|
ARROW MIDLINE 2L 5.5FR X 15CM/CDC 41552
|
Facility
|
OP
|
$883.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
7003026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$220.75 |
| Max. Negotiated Rate |
$838.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$529.80
|
| Rate for Payer: Cash Price |
$529.80
|
| Rate for Payer: Cash Price |
$529.80
|
| Rate for Payer: Cigna Commercial |
$750.55
|
| Rate for Payer: First Health Commercial |
$794.70
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$794.70
|
| Rate for Payer: GEHA Commercial |
$706.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$794.70
|
| Rate for Payer: Humana ChoiceCare |
$229.58
|
| Rate for Payer: Multiplan All |
$803.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$529.80
|
| Rate for Payer: OMNI Networks Commercial |
$618.10
|
| Rate for Payer: One Health Plan PPO/POS |
$794.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$838.85
|
| Rate for Payer: Three Rivers Provider Network All |
$662.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$777.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$220.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$821.19
|
| Rate for Payer: Zelis Auto |
$353.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$441.50
|
|
|
ARROW PICC KIT 1L4.5FR/CDC45541-TTS
|
Facility
|
OP
|
$1,147.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
7003028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$286.75 |
| Max. Negotiated Rate |
$1,089.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$688.20
|
| Rate for Payer: Cash Price |
$688.20
|
| Rate for Payer: Cash Price |
$688.20
|
| Rate for Payer: Cigna Commercial |
$974.95
|
| Rate for Payer: First Health Commercial |
$1,032.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,032.30
|
| Rate for Payer: GEHA Commercial |
$917.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,032.30
|
| Rate for Payer: Humana ChoiceCare |
$298.22
|
| Rate for Payer: Multiplan All |
$1,043.77
|
| Rate for Payer: New Mexico Health Connections Medicare |
$688.20
|
| Rate for Payer: OMNI Networks Commercial |
$802.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,032.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,089.65
|
| Rate for Payer: Three Rivers Provider Network All |
$860.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,009.36
|
| Rate for Payer: United Healthcare Managed Medicaid |
$286.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,066.71
|
| Rate for Payer: Zelis Auto |
$458.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$573.50
|
|
|
ARROW PICC KIT 1L4.5FR/CDC45541-TTS
|
Facility
|
IP
|
$1,147.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
7003028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$458.80 |
| Max. Negotiated Rate |
$1,089.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$917.60
|
| Rate for Payer: Cash Price |
$688.20
|
| Rate for Payer: Cash Price |
$688.20
|
| Rate for Payer: Cigna Commercial |
$974.95
|
| Rate for Payer: First Health Commercial |
$1,032.30
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,032.30
|
| Rate for Payer: GEHA Commercial |
$802.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,032.30
|
| Rate for Payer: Multiplan All |
$1,043.77
|
| Rate for Payer: OMNI Networks Commercial |
$802.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,032.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,089.65
|
| Rate for Payer: Three Rivers Provider Network All |
$860.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,066.71
|
| Rate for Payer: Zelis Auto |
$458.80
|
|
|
ARROW PICC KIT 2L 5.5FR/CDC45552-TTS
|
Facility
|
IP
|
$1,188.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
7003029
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$475.20 |
| Max. Negotiated Rate |
$1,128.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$950.40
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cigna Commercial |
$1,009.80
|
| Rate for Payer: First Health Commercial |
$1,069.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,069.20
|
| Rate for Payer: GEHA Commercial |
$831.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,069.20
|
| Rate for Payer: Multiplan All |
$1,081.08
|
| Rate for Payer: OMNI Networks Commercial |
$831.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,069.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,128.60
|
| Rate for Payer: Three Rivers Provider Network All |
$891.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,104.84
|
| Rate for Payer: Zelis Auto |
$475.20
|
|
|
ARROW PICC KIT 2L 5.5FR/CDC45552-TTS
|
Facility
|
OP
|
$1,188.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
7003029
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$297.00 |
| Max. Negotiated Rate |
$1,128.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$712.80
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cash Price |
$712.80
|
| Rate for Payer: Cigna Commercial |
$1,009.80
|
| Rate for Payer: First Health Commercial |
$1,069.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,069.20
|
| Rate for Payer: GEHA Commercial |
$950.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,069.20
|
| Rate for Payer: Humana ChoiceCare |
$308.88
|
| Rate for Payer: Multiplan All |
$1,081.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$712.80
|
| Rate for Payer: OMNI Networks Commercial |
$831.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,069.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,128.60
|
| Rate for Payer: Three Rivers Provider Network All |
