|
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 |
$560.58 |
| 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 |
$280.29
|
| 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 |
$280.29
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$169.20
|
| Rate for Payer: Humana ChoiceCare |
$308.32
|
| Rate for Payer: Humana Medicare Advantage |
$280.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$470.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$280.29
|
| Rate for Payer: Multiplan All |
$171.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$476.49
|
| 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 |
$280.29
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$178.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$560.58
|
| Rate for Payer: Three Rivers Provider Network All |
$141.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$274.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$280.29
|
| Rate for Payer: United Payors & United Providers UP&UP |
$174.84
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$280.29
|
| Rate for Payer: Zelis Auto |
$75.20
|
| Rate for Payer: Zelis Medicare |
$238.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$336.35
|
| Rate for Payer: Zelis Worker's Compensation |
$51.32
|
|
|
ARTHROCNT ASPIR&/INJ MAJ JT/BURSA W/O US
|
Facility
|
IP
|
$1,586.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
6132405
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$432.98 |
| Max. Negotiated Rate |
$1,506.70 |
| Rate for Payer: Cash Price |
$951.60
|
| Rate for Payer: Cigna Commercial |
$1,348.10
|
| Rate for Payer: First Health Commercial |
$1,427.40
|
| Rate for Payer: First Health Workers Compensation |
$612.35
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,427.40
|
| Rate for Payer: GEHA Commercial |
$1,110.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,427.40
|
| Rate for Payer: Multiplan All |
$1,443.26
|
| Rate for Payer: OMNI Networks Commercial |
$1,110.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,427.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,506.70
|
| Rate for Payer: Three Rivers Provider Network All |
$1,189.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,474.98
|
| Rate for Payer: Zelis Auto |
$634.40
|
| Rate for Payer: Zelis Worker's Compensation |
$432.98
|
|
|
ARTHROCNT ASPIR&/INJ MAJ JT/BURSA W/O US
|
Facility
|
OP
|
$1,586.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
6132405
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$204.72 |
| Max. Negotiated Rate |
$1,506.70 |
| 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 |
$951.60
|
| 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 |
$280.29
|
| Rate for Payer: Cash Price |
$951.60
|
| Rate for Payer: Cash Price |
$951.60
|
| Rate for Payer: Cigna Commercial |
$1,348.10
|
| Rate for Payer: First Health Commercial |
$1,427.40
|
| Rate for Payer: First Health Workers Compensation |
$612.35
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,427.40
|
| Rate for Payer: GEHA Commercial |
$1,268.80
|
| Rate for Payer: GEHA Medicare |
$280.29
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,427.40
|
| Rate for Payer: Humana ChoiceCare |
$308.32
|
| Rate for Payer: Humana Medicare Advantage |
$280.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$470.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$280.29
|
| Rate for Payer: Multiplan All |
$1,443.26
|
| Rate for Payer: New Mexico Health Connections Medicare |
$476.49
|
| Rate for Payer: OMNI Networks Commercial |
$1,110.20
|
| Rate for Payer: One Health Plan PPO/POS |
$1,427.40
|
| 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 |
$280.29
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,506.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$560.58
|
| Rate for Payer: Three Rivers Provider Network All |
$1,189.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$274.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$280.29
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,474.98
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$280.29
|
| Rate for Payer: Zelis Auto |
$634.40
|
| Rate for Payer: Zelis Medicare |
$238.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$336.35
|
| Rate for Payer: Zelis Worker's Compensation |
$432.98
|
|
|
ARTHROCNT ASPIR&/INJ MAJ JT/BURSA W/O US
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
25500033
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$51.32 |
| Max. Negotiated Rate |
$560.58 |
| 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 |
$280.29
|
| 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 |
$280.29
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$169.20
|
| Rate for Payer: Humana ChoiceCare |
$308.32
|
| Rate for Payer: Humana Medicare Advantage |
$280.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$470.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$280.29
|
| Rate for Payer: Multiplan All |
$171.08
|
| Rate for Payer: New Mexico Health Connections Medicare |
$476.49
|
| 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 |
$280.29
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$178.60
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$560.58
|
| Rate for Payer: Three Rivers Provider Network All |
