|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/O
|
Facility
|
IP
|
$1,124.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
1920605
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$306.85 |
| Max. Negotiated Rate |
$1,067.80 |
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cigna Commercial |
$955.40
|
| Rate for Payer: First Health Commercial |
$1,011.60
|
| Rate for Payer: First Health Workers Compensation |
$433.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,011.60
|
| Rate for Payer: GEHA Commercial |
$786.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,011.60
|
| Rate for Payer: Multiplan All |
$1,022.84
|
| Rate for Payer: OMNI Networks Commercial |
$786.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,011.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,067.80
|
| Rate for Payer: Three Rivers Provider Network All |
$843.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,045.32
|
| Rate for Payer: Zelis Auto |
$449.60
|
| Rate for Payer: Zelis Worker's Compensation |
$306.85
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/O
|
Facility
|
OP
|
$1,015.00
|
|
| Hospital Charge Code |
8150062
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$253.75 |
| Max. Negotiated Rate |
$964.25 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$609.00
|
| Rate for Payer: Cash Price |
$609.00
|
| Rate for Payer: Cigna Commercial |
$862.75
|
| Rate for Payer: First Health Commercial |
$913.50
|
| Rate for Payer: First Health Workers Compensation |
$391.89
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$913.50
|
| Rate for Payer: GEHA Commercial |
$812.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$913.50
|
| Rate for Payer: Humana ChoiceCare |
$263.90
|
| Rate for Payer: Multiplan All |
$923.65
|
| Rate for Payer: New Mexico Health Connections Medicare |
$609.00
|
| Rate for Payer: OMNI Networks Commercial |
$710.50
|
| Rate for Payer: One Health Plan PPO/POS |
$913.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$964.25
|
| Rate for Payer: Three Rivers Provider Network All |
$761.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$893.20
|
| Rate for Payer: United Healthcare Managed Medicaid |
$253.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$943.95
|
| Rate for Payer: Zelis Auto |
$406.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$507.50
|
| Rate for Payer: Zelis Worker's Compensation |
$277.10
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/O
|
Facility
|
IP
|
$1,015.00
|
|
| Hospital Charge Code |
8150062
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$277.10 |
| Max. Negotiated Rate |
$964.25 |
| Rate for Payer: Cash Price |
$609.00
|
| Rate for Payer: Cigna Commercial |
$862.75
|
| Rate for Payer: First Health Commercial |
$913.50
|
| Rate for Payer: First Health Workers Compensation |
$391.89
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$913.50
|
| Rate for Payer: GEHA Commercial |
$710.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$913.50
|
| Rate for Payer: Multiplan All |
$923.65
|
| Rate for Payer: OMNI Networks Commercial |
$710.50
|
| Rate for Payer: One Health Plan PPO/POS |
$913.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$964.25
|
| Rate for Payer: Three Rivers Provider Network All |
$761.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$943.95
|
| Rate for Payer: Zelis Auto |
$406.00
|
| Rate for Payer: Zelis Worker's Compensation |
$277.10
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/O
|
Facility
|
OP
|
$154.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
25500032
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.04 |
| Max. Negotiated Rate |
$572.06 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$92.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$204.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$286.03
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cigna Commercial |
$130.90
|
| Rate for Payer: First Health Commercial |
$138.60
|
| Rate for Payer: First Health Workers Compensation |
$59.46
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$138.60
|
| Rate for Payer: GEHA Commercial |
$123.20
|
| Rate for Payer: GEHA Medicare |
$286.03
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$138.60
|
| Rate for Payer: Humana ChoiceCare |
$314.63
|
| Rate for Payer: Humana Medicare Advantage |
$286.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$480.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$286.03
|
| Rate for Payer: Multiplan All |
$140.14
|
| Rate for Payer: New Mexico Health Connections Medicare |
$486.25
|
| Rate for Payer: OMNI Networks Commercial |
$107.80
|
| Rate for Payer: One Health Plan PPO/POS |
$138.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$241.19
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$208.89
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$286.03
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$146.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$572.06
|
| Rate for Payer: Three Rivers Provider Network All |
$115.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$280.31
