|
PARTIAL REMOVAL OF ESOPHAGUS
|
Facility
|
OP
|
$6,110.00
|
|
|
Service Code
|
CPT 43121
|
| Hospital Charge Code |
6143121
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,527.50 |
| Max. Negotiated Rate |
$5,804.50 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,666.00
|
| Rate for Payer: Cash Price |
$3,666.00
|
| Rate for Payer: Cigna Commercial |
$5,193.50
|
| Rate for Payer: First Health Commercial |
$5,499.00
|
| Rate for Payer: First Health Workers Compensation |
$2,359.07
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$5,499.00
|
| Rate for Payer: GEHA Commercial |
$4,888.00
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$5,499.00
|
| Rate for Payer: Humana ChoiceCare |
$1,588.60
|
| Rate for Payer: Multiplan All |
$5,560.10
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,666.00
|
| Rate for Payer: OMNI Networks Commercial |
$4,277.00
|
| Rate for Payer: One Health Plan PPO/POS |
$5,499.00
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,804.50
|
| Rate for Payer: Three Rivers Provider Network All |
$4,582.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$5,376.80
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,527.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5,682.30
|
| Rate for Payer: Zelis Auto |
$2,444.00
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,055.00
|
| Rate for Payer: Zelis Worker's Compensation |
$1,668.03
|
|
|
PARTIAL REMOVAL OF ESOPHAGUS
|
Facility
|
OP
|
$10,583.00
|
|
|
Service Code
|
CPT 43116
|
| Hospital Charge Code |
6143116
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$2,645.75 |
| Max. Negotiated Rate |
$10,053.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,349.80
|
| Rate for Payer: Cash Price |
$6,349.80
|
| Rate for Payer: Cigna Commercial |
$8,995.55
|
| Rate for Payer: First Health Commercial |
$9,524.70
|
| Rate for Payer: First Health Workers Compensation |
$4,086.10
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$9,524.70
|
| Rate for Payer: GEHA Commercial |
$8,466.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$9,524.70
|
| Rate for Payer: Humana ChoiceCare |
$2,751.58
|
| Rate for Payer: Multiplan All |
$9,630.53
|
| Rate for Payer: New Mexico Health Connections Medicare |
$6,349.80
|
| Rate for Payer: OMNI Networks Commercial |
$7,408.10
|
| Rate for Payer: One Health Plan PPO/POS |
$9,524.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$10,053.85
|
| Rate for Payer: Three Rivers Provider Network All |
$7,937.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$9,313.04
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,645.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$9,842.19
|
| Rate for Payer: Zelis Auto |
$4,233.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,291.50
|
| Rate for Payer: Zelis Worker's Compensation |
$2,889.16
|
|
|
PARTIAL REMOVAL OF ESOPHAGUS
|
Facility
|
OP
|
$10,031.00
|
|
|
Service Code
|
CPT 43123
|
| Hospital Charge Code |
6143123
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$2,507.75 |
| Max. Negotiated Rate |
$9,529.45 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$6,018.60
|
| Rate for Payer: Cash Price |
$6,018.60
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: First Health Commercial |
$9,027.90
|
| Rate for Payer: First Health Workers Compensation |
$3,872.97
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$9,027.90
|
| Rate for Payer: GEHA Commercial |
$8,024.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$9,027.90
|
| Rate for Payer: Humana ChoiceCare |
$2,608.06
|
| Rate for Payer: Multiplan All |
$9,128.21
|
| Rate for Payer: New Mexico Health Connections Medicare |
$6,018.60
|
| Rate for Payer: OMNI Networks Commercial |
$7,021.70
|
| Rate for Payer: One Health Plan PPO/POS |
$9,027.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$9,529.45
|
| Rate for Payer: Three Rivers Provider Network All |
$7,523.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$8,827.28
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,507.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$9,328.83
|
| Rate for Payer: Zelis Auto |
$4,012.40
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$5,015.50
|
| Rate for Payer: Zelis Worker's Compensation |
$2,738.46
|
|
|
PARTIAL REMOVAL OF ESOPHAGUS
|
Facility
|