$141.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$274.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$280.29
|
| Rate for Payer: United Payors & United Providers UP&UP |
$174.84
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$280.29
|
| Rate for Payer: Zelis Auto |
$75.20
|
| Rate for Payer: Zelis Medicare |
$238.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$336.35
|
| Rate for Payer: Zelis Worker's Compensation |
$51.32
|
|
|
ARTHROCNT ASPIR&/INJ MAJ JT/BURSA W/O US
|
Facility
|
OP
|
$184.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
7620610
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$50.23 |
| Max. Negotiated Rate |
$560.58 |
| 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 |
$280.29
|
| 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 |
$280.29
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$165.60
|
| Rate for Payer: Humana ChoiceCare |
$308.32
|
| Rate for Payer: Humana Medicare Advantage |
$280.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$470.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$280.29
|
| Rate for Payer: Multiplan All |
$167.44
|
| Rate for Payer: New Mexico Health Connections Medicare |
$476.49
|
| 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 |
$280.29
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$174.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$560.58
|
| Rate for Payer: Three Rivers Provider Network All |
$138.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$274.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$280.29
|
| Rate for Payer: United Payors & United Providers UP&UP |
$171.12
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$280.29
|
| Rate for Payer: Zelis Auto |
$73.60
|
| Rate for Payer: Zelis Medicare |
$238.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$336.35
|
| Rate for Payer: Zelis Worker's Compensation |
$50.23
|
|
|
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 |
$560.58 |
| 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 |
$280.29
|
| 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 |
$280.29
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$165.60
|
| Rate for Payer: Humana ChoiceCare |
$308.32
|
| Rate for Payer: Humana Medicare Advantage |
$280.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$470.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$280.29
|
| Rate for Payer: Multiplan All |
$167.44
|
| Rate for Payer: New Mexico Health Connections Medicare |
$476.49
|
| 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 |
$280.29
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$174.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$560.58
|
| Rate for Payer: Three Rivers Provider Network All |
$138.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$274.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$280.29
|
| Rate for Payer: United Payors & United Providers UP&UP |
$171.12
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$280.29
|
| Rate for Payer: Zelis Auto |
$73.60
|
| Rate for Payer: Zelis Medicare |
$238.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$336.35
|
| Rate for Payer: Zelis Worker's Compensation |
$50.23
|
|
|
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 |
$280.29
|
| 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 |
$280.29
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,206.00
|
| Rate for Payer: Humana ChoiceCare |
$308.32
|
| Rate for Payer: Humana Medicare Advantage |
$280.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$470.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$280.29
|
| Rate for Payer: Multiplan All |
$1,219.40
|
| Rate for Payer: New Mexico Health Connections Medicare |
$476.49
|
| 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 |
$280.29
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,273.00
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$560.58
|
| Rate for Payer: Three Rivers Provider Network All |
$1,005.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$274.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$280.29
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,246.20
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$280.29
|
| Rate for Payer: Zelis Auto |
$536.00
|
| Rate for Payer: Zelis Medicare |
$238.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$336.35
|
| Rate for Payer: Zelis Worker's Compensation |
$365.82
|
|
|
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
|
$183.09
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
8520610
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$49.98 |
| Max. Negotiated Rate |
$560.58 |
| 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 |
$280.29
|
| 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 |
$280.29
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$164.78
|
| Rate for Payer: Humana ChoiceCare |
$308.32
|
| Rate for Payer: Humana Medicare Advantage |
$280.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$470.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$280.29
|
| Rate for Payer: Multiplan All |
$166.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$476.49
|
| 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 |
