|
OCCULT BLOOD FECAL SCREENING IMMUNO
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT 82274
|
| Hospital Charge Code |
2247460
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.71 |
| Max. Negotiated Rate |
$79.80 |
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cigna Commercial |
$71.40
|
| Rate for Payer: First Health Commercial |
$75.60
|
| Rate for Payer: First Health Workers Compensation |
$20.80
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$75.60
|
| Rate for Payer: GEHA Commercial |
$58.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$75.60
|
| Rate for Payer: Multiplan All |
$76.44
|
| Rate for Payer: OMNI Networks Commercial |
$58.80
|
| Rate for Payer: One Health Plan PPO/POS |
$75.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$79.80
|
| Rate for Payer: Three Rivers Provider Network All |
$63.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$78.12
|
| Rate for Payer: Zelis Auto |
$33.60
|
| Rate for Payer: Zelis Worker's Compensation |
$14.71
|
|
|
OCCULT BLOOD FECAL SCREENING IMMUNO
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 82274
|
| Hospital Charge Code |
2247460
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$79.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$28.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$50.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$28.65
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$22.70
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$15.92
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cigna Commercial |
$71.40
|
| Rate for Payer: First Health Commercial |
$75.60
|
| Rate for Payer: First Health Workers Compensation |
$20.80
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$75.60
|
| Rate for Payer: GEHA Commercial |
$67.20
|
| Rate for Payer: GEHA Medicare |
$15.92
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$75.60
|
| Rate for Payer: Humana ChoiceCare |
$17.51
|
| Rate for Payer: Humana Medicare Advantage |
$15.92
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$26.75
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$23.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$15.92
|
| Rate for Payer: Multiplan All |
$76.44
|
| Rate for Payer: New Mexico Health Connections Medicare |
$27.06
|
| Rate for Payer: OMNI Networks Commercial |
$58.80
|
| Rate for Payer: One Health Plan PPO/POS |
$75.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$26.74
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$23.16
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$15.92
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$79.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$31.84
|
| Rate for Payer: Three Rivers Provider Network All |
$63.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$15.60
|
| Rate for Payer: United Healthcare Commercial |
$71.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$23.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.92
|
| Rate for Payer: United Payors & United Providers UP&UP |
$78.12
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$15.92
|
| Rate for Payer: Zelis Auto |
$33.60
|
| Rate for Payer: Zelis Medicare |
$13.53
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$19.10
|
| Rate for Payer: Zelis Worker's Compensation |
$14.71
|
|
|
OCCULT BLOOD FECES
|
Facility
|
OP
|
$71.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
7282270
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$3.72 |
| Max. Negotiated Rate |
$67.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$42.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$4.38
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$60.35
|
| Rate for Payer: First Health Commercial |
$63.90
|
| Rate for Payer: First Health Workers Compensation |
$5.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$63.90
|
| Rate for Payer: GEHA Commercial |
$56.80
|
| Rate for Payer: GEHA Medicare |
$4.38
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$63.90
|
| Rate for Payer: Humana ChoiceCare |
$4.82
|
| Rate for Payer: Humana Medicare Advantage |
$4.38
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$7.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$4.38
|
| Rate for Payer: Multiplan All |
$64.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$7.45
|
| Rate for Payer: OMNI Networks Commercial |
$49.70
|
| Rate for Payer: One Health Plan PPO/POS |
$63.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$7.36
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$4.38
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$67.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$8.76
|
| Rate for Payer: Three Rivers Provider Network All |
$53.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4.29
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.38
|
| Rate for Payer: United Payors & United Providers UP&UP |
$66.03
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$4.38
|
| Rate for Payer: Zelis Auto |
$28.40
|
| Rate for Payer: Zelis Medicare |
$3.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5.26
|
| Rate for Payer: Zelis Worker's Compensation |
$3.90
|
|
|
OCCULT BLOOD FECES
|
Facility
|
IP
|
$71.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
7282270
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$67.45 |