IP
|
$7,851.00
|
|
|
Service Code
|
CPT 43118
|
| Hospital Charge Code |
6143118
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$2,143.32 |
| Max. Negotiated Rate |
$7,458.45 |
| Rate for Payer: Cash Price |
$4,710.60
|
| Rate for Payer: Cigna Commercial |
$6,673.35
|
| Rate for Payer: First Health Commercial |
$7,065.90
|
| Rate for Payer: First Health Workers Compensation |
$3,031.27
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$7,065.90
|
| Rate for Payer: GEHA Commercial |
$5,495.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$7,065.90
|
| Rate for Payer: Multiplan All |
$7,144.41
|
| Rate for Payer: OMNI Networks Commercial |
$5,495.70
|
| Rate for Payer: One Health Plan PPO/POS |
$7,065.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$7,458.45
|
| Rate for Payer: Three Rivers Provider Network All |
$5,888.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$7,301.43
|
| Rate for Payer: Zelis Auto |
$3,140.40
|
| Rate for Payer: Zelis Worker's Compensation |
$2,143.32
|
|
|
PARTIAL REMOVAL OF ESOPHAGUS
|
Facility
|
IP
|
$5,434.00
|
|
|
Service Code
|
CPT 43122
|
| Hospital Charge Code |
6143122
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,483.48 |
| Max. Negotiated Rate |
$5,162.30 |
| Rate for Payer: Cash Price |
$3,260.40
|
| Rate for Payer: Cigna Commercial |
$4,618.90
|
| Rate for Payer: First Health Commercial |
$4,890.60
|
| Rate for Payer: First Health Workers Compensation |
$2,098.07
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,890.60
|
| Rate for Payer: GEHA Commercial |
$3,803.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,890.60
|
| Rate for Payer: Multiplan All |
$4,944.94
|
| Rate for Payer: OMNI Networks Commercial |
$3,803.80
|
| Rate for Payer: One Health Plan PPO/POS |
$4,890.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,162.30
|
| Rate for Payer: Three Rivers Provider Network All |
$4,075.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5,053.62
|
| Rate for Payer: Zelis Auto |
$2,173.60
|
| Rate for Payer: Zelis Worker's Compensation |
$1,483.48
|
|
|
PARTIAL REMOVAL OF ESOPHAGUS
|
Facility
|
OP
|
$5,434.00
|
|
|
Service Code
|
CPT 43122
|
| Hospital Charge Code |
6143122
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,358.50 |
| Max. Negotiated Rate |
$5,162.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,260.40
|
| Rate for Payer: Cash Price |
$3,260.40
|
| Rate for Payer: Cigna Commercial |
$4,618.90
|
| Rate for Payer: First Health Commercial |
$4,890.60
|
| Rate for Payer: First Health Workers Compensation |
$2,098.07
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,890.60
|
| Rate for Payer: GEHA Commercial |
$4,347.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,890.60
|
| Rate for Payer: Humana ChoiceCare |
$1,412.84
|
| Rate for Payer: Multiplan All |
$4,944.94
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,260.40
|
| Rate for Payer: OMNI Networks Commercial |
$3,803.80
|
| Rate for Payer: One Health Plan PPO/POS |
$4,890.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$5,162.30
|
| Rate for Payer: Three Rivers Provider Network All |
$4,075.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4,781.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,358.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$5,053.62
|
| Rate for Payer: Zelis Auto |
$2,173.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,717.00
|
| Rate for Payer: Zelis Worker's Compensation |
$1,483.48
|
|
|
PARTIAL REMOVAL OF ESOPHAGUS
|
Facility
|
IP
|
$10,031.00
|
|
|
Service Code
|
CPT 43123
|
| Hospital Charge Code |
6143123
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$2,738.46 |
| Max. Negotiated Rate |
$9,529.45 |
| Rate for Payer: Cash Price |
$6,018.60
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: First Health Commercial |
$9,027.90
|
| Rate for Payer: First Health Workers Compensation |
$3,872.97
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$9,027.90
|
| Rate for Payer: GEHA Commercial |
$7,021.70
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$9,027.90
|
| Rate for Payer: Multiplan All |
$9,128.21
|
| Rate for Payer: OMNI Networks Commercial |
$7,021.70
|
| Rate for Payer: One Health Plan PPO/POS |
$9,027.90
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$9,529.45
|