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$286.03
|
| Rate for Payer: United Payors & United Providers UP&UP |
$143.22
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$286.03
|
| Rate for Payer: Zelis Auto |
$61.60
|
| Rate for Payer: Zelis Medicare |
$243.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$343.24
|
| Rate for Payer: Zelis Worker's Compensation |
$42.04
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/O
|
Facility
|
OP
|
$154.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
8720605
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.04 |
| Max. Negotiated Rate |
$572.06 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$92.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$204.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$286.03
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cigna Commercial |
$130.90
|
| Rate for Payer: First Health Commercial |
$138.60
|
| Rate for Payer: First Health Workers Compensation |
$59.46
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$138.60
|
| Rate for Payer: GEHA Commercial |
$123.20
|
| Rate for Payer: GEHA Medicare |
$286.03
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$138.60
|
| Rate for Payer: Humana ChoiceCare |
$314.63
|
| Rate for Payer: Humana Medicare Advantage |
$286.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$480.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$286.03
|
| Rate for Payer: Multiplan All |
$140.14
|
| Rate for Payer: New Mexico Health Connections Medicare |
$486.25
|
| Rate for Payer: OMNI Networks Commercial |
$107.80
|
| Rate for Payer: One Health Plan PPO/POS |
$138.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$241.19
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$208.89
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$286.03
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$146.30
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$572.06
|
| Rate for Payer: Three Rivers Provider Network All |
$115.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$280.31
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$286.03
|
| Rate for Payer: United Payors & United Providers UP&UP |
$143.22
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$286.03
|
| Rate for Payer: Zelis Auto |
$61.60
|
| Rate for Payer: Zelis Medicare |
$243.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$343.24
|
| Rate for Payer: Zelis Worker's Compensation |
$42.04
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/O
|
Facility
|
IP
|
$154.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
8820605
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$42.04 |
| Max. Negotiated Rate |
$146.30 |
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cigna Commercial |
$130.90
|
| Rate for Payer: First Health Commercial |
$138.60
|
| Rate for Payer: First Health Workers Compensation |
$59.46
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$138.60
|
| Rate for Payer: GEHA Commercial |
$107.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$138.60
|
| Rate for Payer: Multiplan All |
$140.14
|
| Rate for Payer: OMNI Networks Commercial |
$107.80
|
| Rate for Payer: One Health Plan PPO/POS |
$138.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$146.30
|
| Rate for Payer: Three Rivers Provider Network All |
$115.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$143.22
|
| Rate for Payer: Zelis Auto |
$61.60
|
| Rate for Payer: Zelis Worker's Compensation |
$42.04
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/O
|
Facility
|
IP
|
$153.51
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
7220605
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$41.91 |
| Max. Negotiated Rate |
$145.83 |
| Rate for Payer: Cash Price |
$92.11
|
| Rate for Payer: Cigna Commercial |
$130.48
|
| Rate for Payer: First Health Commercial |
$138.16
|
| Rate for Payer: First Health Workers Compensation |
$59.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$138.16
|
| Rate for Payer: GEHA Commercial |
$107.46
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$138.16
|
| Rate for Payer: Multiplan All |
$139.69
|
| Rate for Payer: OMNI Networks Commercial |
$107.46
|
| Rate for Payer: One Health Plan PPO/POS |
$138.16
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$145.83
|
| Rate for Payer: Three Rivers Provider Network All |
$115.13
|
| Rate for Payer: United Payors & United Providers UP&UP |
$142.76
|
| Rate for Payer: Zelis Auto |
$61.40
|
| Rate for Payer: Zelis Worker's Compensation |
$41.91
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/O
|
Facility
|
OP
|
$1,124.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
9620605
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$204.72 |
| Max. Negotiated Rate |
$1,067.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$674.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$204.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$286.03
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cigna Commercial |
$955.40
|
| Rate for Payer: First Health Commercial |
$1,011.60
|
| Rate for Payer: First Health Workers Compensation |
