|
LAPARO NEW URETER/BLADDER
|
Facility
|
IP
|
$2,641.00
|
|
|
Service Code
|
CPT 50948
|
| Hospital Charge Code |
6150948
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$720.99 |
| Max. Negotiated Rate |
$2,508.95 |
| Rate for Payer: Cash Price |
$1,584.60
|
| Rate for Payer: Cigna Commercial |
$2,244.85
|
| Rate for Payer: First Health Commercial |
$2,376.90
|
| Rate for Payer: First Health Workers Compensation |
$1,019.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,376.90
|
| Rate for Payer: GEHA Commercial |
$1,848.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,376.90
|
| Rate for Payer: Multiplan All |
$2,403.31
|
| Rate for Payer: OMNI Networks Commercial |
$1,848.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,376.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,508.95
|
| Rate for Payer: Three Rivers Provider Network All |
$1,980.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,456.13
|
| Rate for Payer: Zelis Auto |
$1,056.40
|
| Rate for Payer: Zelis Worker's Compensation |
$720.99
|
|
|
LAPARO PARTIAL COLECTOMY
|
Facility
|
IP
|
$3,239.00
|
|
|
Service Code
|
CPT 44204
|
| Hospital Charge Code |
6144204
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$884.25 |
| Max. Negotiated Rate |
$3,077.05 |
| Rate for Payer: Cash Price |
$1,943.40
|
| Rate for Payer: Cigna Commercial |
$2,753.15
|
| Rate for Payer: First Health Commercial |
$2,915.10
|
| Rate for Payer: First Health Workers Compensation |
$1,250.58
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,915.10
|
| Rate for Payer: GEHA Commercial |
$2,267.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,915.10
|
| Rate for Payer: Multiplan All |
$2,947.49
|
| Rate for Payer: OMNI Networks Commercial |
$2,267.30
|
| Rate for Payer: One Health Plan PPO/POS |
$2,915.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,077.05
|
| Rate for Payer: Three Rivers Provider Network All |
$2,429.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,012.27
|
| Rate for Payer: Zelis Auto |
$1,295.60
|
| Rate for Payer: Zelis Worker's Compensation |
$884.25
|
|
|
LAPARO PARTIAL COLECTOMY
|
Facility
|
OP
|
$3,239.00
|
|
|
Service Code
|
CPT 44204
|
| Hospital Charge Code |
6144204
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$809.75 |
| Max. Negotiated Rate |
$3,077.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,943.40
|
| Rate for Payer: Cash Price |
$1,943.40
|
| Rate for Payer: Cigna Commercial |
$2,753.15
|
| Rate for Payer: First Health Commercial |
$2,915.10
|
| Rate for Payer: First Health Workers Compensation |
$1,250.58
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,915.10
|
| Rate for Payer: GEHA Commercial |
$2,591.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,915.10
|
| Rate for Payer: Humana ChoiceCare |
$842.14
|
| Rate for Payer: Multiplan All |
$2,947.49
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,943.40
|
| Rate for Payer: OMNI Networks Commercial |
$2,267.30
|
| Rate for Payer: One Health Plan PPO/POS |
$2,915.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,077.05
|
| Rate for Payer: Three Rivers Provider Network All |
$2,429.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,850.32
|
| Rate for Payer: United Healthcare Managed Medicaid |
$809.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,012.27
|
| Rate for Payer: Zelis Auto |
$1,295.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,619.50
|
| Rate for Payer: Zelis Worker's Compensation |
$884.25
|
|
|
LAPARO PARTIAL NEPHRECTOMY
|
Facility
|
OP
|
$3,071.00
|
|
|
Service Code
|
CPT 50543
|
| Hospital Charge Code |
6150543
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$838.38 |
| Max. Negotiated Rate |
$19,771.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,735.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,842.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,735.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,751.82
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,885.87
|
| Rate for Payer: Cash Price |
$1,842.60
|
| Rate for Payer: Cash Price |
$1,842.60
|
| Rate for Payer: Cigna Commercial |
$2,610.35
|
| Rate for Payer: First Health Commercial |
$2,763.90
|
| Rate for Payer: First Health Workers Compensation |
$1,185.71
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,763.90
|
| Rate for Payer: GEHA Commercial |
$2,456.80
|
| Rate for Payer: GEHA Medicare |
$9,885.87
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,763.90
|
| Rate for Payer: Humana ChoiceCare |
$10,874.46
|
| Rate for Payer: Humana Medicare Advantage |
$9,885.87
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,608.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,828.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,885.87
