network All |
$3,261.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,445.55
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,458.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,475.05
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,043.64
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$1,475.05
|
| Rate for Payer: Zelis Auto |
$1,739.20
|
| Rate for Payer: Zelis Medicare |
$1,253.79
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,770.06
|
| Rate for Payer: Zelis Worker's Compensation |
$1,187.00
|
|
|
INSETION OF MONITORING CATHETER
|
Facility
|
IP
|
$4,348.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
2693503
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,187.00 |
| Max. Negotiated Rate |
$4,130.60 |
| Rate for Payer: Cash Price |
$2,608.80
|
| Rate for Payer: Cigna Commercial |
$3,695.80
|
| Rate for Payer: First Health Commercial |
$3,913.20
|
| Rate for Payer: First Health Workers Compensation |
$1,678.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,913.20
|
| Rate for Payer: GEHA Commercial |
$3,043.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,913.20
|
| Rate for Payer: Multiplan All |
$3,956.68
|
| Rate for Payer: OMNI Networks Commercial |
$3,043.60
|
| Rate for Payer: One Health Plan PPO/POS |
$3,913.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,130.60
|
| Rate for Payer: Three Rivers Provider Network All |
$3,261.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,043.64
|
| Rate for Payer: Zelis Auto |
$1,739.20
|
| Rate for Payer: Zelis Worker's Compensation |
$1,187.00
|
|
|
INS GASTRO TUBE NASO
|
Facility
|
IP
|
$860.00
|
|
| Hospital Charge Code |
2407251
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$234.78 |
| Max. Negotiated Rate |
$817.00 |
| Rate for Payer: Cash Price |
$516.00
|
| Rate for Payer: Cigna Commercial |
$731.00
|
| Rate for Payer: First Health Commercial |
$774.00
|
| Rate for Payer: First Health Workers Compensation |
$332.05
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$774.00
|
| Rate for Payer: GEHA Commercial |
$602.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$774.00
|
| Rate for Payer: Multiplan All |
$782.60
|
| Rate for Payer: OMNI Networks Commercial |
$602.00
|
| Rate for Payer: One Health Plan PPO/POS |
$774.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$817.00
|
| Rate for Payer: Three Rivers Provider Network All |
$645.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$799.80
|
| Rate for Payer: Zelis Auto |
$344.00
|
| Rate for Payer: Zelis Worker's Compensation |
$234.78
|
|
|
INS GASTRO TUBE NASO
|
Facility
|
OP
|
$860.00
|
|
| Hospital Charge Code |
2407251
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$215.00 |
| Max. Negotiated Rate |
$817.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$516.00
|
| Rate for Payer: Cash Price |
$516.00
|
| Rate for Payer: Cigna Commercial |
$731.00
|
| Rate for Payer: First Health Commercial |
$774.00
|
| Rate for Payer: First Health Workers Compensation |
$332.05
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$774.00
|
| Rate for Payer: GEHA Commercial |
$688.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$774.00
|
| Rate for Payer: Humana ChoiceCare |
$223.60
|
| Rate for Payer: Multiplan All |
$782.60
|
| Rate for Payer: New Mexico Health Connections Medicare |
$516.00
|
| Rate for Payer: OMNI Networks Commercial |
$602.00
|
| Rate for Payer: One Health Plan PPO/POS |
$774.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$817.00
|
| Rate for Payer: Three Rivers Provider Network All |
$645.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$756.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$215.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$799.80
|
| Rate for Payer: Zelis Auto |
$344.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$430.00
|
| Rate for Payer: Zelis Worker's Compensation |
$234.78
|
|
|
INS GASTRO TUBE PERC
|
Facility
|
OP
|
$2,789.00
|
|
| Hospital Charge Code |
2407250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$697.25 |
| Max. Negotiated Rate |
$2,649.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,673.40
|
| Rate for Payer: Cash Price |
$1,673.40
|
| Rate for Payer: Cigna Commercial |
$2,370.65
|
| Rate for Payer: First Health Commercial |
$2,510.10
|
| Rate for Payer: First Health Workers Compensation |
$1,076.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,510.10
|
| Rate for Payer: GEHA Commercial |
$2,231.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,510.10
|
| Rate for Payer: Humana ChoiceCare |
$725.14
|
| Rate for Payer: Multiplan All |
$2,537.99
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,673.40
|
| Rate for Payer: OMNI Networks Commercial |
$1,952.30
|
| Rate for Payer: One Health Plan PPO/POS |
$2,510.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,649.55
|
| Rate for Payer: Three Rivers Provider Network All |
$2,091.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,454.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$697.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,593.77
|
| Rate for Payer: Zelis Auto |
$1,115.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,394.50
|
| Rate for Payer: Zelis Worker's Compensation |
$761.40
|
|
|
INS GASTRO TUBE PERC
|
Facility
|
IP
|
$2,789.00
|
|
| Hospital Charge Code |
2407250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$761.40 |
| Max. Negotiated Rate |
$2,649.55 |
| Rate for Payer: Cash Price |
$1,673.40
|
| Rate for Payer: Cigna Commercial |
$2,370.65
|
| Rate for Payer: First Health Commercial |
$2,510.10
|
| Rate for Payer: First Health Workers Compensation |
$1,076.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,510.10
|
| Rate for Payer: GEHA Commercial |
$1,952.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,510.10
|
| Rate for Payer: Multiplan All |
$2,537.99
|
| Rate for Payer: OMNI Networks Commercial |
$1,952.30
|
| Rate for Payer: One Health Plan PPO/POS |
$2,510.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,649.55
|
| Rate for Payer: Three Rivers Provider Network All |
$2,091.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,593.77
|
| Rate for Payer: Zelis Auto |
$1,115.60
|
| Rate for Payer: Zelis Worker's Compensation |