$891.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,045.44
|
| Rate for Payer: United Healthcare Managed Medicaid |
$297.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,104.84
|
| Rate for Payer: Zelis Auto |
$475.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$594.00
|
|
|
ARROW PICC NAVICURVE 1L 4.5FR X 55CM TCG
|
Facility
|
IP
|
$888.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
70006379
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$355.20 |
| Max. Negotiated Rate |
$843.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$710.40
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cigna Commercial |
$754.80
|
| Rate for Payer: First Health Commercial |
$799.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$799.20
|
| Rate for Payer: GEHA Commercial |
$621.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$799.20
|
| Rate for Payer: Multiplan All |
$808.08
|
| Rate for Payer: OMNI Networks Commercial |
$621.60
|
| Rate for Payer: One Health Plan PPO/POS |
$799.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$843.60
|
| Rate for Payer: Three Rivers Provider Network All |
$666.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$825.84
|
| Rate for Payer: Zelis Auto |
$355.20
|
|
|
ARROW PICC NAVICURVE 1L 4.5FR X 55CM TCG
|
Facility
|
OP
|
$888.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
70006379
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$222.00 |
| Max. Negotiated Rate |
$843.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cigna Commercial |
$754.80
|
| Rate for Payer: First Health Commercial |
$799.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$799.20
|
| Rate for Payer: GEHA Commercial |
$710.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$799.20
|
| Rate for Payer: Humana ChoiceCare |
$230.88
|
| Rate for Payer: Multiplan All |
$808.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$532.80
|
| Rate for Payer: OMNI Networks Commercial |
$621.60
|
| Rate for Payer: One Health Plan PPO/POS |
$799.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$843.60
|
| Rate for Payer: Three Rivers Provider Network All |
$666.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$781.44
|
| Rate for Payer: United Healthcare Managed Medicaid |
$222.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$825.84
|
| Rate for Payer: Zelis Auto |
$355.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$444.00
|
|
|
ARROW PICC NAVICURVE 2L 5.5FR X 55CM TCG
|
Facility
|
OP
|
$888.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
70006378
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$222.00 |
| Max. Negotiated Rate |
$843.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cigna Commercial |
$754.80
|
| Rate for Payer: First Health Commercial |
$799.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$799.20
|
| Rate for Payer: GEHA Commercial |
$710.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$799.20
|
| Rate for Payer: Humana ChoiceCare |
$230.88
|
| Rate for Payer: Multiplan All |
$808.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$532.80
|
| Rate for Payer: OMNI Networks Commercial |
$621.60
|
| Rate for Payer: One Health Plan PPO/POS |
$799.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$843.60
|
| Rate for Payer: Three Rivers Provider Network All |
$666.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$781.44
|
| Rate for Payer: United Healthcare Managed Medicaid |
$222.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$825.84
|
| Rate for Payer: Zelis Auto |
$355.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$444.00
|
|
|
ARROW PICC NAVICURVE 2L 5.5FR X 55CM TCG
|
Facility
|
IP
|
$888.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
70006378
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$355.20 |
| Max. Negotiated Rate |
$843.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$710.40
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cigna Commercial |
$754.80
|
| Rate for Payer: First Health Commercial |
$799.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$799.20
|
| Rate for Payer: GEHA Commercial |
$621.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$799.20
|
| Rate for Payer: Multiplan All |
$808.08
|
| Rate for Payer: OMNI Networks Commercial |
$621.60
|
| Rate for Payer: One Health Plan PPO/POS |
$799.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$843.60
|
| Rate for Payer: Three Rivers Provider Network All |
$666.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$825.84
|
| Rate for Payer: Zelis Auto |
$355.20
|
|
|
ARROW PI MIDLINE 1-L 4.5FR X 15CM
|
Facility
|
IP
|
$888.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
70006380
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$355.20 |
| Max. Negotiated Rate |
$843.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$710.40
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cigna Commercial |
$754.80
|
| Rate for Payer: First Health Commercial |
$799.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$799.20
|
| Rate for Payer: GEHA Commercial |
$621.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$799.20
|
| Rate for Payer: Multiplan All |
$808.08
|
| Rate for Payer: OMNI Networks Commercial |
$621.60
|
| Rate for Payer: One Health Plan PPO/POS |
$799.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$843.60
|
| Rate for Payer: Three Rivers Provider Network All |
$666.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$825.84
|
| Rate for Payer: Zelis Auto |
$355.20
|
|
|
ARROW PI MIDLINE 1-L 4.5FR X 15CM
|
Facility
|
OP
|
$888.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
