|
AVL 6MM SUPERIOR
|
Facility
|
IP
|
$2,230.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
90032038
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$892.00 |
| Max. Negotiated Rate |
$2,118.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,784.00
|
| Rate for Payer: Cash Price |
$1,338.00
|
| Rate for Payer: Cash Price |
$1,338.00
|
| Rate for Payer: Cigna Commercial |
$1,895.50
|
| Rate for Payer: First Health Commercial |
$2,007.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,007.00
|
| Rate for Payer: GEHA Commercial |
$1,561.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,007.00
|
| Rate for Payer: Multiplan All |
$2,029.30
|
| Rate for Payer: OMNI Networks Commercial |
$1,561.00
|
| Rate for Payer: One Health Plan PPO/POS |
$2,007.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,118.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,672.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,073.90
|
| Rate for Payer: Zelis Auto |
$892.00
|
|
|
AVL PRIMARY REAMER MD
|
Facility
|
IP
|
$2,230.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
90032039
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$892.00 |
| Max. Negotiated Rate |
$2,118.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,784.00
|
| Rate for Payer: Cash Price |
$1,338.00
|
| Rate for Payer: Cash Price |
$1,338.00
|
| Rate for Payer: Cigna Commercial |
$1,895.50
|
| Rate for Payer: First Health Commercial |
$2,007.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,007.00
|
| Rate for Payer: GEHA Commercial |
$1,561.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,007.00
|
| Rate for Payer: Multiplan All |
$2,029.30
|
| Rate for Payer: OMNI Networks Commercial |
$1,561.00
|
| Rate for Payer: One Health Plan PPO/POS |
$2,007.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,118.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,672.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,073.90
|
| Rate for Payer: Zelis Auto |
$892.00
|
|
|
AVL PRIMARY REAMER MD
|
Facility
|
OP
|
$2,230.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
90032039
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$557.50 |
| Max. Negotiated Rate |
$2,118.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,338.00
|
| Rate for Payer: Cash Price |
$1,338.00
|
| Rate for Payer: Cash Price |
$1,338.00
|
| Rate for Payer: Cigna Commercial |
$1,895.50
|
| Rate for Payer: First Health Commercial |
$2,007.00
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,007.00
|
| Rate for Payer: GEHA Commercial |
$1,784.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,007.00
|
| Rate for Payer: Humana ChoiceCare |
$579.80
|
| Rate for Payer: Multiplan All |
$2,029.30
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,338.00
|
| Rate for Payer: OMNI Networks Commercial |
$1,561.00
|
| Rate for Payer: One Health Plan PPO/POS |
$2,007.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,118.50
|
| Rate for Payer: Three Rivers Provider Network All |
$1,672.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$1,962.40
|
| Rate for Payer: United Healthcare Managed Medicaid |
$557.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,073.90
|
| Rate for Payer: Zelis Auto |
$892.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,115.00
|
|
|
avocado, IgE REF602781
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
2200811
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$53.20 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$9.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$33.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$9.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$7.44
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cigna Commercial |
$47.60
|
| Rate for Payer: First Health Commercial |
$50.40
|
| Rate for Payer: First Health Workers Compensation |
$11.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$50.40
|
| Rate for Payer: GEHA Commercial |
$44.80
|
| Rate for Payer: GEHA Medicare |
$5.22
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$50.40
|
| Rate for Payer: Humana ChoiceCare |
$5.74
|
| Rate for Payer: Humana Medicare Advantage |
$5.22
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$8.77
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$7.59
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$5.22
|
| Rate for Payer: Multiplan All |
$50.96
|
| Rate for Payer: New Mexico Health Connections Medicare |
$8.87
|
| Rate for Payer: OMNI Networks Commercial |
$39.20
|
| Rate for Payer: One Health Plan PPO/POS |
$50.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$8.76
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$7.59
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$5.22
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$53.20
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$10.44
|
| Rate for Payer: Three Rivers Provider Network All |
$42.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5.12
|
| Rate for Payer: United Healthcare Commercial |
$47.60
|
| Rate for Payer: United Healthcare Managed Medicaid |
$7.59
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: United Payors & United Providers UP&UP |
$52.08
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$5.22
|
| Rate for Payer: Zelis Auto |
$22.40
|
| Rate for Payer: Zelis Medicare |
$4.44
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$6.26
|
| Rate for Payer: Zelis Worker's Compensation |
$7.93
|
|
|
avocado, IgE REF602781
|
Facility
|
IP
|
$56.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
2200811
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$53.20 |
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cigna Commercial |
$47.60
|
| Rate for Payer: First Health Commercial |
$50.40
|
| Rate for Payer: First Health Workers Compensation |
