|
INTERNAL NERVE REVISION
|
Facility
|
IP
|
$579.00
|
|
|
Service Code
|
CPT 64727
|
| Hospital Charge Code |
6164727
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$158.07 |
| Max. Negotiated Rate |
$550.05 |
| Rate for Payer: Cash Price |
$347.40
|
| Rate for Payer: Cigna Commercial |
$492.15
|
| Rate for Payer: First Health Commercial |
$521.10
|
| Rate for Payer: First Health Workers Compensation |
$223.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$521.10
|
| Rate for Payer: GEHA Commercial |
$405.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$521.10
|
| Rate for Payer: Multiplan All |
$526.89
|
| Rate for Payer: OMNI Networks Commercial |
$405.30
|
| Rate for Payer: One Health Plan PPO/POS |
$521.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$550.05
|
| Rate for Payer: Three Rivers Provider Network All |
$434.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$538.47
|
| Rate for Payer: Zelis Auto |
$231.60
|
| Rate for Payer: Zelis Worker's Compensation |
$158.07
|
|
|
INTERPHASE IN SITU ISH, 100-300 CELLS
|
Facility
|
OP
|
$59.00
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
2200405
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.75 |
| Max. Negotiated Rate |
$102.38 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$35.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cigna Commercial |
$50.15
|
| Rate for Payer: First Health Commercial |
$53.10
|
| Rate for Payer: First Health Workers Compensation |
$61.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$53.10
|
| Rate for Payer: GEHA Commercial |
$47.20
|
| Rate for Payer: GEHA Medicare |
$51.19
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$53.10
|
| Rate for Payer: Humana ChoiceCare |
$56.31
|
| Rate for Payer: Humana Medicare Advantage |
$51.19
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$86.00
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$51.19
|
| Rate for Payer: Multiplan All |
$53.69
|
| Rate for Payer: New Mexico Health Connections Medicare |
$87.02
|
| Rate for Payer: OMNI Networks Commercial |
$41.30
|
| Rate for Payer: One Health Plan PPO/POS |
$53.10
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$51.19
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$56.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$102.38
|
| Rate for Payer: Three Rivers Provider Network All |
$44.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$50.17
|
| Rate for Payer: United Healthcare Commercial |
$50.15
|
| Rate for Payer: United Healthcare Managed Medicaid |
$14.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$51.19
|
| Rate for Payer: United Payors & United Providers UP&UP |
$54.87
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$51.19
|
| Rate for Payer: Zelis Auto |
$23.60
|
| Rate for Payer: Zelis Medicare |
$43.51
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$61.43
|
| Rate for Payer: Zelis Worker's Compensation |
$43.44
|
|
|
INTERPHASE IN SITU ISH, 100-300 CELLS
|
Facility
|
IP
|
$59.00
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
2200405
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.60 |
| Max. Negotiated Rate |
$61.44 |
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cash Price |
$35.40
|
| Rate for Payer: Cigna Commercial |
$50.15
|
| Rate for Payer: First Health Commercial |
$53.10
|
| Rate for Payer: First Health Workers Compensation |
$61.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$53.10
|
| Rate for Payer: GEHA Commercial |
$41.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$53.10
|
| Rate for Payer: Multiplan All |
$53.69
|
| Rate for Payer: OMNI Networks Commercial |
$41.30
|
| Rate for Payer: One Health Plan PPO/POS |
$53.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$56.05
|
| Rate for Payer: Three Rivers Provider Network All |
$44.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$54.87
|
| Rate for Payer: Zelis Auto |
$23.60
|
| Rate for Payer: Zelis Worker's Compensation |
$43.44
|
|
|
INTERPJ/EXPLNAJ RESULTS PSYCHIATRIC EXAM
|
Facility
|
OP
|
$239.00
|
|
|
Service Code
|
CPT 90887
|
| Hospital Charge Code |
8499247
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$59.75 |
| Max. Negotiated Rate |
$227.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$143.40
|
| Rate for Payer: Cash Price |
$143.40
|
| Rate for Payer: Cash Price |
$143.40
|
| Rate for Payer: Cigna Commercial |
$203.15
|
| Rate for Payer: First Health Commercial |
$215.10
|
| Rate for Payer: First Health Workers Compensation |
$92.28
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$215.10
|
| Rate for Payer: GEHA Commercial |
$191.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$215.10
|
| Rate for Payer: Humana ChoiceCare |
$62.14
|
| Rate for Payer: Multiplan All |
$217.49
|
| Rate for Payer: New Mexico Health Connections Medicare |
$143.40
|
| Rate for Payer: OMNI Networks Commercial |
$167.30
|