|
| Rate for Payer: Multiplan All |
$2,794.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,805.98
|
| Rate for Payer: OMNI Networks Commercial |
$2,149.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,763.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,420.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,828.23
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,885.87
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,917.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,771.74
|
| Rate for Payer: Three Rivers Provider Network All |
$2,303.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,688.15
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,828.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,885.87
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,856.03
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$9,885.87
|
| Rate for Payer: Zelis Auto |
$1,228.40
|
| Rate for Payer: Zelis Medicare |
$8,402.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,863.04
|
| Rate for Payer: Zelis Worker's Compensation |
$838.38
|
|
|
LAPARO PARTIAL NEPHRECTOMY
|
Facility
|
IP
|
$3,071.00
|
|
|
Service Code
|
CPT 50543
|
| Hospital Charge Code |
6150543
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$838.38 |
| Max. Negotiated Rate |
$2,917.45 |
| Rate for Payer: Cash Price |
$1,842.60
|
| Rate for Payer: Cigna Commercial |
$2,610.35
|
| Rate for Payer: First Health Commercial |
$2,763.90
|
| Rate for Payer: First Health Workers Compensation |
$1,185.71
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,763.90
|
| Rate for Payer: GEHA Commercial |
$2,149.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,763.90
|
| Rate for Payer: Multiplan All |
$2,794.61
|
| Rate for Payer: OMNI Networks Commercial |
$2,149.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,763.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,917.45
|
| Rate for Payer: Three Rivers Provider Network All |
$2,303.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,856.03
|
| Rate for Payer: Zelis Auto |
$1,228.40
|
| Rate for Payer: Zelis Worker's Compensation |
$838.38
|
|
|
LAPARO PROC ABDM/PER/OMENT
|
Facility
|
IP
|
$1,931.00
|
|
|
Service Code
|
CPT 49329
|
| Hospital Charge Code |
6144181
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$527.16 |
| Max. Negotiated Rate |
$1,834.45 |
| Rate for Payer: Cash Price |
$1,158.60
|
| Rate for Payer: Cigna Commercial |
$1,641.35
|
| Rate for Payer: First Health Commercial |
$1,737.90
|
| Rate for Payer: First Health Workers Compensation |
$745.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,737.90
|
| Rate for Payer: GEHA Commercial |
$1,351.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,737.90
|
| Rate for Payer: Multiplan All |
$1,757.21
|
| Rate for Payer: OMNI Networks Commercial |
$1,351.70
|
| Rate for Payer: One Health Plan PPO/POS |
$1,737.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,834.45
|
| Rate for Payer: Three Rivers Provider Network All |
$1,448.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,795.83
|
| Rate for Payer: Zelis Auto |
$772.40
|
| Rate for Payer: Zelis Worker's Compensation |
$527.16
|
|
|
LAPARO PROC ABDM/PER/OMENT
|
Facility
|
OP
|
$1,931.00
|
|
|
Service Code
|
CPT 49329
|
| Hospital Charge Code |
6144181
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$527.16 |
| Max. Negotiated Rate |
$11,079.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,847.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,158.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,847.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,048.07
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,539.96
|
| Rate for Payer: Cash Price |
$1,158.60
|
| Rate for Payer: Cash Price |
$1,158.60
|
| Rate for Payer: Cigna Commercial |
$1,641.35
|
| Rate for Payer: First Health Commercial |
$1,737.90
|
| Rate for Payer: First Health Workers Compensation |
$745.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,737.90
|
| Rate for Payer: GEHA Commercial |
$1,544.80
|
| Rate for Payer: GEHA Medicare |
$5,539.96
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,737.90
|
| Rate for Payer: Humana ChoiceCare |
$6,093.96
|
| Rate for Payer: Humana Medicare Advantage |
$5,539.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$9,307.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,110.15
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,539.96
|
| Rate for Payer: Multiplan All |
$1,757.21
|
| Rate for Payer: New Mexico Health Connections Medicare |
$9,417.93
|
| Rate for Payer: OMNI Networks Commercial |
$1,351.70
|
| Rate for Payer: One Health Plan PPO/POS |
