|
LAP, JEJUNOSTOMY
|
Facility
|
IP
|
$1,369.00
|
|
|
Service Code
|
CPT 44186
|
| Hospital Charge Code |
6144186
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$373.74 |
| Max. Negotiated Rate |
$1,300.55 |
| Rate for Payer: Cash Price |
$821.40
|
| Rate for Payer: Cigna Commercial |
$1,163.65
|
| Rate for Payer: First Health Commercial |
$1,232.10
|
| Rate for Payer: First Health Workers Compensation |
$528.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,232.10
|
| Rate for Payer: GEHA Commercial |
$958.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,232.10
|
| Rate for Payer: Multiplan All |
$1,245.79
|
| Rate for Payer: OMNI Networks Commercial |
$958.30
|
| Rate for Payer: One Health Plan PPO/POS |
$1,232.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,300.55
|
| Rate for Payer: Three Rivers Provider Network All |
$1,026.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,273.17
|
| Rate for Payer: Zelis Auto |
$547.60
|
| Rate for Payer: Zelis Worker's Compensation |
$373.74
|
|
|
LAP, JEJUNOSTOMY
|
Facility
|
OP
|
$1,369.00
|
|
|
Service Code
|
CPT 44186
|
| Hospital Charge Code |
6144186
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$373.74 |
| 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 |
$821.40
|
| 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 |
$821.40
|
| Rate for Payer: Cash Price |
$821.40
|
| Rate for Payer: Cigna Commercial |
$1,163.65
|
| Rate for Payer: First Health Commercial |
$1,232.10
|
| Rate for Payer: First Health Workers Compensation |
$528.57
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,232.10
|
| Rate for Payer: GEHA Commercial |
$1,095.20
|
| Rate for Payer: GEHA Medicare |
$5,539.96
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,232.10
|
| 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 |
$1,245.79
|
| Rate for Payer: New Mexico Health Connections Medicare |
$9,417.93
|
| Rate for Payer: OMNI Networks Commercial |
$958.30
|
| Rate for Payer: One Health Plan PPO/POS |
$1,232.10
|
| 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 |
$1,300.55
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$11,079.92
|
| Rate for Payer: Three Rivers Provider Network All |
$1,026.75
|
| 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 |
$1,273.17
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5,539.96
|
| Rate for Payer: Zelis Auto |
$547.60
|
| 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 |
$373.74
|
|
|
LAP, MOBIL SPLENIC FL ADD-ON
|
Facility
|
OP
|
$599.00
|
|
|
Service Code
|
CPT 44213
|
| Hospital Charge Code |
6144213
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$149.75 |
| Max. Negotiated Rate |
$569.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$359.40
|
| Rate for Payer: Cash Price |
$359.40
|
| Rate for Payer: Cigna Commercial |
$509.15
|
| Rate for Payer: First Health Commercial |
$539.10
|
| Rate for Payer: First Health Workers Compensation |
$231.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$539.10
|
| Rate for Payer: GEHA Commercial |
$479.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$539.10
|
| Rate for Payer: Humana ChoiceCare |
$155.74
|
| Rate for Payer: Multiplan All |
$545.09
|
| Rate for Payer: New Mexico Health Connections Medicare |
$359.40
|
| Rate for Payer: OMNI Networks Commercial |
$419.30
|
| Rate for Payer: One Health Plan PPO/POS |
$539.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$569.05
|
| Rate for Payer: Three Rivers Provider Network All |
$449.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$527.12
|
| Rate for Payer: United Healthcare Managed Medicaid |
$149.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$557.07
|
| Rate for Payer: Zelis Auto |
$239.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$299.50
|
| Rate for Payer: Zelis Worker's Compensation |
$163.53
|
|
|
LAP, MOBIL SPLENIC FL ADD-ON
|
Facility
|
IP
|
$599.00
|
|
|
Service Code
|
CPT 44213
|
| Hospital Charge Code |
6144213
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$163.53 |
| Max. Negotiated Rate |
$569.05 |
| Rate for Payer: Cash Price |
$359.40
|
| Rate for Payer: Cigna Commercial |
$509.15
|
| Rate for Payer: First Health Commercial |
$539.10
|
| Rate for Payer: First Health Workers Compensation |
$231.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$539.10
|
| Rate for Payer: GEHA Commercial |
$419.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$539.10
|
| Rate for Payer: Multiplan All |
$545.09
|
| Rate for Payer: OMNI Networks Commercial |
$419.30
|
| Rate for Payer: One Health Plan PPO/POS |
$539.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$569.05
|
| Rate for Payer: Three Rivers Provider Network All |
$449.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$557.07
|
| Rate for Payer: Zelis Auto |
$239.60
|
| Rate for Payer: Zelis Worker's Compensation |