| Rate for Payer: One Health Plan PPO/POS |
$215.10
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$80.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$227.05
|
| Rate for Payer: Three Rivers Provider Network All |
$179.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$210.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$59.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$222.27
|
| Rate for Payer: Zelis Auto |
$95.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$119.50
|
| Rate for Payer: Zelis Worker's Compensation |
$65.25
|
|
|
INTERPJ/EXPLNAJ RESULTS PSYCHIATRIC EXAM
|
Facility
|
IP
|
$239.00
|
|
|
Service Code
|
CPT 90887
|
| Hospital Charge Code |
8499247
|
|
Hospital Revenue Code
|
513
|
| Min. Negotiated Rate |
$65.25 |
| Max. Negotiated Rate |
$227.05 |
| Rate for Payer: Cash Price |
$143.40
|
| Rate for Payer: Cigna Commercial |
$203.15
|
| Rate for Payer: First Health Commercial |
$215.10
|
| Rate for Payer: First Health Workers Compensation |
$92.28
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$215.10
|
| Rate for Payer: GEHA Commercial |
$167.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$215.10
|
| Rate for Payer: Multiplan All |
$217.49
|
| Rate for Payer: OMNI Networks Commercial |
$167.30
|
| Rate for Payer: One Health Plan PPO/POS |
$215.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$227.05
|
| Rate for Payer: Three Rivers Provider Network All |
$179.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$222.27
|
| Rate for Payer: Zelis Auto |
$95.60
|
| Rate for Payer: Zelis Worker's Compensation |
$65.25
|
|
|
INTERPJ/EXPLNAJ RESULTS PSYCHIATRIC EXAM
|
Facility
|
OP
|
$239.00
|
|
|
Service Code
|
CPT 90887
|
| Hospital Charge Code |
9599249
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$59.75 |
| Max. Negotiated Rate |
$227.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$143.40
|
| Rate for Payer: Cash Price |
$143.40
|
| Rate for Payer: Cigna Commercial |
$203.15
|
| Rate for Payer: First Health Commercial |
$215.10
|
| Rate for Payer: First Health Workers Compensation |
$92.28
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$215.10
|
| Rate for Payer: GEHA Commercial |
$191.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$215.10
|
| Rate for Payer: Humana ChoiceCare |
$62.14
|
| Rate for Payer: Multiplan All |
$217.49
|
| Rate for Payer: New Mexico Health Connections Medicare |
$143.40
|
| Rate for Payer: OMNI Networks Commercial |
$167.30
|
| Rate for Payer: One Health Plan PPO/POS |
$215.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$227.05
|
| Rate for Payer: Three Rivers Provider Network All |
$179.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$210.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$59.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$222.27
|
| Rate for Payer: Zelis Auto |
$95.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$119.50
|
| Rate for Payer: Zelis Worker's Compensation |
$65.25
|
|
|
INTERPJ/EXPLNAJ RESULTS PSYCHIATRIC EXAM
|
Facility
|
IP
|
$239.00
|
|
|
Service Code
|
CPT 90887
|
| Hospital Charge Code |
9599249
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$65.25 |
| Max. Negotiated Rate |
$227.05 |
| Rate for Payer: Cash Price |
$143.40
|
| Rate for Payer: Cigna Commercial |
$203.15
|
| Rate for Payer: First Health Commercial |
$215.10
|
| Rate for Payer: First Health Workers Compensation |
$92.28
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$215.10
|
| Rate for Payer: GEHA Commercial |
$167.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$215.10
|
| Rate for Payer: Multiplan All |
$217.49
|
| Rate for Payer: OMNI Networks Commercial |
$167.30
|
| Rate for Payer: One Health Plan PPO/POS |
$215.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$227.05
|
| Rate for Payer: Three Rivers Provider Network All |
$179.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$222.27
|
| Rate for Payer: Zelis Auto |
$95.60
|
| Rate for Payer: Zelis Worker's Compensation |
$65.25
|
|
|
INTERROGATION EVAL REMOTE </90 D 1/2/MLT
|
Facility
|
OP
|
$195.00
|
|
|
Service Code
|
CPT 93295
|
| Hospital Charge Code |
8193295
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$48.75 |
| Max. Negotiated Rate |
$185.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$117.00
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Cigna Commercial |
$165.75
|
| Rate for Payer: First Health Commercial |
$175.50
|
| Rate for Payer: First Health Workers Compensation |
$75.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$175.50
|
| Rate for Payer: GEHA Commercial |
$156.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$175.50
|
| Rate for Payer: Humana ChoiceCare |
$50.70
|
| Rate for Payer: Multiplan All |
$177.45
|
| Rate for Payer: New Mexico Health Connections Medicare |
$117.00
|
| Rate for Payer: OMNI Networks Commercial |
$136.50
|
| Rate for Payer: One Health Plan PPO/POS |