70006380
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$222.00 |
| Max. Negotiated Rate |
$843.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cigna Commercial |
$754.80
|
| Rate for Payer: First Health Commercial |
$799.20
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$799.20
|
| Rate for Payer: GEHA Commercial |
$710.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$799.20
|
| Rate for Payer: Humana ChoiceCare |
$230.88
|
| Rate for Payer: Multiplan All |
$808.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$532.80
|
| Rate for Payer: OMNI Networks Commercial |
$621.60
|
| Rate for Payer: One Health Plan PPO/POS |
$799.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$843.60
|
| Rate for Payer: Three Rivers Provider Network All |
$666.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$781.44
|
| Rate for Payer: United Healthcare Managed Medicaid |
$222.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$825.84
|
| Rate for Payer: Zelis Auto |
$355.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$444.00
|
|
|
ARSENIC
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
2247271
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.12 |
| Max. Negotiated Rate |
$237.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$34.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$150.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$34.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$27.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: First Health Commercial |
$225.00
|
| Rate for Payer: First Health Workers Compensation |
$34.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$225.00
|
| Rate for Payer: GEHA Commercial |
$200.00
|
| Rate for Payer: GEHA Medicare |
$18.97
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$225.00
|
| Rate for Payer: Humana ChoiceCare |
$20.87
|
| Rate for Payer: Humana Medicare Advantage |
$18.97
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$27.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18.97
|
| Rate for Payer: Multiplan All |
$227.50
|
| Rate for Payer: New Mexico Health Connections Medicare |
$32.25
|
| Rate for Payer: OMNI Networks Commercial |
$175.00
|
| Rate for Payer: One Health Plan PPO/POS |
$225.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$31.86
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$27.60
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18.97
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$237.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$37.94
|
| Rate for Payer: Three Rivers Provider Network All |
$187.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18.59
|
| Rate for Payer: United Healthcare Commercial |
$212.50
|
| Rate for Payer: United Healthcare Managed Medicaid |
$27.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.97
|
| Rate for Payer: United Payors & United Providers UP&UP |
$232.50
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$18.97
|
| Rate for Payer: Zelis Auto |
$100.00
|
| Rate for Payer: Zelis Medicare |
$16.12
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$22.76
|
| Rate for Payer: Zelis Worker's Compensation |
$24.44
|
|
|
ARSENIC
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
2247271
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.44 |
| Max. Negotiated Rate |
$237.50 |
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: First Health Commercial |
$225.00
|
| Rate for Payer: First Health Workers Compensation |
$34.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$225.00
|
| Rate for Payer: GEHA Commercial |
$175.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$225.00
|
| Rate for Payer: Multiplan All |
$227.50
|
| Rate for Payer: OMNI Networks Commercial |
$175.00
|
| Rate for Payer: One Health Plan PPO/POS |
$225.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$237.50
|
| Rate for Payer: Three Rivers Provider Network All |
$187.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$232.50
|
| Rate for Payer: Zelis Auto |
$100.00
|
| Rate for Payer: Zelis Worker's Compensation |
$24.44
|
|
|
arsenic 24hr urine REF720847
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
2299991
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.44 |
| Max. Negotiated Rate |
$237.50 |
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: First Health Commercial |
$225.00
|
| Rate for Payer: First Health Workers Compensation |
$34.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$225.00
|
| Rate for Payer: GEHA Commercial |
$175.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$225.00
|
| Rate for Payer: Multiplan All |
$227.50
|
| Rate for Payer: OMNI Networks Commercial |
$175.00
|
| Rate for Payer: One Health Plan PPO/POS |
$225.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$237.50
|
| Rate for Payer: Three Rivers Provider Network All |
$187.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$232.50
|
| Rate for Payer: Zelis Auto |
$100.00
|
| Rate for Payer: Zelis Worker's Compensation |
$24.44
|
|
|
arsenic 24hr urine REF720847
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
2299991
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.12 |
| Max. Negotiated Rate |
$237.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$34.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$150.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$34.14
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$27.05
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: First Health Commercial |
$225.00
|
| Rate for Payer: First Health Workers Compensation |