$163.53
|
|
|
LAP MYOTOMY HELLER
|
Facility
|
OP
|
$2,731.00
|
|
|
Service Code
|
CPT 43279
|
| Hospital Charge Code |
6143279
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$682.75 |
| Max. Negotiated Rate |
$2,594.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,638.60
|
| Rate for Payer: Cash Price |
$1,638.60
|
| Rate for Payer: Cigna Commercial |
$2,321.35
|
| Rate for Payer: First Health Commercial |
$2,457.90
|
| Rate for Payer: First Health Workers Compensation |
$1,054.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,457.90
|
| Rate for Payer: GEHA Commercial |
$2,184.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,457.90
|
| Rate for Payer: Humana ChoiceCare |
$710.06
|
| Rate for Payer: Multiplan All |
$2,485.21
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,638.60
|
| Rate for Payer: OMNI Networks Commercial |
$1,911.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,457.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,594.45
|
| Rate for Payer: Three Rivers Provider Network All |
$2,048.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,403.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$682.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,539.83
|
| Rate for Payer: Zelis Auto |
$1,092.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,365.50
|
| Rate for Payer: Zelis Worker's Compensation |
$745.56
|
|
|
LAP MYOTOMY HELLER
|
Facility
|
IP
|
$2,731.00
|
|
|
Service Code
|
CPT 43279
|
| Hospital Charge Code |
6143279
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$745.56 |
| Max. Negotiated Rate |
$2,594.45 |
| Rate for Payer: Cash Price |
$1,638.60
|
| Rate for Payer: Cigna Commercial |
$2,321.35
|
| Rate for Payer: First Health Commercial |
$2,457.90
|
| Rate for Payer: First Health Workers Compensation |
$1,054.44
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,457.90
|
| Rate for Payer: GEHA Commercial |
$1,911.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,457.90
|
| Rate for Payer: Multiplan All |
$2,485.21
|
| Rate for Payer: OMNI Networks Commercial |
$1,911.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,457.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,594.45
|
| Rate for Payer: Three Rivers Provider Network All |
$2,048.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,539.83
|
| Rate for Payer: Zelis Auto |
$1,092.40
|
| Rate for Payer: Zelis Worker's Compensation |
$745.56
|
|
|
LAP PARAESOPHAG HERN REPAIR
|
Facility
|
OP
|
$3,265.00
|
|
|
Service Code
|
CPT 43281
|
| Hospital Charge Code |
6143281
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$891.35 |
| Max. Negotiated Rate |
$19,771.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7,228.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,959.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7,228.27
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$5,726.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,885.87
|
| Rate for Payer: Cash Price |
$1,959.00
|
| Rate for Payer: Cash Price |
$1,959.00
|
| Rate for Payer: Cigna Commercial |
$2,775.25
|
| Rate for Payer: First Health Commercial |
$2,938.50
|
| Rate for Payer: First Health Workers Compensation |
$1,260.62
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,938.50
|
| Rate for Payer: GEHA Commercial |
$2,612.00
|
| Rate for Payer: GEHA Medicare |
$9,885.87
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,938.50
|
| 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 |
$5,842.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,885.87
|
| Rate for Payer: Multiplan All |
$2,971.15
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,805.98
|
| Rate for Payer: OMNI Networks Commercial |
$2,285.50
|
| Rate for Payer: One Health Plan PPO/POS |
$2,938.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$6,746.39
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$5,842.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,885.87
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,101.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,771.74
|
| Rate for Payer: Three Rivers Provider Network All |
$2,448.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,688.15
|
| Rate for Payer: United Healthcare Managed Medicaid |
$5,842.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,885.87
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,036.45
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$9,885.87
|
| Rate for Payer: Zelis Auto |
$1,306.00
|
| 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 |
$891.35
|
|
|
LAP PARAESOPHAG HERN REPAIR
|
Facility
|
IP
|
$3,265.00
|
|
|
Service Code
|
CPT 43281
|
| Hospital Charge Code |
6143281
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$891.35 |
| Max. Negotiated Rate |
$3,101.75 |
| Rate for Payer: Cash Price |