$433.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,011.60
|
| Rate for Payer: GEHA Commercial |
$899.20
|
| Rate for Payer: GEHA Medicare |
$286.03
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,011.60
|
| Rate for Payer: Humana ChoiceCare |
$314.63
|
| Rate for Payer: Humana Medicare Advantage |
$286.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$480.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$286.03
|
| Rate for Payer: Multiplan All |
$1,022.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$486.25
|
| Rate for Payer: OMNI Networks Commercial |
$786.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,011.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$241.19
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$208.89
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$286.03
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,067.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$572.06
|
| Rate for Payer: Three Rivers Provider Network All |
$843.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$280.31
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$286.03
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,045.32
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$286.03
|
| Rate for Payer: Zelis Auto |
$449.60
|
| Rate for Payer: Zelis Medicare |
$243.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$343.24
|
| Rate for Payer: Zelis Worker's Compensation |
$306.85
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/O
|
Facility
|
IP
|
$154.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
8720605
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.04 |
| Max. Negotiated Rate |
$146.30 |
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cigna Commercial |
$130.90
|
| Rate for Payer: First Health Commercial |
$138.60
|
| Rate for Payer: First Health Workers Compensation |
$59.46
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$138.60
|
| Rate for Payer: GEHA Commercial |
$107.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$138.60
|
| Rate for Payer: Multiplan All |
$140.14
|
| Rate for Payer: OMNI Networks Commercial |
$107.80
|
| Rate for Payer: One Health Plan PPO/POS |
$138.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$146.30
|
| Rate for Payer: Three Rivers Provider Network All |
$115.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$143.22
|
| Rate for Payer: Zelis Auto |
$61.60
|
| Rate for Payer: Zelis Worker's Compensation |
$42.04
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/O
|
Facility
|
OP
|
$153.51
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
7220605
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$41.91 |
| Max. Negotiated Rate |
$572.06 |
| Rate for Payer: Cigna Commercial |
$130.48
|
| Rate for Payer: First Health Commercial |
$138.16
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$92.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$204.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$286.03
|
| Rate for Payer: Cash Price |
$92.11
|
| Rate for Payer: Cash Price |
$92.11
|
| Rate for Payer: First Health Workers Compensation |
$59.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$138.16
|
| Rate for Payer: GEHA Commercial |
$122.81
|
| Rate for Payer: GEHA Medicare |
$286.03
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$138.16
|
| Rate for Payer: Humana ChoiceCare |
$314.63
|
| Rate for Payer: Humana Medicare Advantage |
$286.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$480.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$286.03
|
| Rate for Payer: Multiplan All |
$139.69
|
| Rate for Payer: New Mexico Health Connections Medicare |
$486.25
|
| Rate for Payer: OMNI Networks Commercial |
$107.46
|
| Rate for Payer: One Health Plan PPO/POS |
$138.16
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$241.19
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$208.89
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$286.03
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$145.83
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$572.06
|
| Rate for Payer: Three Rivers Provider Network All |
$115.13
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$280.31
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$286.03
|
| Rate for Payer: United Payors & United Providers UP&UP |
$142.76
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$286.03
|
| Rate for Payer: Zelis Auto |
$61.40
|
| Rate for Payer: Zelis Medicare |
$243.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$343.24
|
| Rate for Payer: Zelis Worker's Compensation |
$41.91
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/O
|
Facility
|
OP
|
$153.51
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
8520605
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$41.91 |
| Max. Negotiated Rate |
$572.06 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$92.11
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$204.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$286.03
|
| Rate for Payer: Cash Price |
$92.11
|
| Rate for Payer: Cash Price |
$92.11
|