$34.56
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$225.00
|
| Rate for Payer: GEHA Commercial |
$200.00
|
| Rate for Payer: GEHA Medicare |
$18.97
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$225.00
|
| Rate for Payer: Humana ChoiceCare |
$20.87
|
| Rate for Payer: Humana Medicare Advantage |
$18.97
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$31.87
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$27.60
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$18.97
|
| Rate for Payer: Multiplan All |
$227.50
|
| Rate for Payer: New Mexico Health Connections Medicare |
$32.25
|
| Rate for Payer: OMNI Networks Commercial |
$175.00
|
| Rate for Payer: One Health Plan PPO/POS |
$225.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$31.86
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$27.60
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$18.97
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$237.50
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$37.94
|
| Rate for Payer: Three Rivers Provider Network All |
$187.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$18.59
|
| Rate for Payer: United Healthcare Commercial |
$212.50
|
| Rate for Payer: United Healthcare Managed Medicaid |
$27.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.97
|
| Rate for Payer: United Payors & United Providers UP&UP |
$232.50
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$18.97
|
| Rate for Payer: Zelis Auto |
$100.00
|
| Rate for Payer: Zelis Medicare |
$16.12
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$22.76
|
| Rate for Payer: Zelis Worker's Compensation |
$24.44
|
|
|
ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX
|
Facility
|
IP
|
$277.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
4020001
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$75.62 |
| Max. Negotiated Rate |
$263.15 |
| Rate for Payer: Cash Price |
$166.20
|
| Rate for Payer: Cigna Commercial |
$235.45
|
| Rate for Payer: First Health Commercial |
$249.30
|
| Rate for Payer: First Health Workers Compensation |
$106.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$249.30
|
| Rate for Payer: GEHA Commercial |
$193.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$249.30
|
| Rate for Payer: Multiplan All |
$252.07
|
| Rate for Payer: OMNI Networks Commercial |
$193.90
|
| Rate for Payer: One Health Plan PPO/POS |
$249.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$263.15
|
| Rate for Payer: Three Rivers Provider Network All |
$207.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$257.61
|
| Rate for Payer: Zelis Auto |
$110.80
|
| Rate for Payer: Zelis Worker's Compensation |
$75.62
|
|
|
ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX
|
Facility
|
IP
|
$220.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
4090009
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$60.06 |
| Max. Negotiated Rate |
$209.00 |
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cigna Commercial |
$187.00
|
| Rate for Payer: First Health Commercial |
$198.00
|
| Rate for Payer: First Health Workers Compensation |
$84.94
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$198.00
|
| Rate for Payer: GEHA Commercial |
$154.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$198.00
|
| Rate for Payer: Multiplan All |
$200.20
|
| Rate for Payer: OMNI Networks Commercial |
$154.00
|
| Rate for Payer: One Health Plan PPO/POS |
$198.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$209.00
|
| Rate for Payer: Three Rivers Provider Network All |
$165.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$204.60
|
| Rate for Payer: Zelis Auto |
$88.00
|
| Rate for Payer: Zelis Worker's Compensation |
$60.06
|
|
|
ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX
|
Facility
|
IP
|
$327.00
|
|
| Hospital Charge Code |
8136600
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$89.27 |
| Max. Negotiated Rate |
$310.65 |
| Rate for Payer: Cash Price |
$196.20
|
| Rate for Payer: Cigna Commercial |
$277.95
|
| Rate for Payer: First Health Commercial |
$294.30
|
| Rate for Payer: First Health Workers Compensation |
$126.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$294.30
|
| Rate for Payer: GEHA Commercial |
$228.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$294.30
|
| Rate for Payer: Multiplan All |
$297.57
|
| Rate for Payer: OMNI Networks Commercial |
$228.90
|
| Rate for Payer: One Health Plan PPO/POS |
$294.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$310.65
|
| Rate for Payer: Three Rivers Provider Network All |
$245.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$304.11
|
| Rate for Payer: Zelis Auto |
$130.80
|
| Rate for Payer: Zelis Worker's Compensation |
$89.27
|
|
|
ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX
|
Facility
|
OP
|
$327.00
|
|
| Hospital Charge Code |
8136600
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$81.75 |
| Max. Negotiated Rate |
$310.65 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$196.20
|
| Rate for Payer: Cash Price |
$196.20
|
| Rate for Payer: Cigna Commercial |
$277.95
|
| Rate for Payer: First Health Commercial |
$294.30
|
| Rate for Payer: First Health Workers Compensation |
$126.25
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$294.30
|
| Rate for Payer: GEHA Commercial |
$261.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$294.30
|
| Rate for Payer: Humana ChoiceCare |
$85.02
|
| Rate for Payer: Multiplan All |
$297.57
|
| Rate for Payer: New Mexico Health Connections Medicare |
$196.20
|
| Rate for Payer: OMNI Networks Commercial |