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$60.35
|
| Rate for Payer: First Health Commercial |
$63.90
|
| Rate for Payer: First Health Workers Compensation |
$5.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$63.90
|
| Rate for Payer: GEHA Commercial |
$49.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$63.90
|
| Rate for Payer: Multiplan All |
$64.61
|
| Rate for Payer: OMNI Networks Commercial |
$49.70
|
| Rate for Payer: One Health Plan PPO/POS |
$63.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$67.45
|
| Rate for Payer: Three Rivers Provider Network All |
$53.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$66.03
|
| Rate for Payer: Zelis Auto |
$28.40
|
| Rate for Payer: Zelis Worker's Compensation |
$3.90
|
|
|
OCCULT BLOOD, FECES - KAYDAHZINNE
|
Facility
|
IP
|
$24.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
9100002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$22.80 |
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna Commercial |
$20.40
|
| Rate for Payer: First Health Commercial |
$21.60
|
| Rate for Payer: First Health Workers Compensation |
$5.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$21.60
|
| Rate for Payer: GEHA Commercial |
$16.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$21.60
|
| Rate for Payer: Multiplan All |
$21.84
|
| Rate for Payer: OMNI Networks Commercial |
$16.80
|
| Rate for Payer: One Health Plan PPO/POS |
$21.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$22.80
|
| Rate for Payer: Three Rivers Provider Network All |
$18.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$22.32
|
| Rate for Payer: Zelis Auto |
$9.60
|
| Rate for Payer: Zelis Worker's Compensation |
$3.90
|
|
|
OCCULT BLOOD, FECES - KAYDAHZINNE
|
Facility
|
OP
|
$24.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
9100002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.72 |
| Max. Negotiated Rate |
$22.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$4.38
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna Commercial |
$20.40
|
| Rate for Payer: First Health Commercial |
$21.60
|
| Rate for Payer: First Health Workers Compensation |
$5.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$21.60
|
| Rate for Payer: GEHA Commercial |
$19.20
|
| Rate for Payer: GEHA Medicare |
$4.38
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$21.60
|
| Rate for Payer: Humana ChoiceCare |
$4.82
|
| Rate for Payer: Humana Medicare Advantage |
$4.38
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$7.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$4.38
|
| Rate for Payer: Multiplan All |
$21.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$7.45
|
| Rate for Payer: OMNI Networks Commercial |
$16.80
|
| Rate for Payer: One Health Plan PPO/POS |
$21.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$7.36
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$4.38
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$22.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$8.76
|
| Rate for Payer: Three Rivers Provider Network All |
$18.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4.29
|
| Rate for Payer: United Healthcare Commercial |
$20.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.38
|
| Rate for Payer: United Payors & United Providers UP&UP |
$22.32
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$4.38
|
| Rate for Payer: Zelis Auto |
$9.60
|
| Rate for Payer: Zelis Medicare |
$3.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5.26
|
| Rate for Payer: Zelis Worker's Compensation |
$3.90
|
|
|
OCCULT BLOOD, FECES - MEMORIAL FAMILY
|
Facility
|
IP
|
$71.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
8582270
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$67.45 |
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$60.35
|
| Rate for Payer: First Health Commercial |
$63.90
|
| Rate for Payer: First Health Workers Compensation |
$5.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$63.90
|
| Rate for Payer: GEHA Commercial |
$49.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$63.90
|
| Rate for Payer: Multiplan All |
$64.61
|
| Rate for Payer: OMNI Networks Commercial |
$49.70
|
| Rate for Payer: One Health Plan PPO/POS |
$63.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$67.45
|
| Rate for Payer: Three Rivers Provider Network All |
$53.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$66.03
|
| Rate for Payer: Zelis Auto |
$28.40
|
| Rate for Payer: Zelis Worker's Compensation |
$3.90
|
|
|
OCCULT BLOOD, FECES - MEMORIAL FAMILY
|
Facility
|
OP
|
$71.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
8582270
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$3.72 |
| Max. Negotiated Rate |
$67.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$42.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$4.38
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cash Price |
$42.60
|
| Rate for Payer: Cigna Commercial |
$60.35
|
| Rate for Payer: First Health Commercial |
$63.90
|
| Rate for Payer: First Health Workers Compensation |
$5.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$63.90
|
| Rate for Payer: GEHA Commercial |
$56.80
|
| Rate for Payer: GEHA Medicare |
$4.38
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$63.90