$1,737.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$3,591.10
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,110.15
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,539.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,834.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,079.92
|
| Rate for Payer: Three Rivers Provider Network All |
$1,448.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,429.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,110.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,539.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,795.83
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,539.96
|
| Rate for Payer: Zelis Auto |
$772.40
|
| Rate for Payer: Zelis Medicare |
$4,708.97
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,647.95
|
| Rate for Payer: Zelis Worker's Compensation |
$527.16
|
|
|
LAPARO RADICAL NEPHRECTOMY
|
Facility
|
OP
|
$2,772.00
|
|
|
Service Code
|
CPT 50545
|
| Hospital Charge Code |
6150545
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$693.00 |
| Max. Negotiated Rate |
$2,633.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,663.20
|
| Rate for Payer: Cash Price |
$1,663.20
|
| Rate for Payer: Cigna Commercial |
$2,356.20
|
| Rate for Payer: First Health Commercial |
$2,494.80
|
| Rate for Payer: First Health Workers Compensation |
$1,070.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,494.80
|
| Rate for Payer: GEHA Commercial |
$2,217.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,494.80
|
| Rate for Payer: Humana ChoiceCare |
$720.72
|
| Rate for Payer: Multiplan All |
$2,522.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,663.20
|
| Rate for Payer: OMNI Networks Commercial |
$1,940.40
|
| Rate for Payer: One Health Plan PPO/POS |
$2,494.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,633.40
|
| Rate for Payer: Three Rivers Provider Network All |
$2,079.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,439.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$693.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,577.96
|
| Rate for Payer: Zelis Auto |
$1,108.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,386.00
|
| Rate for Payer: Zelis Worker's Compensation |
$756.76
|
|
|
LAPARO RADICAL NEPHRECTOMY
|
Facility
|
IP
|
$2,772.00
|
|
|
Service Code
|
CPT 50545
|
| Hospital Charge Code |
6150545
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$756.76 |
| Max. Negotiated Rate |
$2,633.40 |
| Rate for Payer: Cash Price |
$1,663.20
|
| Rate for Payer: Cigna Commercial |
$2,356.20
|
| Rate for Payer: First Health Commercial |
$2,494.80
|
| Rate for Payer: First Health Workers Compensation |
$1,070.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,494.80
|
| Rate for Payer: GEHA Commercial |
$1,940.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,494.80
|
| Rate for Payer: Multiplan All |
$2,522.52
|
| Rate for Payer: OMNI Networks Commercial |
$1,940.40
|
| Rate for Payer: One Health Plan PPO/POS |
$2,494.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,633.40
|
| Rate for Payer: Three Rivers Provider Network All |
$2,079.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,577.96
|
| Rate for Payer: Zelis Auto |
$1,108.80
|
| Rate for Payer: Zelis Worker's Compensation |
$756.76
|
|
|
LAPARO RADICAL PROSTATECTOMY
|
Facility
|
IP
|
$2,860.00
|
|
|
Service Code
|
CPT 55866
|
| Hospital Charge Code |
6155866
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$780.78 |
| Max. Negotiated Rate |
$2,717.00 |
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cigna Commercial |
$2,431.00
|
| Rate for Payer: First Health Commercial |
$2,574.00
|
| Rate for Payer: First Health Workers Compensation |
$1,104.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,574.00
|
| Rate for Payer: GEHA Commercial |
$2,002.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,574.00
|
| Rate for Payer: Multiplan All |
$2,602.60
|
| Rate for Payer: OMNI Networks Commercial |
$2,002.00
|
| Rate for Payer: One Health Plan PPO/POS |
$2,574.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,717.00
|
| Rate for Payer: Three Rivers Provider Network All |
$2,145.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,659.80
|
| Rate for Payer: Zelis Auto |
$1,144.00
|
| Rate for Payer: Zelis Worker's Compensation |
$780.78
|
|
|
LAPARO RADICAL PROSTATECTOMY
|
Facility
|
OP
|
$2,860.00
|
|
|
Service Code
|
CPT 55866
|
| Hospital Charge Code |
6155866
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$780.78 |
| Max. Negotiated Rate |
$19,771.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$11,051.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,716.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$11,051.34