$280.29
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$173.94
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$560.58
|
| Rate for Payer: Three Rivers Provider Network All |
$137.32
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$274.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$280.29
|
| Rate for Payer: United Payors & United Providers UP&UP |
$170.27
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$280.29
|
| Rate for Payer: Zelis Auto |
$73.24
|
| Rate for Payer: Zelis Medicare |
$238.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$336.35
|
| Rate for Payer: Zelis Worker's Compensation |
$49.98
|
|
|
ARTHROCNT ASPIR&/INJ MAJ JT/BURSA W/O US
|
Facility
|
OP
|
$184.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
8800007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$50.23 |
| Max. Negotiated Rate |
$560.58 |
| 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 |
$280.29
|
| 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 |
$280.29
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$165.60
|
| Rate for Payer: Humana ChoiceCare |
$308.32
|
| Rate for Payer: Humana Medicare Advantage |
$280.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$470.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$280.29
|
| Rate for Payer: Multiplan All |
$167.44
|
| Rate for Payer: New Mexico Health Connections Medicare |
$476.49
|
| 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 |
$280.29
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$174.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$560.58
|
| Rate for Payer: Three Rivers Provider Network All |
$138.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$274.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$280.29
|
| Rate for Payer: United Payors & United Providers UP&UP |
$171.12
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$280.29
|
| Rate for Payer: Zelis Auto |
$73.60
|
| Rate for Payer: Zelis Medicare |
$238.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$336.35
|
| Rate for Payer: Zelis Worker's Compensation |
$50.23
|
|
|
ARTHROCNT ASPIR&/INJ MAJ JT/BURSA W/O US
|
Facility
|
OP
|
$184.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
8240000
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$50.23 |
| Max. Negotiated Rate |
$560.58 |
| 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 |
$280.29
|
| 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 |
$280.29
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$165.60
|
| Rate for Payer: Humana ChoiceCare |
$308.32
|
| Rate for Payer: Humana Medicare Advantage |
$280.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$470.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$280.29
|
| Rate for Payer: Multiplan All |
$167.44
|
| Rate for Payer: New Mexico Health Connections Medicare |
$476.49
|
| 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 |
$280.29
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$174.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$560.58
|
| Rate for Payer: Three Rivers Provider Network All |
$138.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$274.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$280.29
|
| Rate for Payer: United Payors & United Providers UP&UP |
$171.12
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$280.29
|
| Rate for Payer: Zelis Auto |
$73.60
|
| Rate for Payer: Zelis Medicare |
$238.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$336.35
|
| Rate for Payer: Zelis Worker's Compensation |
$50.23
|
|
|
ARTHROCNT ASPIR&/INJ MAJ JT/BURSA W/O US
|
Facility
|
IP
|
$184.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
7620610
|
|
Hospital Revenue Code
|
983
|
| 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
|
$183.09
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
7220610
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$49.98 |
| Max. Negotiated Rate |
$560.58 |
| 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 |
$280.29
|
| 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 |
$280.29
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$164.78
|
| Rate for Payer: Humana ChoiceCare |
$308.32
|
| Rate for Payer: Humana Medicare Advantage |
$280.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$470.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$208.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$280.29
|
| Rate for Payer: Multiplan All |
$166.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$476.49
|
| 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 |
$280.29
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$173.94
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$560.58
|
| Rate for Payer: Three Rivers Provider Network All |
$137.32
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$274.68
|
| Rate for Payer: United Healthcare Managed Medicaid |
$208.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$280.29
|
| Rate for Payer: United Payors & United Providers UP&UP |
$170.27
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$280.29
|
| Rate for Payer: Zelis Auto |
$73.24
|
| Rate for Payer: Zelis Medicare |
$238.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$336.35
|
| 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 |