| Rate for Payer: Three Rivers Provider Network All |
$7,523.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$9,328.83
|
| Rate for Payer: Zelis Auto |
$4,012.40
|
| Rate for Payer: Zelis Worker's Compensation |
$2,738.46
|
|
|
PARTIAL REMOVAL OF FIBULA
|
Facility
|
OP
|
$1,372.00
|
|
|
Service Code
|
CPT 27641
|
| Hospital Charge Code |
6127641
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$374.56 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$3,212.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$823.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$3,212.40
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$2,544.86
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cigna Commercial |
$1,166.20
|
| Rate for Payer: First Health Commercial |
$1,234.80
|
| Rate for Payer: First Health Workers Compensation |
$529.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,234.80
|
| Rate for Payer: GEHA Commercial |
$1,097.60
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,234.80
|
| Rate for Payer: Humana ChoiceCare |
$3,388.98
|
| Rate for Payer: Humana Medicare Advantage |
$3,080.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,175.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$2,596.69
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$1,248.52
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$960.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,234.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,998.24
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$2,596.69
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,303.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$1,029.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$2,596.69
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,275.96
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$548.80
|
| Rate for Payer: Zelis Medicare |
$2,618.76
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,697.07
|
| Rate for Payer: Zelis Worker's Compensation |
$374.56
|
|
|
PARTIAL REMOVAL OF FIBULA
|
Facility
|
IP
|
$1,372.00
|
|
|
Service Code
|
CPT 27641
|
| Hospital Charge Code |
6127641
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$374.56 |
| Max. Negotiated Rate |
$1,303.40 |
| Rate for Payer: Cash Price |
$823.20
|
| Rate for Payer: Cigna Commercial |
$1,166.20
|
| Rate for Payer: First Health Commercial |
$1,234.80
|
| Rate for Payer: First Health Workers Compensation |
$529.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$1,234.80
|
| Rate for Payer: GEHA Commercial |
$960.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$1,234.80
|
| Rate for Payer: Multiplan All |
$1,248.52
|
| Rate for Payer: OMNI Networks Commercial |
$960.40
|
| Rate for Payer: One Health Plan PPO/POS |
$1,234.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$1,303.40
|
| Rate for Payer: Three Rivers Provider Network All |
$1,029.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$1,275.96
|
| Rate for Payer: Zelis Auto |
$548.80
|
| Rate for Payer: Zelis Worker's Compensation |
$374.56
|
|
|
PARTIAL REMOVAL OF FOOT BONE
|
Facility
|
OP
|
$898.00
|
|
|
Service Code
|
CPT 28122
|
| Hospital Charge Code |
6128122
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$245.15 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,208.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$538.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,208.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,749.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$538.80
|
| Rate for Payer: Cash Price |
$538.80
|
| Rate for Payer: Cigna Commercial |
$763.30
|
| Rate for Payer: First Health Commercial |
$808.20
|
| Rate for Payer: First Health Workers Compensation |
$346.72
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$808.20
|
| Rate for Payer: GEHA Commercial |
$718.40
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$808.20
|
| Rate for Payer: Humana ChoiceCare |
$3,388.98
|
| Rate for Payer: Humana Medicare Advantage |
$3,080.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,175.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,785.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$817.18
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$628.60
|
| Rate for Payer: One Health Plan PPO/POS |