| Rate for Payer: Cigna Commercial |
$130.48
|
| Rate for Payer: First Health Commercial |
$138.16
|
| Rate for Payer: First Health Workers Compensation |
$59.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$138.16
|
| Rate for Payer: GEHA Commercial |
$122.81
|
| Rate for Payer: GEHA Medicare |
$286.03
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$138.16
|
| Rate for Payer: Humana ChoiceCare |
$314.63
|
| Rate for Payer: Humana Medicare Advantage |
$286.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$480.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$286.03
|
| Rate for Payer: Multiplan All |
$139.69
|
| Rate for Payer: New Mexico Health Connections Medicare |
$486.25
|
| Rate for Payer: OMNI Networks Commercial |
$107.46
|
| Rate for Payer: One Health Plan PPO/POS |
$138.16
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$241.19
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$208.89
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$286.03
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$145.83
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$572.06
|
| Rate for Payer: Three Rivers Provider Network All |
$115.13
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$280.31
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$286.03
|
| Rate for Payer: United Payors & United Providers UP&UP |
$142.76
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$286.03
|
| Rate for Payer: Zelis Auto |
$61.40
|
| Rate for Payer: Zelis Medicare |
$243.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$343.24
|
| Rate for Payer: Zelis Worker's Compensation |
$41.91
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/O
|
Facility
|
IP
|
$154.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
25500032
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$42.04 |
| Max. Negotiated Rate |
$146.30 |
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cigna Commercial |
$130.90
|
| Rate for Payer: First Health Commercial |
$138.60
|
| Rate for Payer: First Health Workers Compensation |
$59.46
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$138.60
|
| Rate for Payer: GEHA Commercial |
$107.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$138.60
|
| Rate for Payer: Multiplan All |
$140.14
|
| Rate for Payer: OMNI Networks Commercial |
$107.80
|
| Rate for Payer: One Health Plan PPO/POS |
$138.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$146.30
|
| Rate for Payer: Three Rivers Provider Network All |
$115.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$143.22
|
| Rate for Payer: Zelis Auto |
$61.60
|
| Rate for Payer: Zelis Worker's Compensation |
$42.04
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/O
|
Facility
|
OP
|
$1,124.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
1920605
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$204.72 |
| Max. Negotiated Rate |
$1,067.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$674.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$204.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$286.03
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cash Price |
$674.40
|
| Rate for Payer: Cigna Commercial |
$955.40
|
| Rate for Payer: First Health Commercial |
$1,011.60
|
| Rate for Payer: First Health Workers Compensation |
$433.98
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,011.60
|
| Rate for Payer: GEHA Commercial |
$899.20
|
| Rate for Payer: GEHA Medicare |
$286.03
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,011.60
|
| Rate for Payer: Humana ChoiceCare |
$314.63
|
| Rate for Payer: Humana Medicare Advantage |
$286.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$480.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$286.03
|
| Rate for Payer: Multiplan All |
$1,022.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$486.25
|
| Rate for Payer: OMNI Networks Commercial |
$786.80
|
| Rate for Payer: One Health Plan PPO/POS |
$1,011.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$241.19
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$208.89
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$286.03
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,067.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$572.06
|
| Rate for Payer: Three Rivers Provider Network All |
$843.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$280.31
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$286.03
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,045.32
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$286.03
|
| Rate for Payer: Zelis Auto |
$449.60
|
| Rate for Payer: Zelis Medicare |
$243.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$343.24
|
| Rate for Payer: Zelis Worker's Compensation |
$306.85
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/US
|
Facility
|
OP
|
$1,528.00
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
8800047
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$250.89 |
| Max. Negotiated Rate |