$11.22
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$50.40
|
| Rate for Payer: GEHA Commercial |
$39.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$50.40
|
| Rate for Payer: Multiplan All |
$50.96
|
| Rate for Payer: OMNI Networks Commercial |
$39.20
|
| Rate for Payer: One Health Plan PPO/POS |
$50.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$53.20
|
| Rate for Payer: Three Rivers Provider Network All |
$42.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$52.08
|
| Rate for Payer: Zelis Auto |
$22.40
|
| Rate for Payer: Zelis Worker's Compensation |
$7.93
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
OP
|
$492.00
|
|
| Hospital Charge Code |
8150040
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$123.00 |
| Max. Negotiated Rate |
$467.40 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$295.20
|
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Cigna Commercial |
$418.20
|
| Rate for Payer: First Health Commercial |
$442.80
|
| Rate for Payer: First Health Workers Compensation |
$189.96
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$442.80
|
| Rate for Payer: GEHA Commercial |
$393.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$442.80
|
| Rate for Payer: Humana ChoiceCare |
$127.92
|
| Rate for Payer: Multiplan All |
$447.72
|
| Rate for Payer: New Mexico Health Connections Medicare |
$295.20
|
| Rate for Payer: OMNI Networks Commercial |
$344.40
|
| Rate for Payer: One Health Plan PPO/POS |
$442.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$467.40
|
| Rate for Payer: Three Rivers Provider Network All |
$369.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$432.96
|
| Rate for Payer: United Healthcare Managed Medicaid |
$123.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$457.56
|
| Rate for Payer: Zelis Auto |
$196.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$246.00
|
| Rate for Payer: Zelis Worker's Compensation |
$134.32
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
OP
|
$172.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
21600087
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$46.96 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$103.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cigna Commercial |
$146.20
|
| Rate for Payer: First Health Commercial |
$154.80
|
| Rate for Payer: First Health Workers Compensation |
$66.41
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$154.80
|
| Rate for Payer: GEHA Commercial |
$137.60
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$154.80
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$156.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$120.40
|
| Rate for Payer: One Health Plan PPO/POS |
$154.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$163.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$129.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$159.96
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$68.80
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$46.96
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
IP
|
$492.00
|
|
| Hospital Charge Code |
8150040
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$134.32 |
| Max. Negotiated Rate |
$467.40 |
| Rate for Payer: Cash Price |
$295.20
|
| Rate for Payer: Cigna Commercial |
$418.20
|
| Rate for Payer: First Health Commercial |
$442.80
|
| Rate for Payer: First Health Workers Compensation |
$189.96
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$442.80
|
| Rate for Payer: GEHA Commercial |
$344.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$442.80
|
| Rate for Payer: Multiplan All |
$447.72
|
| Rate for Payer: OMNI Networks Commercial |
$344.40
|
| Rate for Payer: One Health Plan PPO/POS |
$442.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$467.40
|
| Rate for Payer: Three Rivers Provider Network All |
$369.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$457.56
|
| Rate for Payer: Zelis Auto |
$196.80
|
| Rate for Payer: Zelis Worker's Compensation |
$134.32
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
IP
|
$312.78
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
7211730
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$85.39 |
| Max. Negotiated Rate |
$297.14 |
| Rate for Payer: Cash Price |
$187.67
|
| Rate for Payer: Cigna Commercial |
$265.86
|
| Rate for Payer: First Health Commercial |
$281.50
|
| Rate for Payer: First Health Workers Compensation |
$120.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$281.50
|
| Rate for Payer: GEHA Commercial |
$218.95
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$281.50
|
| Rate for Payer: Multiplan All |
$284.63
|
| Rate for Payer: OMNI Networks Commercial |
$218.95
|
| Rate for Payer: One Health Plan PPO/POS |
$281.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$297.14
|
| Rate for Payer: Three Rivers Provider Network All |
$234.59
|
| Rate for Payer: United Payors & United Providers UP&UP |
$290.89
|
| Rate for Payer: Zelis Auto |
$125.11
|
| Rate for Payer: Zelis Worker's Compensation |
$85.39
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
OP
|
$312.78
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
6111730
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$187.67
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$187.67
|
| Rate for Payer: Cash Price |
$187.67
|
| Rate for Payer: Cigna Commercial |
$265.86
|
| Rate for Payer: First Health Commercial |
$281.50
|
| Rate for Payer: First Health Workers Compensation |
$120.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$281.50
|
| Rate for Payer: GEHA Commercial |
$250.22
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$281.50
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$284.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$218.95