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$8,754.87
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,885.87
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cash Price |
$1,716.00
|
| Rate for Payer: Cigna Commercial |
$2,431.00
|
| Rate for Payer: First Health Commercial |
$2,574.00
|
| Rate for Payer: First Health Workers Compensation |
$1,104.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,574.00
|
| Rate for Payer: GEHA Commercial |
$2,288.00
|
| Rate for Payer: GEHA Medicare |
$9,885.87
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,574.00
|
| Rate for Payer: Humana ChoiceCare |
$10,874.46
|
| Rate for Payer: Humana Medicare Advantage |
$9,885.87
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$16,608.26
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$8,933.17
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,885.87
|
| Rate for Payer: Multiplan All |
$2,602.60
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,805.98
|
| Rate for Payer: OMNI Networks Commercial |
$2,002.00
|
| Rate for Payer: One Health Plan PPO/POS |
$2,574.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$10,314.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$8,933.17
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,885.87
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,717.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,771.74
|
| Rate for Payer: Three Rivers Provider Network All |
$2,145.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,688.15
|
| Rate for Payer: United Healthcare Managed Medicaid |
$8,933.17
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,885.87
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,659.80
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$9,885.87
|
| Rate for Payer: Zelis Auto |
$1,144.00
|
| Rate for Payer: Zelis Medicare |
$8,402.99
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$11,863.04
|
| Rate for Payer: Zelis Worker's Compensation |
$780.78
|
|
|
LAPARO REMOVAL DONOR KIDNEY
|
Facility
|
IP
|
$3,363.00
|
|
|
Service Code
|
CPT 50547
|
| Hospital Charge Code |
6150547
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$918.10 |
| Max. Negotiated Rate |
$3,194.85 |
| Rate for Payer: Cash Price |
$2,017.80
|
| Rate for Payer: Cigna Commercial |
$2,858.55
|
| Rate for Payer: First Health Commercial |
$3,026.70
|
| Rate for Payer: First Health Workers Compensation |
$1,298.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,026.70
|
| Rate for Payer: GEHA Commercial |
$2,354.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,026.70
|
| Rate for Payer: Multiplan All |
$3,060.33
|
| Rate for Payer: OMNI Networks Commercial |
$2,354.10
|
| Rate for Payer: One Health Plan PPO/POS |
$3,026.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,194.85
|
| Rate for Payer: Three Rivers Provider Network All |
$2,522.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,127.59
|
| Rate for Payer: Zelis Auto |
$1,345.20
|
| Rate for Payer: Zelis Worker's Compensation |
$918.10
|
|
|
LAPARO REMOVAL DONOR KIDNEY
|
Facility
|
OP
|
$3,363.00
|
|
|
Service Code
|
CPT 50547
|
| Hospital Charge Code |
6150547
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$840.75 |
| Max. Negotiated Rate |
$3,194.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,017.80
|
| Rate for Payer: Cash Price |
$2,017.80
|
| Rate for Payer: Cigna Commercial |
$2,858.55
|
| Rate for Payer: First Health Commercial |
$3,026.70
|
| Rate for Payer: First Health Workers Compensation |
$1,298.45
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,026.70
|
| Rate for Payer: GEHA Commercial |
$2,690.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,026.70
|
| Rate for Payer: Humana ChoiceCare |
$874.38
|
| Rate for Payer: Multiplan All |
$3,060.33
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,017.80
|
| Rate for Payer: OMNI Networks Commercial |
$2,354.10
|
| Rate for Payer: One Health Plan PPO/POS |
$3,026.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,194.85
|
| Rate for Payer: Three Rivers Provider Network All |
$2,522.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,959.44
|
| Rate for Payer: United Healthcare Managed Medicaid |
$840.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,127.59
|
| Rate for Payer: Zelis Auto |
$1,345.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,681.50
|
| Rate for Payer: Zelis Worker's Compensation |
$918.10
|
|
|
LAPARO REMOVE W/URETER
|
Facility
|
OP
|
$2,789.00
|
|
|
Service Code
|
CPT 50548
|
| Hospital Charge Code |
6150548
|
|
Hospital Revenue Code
|
975
|
| 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
|
|
|
LAPARO REMOVE W/URETER
|
Facility
|
IP
|
$2,789.00
|
|
|
Service Code
|
CPT 50548
|