$1,451.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$316.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$916.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$316.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$250.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$671.04
|
| Rate for Payer: Cash Price |
$916.80
|
| Rate for Payer: Cash Price |
$916.80
|
| Rate for Payer: Cigna Commercial |
$1,298.80
|
| Rate for Payer: First Health Commercial |
$1,375.20
|
| Rate for Payer: First Health Workers Compensation |
$589.96
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,375.20
|
| Rate for Payer: GEHA Commercial |
$1,222.40
|
| Rate for Payer: GEHA Medicare |
$671.04
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,375.20
|
| Rate for Payer: Humana ChoiceCare |
$738.14
|
| Rate for Payer: Humana Medicare Advantage |
$671.04
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,127.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$256.00
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$671.04
|
| Rate for Payer: Multiplan All |
$1,390.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,140.77
|
| Rate for Payer: OMNI Networks Commercial |
$1,069.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,375.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$295.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$256.00
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$671.04
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,451.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,342.08
|
| Rate for Payer: Three Rivers Provider Network All |
$1,146.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$657.62
|
| Rate for Payer: United Healthcare Commercial |
$1,298.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$256.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$671.04
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,421.04
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$671.04
|
| Rate for Payer: Zelis Auto |
$611.20
|
| Rate for Payer: Zelis Medicare |
$570.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$805.25
|
| Rate for Payer: Zelis Worker's Compensation |
$417.14
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/US
|
Facility
|
IP
|
$1,528.00
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
8800047
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$417.14 |
| Max. Negotiated Rate |
$1,451.60 |
| Rate for Payer: Cash Price |
$916.80
|
| Rate for Payer: Cigna Commercial |
$1,298.80
|
| Rate for Payer: First Health Commercial |
$1,375.20
|
| Rate for Payer: First Health Workers Compensation |
$589.96
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,375.20
|
| Rate for Payer: GEHA Commercial |
$1,069.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,375.20
|
| Rate for Payer: Multiplan All |
$1,390.48
|
| Rate for Payer: OMNI Networks Commercial |
$1,069.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,375.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,451.60
|
| Rate for Payer: Three Rivers Provider Network All |
$1,146.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,421.04
|
| Rate for Payer: Zelis Auto |
$611.20
|
| Rate for Payer: Zelis Worker's Compensation |
$417.14
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/US
|
Facility
|
IP
|
$1,528.00
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
8204026
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$417.14 |
| Max. Negotiated Rate |
$1,451.60 |
| Rate for Payer: Cash Price |
$916.80
|
| Rate for Payer: Cigna Commercial |
$1,298.80
|
| Rate for Payer: First Health Commercial |
$1,375.20
|
| Rate for Payer: First Health Workers Compensation |
$589.96
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,375.20
|
| Rate for Payer: GEHA Commercial |
$1,069.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,375.20
|
| Rate for Payer: Multiplan All |
$1,390.48
|
| Rate for Payer: OMNI Networks Commercial |
$1,069.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,375.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,451.60
|
| Rate for Payer: Three Rivers Provider Network All |
$1,146.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,421.04
|
| Rate for Payer: Zelis Auto |
$611.20
|
| Rate for Payer: Zelis Worker's Compensation |
$417.14
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/US
|
Facility
|
IP
|
$855.00
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
7620606
|
|
Hospital Revenue Code
|
511
|
| Min. Negotiated Rate |
$233.41 |
| Max. Negotiated Rate |
$812.25 |
| Rate for Payer: Cash Price |
$513.00
|
| Rate for Payer: Cigna Commercial |
$726.75
|
| Rate for Payer: First Health Commercial |
$769.50
|
| Rate for Payer: First Health Workers Compensation |
$330.12
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$769.50
|
| Rate for Payer: GEHA Commercial |
$598.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$769.50
|
| Rate for Payer: Multiplan All |
$778.05
|
| Rate for Payer: OMNI Networks Commercial |
$598.50
|
| Rate for Payer: One Health Plan PPO/POS |
$769.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$812.25
|
| Rate for Payer: Three Rivers Provider Network All |
$641.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$795.15