$808.20
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,061.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,785.30
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$853.10
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$673.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,785.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$835.14
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$359.20
|
| Rate for Payer: Zelis Medicare |
$2,618.76
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,697.07
|
| Rate for Payer: Zelis Worker's Compensation |
$245.15
|
|
|
PARTIAL REMOVAL OF FOOT BONE
|
Facility
|
IP
|
$873.00
|
|
|
Service Code
|
CPT 28288
|
| Hospital Charge Code |
6128288
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$238.33 |
| Max. Negotiated Rate |
$829.35 |
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Cigna Commercial |
$742.05
|
| Rate for Payer: First Health Commercial |
$785.70
|
| Rate for Payer: First Health Workers Compensation |
$337.07
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$785.70
|
| Rate for Payer: GEHA Commercial |
$611.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$785.70
|
| Rate for Payer: Multiplan All |
$794.43
|
| Rate for Payer: OMNI Networks Commercial |
$611.10
|
| Rate for Payer: One Health Plan PPO/POS |
$785.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$829.35
|
| Rate for Payer: Three Rivers Provider Network All |
$654.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$811.89
|
| Rate for Payer: Zelis Auto |
$349.20
|
| Rate for Payer: Zelis Worker's Compensation |
$238.33
|
|
|
PARTIAL REMOVAL OF FOOT BONE
|
Facility
|
IP
|
$898.00
|
|
|
Service Code
|
CPT 28122
|
| Hospital Charge Code |
6128122
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$245.15 |
| Max. Negotiated Rate |
$853.10 |
| Rate for Payer: Cash Price |
$538.80
|
| Rate for Payer: Cigna Commercial |
$763.30
|
| Rate for Payer: First Health Commercial |
$808.20
|
| Rate for Payer: First Health Workers Compensation |
$346.72
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$808.20
|
| Rate for Payer: GEHA Commercial |
$628.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$808.20
|
| Rate for Payer: Multiplan All |
$817.18
|
| Rate for Payer: OMNI Networks Commercial |
$628.60
|
| Rate for Payer: One Health Plan PPO/POS |
$808.20
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$853.10
|
| Rate for Payer: Three Rivers Provider Network All |
$673.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$835.14
|
| Rate for Payer: Zelis Auto |
$359.20
|
| Rate for Payer: Zelis Worker's Compensation |
$245.15
|
|
|
PARTIAL REMOVAL OF FOOT BONE
|
Facility
|
OP
|
$873.00
|
|
|
Service Code
|
CPT 28288
|
| Hospital Charge Code |
6128288
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$238.33 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,208.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$523.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,208.61
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,749.66
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Cash Price |
$523.80
|
| Rate for Payer: Cigna Commercial |
$742.05
|
| Rate for Payer: First Health Commercial |
$785.70
|
| Rate for Payer: First Health Workers Compensation |
$337.07
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$785.70
|
| Rate for Payer: GEHA Commercial |
$698.40
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$785.70
|
| Rate for Payer: Humana ChoiceCare |
$3,388.98
|
| Rate for Payer: Humana Medicare Advantage |
$3,080.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,175.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,785.30
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$794.43
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$611.10
|
| Rate for Payer: One Health Plan PPO/POS |
$785.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$2,061.37
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,785.30
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$829.35
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$654.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,785.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$811.89
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$349.20
|