$1,959.00
|
| Rate for Payer: Cigna Commercial |
$2,775.25
|
| Rate for Payer: First Health Commercial |
$2,938.50
|
| Rate for Payer: First Health Workers Compensation |
$1,260.62
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,938.50
|
| Rate for Payer: GEHA Commercial |
$2,285.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,938.50
|
| Rate for Payer: Multiplan All |
$2,971.15
|
| Rate for Payer: OMNI Networks Commercial |
$2,285.50
|
| Rate for Payer: One Health Plan PPO/POS |
$2,938.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,101.75
|
| Rate for Payer: Three Rivers Provider Network All |
$2,448.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,036.45
|
| Rate for Payer: Zelis Auto |
$1,306.00
|
| Rate for Payer: Zelis Worker's Compensation |
$891.35
|
|
|
LAP PARAESOPH HER RPR W/MESH
|
Facility
|
OP
|
$3,672.00
|
|
|
Service Code
|
CPT 43282
|
| Hospital Charge Code |
6143282
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,002.46 |
| 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 |
$2,203.20
|
| 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 |
$2,203.20
|
| Rate for Payer: Cash Price |
$2,203.20
|
| Rate for Payer: Cigna Commercial |
$3,121.20
|
| Rate for Payer: First Health Commercial |
$3,304.80
|
| Rate for Payer: First Health Workers Compensation |
$1,417.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,304.80
|
| Rate for Payer: GEHA Commercial |
$2,937.60
|
| Rate for Payer: GEHA Medicare |
$9,885.87
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,304.80
|
| 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 |
$3,341.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,805.98
|
| Rate for Payer: OMNI Networks Commercial |
$2,570.40
|
| Rate for Payer: One Health Plan PPO/POS |
$3,304.80
|
| 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 |
$3,488.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,771.74
|
| Rate for Payer: Three Rivers Provider Network All |
$2,754.00
|
| 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 |
$3,414.96
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$9,885.87
|
| Rate for Payer: Zelis Auto |
$1,468.80
|
| 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 |
$1,002.46
|
|
|
LAP PARAESOPH HER RPR W/MESH
|
Facility
|
IP
|
$3,672.00
|
|
|
Service Code
|
CPT 43282
|
| Hospital Charge Code |
6143282
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,002.46 |
| Max. Negotiated Rate |
$3,488.40 |
| Rate for Payer: Cash Price |
$2,203.20
|
| Rate for Payer: Cigna Commercial |
$3,121.20
|
| Rate for Payer: First Health Commercial |
$3,304.80
|
| Rate for Payer: First Health Workers Compensation |
$1,417.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,304.80
|
| Rate for Payer: GEHA Commercial |
$2,570.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,304.80
|
| Rate for Payer: Multiplan All |
$3,341.52
|
| Rate for Payer: OMNI Networks Commercial |
$2,570.40
|
| Rate for Payer: One Health Plan PPO/POS |
$3,304.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,488.40
|
| Rate for Payer: Three Rivers Provider Network All |
$2,754.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,414.96
|
| Rate for Payer: Zelis Auto |
$1,468.80
|
| Rate for Payer: Zelis Worker's Compensation |
$1,002.46
|
|
|
LAP PART COLECTOMY W/STOMA
|
Facility
|
IP
|
$3,692.00
|
|
|
Service Code
|
CPT 44206
|
| Hospital Charge Code |
6144206
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,007.92 |
| Max. Negotiated Rate |
$3,507.40 |
| Rate for Payer: Cash Price |
$2,215.20
|
| Rate for Payer: Cigna Commercial |
$3,138.20
|
| Rate for Payer: First Health Commercial |
$3,322.80
|
| Rate for Payer: First Health Workers Compensation |
$1,425.48
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,322.80
|
| Rate for Payer: GEHA Commercial |
$2,584.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,322.80
|
| Rate for Payer: Multiplan All |
$3,359.72
|
| Rate for Payer: OMNI Networks Commercial |
$2,584.40
|
| Rate for Payer: One Health Plan PPO/POS |
$3,322.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,507.40
|
| Rate for Payer: Three Rivers Provider Network All |
$2,769.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,433.56
|
| Rate for Payer: Zelis Auto |
$1,476.80
|
| Rate for Payer: Zelis Worker's Compensation |
$1,007.92
|
|
|
LAP PART COLECTOMY W/STOMA
|
Facility
|
OP
|
$3,692.00
|
|
|
Service Code
|
CPT 44206
|
| Hospital Charge Code |
6144206
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$923.00 |
| Max. Negotiated Rate |
$3,507.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,215.20
|
| Rate for Payer: Cash Price |
$2,215.20
|
| Rate for Payer: Cigna Commercial |
$3,138.20
|
| Rate for Payer: First Health Commercial |
$3,322.80
|
| Rate for Payer: First Health Workers Compensation |
$1,425.48