|
| Rate for Payer: One Health Plan PPO/POS |
$281.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$297.14
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$234.59
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$290.89
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$125.11
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$85.39
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
IP
|
$312.78
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
8511730
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$85.39 |
| Max. Negotiated Rate |
$297.14 |
| Rate for Payer: Cash Price |
$187.67
|
| Rate for Payer: Cigna Commercial |
$265.86
|
| Rate for Payer: First Health Commercial |
$281.50
|
| Rate for Payer: First Health Workers Compensation |
$120.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$281.50
|
| Rate for Payer: GEHA Commercial |
$218.95
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$281.50
|
| Rate for Payer: Multiplan All |
$284.63
|
| Rate for Payer: OMNI Networks Commercial |
$218.95
|
| Rate for Payer: One Health Plan PPO/POS |
$281.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$297.14
|
| Rate for Payer: Three Rivers Provider Network All |
$234.59
|
| Rate for Payer: United Payors & United Providers UP&UP |
$290.89
|
| Rate for Payer: Zelis Auto |
$125.11
|
| Rate for Payer: Zelis Worker's Compensation |
$85.39
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
IP
|
$312.78
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
6111730
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$85.39 |
| Max. Negotiated Rate |
$297.14 |
| Rate for Payer: Cash Price |
$187.67
|
| Rate for Payer: Cigna Commercial |
$265.86
|
| Rate for Payer: First Health Commercial |
$281.50
|
| Rate for Payer: First Health Workers Compensation |
$120.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$281.50
|
| Rate for Payer: GEHA Commercial |
$218.95
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$281.50
|
| Rate for Payer: Multiplan All |
$284.63
|
| Rate for Payer: OMNI Networks Commercial |
$218.95
|
| Rate for Payer: One Health Plan PPO/POS |
$281.50
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$297.14
|
| Rate for Payer: Three Rivers Provider Network All |
$234.59
|
| Rate for Payer: United Payors & United Providers UP&UP |
$290.89
|
| Rate for Payer: Zelis Auto |
$125.11
|
| Rate for Payer: Zelis Worker's Compensation |
$85.39
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
OP
|
$324.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
20300019
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$194.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cigna Commercial |
$275.40
|
| Rate for Payer: First Health Commercial |
$291.60
|
| Rate for Payer: First Health Workers Compensation |
$125.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$291.60
|
| Rate for Payer: GEHA Commercial |
$259.20
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$291.60
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$294.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$226.80
|
| Rate for Payer: One Health Plan PPO/POS |
$291.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$307.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$243.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$301.32
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$129.60
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$88.45
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
IP
|
$324.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
8711730
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$88.45 |
| Max. Negotiated Rate |
$307.80 |
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cigna Commercial |
$275.40
|
| Rate for Payer: First Health Commercial |
$291.60
|
| Rate for Payer: First Health Workers Compensation |
$125.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$291.60
|
| Rate for Payer: GEHA Commercial |
$226.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$291.60
|
| Rate for Payer: Multiplan All |
$294.84
|
| Rate for Payer: OMNI Networks Commercial |
$226.80
|
| Rate for Payer: One Health Plan PPO/POS |
$291.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$307.80
|
| Rate for Payer: Three Rivers Provider Network All |
$243.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$301.32
|
| Rate for Payer: Zelis Auto |
$129.60
|
| Rate for Payer: Zelis Worker's Compensation |
$88.45
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
IP
|
$879.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
1900019
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$239.97 |
| Max. Negotiated Rate |
$835.05 |
| Rate for Payer: Cash Price |
$527.40
|
| Rate for Payer: Cigna Commercial |
$747.15
|
| Rate for Payer: First Health Commercial |
$791.10
|
| Rate for Payer: First Health Workers Compensation |
$339.38
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$791.10
|
| Rate for Payer: GEHA Commercial |
$615.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$791.10
|
| Rate for Payer: Multiplan All |
$799.89
|
| Rate for Payer: OMNI Networks Commercial |
$615.30
|
| Rate for Payer: One Health Plan PPO/POS |
$791.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$835.05
|
| Rate for Payer: Three Rivers Provider Network All |
$659.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$817.47
|
| Rate for Payer: Zelis Auto |
$351.60
|
| Rate for Payer: Zelis Worker's Compensation |
$239.97
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
OP
|
$324.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
8811730
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$194.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cigna Commercial |
$275.40
|