| Rate for Payer: Zelis Medicare |
$2,618.76
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,697.07
|
| Rate for Payer: Zelis Worker's Compensation |
$238.33
|
|
|
PARTIAL REMOVAL OF HAND BONE
|
Facility
|
OP
|
$1,012.00
|
|
|
Service Code
|
CPT 26230
|
| Hospital Charge Code |
6126230
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$276.28 |
| Max. Negotiated Rate |
$6,161.78 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$1,723.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$607.20
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$1,723.10
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,365.04
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,080.89
|
| Rate for Payer: Cash Price |
$607.20
|
| Rate for Payer: Cash Price |
$607.20
|
| Rate for Payer: Cigna Commercial |
$860.20
|
| Rate for Payer: First Health Commercial |
$910.80
|
| Rate for Payer: First Health Workers Compensation |
$390.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$910.80
|
| Rate for Payer: GEHA Commercial |
$809.60
|
| Rate for Payer: GEHA Medicare |
$3,080.89
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$910.80
|
| Rate for Payer: Humana ChoiceCare |
$3,388.98
|
| Rate for Payer: Humana Medicare Advantage |
$3,080.89
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,175.90
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,392.84
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,080.89
|
| Rate for Payer: Multiplan All |
$920.92
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,237.51
|
| Rate for Payer: OMNI Networks Commercial |
$708.40
|
| Rate for Payer: One Health Plan PPO/POS |
$910.80
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,608.22
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,392.84
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,080.89
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$961.40
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,161.78
|
| Rate for Payer: Three Rivers Provider Network All |
$759.00
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,019.27
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,392.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,080.89
|
| Rate for Payer: United Payors & United Providers UP&UP |
$941.16
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,080.89
|
| Rate for Payer: Zelis Auto |
$404.80
|
| Rate for Payer: Zelis Medicare |
$2,618.76
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,697.07
|
| Rate for Payer: Zelis Worker's Compensation |
$276.28
|
|
|
PARTIAL REMOVAL OF HAND BONE
|
Facility
|
IP
|
$1,012.00
|
|
|
Service Code
|
CPT 26230
|
| Hospital Charge Code |
6126230
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$276.28 |
| Max. Negotiated Rate |
$961.40 |
| Rate for Payer: Cash Price |
$607.20
|
| Rate for Payer: Cigna Commercial |
$860.20
|
| Rate for Payer: First Health Commercial |
$910.80
|
| Rate for Payer: First Health Workers Compensation |
$390.73
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$910.80
|
| Rate for Payer: GEHA Commercial |
$708.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$910.80
|
| Rate for Payer: Multiplan All |
$920.92
|
| Rate for Payer: OMNI Networks Commercial |
$708.40
|
| Rate for Payer: One Health Plan PPO/POS |
$910.80
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$961.40
|
| Rate for Payer: Three Rivers Provider Network All |
$759.00
|
| Rate for Payer: United Payors & United Providers UP&UP |
$941.16
|
| Rate for Payer: Zelis Auto |
$404.80
|
| Rate for Payer: Zelis Worker's Compensation |
$276.28
|
|
|
PARTIAL REMOVAL OF HYMEN
|
Facility
|
OP
|
$563.00
|
|
|
Service Code
|
CPT 56700
|
| Hospital Charge Code |
6156700
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$153.70 |
| Max. Negotiated Rate |
$6,038.18 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Advantage HMO |
$2,026.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$337.80
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Preferred |
$2,026.76
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Managed Medicaid |
$1,605.60
|
| Rate for Payer: Blue Cross Blue Shield of New Mexico Medicare Advantage |
$3,019.09
|
| Rate for Payer: Cash Price |
$337.80
|
| Rate for Payer: Cash Price |
$337.80
|
| Rate for Payer: Cigna Commercial |