|
| Rate for Payer: Zelis Auto |
$342.00
|
| Rate for Payer: Zelis Worker's Compensation |
$233.41
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/US
|
Facility
|
OP
|
$855.00
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
7620606
|
|
Hospital Revenue Code
|
511
|
| Min. Negotiated Rate |
$233.41 |
| Max. Negotiated Rate |
$1,342.08 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$316.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$513.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$316.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$250.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$671.04
|
| Rate for Payer: Cash Price |
$513.00
|
| Rate for Payer: Cash Price |
$513.00
|
| Rate for Payer: Cigna Commercial |
$726.75
|
| Rate for Payer: First Health Commercial |
$769.50
|
| Rate for Payer: First Health Workers Compensation |
$330.12
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$769.50
|
| Rate for Payer: GEHA Commercial |
$684.00
|
| Rate for Payer: GEHA Medicare |
$671.04
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$769.50
|
| Rate for Payer: Humana ChoiceCare |
$738.14
|
| Rate for Payer: Humana Medicare Advantage |
$671.04
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,127.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$256.00
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$671.04
|
| Rate for Payer: Multiplan All |
$778.05
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,140.77
|
| Rate for Payer: OMNI Networks Commercial |
$598.50
|
| Rate for Payer: One Health Plan PPO/POS |
$769.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$295.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$256.00
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$671.04
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$812.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,342.08
|
| Rate for Payer: Three Rivers Provider Network All |
$641.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$657.62
|
| Rate for Payer: United Healthcare Managed Medicaid |
$256.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$671.04
|
| Rate for Payer: United Payors & United Providers UP&UP |
$795.15
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$671.04
|
| Rate for Payer: Zelis Auto |
$342.00
|
| Rate for Payer: Zelis Medicare |
$570.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$805.25
|
| Rate for Payer: Zelis Worker's Compensation |
$233.41
|
|
|
ARTHROCNT ASPIR&/INJ INTERM JT/BURS W/US
|
Facility
|
OP
|
$1,528.00
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
8204026
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$250.89 |
| Max. Negotiated Rate |
$1,451.60 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$316.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$916.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$316.69
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$250.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$671.04
|
| Rate for Payer: Cash Price |
$916.80
|
| Rate for Payer: Cash Price |
$916.80
|
| Rate for Payer: Cigna Commercial |
$1,298.80
|
| Rate for Payer: First Health Commercial |
$1,375.20
|
| Rate for Payer: First Health Workers Compensation |
$589.96
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,375.20
|
| Rate for Payer: GEHA Commercial |
$1,222.40
|
| Rate for Payer: GEHA Medicare |
$671.04
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,375.20
|
| Rate for Payer: Humana ChoiceCare |
$738.14
|
| Rate for Payer: Humana Medicare Advantage |
$671.04
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$1,127.35
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$256.00
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$671.04
|
| Rate for Payer: Multiplan All |
$1,390.48
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,140.77
|
| Rate for Payer: OMNI Networks Commercial |
$1,069.60
|
| Rate for Payer: One Health Plan PPO/POS |
$1,375.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$295.58
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$256.00
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$671.04
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,451.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$1,342.08
|
| Rate for Payer: Three Rivers Provider Network All |
$1,146.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$657.62
|
| Rate for Payer: United Healthcare Commercial |
$1,298.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$256.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$671.04
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,421.04
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$671.04
|
| Rate for Payer: Zelis Auto |
$611.20
|
| Rate for Payer: Zelis Medicare |
$570.38
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$805.25
|
| Rate for Payer: Zelis Worker's Compensation |
$417.14
|
|
|
ARTHROCNT ASPIR&/INJ MAJ JT/BURSA W/O US
|
Facility
|
OP
|
$184.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
9400089
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$50.23 |
| Max. Negotiated Rate |
