Tynbil: Know the *real* price for healthcare services

New Mexico rates for HCPCS G0381

Level 2 hospital emergency department visit provided in a type B emergency department; (the ED must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 CFR 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.22 / $127.22 / $128.13	Professional	$127.22	$127.22	$128.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $289.75 / $342.17 / $541.32	Facility	$289.75	$342.17	$541.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.70 / $36.70 / $36.70	Professional	$36.70	$36.70	$36.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $60.00 / $1,500.00	Professional	$50.00	$60.00	$1,500.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $105.10 / $127.22 / $263.14	Facility	$105.10	$127.22	$263.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.70 / $36.70 / $2,250,000.00	Professional	$36.70	$36.70	$2,250,000.00