$478.55
|
| Rate for Payer: First Health Commercial |
$506.70
|
| Rate for Payer: First Health Workers Compensation |
$217.37
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$506.70
|
| Rate for Payer: GEHA Commercial |
$450.40
|
| Rate for Payer: GEHA Medicare |
$3,019.09
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$506.70
|
| Rate for Payer: Humana ChoiceCare |
$3,321.00
|
| Rate for Payer: Humana Medicare Advantage |
$3,019.09
|
| Rate for Payer: Molina Healthcare of New Mexico Health Insurance Marketplace |
$5,072.07
|
| Rate for Payer: Molina Healthcare of New Mexico Medicaid |
$1,638.29
|
| Rate for Payer: Molina Healthcare of New Mexico Medicare |
$3,019.09
|
| Rate for Payer: Multiplan All |
$512.33
|
| Rate for Payer: New Mexico Health Connections Medicare |
$5,132.45
|
| Rate for Payer: OMNI Networks Commercial |
$394.10
|
| Rate for Payer: One Health Plan PPO/POS |
$506.70
|
| Rate for Payer: Presbyterian Health Plan Exchange |
$1,891.64
|
| Rate for Payer: Presbyterian Health Plan Medicaid |
$1,638.29
|
| Rate for Payer: Presbyterian Health Plan Medicare HMO/Medicare POS |
$3,019.09
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$534.85
|
| Rate for Payer: Providence Risk & Insurance Services Worker's Compensation |
$6,038.18
|
| Rate for Payer: Three Rivers Provider Network All |
$422.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,958.71
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,638.29
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,019.09
|
| Rate for Payer: United Payors & United Providers UP&UP |
$523.59
|
| Rate for Payer: VistaCare Hospice Medicaid/Medicare |
$3,019.09
|
| Rate for Payer: Zelis Auto |
$225.20
|
| Rate for Payer: Zelis Medicare |
$2,566.23
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$3,622.91
|
| Rate for Payer: Zelis Worker's Compensation |
$153.70
|
|
|
PARTIAL REMOVAL OF HYMEN
|
Facility
|
IP
|
$563.00
|
|
|
Service Code
|
CPT 56700
|
| Hospital Charge Code |
6156700
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$153.70 |
| Max. Negotiated Rate |
$534.85 |
| Rate for Payer: Cash Price |
$337.80
|
| Rate for Payer: Cigna Commercial |
$478.55
|
| Rate for Payer: First Health Commercial |
$506.70
|
| Rate for Payer: First Health Workers Compensation |
$217.37
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$506.70
|
| Rate for Payer: GEHA Commercial |
$394.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$506.70
|
| Rate for Payer: Multiplan All |
$512.33
|
| Rate for Payer: OMNI Networks Commercial |
$394.10
|
| Rate for Payer: One Health Plan PPO/POS |
$506.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$534.85
|
| Rate for Payer: Three Rivers Provider Network All |
$422.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$523.59
|
| Rate for Payer: Zelis Auto |
$225.20
|
| Rate for Payer: Zelis Worker's Compensation |
$153.70
|
|
|
PARTIAL REMOVAL OF KIDNEY
|
Facility
|
OP
|
$2,734.00
|
|
|
Service Code
|
CPT 50240
|
| Hospital Charge Code |
6150240
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$683.50 |
| Max. Negotiated Rate |
$2,597.30 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$1,640.40
|
| Rate for Payer: Cash Price |
$1,640.40
|
| Rate for Payer: Cigna Commercial |
$2,323.90
|
| Rate for Payer: First Health Commercial |
$2,460.60
|
| Rate for Payer: First Health Workers Compensation |
$1,055.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,460.60
|
| Rate for Payer: GEHA Commercial |
$2,187.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,460.60
|
| Rate for Payer: Humana ChoiceCare |
$710.84
|
| Rate for Payer: Multiplan All |
$2,487.94
|
| Rate for Payer: New Mexico Health Connections Medicare |
$1,640.40
|
| Rate for Payer: OMNI Networks Commercial |
$1,913.80
|
| Rate for Payer: One Health Plan PPO/POS |
$2,460.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,597.30
|
| Rate for Payer: Three Rivers Provider Network All |
$2,050.50
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$2,405.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$683.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,542.62
|
| Rate for Payer: Zelis Auto |
$1,093.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$1,367.00
|
| Rate for Payer: Zelis Worker's Compensation |
$746.38
|
