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New Mexico rates for HCPCS G0382

Level 3 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)

Facilitymedian $275 · 10th–90th $229–$7940%20%10th90th$275Professionalmedian $240 · 10th–90th $204–$2400%50%10th$240$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $239.88 / $239.88
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $537.03 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $60.26 / $85.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $239.88 / $346.74
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $741.31