|
| Rate for Payer: Humana ChoiceCare |
$4.82
|
| Rate for Payer: Humana Medicare Advantage |
$4.38
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$7.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$4.38
|
| Rate for Payer: Multiplan All |
$64.61
|
| Rate for Payer: New Mexico Health Connections Medicare |
$7.45
|
| Rate for Payer: OMNI Networks Commercial |
$49.70
|
| Rate for Payer: One Health Plan PPO/POS |
$63.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$7.36
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$4.38
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$67.45
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$8.76
|
| Rate for Payer: Three Rivers Provider Network All |
$53.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4.29
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.38
|
| Rate for Payer: United Payors & United Providers UP&UP |
$66.03
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$4.38
|
| Rate for Payer: Zelis Auto |
$28.40
|
| Rate for Payer: Zelis Medicare |
$3.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5.26
|
| Rate for Payer: Zelis Worker's Compensation |
$3.90
|
|
|
OCCULT BLOOD, FECES - SALGADO
|
Facility
|
IP
|
$24.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
9400040
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$22.80 |
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna Commercial |
$20.40
|
| Rate for Payer: First Health Commercial |
$21.60
|
| Rate for Payer: First Health Workers Compensation |
$5.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$21.60
|
| Rate for Payer: GEHA Commercial |
$16.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$21.60
|
| Rate for Payer: Multiplan All |
$21.84
|
| Rate for Payer: OMNI Networks Commercial |
$16.80
|
| Rate for Payer: One Health Plan PPO/POS |
$21.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$22.80
|
| Rate for Payer: Three Rivers Provider Network All |
$18.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$22.32
|
| Rate for Payer: Zelis Auto |
$9.60
|
| Rate for Payer: Zelis Worker's Compensation |
$3.90
|
|
|
OCCULT BLOOD, FECES - SALGADO
|
Facility
|
OP
|
$24.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
9400040
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.72 |
| Max. Negotiated Rate |
$22.80 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$14.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$4.38
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna Commercial |
$20.40
|
| Rate for Payer: First Health Commercial |
$21.60
|
| Rate for Payer: First Health Workers Compensation |
$5.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$21.60
|
| Rate for Payer: GEHA Commercial |
$19.20
|
| Rate for Payer: GEHA Medicare |
$4.38
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$21.60
|
| Rate for Payer: Humana ChoiceCare |
$4.82
|
| Rate for Payer: Humana Medicare Advantage |
$4.38
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$7.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$4.38
|
| Rate for Payer: Multiplan All |
$21.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$7.45
|
| Rate for Payer: OMNI Networks Commercial |
$16.80
|
| Rate for Payer: One Health Plan PPO/POS |
$21.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$7.36
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$4.38
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$22.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$8.76
|
| Rate for Payer: Three Rivers Provider Network All |
$18.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4.29
|
| Rate for Payer: United Healthcare Commercial |
$20.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.38
|
| Rate for Payer: United Payors & United Providers UP&UP |
$22.32
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$4.38
|
| Rate for Payer: Zelis Auto |
$9.60
|
| Rate for Payer: Zelis Medicare |
$3.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5.26
|
| Rate for Payer: Zelis Worker's Compensation |
$3.90
|
|
|
OCCULT BLOOD GASTRIC
|
Facility
|
OP
|
$58.00
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
22990751
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.32 |
| Max. Negotiated Rate |
$55.10 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$34.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7.98
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6.32
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5.32
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Cigna Commercial |
$49.30
|
| Rate for Payer: First Health Commercial |
$52.20
|
| Rate for Payer: First Health Workers Compensation |
$6.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$52.20
|
| Rate for Payer: GEHA Commercial |
$46.40
|
| Rate for Payer: GEHA Medicare |
$5.32
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$52.20
|
| Rate for Payer: Humana ChoiceCare |
$5.85
|
| Rate for Payer: Humana Medicare Advantage |
$5.32
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$8.94
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6.45
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5.32
|
| Rate for Payer: Multiplan All |
$52.78
|
| Rate for Payer: New Mexico Health Connections Medicare |
$9.04
|
| Rate for Payer: OMNI Networks Commercial |