|
|
PARTIAL REMOVAL OF KIDNEY
|
Facility
|
IP
|
$2,734.00
|
|
|
Service Code
|
CPT 50240
|
| Hospital Charge Code |
6150240
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$746.38 |
| Max. Negotiated Rate |
$2,597.30 |
| Rate for Payer: Cash Price |
$1,640.40
|
| Rate for Payer: Cigna Commercial |
$2,323.90
|
| Rate for Payer: First Health Commercial |
$2,460.60
|
| Rate for Payer: First Health Workers Compensation |
$1,055.60
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$2,460.60
|
| Rate for Payer: GEHA Commercial |
$1,913.80
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$2,460.60
|
| Rate for Payer: Multiplan All |
$2,487.94
|
| Rate for Payer: OMNI Networks Commercial |
$1,913.80
|
| Rate for Payer: One Health Plan PPO/POS |
$2,460.60
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$2,597.30
|
| Rate for Payer: Three Rivers Provider Network All |
$2,050.50
|
| Rate for Payer: United Payors & United Providers UP&UP |
$2,542.62
|
| Rate for Payer: Zelis Auto |
$1,093.60
|
| Rate for Payer: Zelis Worker's Compensation |
$746.38
|
|
|
PARTIAL REMOVAL OF LARYNX
|
Facility
|
OP
|
$5,109.00
|
|
|
Service Code
|
CPT 31368
|
| Hospital Charge Code |
6131368
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,277.25 |
| Max. Negotiated Rate |
$4,853.55 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$3,065.40
|
| Rate for Payer: Cash Price |
$3,065.40
|
| Rate for Payer: Cigna Commercial |
$4,342.65
|
| Rate for Payer: First Health Commercial |
$4,598.10
|
| Rate for Payer: First Health Workers Compensation |
$1,972.58
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,598.10
|
| Rate for Payer: GEHA Commercial |
$4,087.20
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,598.10
|
| Rate for Payer: Humana ChoiceCare |
$1,328.34
|
| Rate for Payer: Multiplan All |
$4,649.19
|
| Rate for Payer: New Mexico Health Connections Medicare |
$3,065.40
|
| Rate for Payer: OMNI Networks Commercial |
$3,576.30
|
| Rate for Payer: One Health Plan PPO/POS |
$4,598.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,853.55
|
| Rate for Payer: Three Rivers Provider Network All |
$3,831.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4,495.92
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,277.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,751.37
|
| Rate for Payer: Zelis Auto |
$2,043.60
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,554.50
|
| Rate for Payer: Zelis Worker's Compensation |
$1,394.76
|
|
|
PARTIAL REMOVAL OF LARYNX
|
Facility
|
IP
|
$4,577.00
|
|
|
Service Code
|
CPT 31367
|
| Hospital Charge Code |
6131367
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,249.52 |
| Max. Negotiated Rate |
$4,348.15 |
| Rate for Payer: Cash Price |
$2,746.20
|
| Rate for Payer: Cigna Commercial |
$3,890.45
|
| Rate for Payer: First Health Commercial |
$4,119.30
|
| Rate for Payer: First Health Workers Compensation |
$1,767.18
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,119.30
|
| Rate for Payer: GEHA Commercial |
$3,203.90
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,119.30
|
| Rate for Payer: Multiplan All |
$4,165.07
|
| Rate for Payer: OMNI Networks Commercial |
$3,203.90
|
| Rate for Payer: One Health Plan PPO/POS |
$4,119.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,348.15
|
| Rate for Payer: Three Rivers Provider Network All |
$3,432.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,256.61
|
| Rate for Payer: Zelis Auto |
$1,830.80
|
| Rate for Payer: Zelis Worker's Compensation |
$1,249.52
|
|
|
PARTIAL REMOVAL OF LARYNX
|
Facility
|
IP
|
$4,429.00
|
|
|
Service Code
|
CPT 31382
|
| Hospital Charge Code |
6131382
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,209.12 |
| Max. Negotiated Rate |
$4,207.55 |
| Rate for Payer: Cash Price |
$2,657.40
|
| Rate for Payer: Cigna Commercial |
$3,764.65
|
| Rate for Payer: First Health Commercial |
$3,986.10
|
| Rate for Payer: First Health Workers Compensation |
$1,710.04
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,986.10
|
| Rate for Payer: GEHA Commercial |
$3,100.30
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,986.10
|
| Rate for Payer: Multiplan All |
$4,030.39
|
| Rate for Payer: OMNI Networks Commercial |
$3,100.30
|
| Rate for Payer: One Health Plan PPO/POS |
$3,986.10