| Rate for Payer: First Health Commercial |
$291.60
|
| Rate for Payer: First Health Workers Compensation |
$125.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$291.60
|
| Rate for Payer: GEHA Commercial |
$259.20
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$291.60
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$294.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$226.80
|
| Rate for Payer: One Health Plan PPO/POS |
$291.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$307.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$243.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$301.32
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$129.60
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$88.45
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
OP
|
$312.78
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
7211730
|
|
Hospital Revenue Code
|
517
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$187.67
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$187.67
|
| Rate for Payer: Cash Price |
$187.67
|
| Rate for Payer: Cigna Commercial |
$265.86
|
| Rate for Payer: First Health Commercial |
$281.50
|
| Rate for Payer: First Health Workers Compensation |
$120.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$281.50
|
| Rate for Payer: GEHA Commercial |
$250.22
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$281.50
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$284.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$218.95
|
| Rate for Payer: One Health Plan PPO/POS |
$281.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$297.14
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$234.59
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$290.89
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$125.11
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$85.39
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
IP
|
$866.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
9611730
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$236.42 |
| Max. Negotiated Rate |
$822.70 |
| Rate for Payer: Cash Price |
$519.60
|
| Rate for Payer: Cigna Commercial |
$736.10
|
| Rate for Payer: First Health Commercial |
$779.40
|
| Rate for Payer: First Health Workers Compensation |
$334.36
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$779.40
|
| Rate for Payer: GEHA Commercial |
$606.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$779.40
|
| Rate for Payer: Multiplan All |
$788.06
|
| Rate for Payer: OMNI Networks Commercial |
$606.20
|
| Rate for Payer: One Health Plan PPO/POS |
$779.40
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$822.70
|
| Rate for Payer: Three Rivers Provider Network All |
$649.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$805.38
|
| Rate for Payer: Zelis Auto |
$346.40
|
| Rate for Payer: Zelis Worker's Compensation |
$236.42
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
OP
|
$324.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
8711730
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$194.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cigna Commercial |
$275.40
|
| Rate for Payer: First Health Commercial |
$291.60
|
| Rate for Payer: First Health Workers Compensation |
$125.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$291.60
|
| Rate for Payer: GEHA Commercial |
$259.20
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$291.60
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$294.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$226.80
|
| Rate for Payer: One Health Plan PPO/POS |
$291.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$307.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$243.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$301.32
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$129.60
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$88.45
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
OP
|
$324.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
8211730
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$194.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cigna Commercial |
$275.40
|
| Rate for Payer: First Health Commercial |
$291.60
|
| Rate for Payer: First Health Workers Compensation |
$125.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$291.60
|
| Rate for Payer: GEHA Commercial |
$259.20
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$291.60
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$294.84
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$226.80
|
| Rate for Payer: One Health Plan PPO/POS |
$291.60
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$307.80
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$243.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$301.32
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$129.60
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$88.45
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
IP
|
$324.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
20300019
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$88.45 |
| Max. Negotiated Rate |
$307.80 |
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cigna Commercial |
$275.40
|
| Rate for Payer: First Health Commercial |
$291.60
|
| Rate for Payer: First Health Workers Compensation |
$125.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$291.60
|
| Rate for Payer: GEHA Commercial |
$226.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$291.60
|
| Rate for Payer: Multiplan All |
$294.84
|
| Rate for Payer: OMNI Networks Commercial |
$226.80
|
| Rate for Payer: One Health Plan PPO/POS |
$291.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$307.80
|
| Rate for Payer: Three Rivers Provider Network All |