$761.40
|
|
|
INS IMPLTBL GLUCOSE SENSOR
|
Facility
|
IP
|
$690.00
|
|
|
Service Code
|
CPT 0446T
|
| Hospital Charge Code |
6191095
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$188.37 |
| Max. Negotiated Rate |
$655.50 |
| Rate for Payer: Cash Price |
$414.00
|
| Rate for Payer: Cigna Commercial |
$586.50
|
| Rate for Payer: First Health Commercial |
$621.00
|
| Rate for Payer: First Health Workers Compensation |
$266.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$621.00
|
| Rate for Payer: GEHA Commercial |
$483.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$621.00
|
| Rate for Payer: Multiplan All |
$627.90
|
| Rate for Payer: OMNI Networks Commercial |
$483.00
|
| Rate for Payer: One Health Plan PPO/POS |
$621.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$655.50
|
| Rate for Payer: Three Rivers Provider Network All |
$517.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$641.70
|
| Rate for Payer: Zelis Auto |
$276.00
|
| Rate for Payer: Zelis Worker's Compensation |
$188.37
|
|
|
INS IMPLTBL GLUCOSE SENSOR
|
Facility
|
OP
|
$690.00
|
|
|
Service Code
|
CPT 0446T
|
| Hospital Charge Code |
6191095
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$188.37 |
| Max. Negotiated Rate |
$6,172.96 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$679.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$414.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$679.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$538.19
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,086.48
|
| Rate for Payer: Cash Price |
$414.00
|
| Rate for Payer: Cash Price |
$414.00
|
| Rate for Payer: Cigna Commercial |
$586.50
|
| Rate for Payer: First Health Commercial |
$621.00
|
| Rate for Payer: First Health Workers Compensation |
$266.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$621.00
|
| Rate for Payer: GEHA Commercial |
$552.00
|
| Rate for Payer: GEHA Medicare |
$3,086.48
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$621.00
|
| Rate for Payer: Humana ChoiceCare |
$3,395.13
|
| Rate for Payer: Humana Medicare Advantage |
$3,086.48
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,185.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$549.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,086.48
|
| Rate for Payer: Multiplan All |
$627.90
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,247.02
|
| Rate for Payer: OMNI Networks Commercial |
$483.00
|
| Rate for Payer: One Health Plan PPO/POS |
$621.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$634.07
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$549.15
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,086.48
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$655.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,172.96
|
| Rate for Payer: Three Rivers Provider Network All |
$517.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,024.75
|
| Rate for Payer: United Healthcare Managed Medicaid |
$549.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,086.48
|
| Rate for Payer: United Payors & United Providers UP&UP |
$641.70
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,086.48
|
| Rate for Payer: Zelis Auto |
$276.00
|
| Rate for Payer: Zelis Medicare |
$2,623.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,703.78
|
| Rate for Payer: Zelis Worker's Compensation |
$188.37
|
|
|
INSJ MESH/PROSTH PELVC FLR DEFECT EA SIT
|
Facility
|
IP
|
$658.00
|
|
|
Service Code
|
CPT 57267
|
| Hospital Charge Code |
6157267
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$179.63 |
| Max. Negotiated Rate |
$625.10 |
| Rate for Payer: Cash Price |
$394.80
|
| Rate for Payer: Cigna Commercial |
$559.30
|
| Rate for Payer: First Health Commercial |
$592.20
|
| Rate for Payer: First Health Workers Compensation |
$254.05
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$592.20
|
| Rate for Payer: GEHA Commercial |
$460.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$592.20
|
| Rate for Payer: Multiplan All |
$598.78
|
| Rate for Payer: OMNI Networks Commercial |
$460.60
|
| Rate for Payer: One Health Plan PPO/POS |
$592.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$625.10
|
| Rate for Payer: Three Rivers Provider Network All |
$493.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$611.94
|
| Rate for Payer: Zelis Auto |
$263.20
|
| Rate for Payer: Zelis Worker's Compensation |
$179.63
|
|
|
INSJ MESH/PROSTH PELVC FLR DEFECT EA SIT
|
Facility
|
OP
|
$658.00
|
|
|
Service Code
|
CPT 57267
|
| Hospital Charge Code |
6157267
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$171.08 |
| Max. Negotiated Rate |
$3,565.77 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,565.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$394.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,565.77
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,824.80
|
| Rate for Payer: Cash Price |
$394.80
|
| Rate for Payer: Cash Price |
$394.80
|
| Rate for Payer: Cigna Commercial |
$559.30
|
| Rate for Payer: First Health Commercial |
$592.20
|
| Rate for Payer: First Health Workers Compensation |
$254.05
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$592.20
|
| Rate for Payer: GEHA Commercial |
$526.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$592.20
|
| Rate for Payer: Humana ChoiceCare |
$171.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,882.33
|
| Rate for Payer: Multiplan All |
$598.78
|
| Rate for Payer: New Mexico Health Connections Medicare |
$394.80
|
| Rate for Payer: OMNI Networks Commercial |
$460.60
|
| Rate for Payer: One Health Plan PPO/POS |
$592.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$3,328.05
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,882.33
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$625.10
|
| Rate for Payer: Three Rivers Provider Network All |
$493.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$579.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,882.33
|
| Rate for Payer: United Payors & United Providers UP&UP |
$611.94
|
| Rate for Payer: Zelis Auto |
$263.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$329.00
|
| Rate for Payer: Zelis Worker's Compensation |
$179.63
|
|