$175.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$185.25
|
| Rate for Payer: Three Rivers Provider Network All |
$146.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$171.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$48.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$181.35
|
| Rate for Payer: Zelis Auto |
$78.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$97.50
|
| Rate for Payer: Zelis Worker's Compensation |
$53.23
|
|
|
INTERROGATION EVAL REMOTE </90 D 1/2/MLT
|
Facility
|
IP
|
$195.00
|
|
|
Service Code
|
CPT 93295
|
| Hospital Charge Code |
8193295
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$53.23 |
| Max. Negotiated Rate |
$185.25 |
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Cigna Commercial |
$165.75
|
| Rate for Payer: First Health Commercial |
$175.50
|
| Rate for Payer: First Health Workers Compensation |
$75.29
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$175.50
|
| Rate for Payer: GEHA Commercial |
$136.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$175.50
|
| Rate for Payer: Multiplan All |
$177.45
|
| Rate for Payer: OMNI Networks Commercial |
$136.50
|
| Rate for Payer: One Health Plan PPO/POS |
$175.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$185.25
|
| Rate for Payer: Three Rivers Provider Network All |
$146.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$181.35
|
| Rate for Payer: Zelis Auto |
$78.00
|
| Rate for Payer: Zelis Worker's Compensation |
$53.23
|
|
|
INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLT
|
Facility
|
IP
|
$282.00
|
|
|
Service Code
|
CPT 93289
|
| Hospital Charge Code |
10000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$76.99 |
| Max. Negotiated Rate |
$267.90 |
| Rate for Payer: Cash Price |
$169.20
|
| Rate for Payer: Cigna Commercial |
$239.70
|
| Rate for Payer: First Health Commercial |
$253.80
|
| Rate for Payer: First Health Workers Compensation |
$108.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$253.80
|
| Rate for Payer: GEHA Commercial |
$197.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$253.80
|
| Rate for Payer: Multiplan All |
$256.62
|
| Rate for Payer: OMNI Networks Commercial |
$197.40
|
| Rate for Payer: One Health Plan PPO/POS |
$253.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$267.90
|
| Rate for Payer: Three Rivers Provider Network All |
$211.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$262.26
|
| Rate for Payer: Zelis Auto |
$112.80
|
| Rate for Payer: Zelis Worker's Compensation |
$76.99
|
|
|
INTESTINAL STRICTUROPLASTY
|
Facility
|
OP
|
$2,265.00
|
|
|
Service Code
|
CPT 44615
|
| Hospital Charge Code |
6144615
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$566.25 |
| Max. Negotiated Rate |
$2,151.75 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,359.00
|
| Rate for Payer: Cash Price |
$1,359.00
|
| Rate for Payer: Cigna Commercial |
$1,925.25
|
| Rate for Payer: First Health Commercial |
$2,038.50
|
| Rate for Payer: First Health Workers Compensation |
$874.52
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,038.50
|
| Rate for Payer: GEHA Commercial |
$1,812.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,038.50
|
| Rate for Payer: Humana ChoiceCare |
$588.90
|
| Rate for Payer: Multiplan All |
$2,061.15
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,359.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,585.50
|
| Rate for Payer: One Health Plan PPO/POS |
$2,038.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,151.75
|
| Rate for Payer: Three Rivers Provider Network All |
$1,698.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,993.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$566.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,106.45
|
| Rate for Payer: Zelis Auto |
$906.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,132.50
|
| Rate for Payer: Zelis Worker's Compensation |
$618.35
|
|
|
INTESTINAL STRICTUROPLASTY
|
Facility
|
IP
|
$2,265.00
|
|
|
Service Code
|
CPT 44615
|
| Hospital Charge Code |
6144615
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$618.35 |
| Max. Negotiated Rate |
$2,151.75 |
| Rate for Payer: Cash Price |
$1,359.00
|
| Rate for Payer: Cigna Commercial |
$1,925.25
|
| Rate for Payer: First Health Commercial |
$2,038.50
|
| Rate for Payer: First Health Workers Compensation |
$874.52
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,038.50
|
| Rate for Payer: GEHA Commercial |
$1,585.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,038.50
|
| Rate for Payer: Multiplan All |
$2,061.15
|
| Rate for Payer: OMNI Networks Commercial |
$1,585.50
|
| Rate for Payer: One Health Plan PPO/POS |
$2,038.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,151.75
|
| Rate for Payer: Three Rivers Provider Network All |
$1,698.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,106.45
|
| Rate for Payer: Zelis Auto |