8800007
|
|
Hospital Revenue Code
|
510
|
| 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
|
IP
|
$184.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
9400089
|
|
Hospital Revenue Code
|
510
|
| 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 SM JT/BURSAW/US REC
|
Facility
|
OP
|
$1,507.00
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
8204023
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$238.25 |
| Max. Negotiated Rate |
$1,431.65 |
| 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 |
$904.20
|
| 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 |
$280.29
|
| Rate for Payer: Cash Price |
$904.20
|
| Rate for Payer: Cash Price |
$904.20
|
| Rate for Payer: Cigna Commercial |
$1,280.95
|
| Rate for Payer: First Health Commercial |
$1,356.30
|
| Rate for Payer: First Health Workers Compensation |
$581.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,356.30
|
| Rate for Payer: GEHA Commercial |
$1,205.60
|
| Rate for Payer: GEHA Medicare |
$280.29
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,356.30
|
| Rate for Payer: Humana ChoiceCare |
$308.32
|
| Rate for Payer: Humana Medicare Advantage |
$280.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$470.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$256.00
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$280.29
|
| Rate for Payer: Multiplan All |
$1,371.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$476.49
|
| Rate for Payer: OMNI Networks Commercial |
$1,054.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,356.30
|
| 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 |
$280.29
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,431.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$560.58
|
| Rate for Payer: Three Rivers Provider Network All |
$1,130.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$274.68
|
| Rate for Payer: United Healthcare Commercial |
$1,280.95
|
| Rate for Payer: United Healthcare Managed Medicaid |
$256.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$280.29
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,401.51
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$280.29
|
| Rate for Payer: Zelis Auto |
$602.80
|
| Rate for Payer: Zelis Medicare |
$238.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$336.35
|
| Rate for Payer: Zelis Worker's Compensation |
$411.41
|
|
|
ARTHROCNT ASPIR&/INJ SM JT/BURSAW/US REC
|
Facility
|
IP
|
$1,507.00
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
8800046
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$411.41 |
| Max. Negotiated Rate |
$1,431.65 |
| Rate for Payer: Cash Price |
$904.20
|
| Rate for Payer: Cigna Commercial |
$1,280.95
|
| Rate for Payer: First Health Commercial |
$1,356.30
|
| Rate for Payer: First Health Workers Compensation |
$581.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,356.30
|
| Rate for Payer: GEHA Commercial |
$1,054.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,356.30
|
| Rate for Payer: Multiplan All |
$1,371.37
|
| Rate for Payer: OMNI Networks Commercial |
$1,054.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,356.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,431.65
|
| Rate for Payer: Three Rivers Provider Network All |
$1,130.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,401.51
|
| Rate for Payer: Zelis Auto |
$602.80
|
| Rate for Payer: Zelis Worker's Compensation |
$411.41
|
|
|
ARTHROCNT ASPIR&/INJ SM JT/BURSAW/US REC
|
Facility
|
IP
|
$1,507.00
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
8204023
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$411.41 |
| Max. Negotiated Rate |
$1,431.65 |
| Rate for Payer: Cash Price |
$904.20
|
| Rate for Payer: Cigna Commercial |
$1,280.95
|
| Rate for Payer: First Health Commercial |
$1,356.30
|
| Rate for Payer: First Health Workers Compensation |
$581.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,356.30
|
| Rate for Payer: GEHA Commercial |
$1,054.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,356.30
|
| Rate for Payer: Multiplan All |
$1,371.37
|
| Rate for Payer: OMNI Networks Commercial |
$1,054.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,356.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,431.65
|
| Rate for Payer: Three Rivers Provider Network All |
$1,130.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,401.51
|
| Rate for Payer: Zelis Auto |
$602.80
|
| Rate for Payer: Zelis Worker's Compensation |
$411.41
|
|
|
ARTHROCNT ASPIR&/INJ SM JT/BURSAW/US REC
|
Facility
|
OP
|
$1,507.00
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
8800046
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$238.25 |
| Max. Negotiated Rate |
$1,431.65 |
| 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 |
$904.20
|
| 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 |
$280.29
|
| Rate for Payer: Cash Price |
$904.20
|
| Rate for Payer: Cash Price |
$904.20
|
| Rate for Payer: Cigna Commercial |
$1,280.95
|
| Rate for Payer: First Health Commercial |
$1,356.30
|
| Rate for Payer: First Health Workers Compensation |
$581.85
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,356.30
|
| Rate for Payer: GEHA Commercial |
$1,205.60
|