$40.60
|
| Rate for Payer: One Health Plan PPO/POS |
$52.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$7.45
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6.45
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5.32
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$55.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10.64
|
| Rate for Payer: Three Rivers Provider Network All |
$43.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5.21
|
| Rate for Payer: United Healthcare Commercial |
$49.30
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.32
|
| Rate for Payer: United Payors & United Providers UP&UP |
$53.94
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5.32
|
| Rate for Payer: Zelis Auto |
$23.20
|
| Rate for Payer: Zelis Medicare |
$4.52
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6.38
|
| Rate for Payer: Zelis Worker's Compensation |
$4.32
|
|
|
OCCULT BLOOD GASTRIC
|
Facility
|
IP
|
$58.00
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
22990751
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.32 |
| Max. Negotiated Rate |
$55.10 |
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Cigna Commercial |
$49.30
|
| Rate for Payer: First Health Commercial |
$52.20
|
| Rate for Payer: First Health Workers Compensation |
$6.11
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$52.20
|
| Rate for Payer: GEHA Commercial |
$40.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$52.20
|
| Rate for Payer: Multiplan All |
$52.78
|
| Rate for Payer: OMNI Networks Commercial |
$40.60
|
| Rate for Payer: One Health Plan PPO/POS |
$52.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$55.10
|
| Rate for Payer: Three Rivers Provider Network All |
$43.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$53.94
|
| Rate for Payer: Zelis Auto |
$23.20
|
| Rate for Payer: Zelis Worker's Compensation |
$4.32
|
|
|
OCCULT BLOOD STOOL
|
Facility
|
IP
|
$61.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
2209205
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$57.95 |
| Rate for Payer: Cash Price |
$36.60
|
| Rate for Payer: Cash Price |
$36.60
|
| Rate for Payer: Cigna Commercial |
$51.85
|
| Rate for Payer: First Health Commercial |
$54.90
|
| Rate for Payer: First Health Workers Compensation |
$5.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$54.90
|
| Rate for Payer: GEHA Commercial |
$42.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$54.90
|
| Rate for Payer: Multiplan All |
$55.51
|
| Rate for Payer: OMNI Networks Commercial |
$42.70
|
| Rate for Payer: One Health Plan PPO/POS |
$54.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$57.95
|
| Rate for Payer: Three Rivers Provider Network All |
$45.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$56.73
|
| Rate for Payer: Zelis Auto |
$24.40
|
| Rate for Payer: Zelis Worker's Compensation |
$3.90
|
|
|
OCCULT BLOOD STOOL
|
Facility
|
OP
|
$61.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
2209205
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.72 |
| Max. Negotiated Rate |
$57.95 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$36.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$4.38
|
| Rate for Payer: Cash Price |
$36.60
|
| Rate for Payer: Cash Price |
$36.60
|
| Rate for Payer: Cigna Commercial |
$51.85
|
| Rate for Payer: First Health Commercial |
$54.90
|
| Rate for Payer: First Health Workers Compensation |
$5.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$54.90
|
| Rate for Payer: GEHA Commercial |
$48.80
|
| Rate for Payer: GEHA Medicare |
$4.38
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$54.90
|
| Rate for Payer: Humana ChoiceCare |
$4.82
|
| Rate for Payer: Humana Medicare Advantage |
$4.38
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$7.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$4.38
|
| Rate for Payer: Multiplan All |
$55.51
|
| Rate for Payer: New Mexico Health Connections Medicare |
$7.45
|
| Rate for Payer: OMNI Networks Commercial |
$42.70
|
| Rate for Payer: One Health Plan PPO/POS |
$54.90
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$7.36
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$4.38
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$57.95
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$8.76
|
| Rate for Payer: Three Rivers Provider Network All |
$45.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4.29
|
| Rate for Payer: United Healthcare Commercial |
$51.85
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.38
|
| Rate for Payer: United Payors & United Providers UP&UP |
$56.73
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$4.38
|
| Rate for Payer: Zelis Auto |
$24.40
|
| Rate for Payer: Zelis Medicare |
$3.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5.26
|
| Rate for Payer: Zelis Worker's Compensation |
$3.90
|
|
|
OCCULT BLOOD STOOL #2
|
Facility
|
IP
|
$5.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
2290010
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$5.51 |
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cigna Commercial |
$4.25
|
| Rate for Payer: First Health Commercial |
$4.50
|
| Rate for Payer: First Health Workers Compensation |
$5.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4.50
|