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,322.80
|
| Rate for Payer: GEHA Commercial |
$2,953.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,322.80
|
| Rate for Payer: Humana ChoiceCare |
$959.92
|
| Rate for Payer: Multiplan All |
$3,359.72
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,215.20
|
| Rate for Payer: OMNI Networks Commercial |
$2,584.40
|
| Rate for Payer: One Health Plan PPO/POS |
$3,322.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,507.40
|
| Rate for Payer: Three Rivers Provider Network All |
$2,769.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,248.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$923.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,433.56
|
| Rate for Payer: Zelis Auto |
$1,476.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,846.00
|
| Rate for Payer: Zelis Worker's Compensation |
$1,007.92
|
|
|
LAP, PLACE GASTR ADJUST BAND
|
Facility
|
OP
|
$2,350.00
|
|
|
Service Code
|
CPT 43770
|
| Hospital Charge Code |
6143770
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$641.55 |
| Max. Negotiated Rate |
$19,771.74 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$14,711.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,410.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$14,711.64
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$11,654.56
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$9,885.87
|
| Rate for Payer: Cash Price |
$1,410.00
|
| Rate for Payer: Cash Price |
$1,410.00
|
| Rate for Payer: Cigna Commercial |
$1,997.50
|
| Rate for Payer: First Health Commercial |
$2,115.00
|
| Rate for Payer: First Health Workers Compensation |
$907.34
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,115.00
|
| Rate for Payer: GEHA Commercial |
$1,880.00
|
| Rate for Payer: GEHA Medicare |
$9,885.87
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,115.00
|
| 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 |
$11,891.91
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$9,885.87
|
| Rate for Payer: Multiplan All |
$2,138.50
|
| Rate for Payer: New Mexico Health Connections Medicare |
$16,805.98
|
| Rate for Payer: OMNI Networks Commercial |
$1,645.00
|
| Rate for Payer: One Health Plan PPO/POS |
$2,115.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$13,730.86
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$11,891.91
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$9,885.87
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,232.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$19,771.74
|
| Rate for Payer: Three Rivers Provider Network All |
$1,762.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,688.15
|
| Rate for Payer: United Healthcare Managed Medicaid |
$11,891.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,885.87
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,185.50
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$9,885.87
|
| Rate for Payer: Zelis Auto |
$940.00
|
| 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 |
$641.55
|
|
|
LAP, PLACE GASTR ADJUST BAND
|
Facility
|
IP
|
$2,350.00
|
|
|
Service Code
|
CPT 43770
|
| Hospital Charge Code |
6143770
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$641.55 |
| Max. Negotiated Rate |
$2,232.50 |
| Rate for Payer: Cash Price |
$1,410.00
|
| Rate for Payer: Cigna Commercial |
$1,997.50
|
| Rate for Payer: First Health Commercial |
$2,115.00
|
| Rate for Payer: First Health Workers Compensation |
$907.34
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,115.00
|
| Rate for Payer: GEHA Commercial |
$1,645.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,115.00
|
| Rate for Payer: Multiplan All |
$2,138.50
|
| Rate for Payer: OMNI Networks Commercial |
$1,645.00
|
| Rate for Payer: One Health Plan PPO/POS |
$2,115.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,232.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,762.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,185.50
|
| Rate for Payer: Zelis Auto |
$940.00
|
| Rate for Payer: Zelis Worker's Compensation |
$641.55
|
|
|
LAP PROCTOPEXY W/SIG RESECT
|
Facility
|
IP
|
$3,181.00
|
|
|
Service Code
|
CPT 45402
|
| Hospital Charge Code |
6145402
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$868.41 |
| Max. Negotiated Rate |
$3,021.95 |
| Rate for Payer: Cash Price |
$1,908.60
|
| Rate for Payer: Cigna Commercial |
$2,703.85
|
| Rate for Payer: First Health Commercial |
$2,862.90
|
| Rate for Payer: First Health Workers Compensation |
$1,228.18
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,862.90
|
| Rate for Payer: GEHA Commercial |
$2,226.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,862.90
|
| Rate for Payer: Multiplan All |
$2,894.71
|
| Rate for Payer: OMNI Networks Commercial |