$243.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$301.32
|
| Rate for Payer: Zelis Auto |
$129.60
|
| Rate for Payer: Zelis Worker's Compensation |
$88.45
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
OP
|
$879.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
1900019
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$835.05 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$527.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$527.40
|
| Rate for Payer: Cash Price |
$527.40
|
| Rate for Payer: Cigna Commercial |
$747.15
|
| Rate for Payer: First Health Commercial |
$791.10
|
| Rate for Payer: First Health Workers Compensation |
$339.38
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$791.10
|
| Rate for Payer: GEHA Commercial |
$703.20
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$791.10
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$799.89
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$615.30
|
| Rate for Payer: One Health Plan PPO/POS |
$791.10
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$835.05
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$659.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$817.47
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$351.60
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$239.97
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
OP
|
$866.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
9611730
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$822.70 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$519.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$519.60
|
| Rate for Payer: Cash Price |
$519.60
|
| Rate for Payer: Cigna Commercial |
$736.10
|
| Rate for Payer: First Health Commercial |
$779.40
|
| Rate for Payer: First Health Workers Compensation |
$334.36
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$779.40
|
| Rate for Payer: GEHA Commercial |
$692.80
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$779.40
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$788.06
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$606.20
|
| Rate for Payer: One Health Plan PPO/POS |
$779.40
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$822.70
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$649.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$805.38
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$346.40
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$236.42
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
IP
|
$324.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
8211730
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$88.45 |
| Max. Negotiated Rate |
$307.80 |
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cigna Commercial |
$275.40
|
| Rate for Payer: First Health Commercial |
$291.60
|
| Rate for Payer: First Health Workers Compensation |
$125.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$291.60
|
| Rate for Payer: GEHA Commercial |
$226.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$291.60
|
| Rate for Payer: Multiplan All |
$294.84
|
| Rate for Payer: OMNI Networks Commercial |
$226.80
|
| Rate for Payer: One Health Plan PPO/POS |
$291.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$307.80
|
| Rate for Payer: Three Rivers Provider Network All |
$243.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$301.32
|
| Rate for Payer: Zelis Auto |
$129.60
|
| Rate for Payer: Zelis Worker's Compensation |
$88.45
|
|
|
AVULSION NAIL PLATE PART/COMPL SIMPLE 1
|
Facility
|
OP
|
$312.78
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
8511730
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$70.39 |
| Max. Negotiated Rate |
$377.34 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$187.67
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$88.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$70.39
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$188.67
|
| Rate for Payer: Cash Price |
$187.67
|
| Rate for Payer: Cash Price |
$187.67
|
| Rate for Payer: Cigna Commercial |
$265.86
|
| Rate for Payer: First Health Commercial |
$281.50
|
| Rate for Payer: First Health Workers Compensation |
$120.76
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$281.50
|
| Rate for Payer: GEHA Commercial |
$250.22
|
| Rate for Payer: GEHA Medicare |
$188.67
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$281.50
|
| Rate for Payer: Humana ChoiceCare |
$207.54
|
| Rate for Payer: Humana Medicare Advantage |
$188.67
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$316.97
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$71.83
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$188.67
|
| Rate for Payer: Multiplan All |
$284.63
|
| Rate for Payer: New Mexico Health Connections Medicare |
$320.74
|
| Rate for Payer: OMNI Networks Commercial |
$218.95
|
| Rate for Payer: One Health Plan PPO/POS |
$281.50
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$82.94
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$71.83
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$188.67
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$297.14
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$377.34
|
| Rate for Payer: Three Rivers Provider Network All |
$234.59
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$184.90
|
| Rate for Payer: United Healthcare Managed Medicaid |
$71.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$188.67
|
| Rate for Payer: United Payors & United Providers UP&UP |
$290.89
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$188.67
|
| Rate for Payer: Zelis Auto |
$125.11
|
| Rate for Payer: Zelis Medicare |
$160.37
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$226.40
|
| Rate for Payer: Zelis Worker's Compensation |
$85.39
|
|