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,207.55
|
| Rate for Payer: Three Rivers Provider Network All |
$3,321.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,118.97
|
| Rate for Payer: Zelis Auto |
$1,771.60
|
| Rate for Payer: Zelis Worker's Compensation |
$1,209.12
|
|
|
PARTIAL REMOVAL OF LARYNX
|
Facility
|
IP
|
$4,303.00
|
|
|
Service Code
|
CPT 31370
|
| Hospital Charge Code |
6131370
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,174.72 |
| Max. Negotiated Rate |
$4,087.85 |
| Rate for Payer: Cash Price |
$2,581.80
|
| Rate for Payer: Cigna Commercial |
$3,657.55
|
| Rate for Payer: First Health Commercial |
$3,872.70
|
| Rate for Payer: First Health Workers Compensation |
$1,661.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,872.70
|
| Rate for Payer: GEHA Commercial |
$3,012.10
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,872.70
|
| Rate for Payer: Multiplan All |
$3,915.73
|
| Rate for Payer: OMNI Networks Commercial |
$3,012.10
|
| Rate for Payer: One Health Plan PPO/POS |
$3,872.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,087.85
|
| Rate for Payer: Three Rivers Provider Network All |
$3,227.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,001.79
|
| Rate for Payer: Zelis Auto |
$1,721.20
|
| Rate for Payer: Zelis Worker's Compensation |
$1,174.72
|
|
|
PARTIAL REMOVAL OF LARYNX
|
Facility
|
OP
|
$4,303.00
|
|
|
Service Code
|
CPT 31370
|
| Hospital Charge Code |
6131370
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,075.75 |
| Max. Negotiated Rate |
$4,087.85 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,581.80
|
| Rate for Payer: Cash Price |
$2,581.80
|
| Rate for Payer: Cigna Commercial |
$3,657.55
|
| Rate for Payer: First Health Commercial |
$3,872.70
|
| Rate for Payer: First Health Workers Compensation |
$1,661.39
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$3,872.70
|
| Rate for Payer: GEHA Commercial |
$3,442.40
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$3,872.70
|
| Rate for Payer: Humana ChoiceCare |
$1,118.78
|
| Rate for Payer: Multiplan All |
$3,915.73
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,581.80
|
| Rate for Payer: OMNI Networks Commercial |
$3,012.10
|
| Rate for Payer: One Health Plan PPO/POS |
$3,872.70
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,087.85
|
| Rate for Payer: Three Rivers Provider Network All |
$3,227.25
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$3,786.64
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,075.75
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,001.79
|
| Rate for Payer: Zelis Auto |
$1,721.20
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,151.50
|
| Rate for Payer: Zelis Worker's Compensation |
$1,174.72
|
|
|
PARTIAL REMOVAL OF LARYNX
|
Facility
|
OP
|
$4,577.00
|
|
|
Service Code
|
CPT 31367
|
| Hospital Charge Code |
6131367
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,144.25 |
| Max. Negotiated Rate |
$4,348.15 |
| Rate for Payer: Blue Cross Blue Shield of New Mexico Blue Community HMO |
$2,746.20
|
| Rate for Payer: Cash Price |
$2,746.20
|
| Rate for Payer: Cigna Commercial |
$3,890.45
|
| Rate for Payer: First Health Commercial |
$4,119.30
|
| Rate for Payer: First Health Workers Compensation |
$1,767.18
|
| Rate for Payer: Galaxy Health Commercial/Workers Compensation |
$4,119.30
|
| Rate for Payer: GEHA Commercial |
$3,661.60
|
| Rate for Payer: Great West Healthcare (Cigna) Commercial |
$4,119.30
|
| Rate for Payer: Humana ChoiceCare |
$1,190.02
|
| Rate for Payer: Multiplan All |
$4,165.07
|
| Rate for Payer: New Mexico Health Connections Medicare |
$2,746.20
|
| Rate for Payer: OMNI Networks Commercial |
$3,203.90
|
| Rate for Payer: One Health Plan PPO/POS |
$4,119.30
|
| Rate for Payer: Providence Risk & Insurance Services Commercial |
$4,348.15
|
| Rate for Payer: Three Rivers Provider Network All |
$3,432.75
|
| Rate for Payer: TriWest Veterans Administration/VAPC3 |
$4,027.76
|
| Rate for Payer: United Healthcare Managed Medicaid |
$1,144.25
|
| Rate for Payer: United Payors & United Providers UP&UP |
$4,256.61
|
| Rate for Payer: Zelis Auto |
$1,830.80
|
| Rate for Payer: Zelis Primary Direct / Supplemental Network |
$2,288.50
|
| Rate for Payer: Zelis Worker's Compensation |
$1,249.52
|
|