| Rate for Payer: GEHA Commercial |
$3.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4.50
|
| Rate for Payer: Multiplan All |
$4.55
|
| Rate for Payer: OMNI Networks Commercial |
$3.50
|
| Rate for Payer: One Health Plan PPO/POS |
$4.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4.75
|
| Rate for Payer: Three Rivers Provider Network All |
$3.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4.65
|
| Rate for Payer: Zelis Auto |
$2.00
|
| Rate for Payer: Zelis Worker's Compensation |
$3.90
|
|
|
OCCULT BLOOD STOOL #2
|
Facility
|
OP
|
$5.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
2290010
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$8.76 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$4.38
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cigna Commercial |
$4.25
|
| Rate for Payer: First Health Commercial |
$4.50
|
| Rate for Payer: First Health Workers Compensation |
$5.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4.50
|
| Rate for Payer: GEHA Commercial |
$4.00
|
| Rate for Payer: GEHA Medicare |
$4.38
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4.50
|
| Rate for Payer: Humana ChoiceCare |
$4.82
|
| Rate for Payer: Humana Medicare Advantage |
$4.38
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$7.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$4.38
|
| Rate for Payer: Multiplan All |
$4.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$7.45
|
| Rate for Payer: OMNI Networks Commercial |
$3.50
|
| Rate for Payer: One Health Plan PPO/POS |
$4.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$7.36
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$4.38
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$8.76
|
| Rate for Payer: Three Rivers Provider Network All |
$3.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4.29
|
| Rate for Payer: United Healthcare Commercial |
$4.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.38
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$4.38
|
| Rate for Payer: Zelis Auto |
$2.00
|
| Rate for Payer: Zelis Medicare |
$3.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5.26
|
| Rate for Payer: Zelis Worker's Compensation |
$3.90
|
|
|
OCCULT BLOOD STOOL #3
|
Facility
|
IP
|
$5.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
2290011
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$5.51 |
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cigna Commercial |
$4.25
|
| Rate for Payer: First Health Commercial |
$4.50
|
| Rate for Payer: First Health Workers Compensation |
$5.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4.50
|
| Rate for Payer: GEHA Commercial |
$3.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4.50
|
| Rate for Payer: Multiplan All |
$4.55
|
| Rate for Payer: OMNI Networks Commercial |
$3.50
|
| Rate for Payer: One Health Plan PPO/POS |
$4.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4.75
|
| Rate for Payer: Three Rivers Provider Network All |
$3.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4.65
|
| Rate for Payer: Zelis Auto |
$2.00
|
| Rate for Payer: Zelis Worker's Compensation |
$3.90
|
|
|
OCCULT BLOOD STOOL #3
|
Facility
|
OP
|
$5.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
2290011
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$8.76 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7.89
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6.25
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$4.38
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cigna Commercial |
$4.25
|
| Rate for Payer: First Health Commercial |
$4.50
|
| Rate for Payer: First Health Workers Compensation |
$5.51
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4.50
|
| Rate for Payer: GEHA Commercial |
$4.00
|
| Rate for Payer: GEHA Medicare |
$4.38
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4.50
|
| Rate for Payer: Humana ChoiceCare |
$4.82
|
| Rate for Payer: Humana Medicare Advantage |
$4.38
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$7.36
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6.38
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$4.38
|
| Rate for Payer: Multiplan All |
$4.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$7.45
|
| Rate for Payer: OMNI Networks Commercial |
$3.50
|
| Rate for Payer: One Health Plan PPO/POS |
$4.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$7.36
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6.38
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$4.38
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$8.76
|
| Rate for Payer: Three Rivers Provider Network All |
$3.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4.29
|
| Rate for Payer: United Healthcare Commercial |
$4.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.38
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$4.38
|
| Rate for Payer: Zelis Auto |
$2.00
|
| Rate for Payer: Zelis Medicare |
$3.72
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5.26
|
| Rate for Payer: Zelis Worker's Compensation |
$3.90
|
|
|
OCCULT BLOOD STOOL FIRST SAMPLE
|
Facility
|
OP
|
$5.00
|
|
|
Service Code
|
CPT 82272
|
| Hospital Charge Code |
2300036
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$8.46 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$4.23