$228.90
|
| Rate for Payer: One Health Plan PPO/POS |
$294.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$310.65
|
| Rate for Payer: Three Rivers Provider Network All |
$245.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$287.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$81.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$304.11
|
| Rate for Payer: Zelis Auto |
$130.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$163.50
|
| Rate for Payer: Zelis Worker's Compensation |
$89.27
|
|
|
ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX
|
Facility
|
OP
|
$277.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
4020001
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$21.41 |
| Max. Negotiated Rate |
$263.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$27.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$166.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$27.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$21.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$122.40
|
| Rate for Payer: Cash Price |
$166.20
|
| Rate for Payer: Cash Price |
$166.20
|
| Rate for Payer: Cigna Commercial |
$235.45
|
| Rate for Payer: First Health Commercial |
$249.30
|
| Rate for Payer: First Health Workers Compensation |
$106.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$249.30
|
| Rate for Payer: GEHA Commercial |
$221.60
|
| Rate for Payer: GEHA Medicare |
$122.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$249.30
|
| Rate for Payer: Humana ChoiceCare |
$134.64
|
| Rate for Payer: Humana Medicare Advantage |
$122.40
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$205.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$21.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$122.40
|
| Rate for Payer: Multiplan All |
$252.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$208.08
|
| Rate for Payer: OMNI Networks Commercial |
$193.90
|
| Rate for Payer: One Health Plan PPO/POS |
$249.30
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$25.23
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$21.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$122.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$263.15
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$244.80
|
| Rate for Payer: Three Rivers Provider Network All |
$207.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$119.95
|
| Rate for Payer: United Healthcare Commercial |
$235.45
|
| Rate for Payer: United Healthcare Managed Medicaid |
$21.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$122.40
|
| Rate for Payer: United Payors & United Providers UP&UP |
$257.61
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$122.40
|
| Rate for Payer: Zelis Auto |
$110.80
|
| Rate for Payer: Zelis Medicare |
$104.04
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$146.88
|
| Rate for Payer: Zelis Worker's Compensation |
$75.62
|
|
|
ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX
|
Facility
|
OP
|
$220.00
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
4090009
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$21.41 |
| Max. Negotiated Rate |
$244.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$27.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$132.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$27.03
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$21.41
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$122.40
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cigna Commercial |
$187.00
|
| Rate for Payer: First Health Commercial |
$198.00
|
| Rate for Payer: First Health Workers Compensation |
$84.94
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$198.00
|
| Rate for Payer: GEHA Commercial |
$176.00
|
| Rate for Payer: GEHA Medicare |
$122.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$198.00
|
| Rate for Payer: Humana ChoiceCare |
$134.64
|
| Rate for Payer: Humana Medicare Advantage |
$122.40
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$205.63
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$21.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$122.40
|
| Rate for Payer: Multiplan All |
$200.20
|
| Rate for Payer: New Mexico Health Connections Medicare |
$208.08
|
| Rate for Payer: OMNI Networks Commercial |
$154.00
|
| Rate for Payer: One Health Plan PPO/POS |
$198.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$25.23
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$21.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$122.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$209.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$244.80
|
| Rate for Payer: Three Rivers Provider Network All |
$165.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$119.95
|
| Rate for Payer: United Healthcare Commercial |
$187.00
|
| Rate for Payer: United Healthcare Managed Medicaid |
$21.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$122.40
|
| Rate for Payer: United Payors & United Providers UP&UP |
$204.60
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$122.40
|
| Rate for Payer: Zelis Auto |
$88.00
|
| Rate for Payer: Zelis Medicare |
$104.04
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$146.88
|
| Rate for Payer: Zelis Worker's Compensation |
$60.06
|
|
|
ARTERY BYPASS GRAFT
|
Facility
|
IP
|
$3,041.00
|
|
|
Service Code
|
CPT 35556
|
| Hospital Charge Code |
6135556
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$830.19 |
| Max. Negotiated Rate |
$2,888.95 |
| Rate for Payer: Cash Price |
$1,824.60
|
| Rate for Payer: Cigna Commercial |
$2,584.85