$906.00
|
| Rate for Payer: Zelis Worker's Compensation |
$618.35
|
|
|
INT HRHC BY LIGATION SINGLE HROID W/O IM
|
Facility
|
IP
|
$695.00
|
|
|
Service Code
|
CPT 46945
|
| Hospital Charge Code |
6146945
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$189.74 |
| Max. Negotiated Rate |
$660.25 |
| Rate for Payer: Cash Price |
$417.00
|
| Rate for Payer: Cigna Commercial |
$590.75
|
| Rate for Payer: First Health Commercial |
$625.50
|
| Rate for Payer: First Health Workers Compensation |
$268.34
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$625.50
|
| Rate for Payer: GEHA Commercial |
$486.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$625.50
|
| Rate for Payer: Multiplan All |
$632.45
|
| Rate for Payer: OMNI Networks Commercial |
$486.50
|
| Rate for Payer: One Health Plan PPO/POS |
$625.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$660.25
|
| Rate for Payer: Three Rivers Provider Network All |
$521.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$646.35
|
| Rate for Payer: Zelis Auto |
$278.00
|
| Rate for Payer: Zelis Worker's Compensation |
$189.74
|
|
|
INT HRHC BY LIGATION SINGLE HROID W/O IM
|
Facility
|
OP
|
$951.00
|
|
|
Service Code
|
CPT 46945
|
| Hospital Charge Code |
20300078
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$259.62 |
| Max. Negotiated Rate |
$5,208.02 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,427.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$570.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,427.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,130.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,604.01
|
| Rate for Payer: Cash Price |
$570.60
|
| Rate for Payer: Cash Price |
$570.60
|
| Rate for Payer: Cigna Commercial |
$808.35
|
| Rate for Payer: First Health Commercial |
$855.90
|
| Rate for Payer: First Health Workers Compensation |
$367.18
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$855.90
|
| Rate for Payer: GEHA Commercial |
$760.80
|
| Rate for Payer: GEHA Medicare |
$2,604.01
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$855.90
|
| Rate for Payer: Humana ChoiceCare |
$2,864.41
|
| Rate for Payer: Humana Medicare Advantage |
$2,604.01
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,374.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,153.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,604.01
|
| Rate for Payer: Multiplan All |
$865.41
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,426.82
|
| Rate for Payer: OMNI Networks Commercial |
$665.70
|
| Rate for Payer: One Health Plan PPO/POS |
$855.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,331.92
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,153.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,604.01
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$903.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,208.02
|
| Rate for Payer: Three Rivers Provider Network All |
$713.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,551.93
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,153.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,604.01
|
| Rate for Payer: United Payors & United Providers UP&UP |
$884.43
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,604.01
|
| Rate for Payer: Zelis Auto |
$380.40
|
| Rate for Payer: Zelis Medicare |
$2,213.41
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,124.81
|
| Rate for Payer: Zelis Worker's Compensation |
$259.62
|
|
|
INT HRHC BY LIGATION SINGLE HROID W/O IM
|
Facility
|
IP
|
$951.00
|
|
|
Service Code
|
CPT 46945
|
| Hospital Charge Code |
20300078
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$259.62 |
| Max. Negotiated Rate |
$903.45 |
| Rate for Payer: Cash Price |
$570.60
|
| Rate for Payer: Cigna Commercial |
$808.35
|
| Rate for Payer: First Health Commercial |
$855.90
|
| Rate for Payer: First Health Workers Compensation |
$367.18
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$855.90
|
| Rate for Payer: GEHA Commercial |
$665.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$855.90
|
| Rate for Payer: Multiplan All |
$865.41
|
| Rate for Payer: OMNI Networks Commercial |
$665.70
|
| Rate for Payer: One Health Plan PPO/POS |
$855.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$903.45
|
| Rate for Payer: Three Rivers Provider Network All |
$713.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$884.43
|
| Rate for Payer: Zelis Auto |
$380.40
|
| Rate for Payer: Zelis Worker's Compensation |
$259.62
|
|
|
INT HRHC BY LIGATION SINGLE HROID W/O IM
|
Facility
|
OP
|
$695.00
|
|
|
Service Code
|
CPT 46945
|
| Hospital Charge Code |
6146945
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$189.74 |
| Max. Negotiated Rate |
$5,208.02 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,427.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$417.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,427.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,130.51