$572.06 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$110.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$204.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$286.03
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cigna Commercial |
$156.40
|
| Rate for Payer: First Health Commercial |
$165.60
|
| Rate for Payer: First Health Workers Compensation |
$71.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$165.60
|
| Rate for Payer: GEHA Commercial |
$147.20
|
| Rate for Payer: GEHA Medicare |
$286.03
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$165.60
|
| Rate for Payer: Humana ChoiceCare |
$314.63
|
| Rate for Payer: Humana Medicare Advantage |
$286.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$480.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$286.03
|
| Rate for Payer: Multiplan All |
$167.44
|
| Rate for Payer: New Mexico Health Connections Medicare |
$486.25
|
| Rate for Payer: OMNI Networks Commercial |
$128.80
|
| Rate for Payer: One Health Plan PPO/POS |
$165.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$241.19
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$208.89
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$286.03
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$174.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$572.06
|
| Rate for Payer: Three Rivers Provider Network All |
$138.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$280.31
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$286.03
|
| Rate for Payer: United Payors & United Providers UP&UP |
$171.12
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$286.03
|
| Rate for Payer: Zelis Auto |
$73.60
|
| Rate for Payer: Zelis Medicare |
$243.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$343.24
|
| Rate for Payer: Zelis Worker's Compensation |
$50.23
|
|
|
ARTHROCNT ASPIR&/INJ MAJ JT/BURSA W/O US
|
Facility
|
OP
|
$183.09
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
7220610
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$49.98 |
| Max. Negotiated Rate |
$572.06 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$109.85
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$204.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$286.03
|
| Rate for Payer: Cash Price |
$109.85
|
| Rate for Payer: Cash Price |
$109.85
|
| Rate for Payer: Cigna Commercial |
$155.63
|
| Rate for Payer: First Health Commercial |
$164.78
|
| Rate for Payer: First Health Workers Compensation |
$70.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$164.78
|
| Rate for Payer: GEHA Commercial |
$146.47
|
| Rate for Payer: GEHA Medicare |
$286.03
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$164.78
|
| Rate for Payer: Humana ChoiceCare |
$314.63
|
| Rate for Payer: Humana Medicare Advantage |
$286.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$480.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$286.03
|
| Rate for Payer: Multiplan All |
$166.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$486.25
|
| Rate for Payer: OMNI Networks Commercial |
$128.16
|
| Rate for Payer: One Health Plan PPO/POS |
$164.78
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$241.19
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$208.89
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$286.03
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$173.94
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$572.06
|
| Rate for Payer: Three Rivers Provider Network All |
$137.32
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$280.31
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$286.03
|
| Rate for Payer: United Payors & United Providers UP&UP |
$170.27
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$286.03
|
| Rate for Payer: Zelis Auto |
$73.24
|
| Rate for Payer: Zelis Medicare |
$243.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$343.24
|
| Rate for Payer: Zelis Worker's Compensation |
$49.98
|
|
|
ARTHROCNT ASPIR&/INJ MAJ JT/BURSA W/O US
|
Facility
|
OP
|
$1,340.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
8150063
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$204.72 |
| Max. Negotiated Rate |
$1,273.00 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$804.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$204.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$286.03
|
| Rate for Payer: Cash Price |
$804.00
|
| Rate for Payer: Cash Price |
$804.00
|
| Rate for Payer: Cigna Commercial |
$1,139.00
|
| Rate for Payer: First Health Commercial |
$1,206.00
|
| Rate for Payer: First Health Workers Compensation |
$517.37
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,206.00
|
| Rate for Payer: GEHA Commercial |
$1,072.00
|
| Rate for Payer: GEHA Medicare |
$286.03
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,206.00
|
| Rate for Payer: Humana ChoiceCare |
$314.63
|
| Rate for Payer: Humana Medicare Advantage |
$286.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$480.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$286.03
|
| Rate for Payer: Multiplan All |
$1,219.40
|
| Rate for Payer: New Mexico Health Connections Medicare |