| Rate for Payer: GEHA Medicare |
$280.29
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,356.30
|
| Rate for Payer: Humana ChoiceCare |
$308.32
|
| Rate for Payer: Humana Medicare Advantage |
$280.29
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$470.89
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$256.00
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$280.29
|
| Rate for Payer: Multiplan All |
$1,371.37
|
| Rate for Payer: New Mexico Health Connections Medicare |
$476.49
|
| Rate for Payer: OMNI Networks Commercial |
$1,054.90
|
| Rate for Payer: One Health Plan PPO/POS |
$1,356.30
|
| 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 |
$280.29
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,431.65
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$560.58
|
| Rate for Payer: Three Rivers Provider Network All |
$1,130.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$274.68
|
| Rate for Payer: United Healthcare Commercial |
$1,280.95
|
| Rate for Payer: United Healthcare Managed Medicaid |
$256.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$280.29
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,401.51
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$280.29
|
| Rate for Payer: Zelis Auto |
$602.80
|
| Rate for Payer: Zelis Medicare |
$238.25
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$336.35
|
| Rate for Payer: Zelis Worker's Compensation |
$411.41
|
|
|
ARTHRODESIS; SUBTALAR
|
Facility
|
OP
|
$24,435.12
|
|
|
Service Code
|
CPT 28725
|
| Hospital Charge Code |
6128725
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,207.24 |
| Max. Negotiated Rate |
$24,435.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,310.82
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,310.82
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,207.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,217.56
|
| Rate for Payer: First Health Workers Compensation |
$15,724.00
|
| Rate for Payer: GEHA Medicare |
$12,217.56
|
| 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 |
$4,292.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,217.56
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,769.85
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,956.77
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,292.92
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,217.56
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,435.12
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,973.21
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,292.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,217.56
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$12,217.56
|
| 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 |
$11,117.98
|
|
|
ARTHRODESIS; SUBTALAR
|
Facility
|
IP
|
$1,595.00
|
|
|
Service Code
|
CPT 28725
|
| Hospital Charge Code |
6128725
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$435.44 |
| Max. Negotiated Rate |
$1,515.25 |
| Rate for Payer: Cash Price |
$957.00
|
| Rate for Payer: Cigna Commercial |
$1,355.75
|
| Rate for Payer: First Health Commercial |
$1,435.50
|
| Rate for Payer: First Health Workers Compensation |
$615.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,435.50
|
| Rate for Payer: GEHA Commercial |
$1,116.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,435.50
|
| Rate for Payer: Multiplan All |
$1,451.45
|
| Rate for Payer: OMNI Networks Commercial |
$1,116.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,435.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,515.25
|
| Rate for Payer: Three Rivers Provider Network All |
$1,196.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,483.35
|
| Rate for Payer: Zelis Auto |
$638.00
|
| Rate for Payer: Zelis Worker's Compensation |
$435.44
|
|
|
ARTHRODESIS; SUBTALAR
|
Facility
|
OP
|
$1,595.00
|
|
|
Service Code
|
CPT 28725
|
| Hospital Charge Code |
6128725
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$435.44 |
| Max. Negotiated Rate |
$24,435.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,310.82
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$957.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,310.82
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,207.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,217.56
|
| Rate for Payer: Cash Price |
$957.00
|
| Rate for Payer: Cash Price |
$957.00
|
| Rate for Payer: Cigna Commercial |
$1,355.75
|
| Rate for Payer: First Health Commercial |
$1,435.50
|
| Rate for Payer: First Health Workers Compensation |
$615.83
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,435.50
|
| Rate for Payer: GEHA Commercial |
$1,276.00
|
| Rate for Payer: GEHA Medicare |
$12,217.56
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,435.50
|
| 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 |
$4,292.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,217.56
|
| Rate for Payer: Multiplan All |
$1,451.45
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,769.85
|
| Rate for Payer: OMNI Networks Commercial |
$1,116.50
|
| Rate for Payer: One Health Plan PPO/POS |
$1,435.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,956.77
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,292.92