| Hospital Charge Code |
6150548
|
|
Hospital Revenue Code
|
975
|
| 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
|
|
|
LAPAROSCOPIC CHOLECYSTECTOMY
|
Facility
|
IP
|
$2,106.00
|
|
|
Service Code
|
CPT 47562
|
| Hospital Charge Code |
6147562
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$574.94 |
| Max. Negotiated Rate |
$2,000.70 |
| Rate for Payer: Cash Price |
$1,263.60
|
| Rate for Payer: Cigna Commercial |
$1,790.10
|
| Rate for Payer: First Health Commercial |
$1,895.40
|
| Rate for Payer: First Health Workers Compensation |
$813.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,895.40
|
| Rate for Payer: GEHA Commercial |
$1,474.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,895.40
|
| Rate for Payer: Multiplan All |
$1,916.46
|
| Rate for Payer: OMNI Networks Commercial |
$1,474.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,895.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,000.70
|
| Rate for Payer: Three Rivers Provider Network All |
$1,579.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,958.58
|
| Rate for Payer: Zelis Auto |
$842.40
|
| Rate for Payer: Zelis Worker's Compensation |
$574.94
|
|
|
LAPAROSCOPIC CHOLECYSTECTOMY
|
Facility
|
OP
|
$2,106.00
|
|
|
Service Code
|
CPT 47562
|
| Hospital Charge Code |
6147562
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$574.94 |
| Max. Negotiated Rate |
$11,079.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,735.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,263.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,735.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,751.82
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,539.96
|
| Rate for Payer: Cash Price |
$1,263.60
|
| Rate for Payer: Cash Price |
$1,263.60
|
| Rate for Payer: Cigna Commercial |
$1,790.10
|
| Rate for Payer: First Health Commercial |
$1,895.40
|
| Rate for Payer: First Health Workers Compensation |
$813.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,895.40
|
| Rate for Payer: GEHA Commercial |
$1,684.80
|
| Rate for Payer: GEHA Medicare |
$5,539.96
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,895.40
|
| Rate for Payer: Humana ChoiceCare |
$6,093.96
|
| Rate for Payer: Humana Medicare Advantage |
$5,539.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$9,307.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,828.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,539.96
|
| Rate for Payer: Multiplan All |
$1,916.46
|
| Rate for Payer: New Mexico Health Connections Medicare |
$9,417.93
|
| Rate for Payer: OMNI Networks Commercial |
$1,474.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,895.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,420.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,828.23
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,539.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,000.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,079.92
|
| Rate for Payer: Three Rivers Provider Network All |
$1,579.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,429.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,828.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,539.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,958.58
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,539.96
|
| Rate for Payer: Zelis Auto |
$842.40
|
| Rate for Payer: Zelis Medicare |
$4,708.97
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,647.95
|
| Rate for Payer: Zelis Worker's Compensation |
$574.94
|
|
|
LAPAROSCOPIC NEPHRECTOMY
|
Facility
|
OP
|
$2,488.00
|
|
|
Service Code
|
CPT 50546
|
| Hospital Charge Code |
6150546
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$622.00 |
| Max. Negotiated Rate |
$2,363.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,492.80
|
| Rate for Payer: Cash Price |
$1,492.80
|
| Rate for Payer: Cigna Commercial |
$2,114.80
|
| Rate for Payer: First Health Commercial |
$2,239.20
|
| Rate for Payer: First Health Workers Compensation |
$960.62
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,239.20
|
| Rate for Payer: GEHA Commercial |
$1,990.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,239.20
|
| Rate for Payer: Humana ChoiceCare |
$646.88
|
| Rate for Payer: Multiplan All |
$2,264.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,492.80
|
| Rate for Payer: OMNI Networks Commercial |
$1,741.60
|
| Rate for Payer: One Health Plan PPO/POS |
$2,239.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,363.60
|
| Rate for Payer: Three Rivers Provider Network All |
$1,866.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,189.44
|
| Rate for Payer: United Healthcare Managed Medicaid |
$622.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,313.84