$486.25
|
| Rate for Payer: OMNI Networks Commercial |
$938.00
|
| Rate for Payer: One Health Plan PPO/POS |
$1,206.00
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$241.19
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$208.89
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$286.03
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,273.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$572.06
|
| Rate for Payer: Three Rivers Provider Network All |
$1,005.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$280.31
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$286.03
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,246.20
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$286.03
|
| Rate for Payer: Zelis Auto |
$536.00
|
| Rate for Payer: Zelis Medicare |
$243.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$343.24
|
| Rate for Payer: Zelis Worker's Compensation |
$365.82
|
|
|
ARTHROCNT ASPIR&/INJ MAJ JT/BURSA W/O US
|
Facility
|
IP
|
$183.09
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
8520610
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$49.98 |
| Max. Negotiated Rate |
$173.94 |
| Rate for Payer: Cash Price |
$109.85
|
| Rate for Payer: Cigna Commercial |
$155.63
|
| Rate for Payer: First Health Commercial |
$164.78
|
| Rate for Payer: First Health Workers Compensation |
$70.69
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$164.78
|
| Rate for Payer: GEHA Commercial |
$128.16
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$164.78
|
| Rate for Payer: Multiplan All |
$166.61
|
| Rate for Payer: OMNI Networks Commercial |
$128.16
|
| Rate for Payer: One Health Plan PPO/POS |
$164.78
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$173.94
|
| Rate for Payer: Three Rivers Provider Network All |
$137.32
|
| Rate for Payer: United Payors & United Providers UP&UP |
$170.27
|
| Rate for Payer: Zelis Auto |
$73.24
|
| Rate for Payer: Zelis Worker's Compensation |
$49.98
|
|
|
ARTHROCNT ASPIR&/INJ MAJ JT/BURSA W/O US
|
Facility
|
IP
|
$184.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
8240000
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$50.23 |
| Max. Negotiated Rate |
$174.80 |
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cigna Commercial |
$156.40
|
| Rate for Payer: First Health Commercial |
$165.60
|
| Rate for Payer: First Health Workers Compensation |
$71.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$165.60
|
| Rate for Payer: GEHA Commercial |
$128.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$165.60
|
| Rate for Payer: Multiplan All |
$167.44
|
| Rate for Payer: OMNI Networks Commercial |
$128.80
|
| Rate for Payer: One Health Plan PPO/POS |
$165.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$174.80
|
| Rate for Payer: Three Rivers Provider Network All |
$138.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$171.12
|
| Rate for Payer: Zelis Auto |
$73.60
|
| Rate for Payer: Zelis Worker's Compensation |
$50.23
|
|
|
ARTHROCNT ASPIR&/INJ MAJ JT/BURSA W/O US
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
21600033
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$51.32 |
| Max. Negotiated Rate |
$572.06 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$112.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$258.42
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$204.72
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$286.03
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cigna Commercial |
$159.80
|
| Rate for Payer: First Health Commercial |
$169.20
|
| Rate for Payer: First Health Workers Compensation |
$72.59
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$169.20
|
| Rate for Payer: GEHA Commercial |
$150.40
|
| Rate for Payer: GEHA Medicare |
$286.03
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$169.20
|
| Rate for Payer: Humana ChoiceCare |
$314.63
|
| Rate for Payer: Humana Medicare Advantage |
$286.03
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$480.53
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$286.03
|
| Rate for Payer: Multiplan All |
$171.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$486.25
|
| Rate for Payer: OMNI Networks Commercial |
$131.60
|
| Rate for Payer: One Health Plan PPO/POS |
$169.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$241.19
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$208.89
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$286.03
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$178.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$572.06
|
| Rate for Payer: Three Rivers Provider Network All |
$141.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$280.31
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$286.03
|
| Rate for Payer: United Payors & United Providers UP&UP |
$174.84
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$286.03
|
| Rate for Payer: Zelis Auto |
$75.20
|
| Rate for Payer: Zelis Medicare |
$243.13
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$343.24
|
| Rate for Payer: Zelis Worker's Compensation |
$51.32
|
|