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$2,604.01
|
| Rate for Payer: Cash Price |
$417.00
|
| Rate for Payer: Cash Price |
$417.00
|
| Rate for Payer: Cigna Commercial |
$590.75
|
| Rate for Payer: First Health Commercial |
$625.50
|
| Rate for Payer: First Health Workers Compensation |
$268.34
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$625.50
|
| Rate for Payer: GEHA Commercial |
$556.00
|
| Rate for Payer: GEHA Medicare |
$2,604.01
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$625.50
|
| Rate for Payer: Humana ChoiceCare |
$2,864.41
|
| Rate for Payer: Humana Medicare Advantage |
$2,604.01
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$4,374.74
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,153.54
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$2,604.01
|
| Rate for Payer: Multiplan All |
$632.45
|
| Rate for Payer: New Mexico Health Connections Medicare |
$4,426.82
|
| Rate for Payer: OMNI Networks Commercial |
$486.50
|
| Rate for Payer: One Health Plan PPO/POS |
$625.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,331.92
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,153.54
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$2,604.01
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$660.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$5,208.02
|
| Rate for Payer: Three Rivers Provider Network All |
$521.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,551.93
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,153.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,604.01
|
| Rate for Payer: United Payors & United Providers UP&UP |
$646.35
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$2,604.01
|
| Rate for Payer: Zelis Auto |
$278.00
|
| Rate for Payer: Zelis Medicare |
$2,213.41
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,124.81
|
| Rate for Payer: Zelis Worker's Compensation |
$189.74
|
|
|
INTL OR SUBSQNT PSYCH CCM
|
Facility
|
OP
|
$660.00
|
|
|
Service Code
|
CPT 99494
|
| Hospital Charge Code |
9199509
|
|
Hospital Revenue Code
|
529
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$627.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$396.00
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cigna Commercial |
$561.00
|
| Rate for Payer: First Health Commercial |
$594.00
|
| Rate for Payer: First Health Workers Compensation |
$254.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$594.00
|
| Rate for Payer: GEHA Commercial |
$528.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$594.00
|
| Rate for Payer: Humana ChoiceCare |
$171.60
|
| Rate for Payer: Multiplan All |
$600.60
|
| Rate for Payer: New Mexico Health Connections Medicare |
$396.00
|
| Rate for Payer: OMNI Networks Commercial |
$462.00
|
| Rate for Payer: One Health Plan PPO/POS |
$594.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$627.00
|
| Rate for Payer: Three Rivers Provider Network All |
$495.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$580.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$165.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$613.80
|
| Rate for Payer: Zelis Auto |
$264.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$330.00
|
| Rate for Payer: Zelis Worker's Compensation |
$180.18
|
|
|
INTL OR SUBSQNT PSYCH CCM
|
Facility
|
IP
|
$660.00
|
|
|
Service Code
|
CPT 99494
|
| Hospital Charge Code |
9199509
|
|
Hospital Revenue Code
|
529
|
| Min. Negotiated Rate |
$180.18 |
| Max. Negotiated Rate |
$627.00 |
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cigna Commercial |
$561.00
|
| Rate for Payer: First Health Commercial |
$594.00
|
| Rate for Payer: First Health Workers Compensation |
$254.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$594.00
|
| Rate for Payer: GEHA Commercial |
$462.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$594.00
|
| Rate for Payer: Multiplan All |
$600.60
|
| Rate for Payer: OMNI Networks Commercial |
$462.00
|
| Rate for Payer: One Health Plan PPO/POS |
$594.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$627.00
|
| Rate for Payer: Three Rivers Provider Network All |
$495.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$613.80
|
| Rate for Payer: Zelis Auto |
$264.00
|
| Rate for Payer: Zelis Worker's Compensation |
$180.18
|
|
|
INTMD RPR FACE/MM 20.1-30.0
|
Facility
|
IP
|
$966.00
|
|
|
Service Code
|
CPT 12056
|
| Hospital Charge Code |
6112056
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$263.72 |
| Max. Negotiated Rate |
$917.70 |
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Cigna Commercial |
$821.10
|
| Rate for Payer: First Health Commercial |
$869.40
|
| Rate for Payer: First Health Workers Compensation |
$372.97
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$869.40
|
| Rate for Payer: GEHA Commercial |