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,217.56
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,515.25
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,435.12
|
| Rate for Payer: Three Rivers Provider Network All |
$1,196.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,973.21
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,292.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,217.56
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,483.35
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$12,217.56
|
| Rate for Payer: Zelis Auto |
$638.00
|
| 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 |
$435.44
|
|
|
ARTHRODESIS; SUBTALAR
|
Facility
|
OP
|
$24,435.12
|
|
|
Service Code
|
CPT 28725
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,207.24 |
| Max. Negotiated Rate |
$24,435.12 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$5,310.82
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$5,310.82
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$4,207.24
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$12,217.56
|
| Rate for Payer: First Health Workers Compensation |
$15,724.00
|
| Rate for Payer: GEHA Medicare |
$12,217.56
|
| 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 |
$4,292.92
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$12,217.56
|
| Rate for Payer: New Mexico Health Connections Medicare |
$20,769.85
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,956.77
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$4,292.92
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$12,217.56
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$24,435.12
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$11,973.21
|
| Rate for Payer: United Healthcare Managed Medicaid |
$4,292.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,217.56
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$12,217.56
|
| 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 |
$11,117.98
|
|
|
ARTHRODESIS, WRIST; COMPLETE, WITHOUT BONE GRAFT (INCLUDES RADIOCARPAL AND/OR INTERCARPAL AND/OR CARPOMETACARPAL JOINTS)
|
Facility
|
OP
|
$13,566.52
|
|
|
Service Code
|
CPT 25800
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,765.77 |
| Max. Negotiated Rate |
$13,566.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$8,963.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$8,963.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7,100.90
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,783.26
|
| Rate for Payer: First Health Workers Compensation |
$8,730.06
|
| Rate for Payer: GEHA Medicare |
$6,783.26
|
| Rate for Payer: Humana ChoiceCare |
$7,461.59
|
| Rate for Payer: Humana Medicare Advantage |
$6,783.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,395.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7,245.51
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,783.26
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,531.54
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$8,365.95
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7,245.51
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,783.26
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,566.52
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,647.59
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7,245.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,783.26
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,783.26
|
| Rate for Payer: Zelis Medicare |
$5,765.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,139.91
|
| Rate for Payer: Zelis Worker's Compensation |
$6,172.77
|
|
|
ARTHRODESIS, WRIST; LIMITED, WITHOUT BONE GRAFT (EG, INTERCARPAL OR RADIOCARPAL)
|
Facility
|
OP
|
$13,566.52
|
|
|
Service Code
|
CPT 25820
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,730.88 |
| Max. Negotiated Rate |
$13,566.52 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$4,709.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$4,709.52
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$3,730.88
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$6,783.26
|
| Rate for Payer: First Health Workers Compensation |
$8,730.06
|
| Rate for Payer: GEHA Medicare |
$6,783.26
|
| Rate for Payer: Humana ChoiceCare |
$7,461.59
|
| Rate for Payer: Humana Medicare Advantage |
$6,783.26
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$11,395.88
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$3,806.86
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$6,783.26
|
| Rate for Payer: New Mexico Health Connections Medicare |
$11,531.54
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$4,395.55
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$3,806.86
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$6,783.26
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$13,566.52
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$6,647.59
|
| Rate for Payer: United Healthcare Managed Medicaid |
$3,806.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,783.26
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$6,783.26
|
| Rate for Payer: Zelis Medicare |
$5,765.77
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$8,139.91
|
| Rate for Payer: Zelis Worker's Compensation |
$6,172.77
|
|