|
| Rate for Payer: Zelis Auto |
$995.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,244.00
|
| Rate for Payer: Zelis Worker's Compensation |
$679.22
|
|
|
LAPAROSCOPIC NEPHRECTOMY
|
Facility
|
IP
|
$2,488.00
|
|
|
Service Code
|
CPT 50546
|
| Hospital Charge Code |
6150546
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$679.22 |
| Max. Negotiated Rate |
$2,363.60 |
| Rate for Payer: Cash Price |
$1,492.80
|
| Rate for Payer: Cigna Commercial |
$2,114.80
|
| Rate for Payer: First Health Commercial |
$2,239.20
|
| Rate for Payer: First Health Workers Compensation |
$960.62
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,239.20
|
| Rate for Payer: GEHA Commercial |
$1,741.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,239.20
|
| Rate for Payer: Multiplan All |
$2,264.08
|
| Rate for Payer: OMNI Networks Commercial |
$1,741.60
|
| Rate for Payer: One Health Plan PPO/POS |
$2,239.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,363.60
|
| Rate for Payer: Three Rivers Provider Network All |
$1,866.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,313.84
|
| Rate for Payer: Zelis Auto |
$995.20
|
| Rate for Payer: Zelis Worker's Compensation |
$679.22
|
|
|
LAPAROSCOPIC PROC
|
Facility
|
IP
|
$2,380.00
|
|
|
Service Code
|
CPT 45400
|
| Hospital Charge Code |
6145400
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$649.74 |
| Max. Negotiated Rate |
$2,261.00 |
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cigna Commercial |
$2,023.00
|
| Rate for Payer: First Health Commercial |
$2,142.00
|
| Rate for Payer: First Health Workers Compensation |
$918.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,142.00
|
| Rate for Payer: GEHA Commercial |
$1,666.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,142.00
|
| Rate for Payer: Multiplan All |
$2,165.80
|
| Rate for Payer: OMNI Networks Commercial |
$1,666.00
|
| Rate for Payer: One Health Plan PPO/POS |
$2,142.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,261.00
|
| Rate for Payer: Three Rivers Provider Network All |
$1,785.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,213.40
|
| Rate for Payer: Zelis Auto |
$952.00
|
| Rate for Payer: Zelis Worker's Compensation |
$649.74
|
|
|
LAPAROSCOPIC PROC
|
Facility
|
OP
|
$2,380.00
|
|
|
Service Code
|
CPT 45400
|
| Hospital Charge Code |
6145400
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$595.00 |
| Max. Negotiated Rate |
$2,261.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,428.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cigna Commercial |
$2,023.00
|
| Rate for Payer: First Health Commercial |
$2,142.00
|
| Rate for Payer: First Health Workers Compensation |
$918.92
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,142.00
|
| Rate for Payer: GEHA Commercial |
$1,904.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,142.00
|
| Rate for Payer: Humana ChoiceCare |
$618.80
|
| Rate for Payer: Multiplan All |
$2,165.80
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,428.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,666.00
|
| Rate for Payer: One Health Plan PPO/POS |
$2,142.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,261.00
|
| Rate for Payer: Three Rivers Provider Network All |
$1,785.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,094.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$595.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,213.40
|
| Rate for Payer: Zelis Auto |
$952.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,190.00
|
| Rate for Payer: Zelis Worker's Compensation |
$649.74
|
|
|
LAPAROSCOPY ADRENALECTOMY
|
Facility
|
IP
|
$2,502.00
|
|
|
Service Code
|
CPT 60650
|
| Hospital Charge Code |
6160650
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$683.05 |
| Max. Negotiated Rate |
$2,376.90 |
| Rate for Payer: Cash Price |
$1,501.20
|
| Rate for Payer: Cigna Commercial |
$2,126.70
|
| Rate for Payer: First Health Commercial |
$2,251.80
|
| Rate for Payer: First Health Workers Compensation |
$966.02
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,251.80
|
| Rate for Payer: GEHA Commercial |
$1,751.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,251.80
|
| Rate for Payer: Multiplan All |
$2,276.82
|
| Rate for Payer: OMNI Networks Commercial |
$1,751.40
|
| Rate for Payer: One Health Plan PPO/POS |
$2,251.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,376.90
|
| Rate for Payer: Three Rivers Provider Network All |
$1,876.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,326.86
|
| Rate for Payer: Zelis Auto |
$1,000.80
|
| Rate for Payer: Zelis Worker's Compensation |
$683.05
|
|
|
LAPAROSCOPY ADRENALECTOMY
|
Facility
|
OP
|
$2,502.00
|
|
|
Service Code