$2,226.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,862.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,021.95
|
| Rate for Payer: Three Rivers Provider Network All |
$2,385.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,958.33
|
| Rate for Payer: Zelis Auto |
$1,272.40
|
| Rate for Payer: Zelis Worker's Compensation |
$868.41
|
|
|
LAP PROCTOPEXY W/SIG RESECT
|
Facility
|
OP
|
$3,181.00
|
|
|
Service Code
|
CPT 45402
|
| Hospital Charge Code |
6145402
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$795.25 |
| Max. Negotiated Rate |
$3,021.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,908.60
|
| Rate for Payer: Cash Price |
$1,908.60
|
| Rate for Payer: Cigna Commercial |
$2,703.85
|
| Rate for Payer: First Health Commercial |
$2,862.90
|
| Rate for Payer: First Health Workers Compensation |
$1,228.18
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,862.90
|
| Rate for Payer: GEHA Commercial |
$2,544.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,862.90
|
| Rate for Payer: Humana ChoiceCare |
$827.06
|
| Rate for Payer: Multiplan All |
$2,894.71
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,908.60
|
| Rate for Payer: OMNI Networks Commercial |
$2,226.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,862.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,021.95
|
| Rate for Payer: Three Rivers Provider Network All |
$2,385.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,799.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$795.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,958.33
|
| Rate for Payer: Zelis Auto |
$1,272.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,590.50
|
| Rate for Payer: Zelis Worker's Compensation |
$868.41
|
|
|
LAP REMOV ADJ GAST BAND/PORT
|
Facility
|
IP
|
$2,018.00
|
|
|
Service Code
|
CPT 43774
|
| Hospital Charge Code |
6143774
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$550.91 |
| Max. Negotiated Rate |
$1,917.10 |
| Rate for Payer: Cash Price |
$1,210.80
|
| Rate for Payer: Cigna Commercial |
$1,715.30
|
| Rate for Payer: First Health Commercial |
$1,816.20
|
| Rate for Payer: First Health Workers Compensation |
$779.15
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,816.20
|
| Rate for Payer: GEHA Commercial |
$1,412.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,816.20
|
| Rate for Payer: Multiplan All |
$1,836.38
|
| Rate for Payer: OMNI Networks Commercial |
$1,412.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,816.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,917.10
|
| Rate for Payer: Three Rivers Provider Network All |
$1,513.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,876.74
|
| Rate for Payer: Zelis Auto |
$807.20
|
| Rate for Payer: Zelis Worker's Compensation |
$550.91
|
|
|
LAP REMOV ADJ GAST BAND/PORT
|
Facility
|
OP
|
$2,018.00
|
|
|
Service Code
|
CPT 43774
|
| Hospital Charge Code |
6143774
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$550.91 |
| Max. Negotiated Rate |
$7,225.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,991.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,210.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,991.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,162.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,612.55
|
| Rate for Payer: Cash Price |
$1,210.80
|
| Rate for Payer: Cash Price |
$1,210.80
|
| Rate for Payer: Cigna Commercial |
$1,715.30
|
| Rate for Payer: First Health Commercial |
$1,816.20
|
| Rate for Payer: First Health Workers Compensation |
$779.15
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,816.20
|
| Rate for Payer: GEHA Commercial |
$1,614.40
|
| Rate for Payer: GEHA Medicare |
$3,612.55
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,816.20
|
| Rate for Payer: Humana ChoiceCare |
$3,973.80
|
| Rate for Payer: Humana Medicare Advantage |
$3,612.55
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$6,069.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,226.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,612.55
|
| Rate for Payer: Multiplan All |
$1,836.38
|
| Rate for Payer: New Mexico Health Connections Medicare |
$6,141.34
|
| Rate for Payer: OMNI Networks Commercial |
$1,412.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,816.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$3,725.60
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,226.63
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,612.55
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,917.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$7,225.10
|
| Rate for Payer: Three Rivers Provider Network All |
$1,513.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,540.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,226.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,612.55