$676.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$869.40
|
| Rate for Payer: Multiplan All |
$879.06
|
| Rate for Payer: OMNI Networks Commercial |
$676.20
|
| Rate for Payer: One Health Plan PPO/POS |
$869.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$917.70
|
| Rate for Payer: Three Rivers Provider Network All |
$724.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$898.38
|
| Rate for Payer: Zelis Auto |
$386.40
|
| Rate for Payer: Zelis Worker's Compensation |
$263.72
|
|
|
INTMD RPR FACE/MM 20.1-30.0
|
Facility
|
OP
|
$966.00
|
|
|
Service Code
|
CPT 12056
|
| Hospital Charge Code |
6112056
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$252.37 |
| Max. Negotiated Rate |
$917.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$318.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$579.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$318.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$252.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Cigna Commercial |
$821.10
|
| Rate for Payer: First Health Commercial |
$869.40
|
| Rate for Payer: First Health Workers Compensation |
$372.97
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$869.40
|
| Rate for Payer: GEHA Commercial |
$772.80
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$869.40
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$257.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$879.06
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$676.20
|
| Rate for Payer: One Health Plan PPO/POS |
$869.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$297.33
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$257.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$917.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$724.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$257.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$898.38
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$386.40
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$263.72
|
|
|
INTMD RPR FACE/MM >30.0 CM
|
Facility
|
IP
|
$838.00
|
|
|
Service Code
|
CPT 12057
|
| Hospital Charge Code |
6112057
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$228.77 |
| Max. Negotiated Rate |
$796.10 |
| Rate for Payer: Cash Price |
$502.80
|
| Rate for Payer: Cigna Commercial |
$712.30
|
| Rate for Payer: First Health Commercial |
$754.20
|
| Rate for Payer: First Health Workers Compensation |
$323.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$754.20
|
| Rate for Payer: GEHA Commercial |
$586.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$754.20
|
| Rate for Payer: Multiplan All |
$762.58
|
| Rate for Payer: OMNI Networks Commercial |
$586.60
|
| Rate for Payer: One Health Plan PPO/POS |
$754.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$796.10
|
| Rate for Payer: Three Rivers Provider Network All |
$628.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$779.34
|
| Rate for Payer: Zelis Auto |
$335.20
|
| Rate for Payer: Zelis Worker's Compensation |
$228.77
|
|
|
INTMD RPR FACE/MM >30.0 CM
|
Facility
|
OP
|
$838.00
|
|
|
Service Code
|
CPT 12057
|
| Hospital Charge Code |
6112057
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$228.77 |
| Max. Negotiated Rate |
$796.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$318.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$502.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$318.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$252.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$379.37
|
| Rate for Payer: Cash Price |
$502.80
|
| Rate for Payer: Cash Price |
$502.80
|
| Rate for Payer: Cigna Commercial |
$712.30
|
| Rate for Payer: First Health Commercial |
$754.20
|
| Rate for Payer: First Health Workers Compensation |
$323.55
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$754.20
|
| Rate for Payer: GEHA Commercial |
$670.40
|
| Rate for Payer: GEHA Medicare |
$379.37
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$754.20
|
| Rate for Payer: Humana ChoiceCare |
$417.31
|
| Rate for Payer: Humana Medicare Advantage |
$379.37
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$637.34
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$257.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$379.37
|
| Rate for Payer: Multiplan All |
$762.58
|
| Rate for Payer: New Mexico Health Connections Medicare |
$644.93
|
| Rate for Payer: OMNI Networks Commercial |
$586.60
|
| Rate for Payer: One Health Plan PPO/POS |
$754.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$297.33
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$257.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$379.37
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$796.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$758.74
|
| Rate for Payer: Three Rivers Provider Network All |
$628.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$371.78