|
| Rate for Payer: First Health Commercial |
$2,736.90
|
| Rate for Payer: First Health Workers Compensation |
$1,174.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,736.90
|
| Rate for Payer: GEHA Commercial |
$2,128.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,736.90
|
| Rate for Payer: Multiplan All |
$2,767.31
|
| Rate for Payer: OMNI Networks Commercial |
$2,128.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,736.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,888.95
|
| Rate for Payer: Three Rivers Provider Network All |
$2,280.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,828.13
|
| Rate for Payer: Zelis Auto |
$1,216.40
|
| Rate for Payer: Zelis Worker's Compensation |
$830.19
|
|
|
ARTERY BYPASS GRAFT
|
Facility
|
OP
|
$3,041.00
|
|
|
Service Code
|
CPT 35556
|
| Hospital Charge Code |
6135556
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$760.25 |
| Max. Negotiated Rate |
$2,888.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,824.60
|
| Rate for Payer: Cash Price |
$1,824.60
|
| Rate for Payer: Cigna Commercial |
$2,584.85
|
| Rate for Payer: First Health Commercial |
$2,736.90
|
| Rate for Payer: First Health Workers Compensation |
$1,174.13
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,736.90
|
| Rate for Payer: GEHA Commercial |
$2,432.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,736.90
|
| Rate for Payer: Humana ChoiceCare |
$790.66
|
| Rate for Payer: Multiplan All |
$2,767.31
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,824.60
|
| Rate for Payer: OMNI Networks Commercial |
$2,128.70
|
| Rate for Payer: One Health Plan PPO/POS |
$2,736.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,888.95
|
| Rate for Payer: Three Rivers Provider Network All |
$2,280.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,676.08
|
| Rate for Payer: United Healthcare Managed Medicaid |
$760.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,828.13
|
| Rate for Payer: Zelis Auto |
$1,216.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,520.50
|
| Rate for Payer: Zelis Worker's Compensation |
$830.19
|
|
|
ARTH AID TRTMNT OF TIBIAL FX PROX/BICON
|
Facility
|
OP
|
$2,507.97
|
|
|
Service Code
|
CPT 29856
|
| Hospital Charge Code |
6129856
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$684.68 |
| Max. Negotiated Rate |
$24,435.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,935.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,504.78
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,935.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,910.22
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,217.56
|
| Rate for Payer: Cash Price |
$1,504.78
|
| Rate for Payer: Cash Price |
$1,504.78
|
| Rate for Payer: Cigna Commercial |
$2,131.77
|
| Rate for Payer: First Health Commercial |
$2,257.17
|
| Rate for Payer: First Health Workers Compensation |
$968.33
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,257.17
|
| Rate for Payer: GEHA Commercial |
$2,006.38
|
| Rate for Payer: GEHA Medicare |
$12,217.56
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,257.17
|
| Rate for Payer: Humana ChoiceCare |
$13,439.32
|
| Rate for Payer: Humana Medicare Advantage |
$12,217.56
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$20,525.50
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,989.85
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,217.56
|
| Rate for Payer: Multiplan All |
$2,282.25
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,769.85
|
| Rate for Payer: OMNI Networks Commercial |
$1,755.58
|
| Rate for Payer: One Health Plan PPO/POS |
$2,257.17
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,606.84
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,989.85
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,217.56
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,382.57
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,435.12
|
| Rate for Payer: Three Rivers Provider Network All |
$1,880.98
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,973.21
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,989.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,217.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,332.41
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$12,217.56
|
| Rate for Payer: Zelis Auto |
$1,003.19
|
| Rate for Payer: Zelis Medicare |
$10,384.93
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$14,661.07
|
| Rate for Payer: Zelis Worker's Compensation |
$684.68
|
|
|
ARTH AID TRTMNT OF TIBIAL FX PROX/BICON
|
Facility
|
IP
|
$2,507.97
|
|
|
Service Code
|
CPT 29856
|
| Hospital Charge Code |
6129856
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$684.68 |
| Max. Negotiated Rate |
$2,382.57 |
| Rate for Payer: Cash Price |
$1,504.78
|
| Rate for Payer: Cigna Commercial |
$2,131.77
|
| Rate for Payer: First Health Commercial |
$2,257.17
|
| Rate for Payer: First Health Workers Compensation |
$968.33
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,257.17
|
| Rate for Payer: GEHA Commercial |
$1,755.58
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,257.17
|
| Rate for Payer: Multiplan All |
$2,282.25
|
| Rate for Payer: OMNI Networks Commercial |
$1,755.58
|
| Rate for Payer: One Health Plan PPO/POS |
$2,257.17
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,382.57
|
| Rate for Payer: Three Rivers Provider Network All |
$1,880.98
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,332.41
|
| Rate for Payer: Zelis Auto |
$1,003.19
|
| Rate for Payer: Zelis Worker's Compensation |
$684.68
|
|