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cigna Commercial |
$4.25
|
| Rate for Payer: First Health Commercial |
$4.50
|
| Rate for Payer: First Health Workers Compensation |
$6.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4.50
|
| Rate for Payer: GEHA Commercial |
$4.00
|
| Rate for Payer: GEHA Medicare |
$4.23
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4.50
|
| Rate for Payer: Humana ChoiceCare |
$4.65
|
| Rate for Payer: Humana Medicare Advantage |
$4.23
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$7.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$4.23
|
| Rate for Payer: Multiplan All |
$4.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$7.19
|
| Rate for Payer: OMNI Networks Commercial |
$3.50
|
| Rate for Payer: One Health Plan PPO/POS |
$4.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$7.11
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6.16
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$4.23
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$8.46
|
| Rate for Payer: Three Rivers Provider Network All |
$3.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4.15
|
| Rate for Payer: United Healthcare Commercial |
$4.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.23
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$4.23
|
| Rate for Payer: Zelis Auto |
$2.00
|
| Rate for Payer: Zelis Medicare |
$3.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5.08
|
| Rate for Payer: Zelis Worker's Compensation |
$4.91
|
|
|
OCCULT BLOOD STOOL FIRST SAMPLE
|
Facility
|
IP
|
$5.00
|
|
|
Service Code
|
CPT 82272
|
| Hospital Charge Code |
2300036
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$6.95 |
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cigna Commercial |
$4.25
|
| Rate for Payer: First Health Commercial |
$4.50
|
| Rate for Payer: First Health Workers Compensation |
$6.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4.50
|
| Rate for Payer: GEHA Commercial |
$3.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4.50
|
| Rate for Payer: Multiplan All |
$4.55
|
| Rate for Payer: OMNI Networks Commercial |
$3.50
|
| Rate for Payer: One Health Plan PPO/POS |
$4.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4.75
|
| Rate for Payer: Three Rivers Provider Network All |
$3.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4.65
|
| Rate for Payer: Zelis Auto |
$2.00
|
| Rate for Payer: Zelis Worker's Compensation |
$4.91
|
|
|
OCCULT BLOOD STOOL SECOND SAMPLE
|
Facility
|
IP
|
$5.00
|
|
|
Service Code
|
CPT 82272
|
| Hospital Charge Code |
2300037
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$6.95 |
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cigna Commercial |
$4.25
|
| Rate for Payer: First Health Commercial |
$4.50
|
| Rate for Payer: First Health Workers Compensation |
$6.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4.50
|
| Rate for Payer: GEHA Commercial |
$3.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4.50
|
| Rate for Payer: Multiplan All |
$4.55
|
| Rate for Payer: OMNI Networks Commercial |
$3.50
|
| Rate for Payer: One Health Plan PPO/POS |
$4.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4.75
|
| Rate for Payer: Three Rivers Provider Network All |
$3.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4.65
|
| Rate for Payer: Zelis Auto |
$2.00
|
| Rate for Payer: Zelis Worker's Compensation |
$4.91
|
|
|
OCCULT BLOOD STOOL SECOND SAMPLE
|
Facility
|
OP
|
$5.00
|
|
|
Service Code
|
CPT 82272
|
| Hospital Charge Code |
2300037
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$8.46 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$4.23
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cigna Commercial |
$4.25
|
| Rate for Payer: First Health Commercial |
$4.50
|
| Rate for Payer: First Health Workers Compensation |
$6.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4.50
|
| Rate for Payer: GEHA Commercial |
$4.00
|
| Rate for Payer: GEHA Medicare |
$4.23
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4.50
|
| Rate for Payer: Humana ChoiceCare |
$4.65
|
| Rate for Payer: Humana Medicare Advantage |
$4.23
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$7.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$4.23
|
| Rate for Payer: Multiplan All |
$4.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$7.19
|
| Rate for Payer: OMNI Networks Commercial |
$3.50
|
| Rate for Payer: One Health Plan PPO/POS |
$4.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$7.11
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6.16
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$4.23
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$8.46
|
| Rate for Payer: Three Rivers Provider Network All |
$3.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4.15
|
| Rate for Payer: United Healthcare Commercial |
$4.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.23
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$4.23
|
| Rate for Payer: Zelis Auto |
$2.00
|
| Rate for Payer: Zelis Medicare |
$3.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5.08
|
| Rate for Payer: Zelis Worker's Compensation |
$4.91
|
|
|
OCCULT BLOOD STOOL THIRD SAMPLE
|
Facility
|
OP
|
$5.00
|
|
|
Service Code
|
CPT 82272
|
| Hospital Charge Code |
2300038