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,876.74
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,612.55
|
| Rate for Payer: Zelis Auto |
$807.20
|
| Rate for Payer: Zelis Medicare |
$3,070.67
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,335.06
|
| Rate for Payer: Zelis Worker's Compensation |
$550.91
|
|
|
LAP REMOVAL OF RECTUM
|
Facility
|
IP
|
$4,132.00
|
|
|
Service Code
|
CPT 45395
|
| Hospital Charge Code |
6145395
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,128.04 |
| Max. Negotiated Rate |
$3,925.40 |
| Rate for Payer: Cash Price |
$2,479.20
|
| Rate for Payer: Cigna Commercial |
$3,512.20
|
| Rate for Payer: First Health Commercial |
$3,718.80
|
| Rate for Payer: First Health Workers Compensation |
$1,595.37
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,718.80
|
| Rate for Payer: GEHA Commercial |
$2,892.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,718.80
|
| Rate for Payer: Multiplan All |
$3,760.12
|
| Rate for Payer: OMNI Networks Commercial |
$2,892.40
|
| Rate for Payer: One Health Plan PPO/POS |
$3,718.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,925.40
|
| Rate for Payer: Three Rivers Provider Network All |
$3,099.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,842.76
|
| Rate for Payer: Zelis Auto |
$1,652.80
|
| Rate for Payer: Zelis Worker's Compensation |
$1,128.04
|
|
|
LAP REMOVAL OF RECTUM
|
Facility
|
OP
|
$4,132.00
|
|
|
Service Code
|
CPT 45395
|
| Hospital Charge Code |
6145395
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,033.00 |
| Max. Negotiated Rate |
$3,925.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,479.20
|
| Rate for Payer: Cash Price |
$2,479.20
|
| Rate for Payer: Cigna Commercial |
$3,512.20
|
| Rate for Payer: First Health Commercial |
$3,718.80
|
| Rate for Payer: First Health Workers Compensation |
$1,595.37
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,718.80
|
| Rate for Payer: GEHA Commercial |
$3,305.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,718.80
|
| Rate for Payer: Humana ChoiceCare |
$1,074.32
|
| Rate for Payer: Multiplan All |
$3,760.12
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,479.20
|
| Rate for Payer: OMNI Networks Commercial |
$2,892.40
|
| Rate for Payer: One Health Plan PPO/POS |
$3,718.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$3,925.40
|
| Rate for Payer: Three Rivers Provider Network All |
$3,099.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,636.16
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,033.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$3,842.76
|
| Rate for Payer: Zelis Auto |
$1,652.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,066.00
|
| Rate for Payer: Zelis Worker's Compensation |
$1,128.04
|
|
|
LAP, REMOVE ADJUST GAST BAND
|
Facility
|
OP
|
$1,995.00
|
|
|
Service Code
|
CPT 43772
|
| Hospital Charge Code |
6143772
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$544.63 |
| Max. Negotiated Rate |
$7,225.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,991.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,197.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,991.71
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,162.23
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,612.55
|
| Rate for Payer: Cash Price |
$1,197.00
|
| Rate for Payer: Cash Price |
$1,197.00
|
| Rate for Payer: Cigna Commercial |
$1,695.75
|
| Rate for Payer: First Health Commercial |
$1,795.50
|
| Rate for Payer: First Health Workers Compensation |
$770.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,795.50
|
| Rate for Payer: GEHA Commercial |
$1,596.00
|
| Rate for Payer: GEHA Medicare |
$3,612.55
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,795.50
|
| Rate for Payer: Humana ChoiceCare |
$3,973.80
|
| Rate for Payer: Humana Medicare Advantage |
$3,612.55
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$6,069.08
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,226.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,612.55
|
| Rate for Payer: Multiplan All |
$1,815.45
|
| Rate for Payer: New Mexico Health Connections Medicare |
$6,141.34
|
| Rate for Payer: OMNI Networks Commercial |
$1,396.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,795.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$3,725.60
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,226.63
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,612.55
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,895.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$7,225.10
|
| Rate for Payer: Three Rivers Provider Network All |
$1,496.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,540.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,226.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,612.55