|
CPT 60650
|
| Hospital Charge Code |
6160650
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$625.50 |
| Max. Negotiated Rate |
$2,376.90 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,501.20
|
| Rate for Payer: Cash Price |
$1,501.20
|
| Rate for Payer: Cigna Commercial |
$2,126.70
|
| Rate for Payer: First Health Commercial |
$2,251.80
|
| Rate for Payer: First Health Workers Compensation |
$966.02
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,251.80
|
| Rate for Payer: GEHA Commercial |
$2,001.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,251.80
|
| Rate for Payer: Humana ChoiceCare |
$650.52
|
| Rate for Payer: Multiplan All |
$2,276.82
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,501.20
|
| Rate for Payer: OMNI Networks Commercial |
$1,751.40
|
| Rate for Payer: One Health Plan PPO/POS |
$2,251.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,376.90
|
| Rate for Payer: Three Rivers Provider Network All |
$1,876.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,201.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$625.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,326.86
|
| Rate for Payer: Zelis Auto |
$1,000.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,251.00
|
| Rate for Payer: Zelis Worker's Compensation |
$683.05
|
|
|
LAPAROSCOPY APPENDECTOMY
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 44970
|
| Hospital Charge Code |
6144970
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$343.98 |
| Max. Negotiated Rate |
$1,197.00 |
| Rate for Payer: Cash Price |
$756.00
|
| Rate for Payer: Cigna Commercial |
$1,071.00
|
| Rate for Payer: First Health Commercial |
$1,134.00
|
| Rate for Payer: First Health Workers Compensation |
$486.49
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,134.00
|
| Rate for Payer: GEHA Commercial |
$882.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,134.00
|
| Rate for Payer: Multiplan All |
$1,146.60
|
| Rate for Payer: OMNI Networks Commercial |
$882.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,134.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,197.00
|
| Rate for Payer: Three Rivers Provider Network All |
$945.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,171.80
|
| Rate for Payer: Zelis Auto |
$504.00
|
| Rate for Payer: Zelis Worker's Compensation |
$343.98
|
|
|
LAPAROSCOPY APPENDECTOMY
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 44970
|
| Hospital Charge Code |
6144970
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$343.98 |
| Max. Negotiated Rate |
$11,079.92 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,735.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$756.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,735.95
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,751.82
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5,539.96
|
| Rate for Payer: Cash Price |
$756.00
|
| Rate for Payer: Cash Price |
$756.00
|
| Rate for Payer: Cigna Commercial |
$1,071.00
|
| Rate for Payer: First Health Commercial |
$1,134.00
|
| Rate for Payer: First Health Workers Compensation |
$486.49
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,134.00
|
| Rate for Payer: GEHA Commercial |
$1,008.00
|
| Rate for Payer: GEHA Medicare |
$5,539.96
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,134.00
|
| Rate for Payer: Humana ChoiceCare |
$6,093.96
|
| Rate for Payer: Humana Medicare Advantage |
$5,539.96
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$9,307.13
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,828.23
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5,539.96
|
| Rate for Payer: Multiplan All |
$1,146.60
|
| Rate for Payer: New Mexico Health Connections Medicare |
$9,417.93
|
| Rate for Payer: OMNI Networks Commercial |
$882.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,134.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,420.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,828.23
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5,539.96
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,197.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,079.92
|
| Rate for Payer: Three Rivers Provider Network All |
$945.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,429.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,828.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5,539.96
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,171.80
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,539.96
|
| Rate for Payer: Zelis Auto |
$504.00
|
| Rate for Payer: Zelis Medicare |
$4,708.97
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6,647.95
|
| Rate for Payer: Zelis Worker's Compensation |
$343.98
|
|