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$8.46 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$7.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3.00
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$7.62
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$6.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$4.23
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cigna Commercial |
$4.25
|
| Rate for Payer: First Health Commercial |
$4.50
|
| Rate for Payer: First Health Workers Compensation |
$6.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4.50
|
| Rate for Payer: GEHA Commercial |
$4.00
|
| Rate for Payer: GEHA Medicare |
$4.23
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4.50
|
| Rate for Payer: Humana ChoiceCare |
$4.65
|
| Rate for Payer: Humana Medicare Advantage |
$4.23
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$7.11
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$6.16
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$4.23
|
| Rate for Payer: Multiplan All |
$4.55
|
| Rate for Payer: New Mexico Health Connections Medicare |
$7.19
|
| Rate for Payer: OMNI Networks Commercial |
$3.50
|
| Rate for Payer: One Health Plan PPO/POS |
$4.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$7.11
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$6.16
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$4.23
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4.75
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$8.46
|
| Rate for Payer: Three Rivers Provider Network All |
$3.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4.15
|
| Rate for Payer: United Healthcare Commercial |
$4.25
|
| Rate for Payer: United Healthcare Managed Medicaid |
$6.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.23
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4.65
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$4.23
|
| Rate for Payer: Zelis Auto |
$2.00
|
| Rate for Payer: Zelis Medicare |
$3.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5.08
|
| Rate for Payer: Zelis Worker's Compensation |
$4.91
|
|
|
OCCULT BLOOD STOOL THIRD SAMPLE
|
Facility
|
IP
|
$5.00
|
|
|
Service Code
|
CPT 82272
|
| Hospital Charge Code |
2300038
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$6.95 |
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cigna Commercial |
$4.25
|
| Rate for Payer: First Health Commercial |
$4.50
|
| Rate for Payer: First Health Workers Compensation |
$6.95
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4.50
|
| Rate for Payer: GEHA Commercial |
$3.50
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4.50
|
| Rate for Payer: Multiplan All |
$4.55
|
| Rate for Payer: OMNI Networks Commercial |
$3.50
|
| Rate for Payer: One Health Plan PPO/POS |
$4.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4.75
|
| Rate for Payer: Three Rivers Provider Network All |
$3.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4.65
|
| Rate for Payer: Zelis Auto |
$2.00
|
| Rate for Payer: Zelis Worker's Compensation |
$4.91
|
|
|
OCRELIZUMAB 300 MG/10 ML INJ PT OWN
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT J2350
|
| Hospital Charge Code |
3303210
|
|
Hospital Revenue Code
|
636
|
| Max. Negotiated Rate |
$118.82 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$107.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$0.01
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$107.37
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$85.06
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$59.41
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: First Health Commercial |
$0.01
|
| Rate for Payer: First Health Workers Compensation |
$0.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$0.01
|
| Rate for Payer: GEHA Commercial |
$65.35
|
| Rate for Payer: GEHA Medicare |
$59.41
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$0.01
|
| Rate for Payer: Humana ChoiceCare |
$65.35
|
| Rate for Payer: Humana Medicare Advantage |
$59.41
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$99.81
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$86.79
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$59.41
|
| Rate for Payer: Multiplan All |
$0.01
|
| Rate for Payer: New Mexico Health Connections Medicare |
$101.00
|
| Rate for Payer: OMNI Networks Commercial |
$0.01
|
| Rate for Payer: One Health Plan PPO/POS |
$0.01
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$100.21
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$86.79
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$59.41
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$0.01
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$118.82
|
| Rate for Payer: Three Rivers Provider Network All |
$0.01
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$58.22
|
| Rate for Payer: United Healthcare Managed Medicaid |
$86.79
|
| Rate for Payer: United Healthcare Medicare Advantage |
$59.41
|
| Rate for Payer: United Payors & United Providers UP&UP |
$0.01
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$59.41
|
| Rate for Payer: Zelis Auto |
$0.00
|
| Rate for Payer: Zelis Medicare |
$50.50
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$71.29
|
| Rate for Payer: Zelis Worker's Compensation |
$0.00
|
|