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,855.35
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,612.55
|
| Rate for Payer: Zelis Auto |
$798.00
|
| Rate for Payer: Zelis Medicare |
$3,070.67
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$4,335.06
|
| Rate for Payer: Zelis Worker's Compensation |
$544.63
|
|
|
LAP, REMOVE ADJUST GAST BAND
|
Facility
|
IP
|
$1,995.00
|
|
|
Service Code
|
CPT 43772
|
| Hospital Charge Code |
6143772
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$544.63 |
| Max. Negotiated Rate |
$1,895.25 |
| Rate for Payer: Cash Price |
$1,197.00
|
| Rate for Payer: Cigna Commercial |
$1,695.75
|
| Rate for Payer: First Health Commercial |
$1,795.50
|
| Rate for Payer: First Health Workers Compensation |
$770.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,795.50
|
| Rate for Payer: GEHA Commercial |
$1,396.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,795.50
|
| Rate for Payer: Multiplan All |
$1,815.45
|
| Rate for Payer: OMNI Networks Commercial |
$1,396.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,795.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,895.25
|
| Rate for Payer: Three Rivers Provider Network All |
$1,496.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,855.35
|
| Rate for Payer: Zelis Auto |
$798.00
|
| Rate for Payer: Zelis Worker's Compensation |
$544.63
|
|
|
LAP REMOVE RECTUM W/POUCH
|
Facility
|
IP
|
$4,498.00
|
|
|
Service Code
|
CPT 45397
|
| Hospital Charge Code |
6145397
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,227.95 |
| Max. Negotiated Rate |
$4,273.10 |
| Rate for Payer: Cash Price |
$2,698.80
|
| Rate for Payer: Cigna Commercial |
$3,823.30
|
| Rate for Payer: First Health Commercial |
$4,048.20
|
| Rate for Payer: First Health Workers Compensation |
$1,736.68
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,048.20
|
| Rate for Payer: GEHA Commercial |
$3,148.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,048.20
|
| Rate for Payer: Multiplan All |
$4,093.18
|
| Rate for Payer: OMNI Networks Commercial |
$3,148.60
|
| Rate for Payer: One Health Plan PPO/POS |
$4,048.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,273.10
|
| Rate for Payer: Three Rivers Provider Network All |
$3,373.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,183.14
|
| Rate for Payer: Zelis Auto |
$1,799.20
|
| Rate for Payer: Zelis Worker's Compensation |
$1,227.95
|
|
|
LAP REMOVE RECTUM W/POUCH
|
Facility
|
OP
|
$4,498.00
|
|
|
Service Code
|
CPT 45397
|
| Hospital Charge Code |
6145397
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,124.50 |
| Max. Negotiated Rate |
$4,273.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,698.80
|
| Rate for Payer: Cash Price |
$2,698.80
|
| Rate for Payer: Cigna Commercial |
$3,823.30
|
| Rate for Payer: First Health Commercial |
$4,048.20
|
| Rate for Payer: First Health Workers Compensation |
$1,736.68
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,048.20
|
| Rate for Payer: GEHA Commercial |
$3,598.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,048.20
|
| Rate for Payer: Humana ChoiceCare |
$1,169.48
|
| Rate for Payer: Multiplan All |
$4,093.18
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,698.80
|
| Rate for Payer: OMNI Networks Commercial |
$3,148.60
|
| Rate for Payer: One Health Plan PPO/POS |
$4,048.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,273.10
|
| Rate for Payer: Three Rivers Provider Network All |
$3,373.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,958.24
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,124.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,183.14
|
| Rate for Payer: Zelis Auto |
$1,799.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,249.00
|
| Rate for Payer: Zelis Worker's Compensation |
$1,227.95
|
|
|
LAP RESECT S/INTESTINE, ADDL
|
Facility
|
IP
|
$641.00
|
|
|
Service Code
|
CPT 44203
|
| Hospital Charge Code |
6144203
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$174.99 |
| Max. Negotiated Rate |
$608.95 |
| Rate for Payer: Cash Price |
$384.60
|
| Rate for Payer: Cigna Commercial |
$544.85
|
| Rate for Payer: First Health Commercial |
$576.90
|
| Rate for Payer: First Health Workers Compensation |
$247.49
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$576.90
|
| Rate for Payer: GEHA Commercial |
$448.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$576.90
|
| Rate for Payer: Multiplan All |
$583.31
|
| Rate for Payer: OMNI Networks Commercial |
$448.70
|
| Rate for Payer: One Health Plan PPO/POS |
$576.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$608.95
|
| Rate for Payer: Three Rivers Provider Network All |
$480.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$596.13
|
| Rate for Payer: Zelis Auto |
$256.40
|
| Rate for Payer: Zelis Worker's Compensation |
$174.99
|
|