|
| Rate for Payer: United Healthcare Managed Medicaid |
$257.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$379.37
|
| Rate for Payer: United Payors & United Providers UP&UP |
$779.34
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$379.37
|
| Rate for Payer: Zelis Auto |
$335.20
|
| Rate for Payer: Zelis Medicare |
$322.46
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$455.24
|
| Rate for Payer: Zelis Worker's Compensation |
$228.77
|
|
|
INTMD RPR N-HF/GENIT12.6-20
|
Facility
|
IP
|
$690.00
|
|
|
Service Code
|
CPT 12045
|
| Hospital Charge Code |
6112045
|
|
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
|
|
|
INTMD RPR N-HF/GENIT12.6-20
|
Facility
|
OP
|
$690.00
|
|
|
Service Code
|
CPT 12045
|
| Hospital Charge Code |
6112045
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$188.37 |
| Max. Negotiated Rate |
$1,162.48 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$318.57
|
| 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 |
$318.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$252.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$581.24
|
| 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 |
$581.24
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$621.00
|
| Rate for Payer: Humana ChoiceCare |
$639.36
|
| Rate for Payer: Humana Medicare Advantage |
$581.24
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$976.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$257.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$581.24
|
| Rate for Payer: Multiplan All |
$627.90
|
| Rate for Payer: New Mexico Health Connections Medicare |
$988.11
|
| 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 |
$297.33
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$257.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$581.24
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$655.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,162.48
|
| Rate for Payer: Three Rivers Provider Network All |
$517.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$569.62
|
| Rate for Payer: United Healthcare Managed Medicaid |
$257.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$581.24
|
| Rate for Payer: United Payors & United Providers UP&UP |
$641.70
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$581.24
|
| Rate for Payer: Zelis Auto |
$276.00
|
| Rate for Payer: Zelis Medicare |
$494.05
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$697.49
|
| Rate for Payer: Zelis Worker's Compensation |
$188.37
|
|
|
INTMD RPR N-HF/GENIT20.1-30
|
Facility
|
OP
|
$800.00
|
|
|
Service Code
|
CPT 12046
|
| Hospital Charge Code |
6112046
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$218.40 |
| Max. Negotiated Rate |
$1,162.48 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$318.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$480.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$318.57
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$252.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$581.24
|
| Rate for Payer: Cash Price |
$480.00
|
| Rate for Payer: Cash Price |
$480.00
|
| Rate for Payer: Cigna Commercial |
$680.00
|
| Rate for Payer: First Health Commercial |
$720.00
|
| Rate for Payer: First Health Workers Compensation |
$308.88
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$720.00
|
| Rate for Payer: GEHA Commercial |
$640.00
|
| Rate for Payer: GEHA Medicare |
$581.24
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$720.00
|
| Rate for Payer: Humana ChoiceCare |
$639.36
|
| Rate for Payer: Humana Medicare Advantage |
$581.24
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$976.48
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$257.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$581.24
|
| Rate for Payer: Multiplan All |
$728.00
|
| Rate for Payer: New Mexico Health Connections Medicare |
$988.11
|
| Rate for Payer: OMNI Networks Commercial |
$560.00
|
| Rate for Payer: One Health Plan PPO/POS |
$720.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$297.33
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$257.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$581.24
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$760.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,162.48
|
| Rate for Payer: Three Rivers Provider Network All |
$600.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$569.62
|
| Rate for Payer: United Healthcare Managed Medicaid |
$257.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$581.24
|
| Rate for Payer: United Payors & United Providers UP&UP |
$744.00
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$581.24
|
| Rate for Payer: Zelis Auto |
$320.00
|
| Rate for Payer: Zelis Medicare |
$494.05
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$697.49
|
| Rate for Payer: Zelis Worker's Compensation |
$218.40
|
|
